CSF 2

Yves Laure Pimentel · 70問 · 2年前

通報

問題一覧

Indicative of DE MYELINATION : destruction of myelin sheath that protects axons

MYELIN BASIC PROTEIN

Monitor course Of MS

MYELIN BASIC PROTEIN

MYELIN BASIC PROTEIN Detected by

radicimmunodiffusion

Determination of MENINGITIS

CSF GLUCOSE

CSF glucose is____that of he plasma glucose

60-70%

Blood glucose should be drawn ___ before the spinal tap for equilibration bet. The blood and fluid

2 hours

Increased CSF glucose: increased plasma glucose:

DM, encephalitis, Intracranial pressure

Decreased: alterations in the mechanism of glucose transport and by increased use of glucose by the brain cells

MENINGITIS

CSFLACTATE NORMAL VALUE:

25 MG/DL

Aids in the diagnosis and m nagement of meningitis

CSF LACTATE

Sensitive method for evaluating effectiveness of antibiotic therapy

CSF LACTATE

Used to monitor severe head Injuries and RBCs contain high lactate

CSF LACTATE

INCREASED in conditions that causes Hypoxia »

INCREASED LACTIC ACIDS

INCREASED CSFLACTATE in conditions that causes

Hypoxia

Tubercular, Fungal Meningitis

>25 MG/DL

Tubercular, Fungal Meningitis

Bacterial meningitis

>30 MG/DL

Bacterial meningitis

Viral

>25 MG/DL

Viral

CSF GLUTAMINE o NORMAL VALUE:

8-18 MG/DL

produced from AMMONIA by the brain cells to remove toxic metabolic waste product of ammonina from the CNS

Glutamine

Glutamine produced from ______ by the brain cells to remove toxic metabolic waste product of ammonina from the CNS

AMMONIA

Increased in liver disorders

CSF GLUTAMINE

Disturbance of consciousness CSF GLUTAMINE

> 35 mg/dl

75% of children, INCRASED GLUTAMINE

REYE'S SYNDROME

ELVATED GLUTAMINE DISEASES

LIVER DISORDERS, COMA, REYE'S SYNDROME

ENZYMES : Brain Tissue Destruction

LD1 & 2

ENZYMES: viral Meningitis

LD2 & 3

ENZYMES :Bacterial meningitis

LD4 &5

ENZYMES: <17 mg/dl: Recovery From Cardiac Arrest After Resucitation

CK- BB

LD 4 & 5

Bacterial meningitis

LD 1 & 2

Brain Tissue Destruction

LD 2 & 3

viral Meningitis

Cell Count : routinely performed

WBC COUNT

Cell Count : performed if traumatic tap/IH occur

RBC COUNT

: Total cell count - WBC count

RBC COUNT

Total cell count - WBC count

Cell count must be performed immediately: BECAUSE

RBCs lyse w/n1h , 40% of WBC disintegrate after 2 hrs.

Spx that cannot be analysed immediately

Refrigerated

HOW MANY WBC AND RBC WHEN Clear so microscopic exam is needed

200 WBC or 400 RBC/ul:

CSF cell count

Number of cells counted x dilution /Number of squares counted x volume of 1 square = CELLS/ UL

WHAT IS USED TO LYSE RBC

3% ACETIC ACID

Stains the WBC & better diff between neutrophils ang mononuclear cells

METHYLENE BLUE

counted in the four corner squares and center square on both sides

WBC

WBC counted in the

four corner squares and center square on both sides

WBC COUNT FORMULA

Number x dilution factor = WBC/ ul

Undiluted & phase microscope o large squares, 0.2 mm depth = Twhid o Cells/ul= # of cells /3

FUCH'S ROSENTHAL COUNTING CHAMBER

____diluents are checked for contaminations in counting chamber

WEEKLY

speed of cytocentrifuge Quality control: ?

MONTHLY

INSTRUMENT USED FOR THE speed of cytocentrifuge Quality control

tachometer , STROBE LIGHT AND TIMER

Counting Chambers: soaked in a bactericidal solution for

15 min.

Specimen should be concentrated and stained = 100 cells should be counted; reporting: percentage; * [If cell <100, report only the numbers of the cell types seen

DIFFERENTIAL COUNT

DIFFERENTIAL COUNT _____ cells should be counted; reporting: ___;

100: percentage

Fluid 2 conical chamber 2 cells - forced to a monolayer w/n 6 mm Gor hon circle on slide

CYTOCENTRIFUGATION

increased number of these normal cells

PLEOCYTOSIS

increased: Bacterial Meningitis increased early stages (1-2 days) of viral, fungal, tubercular, parasitic meningitis increased also in CNS haemorrhage. Repeated lumbar puncture, medications, radiographic dye

Neutrophils

Centrifugation in CSF

5-10 minutes

not routinely performed less cellular distortion

FILTRATION

Viral (presence of Reactive Lymphocytes) , tubercular, fungal meningitis o increased: HIV/AIDS

Lymphocytes and monocytes

: High WBC count (<50 WBC/ul) w/ increased lymphocytes and plasma cells

MULTIPLE SCLEROSIS

Parasitic Infections, Fungal (?) o Medications, shunt in CNS

EOSINOPHIL Coccidiodes immitis

Appear w/n 2-4 hrs after RBC enters CSF ff. repeated taps (to remove RBC) Hemorrhage Phagocytized RBC = Black iron-containing hemosiderin granules > HEMATOIDIN CRYSTALS

MACROPHAGE

came from the epithelial lining of the choroid plexus

CHOROIDAL CELLS

:lining of ventricles, and neural canal

EPYDEMAL CELLS

lining cells from the arachnoid

SPINDLE SHAPED CELLS

lymphoblasts, myeloblasts, monoblasts

ACUTE LEUKEMIA

: dissemination from the lymphoid tissue

LYMPHOMA

from lung, breast, rena, GIT malignancies

METASTATIC CARCINOMA

Asctrocytomas, retinoblastomas, medullablastomas

PRIMARY CNS TUMOR

Asctrocytomas, retinoblastomas, medullablastomas

Identification of the causative agents of Meningitis * Incubation in culture medium (24 hrs: bacterial; 1-6 weeks for tubercular)

MICROBIOLOGY TESTS

Incubation in culture medium (? bacterial; ? for tubercular)

24 hrs: 1-6 weeks

o Routinely performed on CSF & the recommended method

GRAM STAIN

Performed on concentrated spx -> centrifuge at

1500g for 15 min.

microorganism can be in blood/ CSF

BLOOD CULTURE

tubercular meningitis STAIN

ACID FAST STAIN

Cryptococcus neoformans (star-burst pattern) test

india ink

H influenza type B, Streptococcus group B, N. meningitides A, B, C, Y, W135 E-coli Kl ag

latex agglutination

meningitis test

BACTERIAL ANTIGEN TEST

Detects C. neoformans antigen (RF: interference)

REVERSE LATEX AGGLUTINATION

detects G(-) organisms by detecting endotoxins o Uses blood cells of Horseshoe Crab (Limulus polyphemus) termed "amebocytes" w/c contain Copper Complex responsible for BLUE color

LIMULUS LYSATE

other names parasitology

other names parasitology

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