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CSF > Intro CSF > Flashcards

Intro CSF Flashcards

1
Q

where is CSF fluid found

A

in subarachnoid space between pia mater and dura mater

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2
Q

what are the spinal meninges

A

pia mater, arachnoid mater, and dura mater

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3
Q

where is spinal fluid produced

A

choroid plexus

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4
Q

blood brain barrier purpose

A

bidirectional siv between blood and spinal fluid

-keeps SF sterile

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5
Q

how much SF is produced is produced every hour in an adult

A

20 mL

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6
Q

at any given time how much SF does an adult have

A

90-150 mL

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7
Q

at any give time how much SF does a child have

A

10-60 mL

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8
Q

function of SF

A

-brings nutrients to cord and nerve tissue and remove waste products
-serves as cushion to protein brain and spinal cord

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9
Q

only time looking for SF

A

spinal tap
lumbar puncture

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10
Q

reasons for looking for SF

A
  1. sus meningitis
  2. diagnosis demyelinating disease
  3. diagnosis subarachnoid hemorrhage
  4. malignancy or cancerous growth diagnosis
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11
Q

how to get SF?

A

-between L3 and L4 or L4 and L5
-xray to see
-fetal position opens up vertebrae
-lay flat for 30 min to an hour
-draw in tubes 1-4

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12
Q

tube 1 goes to

A

chem and serology

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13
Q

tube 2 goes to

A

micro
if multiple tubes give to micro
tube 2 will be cleaner
NO refrigerate!! kill of pathogens
STAT

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14
Q

tube 3 and 4 goes to

A

heme
-blood will be in other tubes not this one if a traumatic tap

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15
Q

if only can get 1 tube

A

MICRO- less risk of contamination

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16
Q

if any SF left over

A

keep for 6 months frozen

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17
Q

before and after taking SF need to measure

A

cranial pressure

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18
Q

how to measure pressure of SF

A

manometer and needle

once drawn should be 90-180 mL mercury

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19
Q

how much SF to remove for a norm adult

A

20 mL

if rapid decrease STOP

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20
Q

once done pressure should not drop more between

A

10-30 mg

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21
Q

if pressure is above or below certain values

A

> 200 or <90 make decision and only take 2 mL

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22
Q

appearance of SF

A

clear

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23
Q

1st thing done when get SF

A

macro description

always note TURBIDITY- seen in meningitis

blood?

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24
Q

traumatic tap in tubes looks like

A

blood decreases as # of tubes increase

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25
Q

1 reason for seeing RBC in SF

A

traumatic tap

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26
Q

what does hemorrhage look like in tubes

A

of RBC evenly distributed in all tubes
-no clotting

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27
Q

what does xanthochromic mean

A

slightly yellow or pinkish

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28
Q

what can cause xanthochromic SF

A

bilirubin
-seen in neonates because immature liver and nRBCs

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29
Q

what no xanthochromic/bili in traumatic tap

A

not sitting around long enough

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30
Q

what does micro look for

A

meningitis
always cytocentrifuge

anything in SF can cause meningitis

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31
Q

neisseria meningitis

A

1 cause of mening.

