CSF Flashcards by Anne Cruz

IS A MAJOR FLUID OF BODY

THIS FLUID PROVIDES PHYSICIANS WITH A TOOL TO EVALUATE CENTRAL NERVOUS SYSTEM

CEREBROSPINAL FLUID

How well did you know this?

Not at all

Perfectly

CSF FUNCTION

_____TO NERVOUS TISSUE

REMOVE______

PRODUCE A MECHANICAL BARRIER TO CUSHION _____&_______AGAINTS TRAUMA

SUPPLY NUTRIENTS

METABOLIC WASTE

BRAIN & SPINAL CORD

How well did you know this?

Not at all

Perfectly

BRAIN AND SPINAL CORD ARE LINED WITH _____

MENINGES

How well did you know this?

Not at all

Perfectly

LINES THE SKULL AND VERTEBRAL CANAL

DURA MATER

How well did you know this?

Not at all

Perfectly

FILAMENTOUS AND SPIDER LIKE

ARACHNOID

How well did you know this?

Not at all

Perfectly

THIN MEMBRANE LINING THE SURFACES OF BRAIN AND SPINAL CORD

PIA

How well did you know this?

Not at all

Perfectly

CSF IS PRODUCED IN THE _______ OF_________ AND_________

CHOROID PLEXUSES

TWO LUMBAR VENTRICLES AND THIRD AND FOURTH VENTRICLES

How well did you know this?

Not at all

Perfectly

IN ADULTS APPROXIMATELY _________OF FLUID IS PRODUCED EVERY HOUR

20 mL

How well did you know this?

Not at all

Perfectly

TO MAINTAIN A VOLUME OF ________IN ADULTS AND _______IN NEONATES THE CIRCULATING FLUID IS REABSORBED BACK INTO THE BLOOD CAPILLARIES IN THE __________OR_____ AT A RATE EQUAL TO ITS PRODUCTION

90 to 150 mL

10 to 60 mL

Arachnoid granulations/ VILLAE

How well did you know this?

Not at all

Perfectly

CAPILLARY NETWORKS THAT FORM CSF FROM PLASMA BY MECHANISMS OF SELECTIVE FILTRATION UNDER __________AND__________

CHOROID PLEXUSES

HYDROSTATIC PRESSURE & ACTIVE TRANSPORT SECRETION

How well did you know this?

Not at all

Perfectly

FLUID FLOWS THROUGH THE _________LOCATED BETWEEN THE ______AND______

SUBARACHNOID SPACE

ARACHNOID & PIA MATER

How well did you know this?

Not at all

Perfectly

TIGHT-FITTING STRUCTURE OF THE ENDOTHELIAL CELLS IN CHOROID PLEXUSES IS TERMED THE

BLOOD-BRAIN BARRIER

How well did you know this?

Not at all

Perfectly

PROCEDURE FOR OBTAINING CSF IS KNOWN AS A

LUMBAR PUNCTURE

How well did you know this?

Not at all

Perfectly

______OF CSF IS SLOWLY REMOVED INTO 3 OR 4 STERILE TUBES THAT ARE NUMBERED SEQUENTIALLY

10-20 mL

How well did you know this?

Not at all

Perfectly

TUBE # 1

USE:
COMMENT:
PRESERCATION:

CHEMICAL AND SEROLOGICAL TEST

LEAST AFFECTED BY BLOOD OR BACTERIA AS A RESULT OF TAP PROCEDURE

FROZEN

How well did you know this?

Not at all

Perfectly

TUBE # 2

USE:
COMMENT:
PRESERVATION:

MICROBIOLOGY LABORATORY

NONE

REMAIN AT ROOM TEMP

How well did you know this?

Not at all

Perfectly

TUBE # 3

USE:
COMMENT:
PRESERVATION:

CELL COUNT

LEAST LIKELY TO CONTAIN CELLS BY SPINAL TAP PROCEDURE

REFRIGERATED

How well did you know this?

Not at all

Perfectly

TUBE # 4

USE:
COMMENT:
PRESERVATION:

MICROBIOLOGY AND ADDITIONAL SEROLOGUCAL TEST

PROVIDE BETTER EXCLUSION OF SKIN CONTAMINATION

How well did you know this?

