Chapter 13 fundamentals of urine and body fluids

What procedures frequently provides a rapid a rapid presumptive diagnosis of bacterial meningitis?

A csf gram stain

What protein in csf is used to monitor the integrity of the blood brain barrier?

Albumin

Pleocytosis

An increased number of cells in the csf.

Meaning of high levels of lactate in the csf

Anaerobic metabolism with in the central nervous system because of tissue hypoxia or decreased oxygenation of the brain.

CSF is found between the?

Arachnoid and pia mater.

Neutrophils in csf

Bacterial meningitis, early viral meningitis, tb, fungal, and anemic encephalomyelitis

What increases the protein in csf?

Bacterial, viral, and other forms of meningitis. Cerebral infarction, hemorrhage, endocrine disorders, ms, trama, and obstruction.

When choroid plexus cells and ependymal cells are present in csf they...

Can closely resemble clusters of malignant cells.

Tube 3

Cell counts and cytology

Tube 1

Chemical, immunology, serology

The first collection tube of csf removed should be used for?

Chemistry

True or false. Increased csf glucose values are diagnostically significant.

False

True or false. The oligoclonal bands usually correlate with the stage of disease and can be used to predict disease progression.

False

Which protein is not normally present in csf?

Fibrinogen

Which substance does not normally pass through the blood brain barrier?

Fibrinogen

Macrophages

Following hemorrhage and various other conditions because of their active phagocytic ability

India ink preparations and microbial antigen tests on csf can aid in the diagnosis of?

Fungal meningitis

What can cause Xanthochromia?

High concentrations of protein and bilirubin, and erythrocytes from a tramatic tap.

Xanthochromia in neonates results from

Increased bilirubin and protein due to immaturity in the blood brain barrier.

Decreases protein.

Increased intracranial pressure, loss of fluid

Meningitis

Inflammation of the meninges.

An immunoglobulin g index greater than .70 indicates?

Intrathecal synthesis of immunoglobulin g.

What cells can be present in small numbers in normal csf?

Lymphocytes

Which cell type predominates in csf during a classic case of viral meningitis?

Lymphocytes

Tube 2

Microbiological studies

Oligoclonal bands

Multiple discrete bands in the v region noted during electrophoresis of plama or other body fluids.

Which cell type predominate in csf during a classic case of bacterial meningitis?

Neutrophils

Eosinophils

Parasitic infections

An unknown fluid can be positively identified as csf by determining the..

Presence of carbohydrate deficient transferrin on electrophoresis

Myelin

Primary lipid substance, surrounds the axons of nerves and is necessary for proper nerve conduction.

CSF is produced primarily from?

Secretions by the choroid plexus.

The second transferrin band is known as

Tau transferrin. Only in csf

Monocytes

Tb and fungal

The bulk of csf protein is derived from the transport of plasma protein through

The capillary endothelium in the choroid plexus and meninges.

Pleocytosis

The presence of a greater than normal number of cells in csf.

Subarachnoid space

The space between the arachnoid and the pia mater.

Meninges

The three membranes that surround the brain and spinal cord. The innermost membrane is the pia mater, the outermost membrane is the dura mater, and the centrally located membrane is the arachnoid.

Teams to the central nervous system, resulting in fluid loss does not increase what?

Total protein

What 4 bands predominate in a normal csf pattern?

Transthyretin, albumin, and 2 distinct transferrin bands.

Igg, is a large molecular weight protein that is normally present in csf

True

Protein electrophoresis reveals the composition and distribution of protein in csf.

True

The total protein is most commonly used to assess the integrity of the blood brain barrier?

True

True or false only low molecular weight proteins are present in the csf.

True

True or false, csf is constantly produced?

True

What would be an indication of a tramatic tap?

Uneven distribution of blood in the csf collection tubes.

Normal csf lactate levels (less than 25 mg/dL) are commonly found in patients with.

Viral meningitis

Lymphocytes

Viral, tb, fungal, syphilis

Intrathecal

Within the spinal cord or subarachnoid space.

How many leukocytes are normally present in the csf obtained from an adult?

0 to 5 cells/mL

Ventricles

The four fluid-filled cavities in the brain lines with ependymal cells.

Choroid plexus

The highly vascular folds of capillaries, nerves, and ependymal cells in the pia mater. Located in the four ventricles of the brain, the choroid plexus activity synthesizes csf.

What is not an analytical concern when the processing and testing of csf are delayed?

The lysis of leukocytes and erythrocytes.

CSF

The normally clear, colorless fluid present between the arachnoid and the pia mater in the brain and spinal cord. This fluid is formed primarily by selective secretions of plasma by choroid plexus into the ventricles and to a lesser extent from internal synthesis by ependymal cells.

Blood brain barrier

The physiologic interface between the vascular system and the cerebrospinal fluid. Changes in the blood brain barrier can result in changes in the normal chemical an ec cellular composition of the csf.

Xanthochromia

The pink, orange, or yellowish discoloration of supernantant csf following centrifugation.