Lumber Puncture Flashcards

1
Q

List 4 reasons that indicate lumbar puncture

A

primary or metastatic neoplasm, cerebral hemorrhage, meningitis, encephilitis

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2
Q

from what space is CSF obtained

A

subarachnoid

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3
Q

What is normal P for CSF

A

70-200 mm H2O

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4
Q

What is a normal WBC count in CSF

A

0-5 cells/mcL adult (0-20 for kiddos)

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5
Q

Which WBC type makes up 40-80% of CSF

A

lymphocytes

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6
Q

What is the normal protein value in CSF

A

15-45 mg/dL

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7
Q

What is the normal glucose value in CSF

A

50-75 mg/dL (60-70% of serum glucose. serum levels must be taken before LP)

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8
Q

What is the normal Cl value in CSF (not normally tested)

A

700-750 mg/dL

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9
Q

serology is performed on CSF to screen for what condition

A

neurosyphils

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10
Q

what 2 conditions present with increased (>40 units/L) CSF lactate dehydrogenase (LDH)

A

inflammation or bacterial meningitis (produced by neutrophil)

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11
Q

4 ways bacterial meningitis (MCC strep pneumoniae) would present in CSF values

A

200-20,000 PMNs, glucose50 mg/dL

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12
Q

4 ways aseptic meningitis would present in CSF values

A

25-2,000 LYMPHOCYTES, glucose normal to low, proteins>50 mg/dL, slightly increased P

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13
Q

4 ways granulomatous meningitis would present in CSF values

A

100-1,000 LYMPHOCYTES, glucose < 45, slightly increased P, Protein >50 mg/dL

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14
Q

why is opening pressure increased for lumbar puncture (4)

A

tumors, infection, hydrocephalous, intercranial bleeding

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15
Q

why is opening pressure decreased for lumbar puncture (3)

A

hypovolemia (shock or dehydration), chronic leakage of CSF (previous puncture site), nasal sinus fracture

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16
Q

2 ways to differentiate between a traumatic tap and a subarachnoid bleed

A

traumatic tap will show clotting (if no blood thinners) and the redness should decrease in the fluid when it starts flowing

17
Q

what is yellow tinged CSF called? what can it indicate (3)?

A

xanthochromia= hyperbilirubinemia, hypercarotenemia (normal in kiddos), melanoma

18
Q

cerebral absess and bacterial meningitis both present with these WBCs in CSF

19
Q

In what conditions are mononuclearleukocytes elevated in CSF (3)

A

viral infection, tubercular infection, encephalitis

20
Q

4 examples of noninfectious menigeal irritation

A

carcinomatosis, sarcoidosis, SLE, chemical menigitis

21
Q

3 ways noninfectious meningitis would present in CSF values

A

increased WBC count, increased protein, low or normal glucose

22
Q

what form of meningitis is most common in young adults and teens

A

Neisseria menigitidis

23
Q

4 most common causes viral (aseptic) meningitis

A

Herpes simplex, Coxsackievirus, Echovirus, Infectious mononucleosis

24
Q

4 most common causes of encephalitis

A

Herpes simplex, arbovirus, rabies virus, flavivirus (West Nile and Japanese)

25
Conditions tested in CSF protein electrophoresis
multiple sclerosis, neurosyphilis, immunogenic degenerative processes
26
Conditions where lactic acid of CSF is increased
anaerobic metabolism (low blood flow or decreased oxygenation), bacterial infections, fungal infections, low CSF glucose
27
Tumor markers used in CSF
CEA, Alpha-fetoprotein, hCG