Not at all

Perfectly

CSF APPEARANCE

•CRYSTAL CLEAR
SIGNIFICANCE:

•HAZY, TURBID, MILKY , CLOUDY
CAUSE:
SIGNIFICANCE:

•BLOODY
CAUSE:
SIGNIFICANCE:

•CLOTTED
CAUSE:
SIGNIFICANCE:

•XANTHOCHROMIC
CAUSE:
SIGNIFICANCE:

•PELLICLE
CAUSE:
SIGNIFICANCE:

WBCs
MICROORGANISMS
PROTEIN
—
MENINGITIS
DISORDERS THAT AFFECT BLOOD-BRAIN BARRIER
PRODUCTION OF IgG within CNS

RBCs
___
HEMORRHAGE
TRAUMATIC TAP

PROTEIN
CLOTTING FACTORS
—
DISORDERS AFFECTINF BLOOD BRAIN BARRIER
TRAUMATIC CAP

HEMOGLOBIN
BILIRUBIN
CAROTENE
PROTEIN
MELANIN
—
OLD HEMORRHAGE
LYSED CELLS FROM TRAUMATIC CAP
RBC DEGREDATION
ELEVATED SERUM BILIRUBIN LEVEL
INC SERUM LEVELS
MENINGEAL MELANOSARCOMA

PROTEIN
CLOTTING FACTORS
—
TUBERCULAR MENINGITIS

How well did you know this?

Not at all

Perfectly

BLOODY CSF CAN BE INDICATION OF _______&________

TRAUMATIC TAP
&
INTRACRANIAL HEMORRHAGE

How well did you know this?

Not at all

Perfectly

TRAUMATIC TAP

DISTRIBUTION OF BLOOD:
CLOT FORMATION:
XANTHOCHROMIC SUPERNATANT:

UNEVEN ; 1ST CONTAINER - GREATEST ; 3RD TUBE- LESSER BLOOD/ NO BLOOD AT ALL

INTRODUCTION OF FIBRINOGEN

CLEAR SUPERNATANT

How well did you know this?

Not at all

Perfectly

INTRACRANIAL HEMORRHAGE

DISTRIBUTION OF BLOOD:
CLOT FORMATION:
XANTHOCHROMIC SUPERNATANT:
BACKUP TEST:

EVEN ; CONSISTENT RED COLOR FOR ALL CONTAINER

NOT ENOUGH FIBRINOGEN TO CLOT

RBC THAT STAY IN CSF FOR 2 HOURS HEMOLYSIS WILL OCCUR

D-DIMER TEST & MICROSCOPIC FINDING

How well did you know this?

Not at all

Perfectly

QUALITY CONTROL OF CSF

_______FOR SPINAL FLUID RBC AND WBC COUNTS ARE AVAILABLE

ALL DILUENTS SHOULD BE CHECKED_______FOR CONTAMINATION

SPEED OF CYTOCENTRIFUGE SHOULD BE CHECKED_______WITH A_______

IF NON DISPOSABLE COUNTING CHAMBERS ARE USED THEY MUST BE SOAKED IN ________FOR AT LEAST______THEN RINSED WITH____AND CLEANED WITH________AFTER EACH USE

LIQUID COMMERCIAL CONTROLS

WEEKLY

MONTHLY ; TACHOMETER

BACTERICIDAL SOLUTION ; 15 MINS ; WATER & ISOPROPYL ALCOHOL

How well did you know this?

Not at all

Perfectly

CELL COUNT

SHOULD BE PERFORMED IMMEDIATELY

WBCs:

SPECIMENS THAT CONTAIN UP TO ______OR_____MAY APPEAR CLEAR

UTILIZES _________USED FOR BLOOD CELL COUNTS

0-5/uL

200 WBCs or 400 RBCs/uL

STANDARD NEUBAUER CALCULATION FORMULA

How well did you know this?

Not at all

Perfectly

CELL COUNT FORMULA

NO. Cell x DILUTION / NO. SQUARES x VOL SQUARE 1 = CELLS/UL

WBC COUNT _______LYSE RBC _____ADDED TO DILUTING FLUID TO STAIN AND DIFFERENTIATE NEUTROPHILS AND MONONUCLEAR CELLS

3% GLACIAL ACETIC ACID METHYLENE BLUE

DIFFERENTIA COUNT PERFORMED ON A _______ ___,______,______,______ CYTOCENTRIFUGE/ CENTRIFUGE FOR ______ 100 CELLS: <100 CELLS:

WRIGHT STAINED SMEAR SEDIMENTATION, FILTRATION, CENTRIFUGAION, CYTOCENTRIFUGATION 5-10 MINS REPORT IN PERCENTAGE REPORT IN NUMBER PER CELL