gram - diplo cocci

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32
Q

haemophilus influenze

A

2 cause

gram - rods

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33
Q

beta strep group B

A

gram + cocci

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34
Q

strep pneumoniae

A

lancaid shape

gram + cocci; elongated

35
Q

what to use in gram stain for SF

A

acridine orange
-small amounts of bacteria and gets rid of cellular debris

36
Q

to plate SF what plates and broth

A

BAP and choc

cooked meat or thioglycolate

37
Q

if only 1 tube given what media and broth

A

choc- haemophilus
cooked meat broth

38
Q

TB in sterile fluid

A

no digest procedure because no normal fluid to get rid of

39
Q

other things found in SF

A

classic TB- spider web like
-enhanced in fridge

fungal culture
-cryptococcus neoformans - AIDS
-india ink

parasites
-naegleria fowleri

40
Q

viral meningitis

A

no testing -send out

NOT as deadly as bacterial

41
Q

first thing done with SF in chem

A

glucose values : 70% of serum values

need blood glucose first; 30 min later SF glucose

42
Q

look for a decrease in glucose values bc

A

1 bacterial meningitis

#2 malignancy and hemorrhaging

no reason to see increase in glucose

43
Q

2 thing to look for SF chem

A

protein

normal 15-45 in SF

44
Q

normal protein in serum

A

6.5-8

45
Q

INCREASE in protein = bad in SF

A

bacterial meningits

classic is increase protein and decrease glucose

46
Q

decrease in protein could be

A

spinal fluid leak or hyperthyroidism

47
Q

normal protein in SF

A

prealbumin
albumin
tau protein
IgG

48
Q

tau protein

A

form of transferrin
-only found in SF!!!!

49
Q

new name of prealbumin

A

transthyretin

50
Q

not normal protein in SF

A

IgA and IgM

CAN:T cross barrier

51
Q

to determine if blood brain barrier leak

A

more protein will leak into spinal fluid

52
Q

how to determine if damage or synthesized protein??

A

spinal fluid to albumin ratio

53
Q

equation for SF: albumin

A

SF albumin mg/dL / serum albumin g/dL

normal <9

> 9 damage to barrier

54
Q

if abnormal proteins in SF normally means

A

MS- damage to myelin sheath

synthesize IgG

55
Q

test for MS

A

IgG index

56
Q

abnormal protein MS in gamma region

A

oligoclonal band- only seen in SF

90% patients with MS have

correlate both with serum

57
Q

another abnormal protein seen in SF

A

myelin basic protein

58
Q

mylein basic protein

A

autoantibody against sheath

59
Q

glutamine

A

abnormal protein in SF
-if found =liver failure
-breakdown product of ammonia

60
Q

reye’s syndrome

A

seen in children from taking aspirin during viral infection
-fatty infiltration of liver

61
Q

lactate

A

abnormal protein seen in SF
-due to inflammatory response or hypoxia

62
Q

lactate > 25 helps diagnose

A

bacterial meningitis

63
Q

when can’t you do levels of lactate

A

on traumatic tap because lactate found in RBC and falsely increase

64
Q

1 test for in serology

A

neurosyphilis

65
Q

screening tests for syphilis

A

RPR- rapid plasma reagin
VDRL- venereal disease research lab

both look non specifically for reagin

66
Q

RPR

A

antigen comes premade with charcoal and choline chloride
CANNOT dilute

67
Q

VDRL

A

made daily antigen
-only FDA approved for SF
no choline chloride or charcoal
-we can dilute

ONLY USED for SF

68
Q

we need to dilute antigen in VDRL because

A

too much antigen= post zone

69
Q

other serology test for SF

A

cryptococcus antigen

70
Q

what can give a false + in cryptococcus antigen

A

rheumatid factor in RA

this is IgM produced against altered IgG

71
Q

SF can’t be put onto automated analyzer

A

not enough cells

72
Q

adding albumin to a slide with concentrated SF

A

draws cells based on a charge

73
Q

in heme do RBC count only if

A

true hemorrhage

74
Q

if a traumatic tap and need to destroy RBC’s use

A

glacial acetic acid

75
Q

when to do WBC count on SF

A

at least 1 hr of coming down or else will falsey decrease if left out

use hemocytometer

76
Q

newborn normal cells are

A

monocytes

77
Q

increase in neutrophils

A

bacterial meningitis

78
Q

for a diff for SF

A

count 30 cells and report as %

79
Q

not uncommon to see ____ in neonates

A

nRBCs

80
Q

when would you see brain matter in SF

A

after surgery OR leukemia

81
Q

large cells with round nuclei, frayed edges

A

lining cells

82
Q

macrophage with ingested RBC

A

erythrophage

indication of hemorrhage

83
Q

macrophage with hemosiderin granules seen in

A

hemorrhage

84
Q

malignant cells

A

abnormal weird shape

most common signet

CSF (8 decks)

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