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Cytodiagnostics (Spring 2016) > L11: CSF Analysis (Beatty) > Flashcards

L11: CSF Analysis (Beatty) Flashcards

1
Q

Where should you collect CSF?**

A

DISTAL to lesion

-atlanto-occipital protein lower than lumbosacral protein

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2
Q

Fx of CSF

A
  • mechanical protection

- metabolic: transport and excretion

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3
Q

4 part CSF analysis

A

1) physical features (color, clarity)
2) microprotein conc.
3) cell counts
4) microscopic exam

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4
Q

? –> Yellow/orange CSF

A

RBC breakdown (xanthochromia)

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5
Q

? –> red CSF

A

Hemorrhage

-EEE, herpesvirus

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6
Q

? –> grey/black CSF

A

Melanoma (uncommon)

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7
Q

At what WBC count does CSF become cloudy?

A

> 300-500 WBC/uL

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8
Q

Spectrophotometer is the only way to precisely measure CSF microprotein

A

(Albustix can estimate only)

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9
Q

Pleocytosis

A

Elevated WBCs (cell count) in CSF

  • classified by predominant cell type
  • usually a concurrent increase in protein conc. Is present
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10
Q

Normal WBC/uL

A
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11
Q

Normal RBC/uL in CSF

A

0

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12
Q

Normal % of cells in CSF

A

60-70% lymphs

30-40% large mononuclear phagocytes

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13
Q

Must concentrate CSF before evaluating

A

:)

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14
Q

Preservation of CSF

A
  • send 2 aliquouts: 1 plain, one w/ hetastarch or serum
  • plain used for protein
  • serum or hetastarch used for cell counts/cytology
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15
Q

How to distinguish iatrogenic from pathologic blood contamination of CSF***

A
  • absence of platelets: pathologic
  • presence of platelets: iatrogenic
  • increased protein and cell counts in both
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16
Q

Albuminocytologic dissociation in CSF means:

A

Increased protein concentration with NORMAL cell count

  • seen with lesions that damage BBB, obstruct CSF flow, cause localized tissue damage/necrosis, cause inc. protein prod. In the CNS (infectious, neoplasia)
  • can also be a non-specific finding
  • don’t give steroids
  • don’t know if albumin or globulins increased
17
Q

Types of CSF abnormalities

A
  • albuminocytologic dissociation
  • inc. protein w/ normal cell count but increased neuts
  • pleocytosis
  • neoplastic
  • other (myelin, infectious agents, etc. found)
18
Q

What can cause CSF to have increased protein conc. W/ normal cell count BUT increased neuts (>25%)?

A
  • early/mild inflammatory dz
  • lesions NOT involving the meninges (IVDD, cervical stenotic myelopathy, spinal fx, severe seizure, CNS necrosis)
  • blood contamination
  • prior steroid or abx use*
19
Q

Effect of steroids on WBCs

A

Down regulate adhesion molecules that neuts use to attach to endothelium (FYI)

20
Q

2 pools of neuts

A

1) circulating

2) marginating (attached to endothelial cells)

21
Q

Neutrophilic pleocytosis ddx

A

Always consider bacterial meningitis

Dogs:

  • Steroid responsive meningitis-arteritis
  • infectious etiology
  • FCE
  • chiari-malformation

Cats:

  • infectious
  • thiamine deficiency

Horses:
-EEE, WEE, VEE, bacterial

Others: contrast medium, CNS neoplasia

22
Q

Ddx of lymphocytic pleocytosis

A

-viral meningitis most common

Dogs:

  • usually immune mediated dz
  • necrotizing meningoencephalitis
  • infectious (rabies, distemper, toxo, coccidio)

Horses: WNV, EPM, Rabies, EHV, EEE, WEE, VEE

Young cats: feline polioencephalomyelitis

Can be lymphoma in any species

23
Q

Ddx of mixed cell pleocytosis

A

Dogs:

  • GME
  • chronic SRMA
  • infectious (fungal, protozoal)

Cats:
-chronic FIP

LA: listeriosis

24
Q

Eosinophils don’t belong in a mixed cell pleocytosis; if they are present, it is automatically an eosinophilic pleocytosis

A

:)

25
Q

Ddx for eosinophilic pleocytosis

A
  • Eosinophilic steroid responsive meningitis (goldens)
  • Infectious: parasites, protoza, algal
  • CNS abscess in sheep
  • P. Tenuis in alpacas
26
Q

Cryptococcus in CSF of cat***

A

Causes mixed inflammatory population

27
Q

When do you see myelin in CSF?

A
  • demyelinating diseases (ie. Degenerative myelopathy in a GSD)
  • iatrogenic if poke the spinal cord
28
Q

Can see canine distemper inclusions on CSF

A

Diff quick best stain for it!

-lymphocytic plasmacytic inclusions

29
Q

Can dx lymphoma on CSF if lymphoid population is lymphoblasts

A

Can’t call it if small cell lymphoma

30
Q

Formation of CSF

A
  • ultrafiltrate of plasma
  • prod. mainly by choroid plexus
  • moves caudally
  • partially reabsorbed

Cytodiagnostics (Spring 2016) (12 decks)

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