NUMBER OF WBCs COUNTED IN CHAMBER 0: 1-5: 6-10: 11-20: 20: NUMBER OF CELLS ON CYTOCENTRIFUGE SLIDE

0-40 20-100 60-150 150-250 250

•LYMPHOCYTE SIGNIFICANCE: MICROSCOPIC: •NEUTROPHILS SIGNIFICANCE: MICROSCOPIC: •MONOCYTES SIGNIFICANCE: MICROSCOPIC: •MACROPHAGES SIGNIFICANCE: MICROSCOPIC: •BLAST FORMS SIGNIFICANCE: MICROSCOPIC: •PLASMA CELLS SIGNIFICANCE: MICROSCOPIC:

NORMAL VIRAL, TUBULAR, FUNGAL MENINGITIS MULTIPLE SCLEROSIS ____ ALL STAGES OF DEVELOPMENT MAY BE FOUND BACTERIAL MENINGITIS EARLY CASES OF VIRAL, TUBERCULAR, FUNGAL MENINGITIS CEREBRAL HEMORRHAGE ___ GRANULES MAY BE LESS PROMINENT THAN BLOOD CELLS DISINTEGRATR RAPIDLY NORMAL VIRAL, TUBULAR, FUNGAL MENINGITIS MULTIPLE SCLEROSIS — FOUND MIXED WITH LYMPHOCYTES RBCs IN SPINAL CONTRAST MEDIA — CONTAIN PHAGOCYTIZED RBC AS EMPTY VACUOLES AND GHOST CELLS, HEMOSIDERIN GRANULES , HEMATOIDIN CRYSTALS ACUTE LEUKEMIA — LYMPHOBLASTS MYELOBLASTS MONOBLASTS MULTIPLE SCLEROSIS LYMPHOCYTE REACTIONS — TRADITIONAL AND CLASSIC FORM SEEN

NON PATHOLOGICALLY SIGNIFICANT CELLS (3)

CHOROIDAL CELLS EPENDYMAL CELLS SPINDLE SHAPED CELLS

MALIGNANT CELLS (HEMATOLOGIC) (4)

LYMPHOBLAST MYELOBLAST MONOBLAST LYMPHOMA CELLS

MALIGNANT CELLS (NON HEMATOLOGIC) (3)

ASTROCYTOMA RETINOBLASTOMA MEDULLOBLASTOMA

SHOWING DISTINCT CELL BORDERS AND NUCLEAR UNIFORMITY (x500) FROM THE EPITHELIAL LINING OF CHOROID PLEXUS SEEN IN SINGULARLY AND IN CLUMPS NUCLEOLI IS ABSENT NUCLEI HAVE UNIFORM APPEARANCE

CHOROIDAL CELLS

NOTICE NUCLEOLI AND LESS DISTINCT CELL BORDERS (x1000) FROM THE LINING OF VENTRICLES AND NEURAL CANAL HAVE LESS DEFINED CELL MEMBRANES SEEN IN CLUSTERS NUCLEOLI IS PRESENT

EPENDYMAL CELLS

(X500) REPRESENT LINING CELLS FROM ARACHNOID SEEN IN CLUSTERS SEEN WITH SYSTEMIC MALIGNANCIES

SPINDLE-SHAPED CELLS

CSF PROTEINS NORMAL VALUE ADULTS: INFANTS: IMMATURES:

15 - 45 mg/dL 150 mg/dL 500 mg/dL

CSF PROTEINS INCREASED IN (2) CSF PROTEINS DECREASED IN (1)

DAMAGE TO BBB PRODUCTION OF Igs in CNS CSF LEAKAGE

MAJOR CSF PROTEIN: SECOND MOST PREVALENT FRACTION IN CSF: HAS HAPTOGLOBIN AND CERULOPLASMIN HAS B-TRANSFFERIN AND CARBOHYDRATE DEFICIENT TRANSFFERIN “TAU PROTEIN” UNIQUE TO CSF. FOUND IN CSF BUT NOT IN SERUM HAS IgG AND IgA NOT FOUND IN CSF: IgM, FIBRINOGEN AND LIPIDS

ALBUMIN PREALBUMIN a-GLOBULIN BETA-GLOBULIN GAMMA- GLOBULIN

NORMAL VALUE PROTEIN GLUCOSE LACTATE GLUTAMINE

15 to 45 mg/dL 60% - 70% OF PLASMA GLUCOSE 10 to 24 mg/dL 8 to 18 mg/dL

CULTURE CONFIRMATORY 24 HR: 6 WEEKS:

BACTERIAL TUBERCULAR

GRAM STAIN BACTERIA (4)

STREP PNEUMONIAE H.INFLUENZAE E.COLI N. MENINGITIDIS

TEST FOR FUNGAL MENINGITIS (2)

INDIA INK PREPARATION GRAM STAIN (STARBURST PATTERN)

BIRTH TO 1 MONTH CAUSATIVE AGENT: 1 MONTH TO 5 Y/O CAUSATIVE AGENT: 5 TO 29 Y/O CAUSATIVE AGENT: >29 Y/O CAUSATIVE AGENT: INFANTS, ELDERLY, IMMUNOCOMPROMISED CAUSATIVE AGENT:

STREP AGALACTIAE H. INFLUENZA N. MENINGITIDIS STERP PNEUMONIA LISTERIA MONOCYTOGENES

DETECT THE PRESENCE OF C. NEOFORMANS ANTIGEN IN SERUM AND CSF PROVIDE MORE SENSITIVE METHOD THAN INDIA INK PREPARATION

LATEX AGGLUTINATION TEST

CAN PROVIDE A RAPID METHOD FOR DETECTING C. NEOFORMANS REAGENT STRIP REACT WITH CRYPTOCOCCAL POLYSACCHARIDE CAPSULE

LATERAL FLOW ASSAY

PROVIDE A RAPID MEAN FOR DETECTING AND IDENTIFYING MICROORGANISMS IN CSF

LATEX AGGLUTINATION AND ENZYME-LINKED IMMUNOSORBENT ASSAY METHOD

DOES NOT APPEAR TO BE SENSITIVE TO N. MENINGITIDIS

BACTERIAL ANTIGEN TEST

SEROLOGICAL TESTING ______FOR NEUROSYPHILIS _________FOR SYPHILIS ______NOT RECOMMENDED BECAUSE IT IS LESS SENSITIVE THAN VDRL

VENEREAL DISEASE RESEARCH LABORATORIES FLUOROSCENT TREPONEMAL ANTIBODY ABSORPTION TEST RAPID PLASMA REGAIN

The functions of the CSF include all of the following except

Producing an ultrafiltrate of plasma

The CSF flows through the

Arachnoid space

Substances present in the CSF are controlled by the

Blood-brain barrier

What department is the CSF tube labeled 3 routinely sent to

Hematology

CSF tube that should be kept at room temperature is

Tube 2

The presence of xanthochromia can be caused by all of the following, except

A recent hemorrhage

A web like pellicle in a refrigerated CSF specimen indicates

Tubercular meningitis

A CSF WBC count is diluted with

Acetic acid

Total CSF cell count on a clear fluid should be

Counted undiluted

Purpose of adding albumin to CSF before cytocentrifugation is to

Increase the cell yield Decrease the cellular distortion

Primary concern when pleocytosis of neutrophils and lymphocytes is found in the CSF is

Meningitis

Neutrophils with pyknotic nuclei may be mistaken for

Nucleated RBCs

Presence of which of the following cells is increased in a parasitic infection

Eosinophils

Macrophages appear in the CSF after

Hemorrhage Repeated spinal taps Diagnostic procedures

After CNS diagnostic procedure, which of the following might be seen in the CSF

Choroidal cells ependymal cells spindle shape cells

Nucleated RBC are seen in the CSF as a result of

Bone marrow contamination

Hemosiderin granules and hematoidin crystals are seen in

Macrophages

Cells resembling large and small lymphocytes with cleaved nuclei represent

Lymphoma cells

Reference range for CSF protein is

15 to 45 g/dL

Myeloblasts are seen in the CSF

As a complication of acute leukemia

In the serum, the second most prevalent protein is IgG IN THE CSF the second most prevalent protein is

Prealbumin

CSF can be differentiated from serum by the presence of

Globulin

Elevated CSF protein values can be caused by all of the following except

Fluid leakage

The integrity of the blood brain barrier is measured using the

CSF/serum albumin index

Finding of a oligoclonal bands in the CSF and not in the serum is seen with

Multiple sclerosis

CSF lactate will be more consistently decreased in

Bacterial meningitis

Measurement of which of the following can be replaced by CSF glutamine analysis in children with Reye syndrome

Ammonia

Before performing a gram stain on CSF the specimen must be

Centrifuged

All of the following statements are true about cryptococcal meningitis except

The Wbc count is over 2000

The test of choice to detect neurosyphilis is the

FTA-ABS

CSF Flashcards

(78 cards)