Lorenzo Comprehensive Overview of Body Fluids and Their Analysis

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643 Terms

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Functions of CSF

Removal of metabolic wastes, Supplying nutrients to the CNS, Protection of the brain and spinal cord

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NOT a function of CSF

Producing an ultrafiltrate of plasma

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CSF flow location

Subarachnoid space

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Control of substances in CSF

By blood-brain barrier

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CSF tube labeled 3

Sent to Hematology department

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CSF tube that should be refrigerated

Tube 3

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Traumatic tap

Concentration of blood in tube 1>2>3, Specimen contains clots, Clear supernatant

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Intracranial hemorrhage

Even distribution of blood in all tubes, No clot formation (CSF no fibrinogen), Xanthochromic supernatant

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Xanthochromia causes

Presence of RBC degradation products, Elevated serum bilirubin, Presence of the pigment carotene

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Xanthochromia EXCEPT

TRAUMATIC TAP, RECENT hemorrhage (clear)

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Web-like pellicle in CSF

Tubercular meningitis

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WBC count calculation

CSF WBC count: 800 WBCs/μL, WBC=WBCxDIL=80x10=800 WBCs/μL

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CSF TOOTAL cell count dilution

Diluted with Normal saline

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Total CSF cell count on CLEAR fluid

Should be counted undiluted (CLEAR SPECIMEN), Increases cell yield

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Adding albumin to CSF before cytocentrifugation

Decreases cellular distortion

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Primary concern with increased neutrophils and lymphocytes in CSF

Meningitis

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Neutrophils with pyknotic nuclei

Indicate degenerating cells, Resemble nucleated RBCs

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Increased eosinophils

When a CNS shunt malfunctions

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Macrophages in CSF

Appear following HEMORRHAGE, Repeated spinal taps, Diagnostic procedures

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Nucleated RBCs in CSF

Seen as a result of Bone marrow contamination

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Cells seen after CNS diagnostic procedure

Choroidal cells, Ependymal cells, Spindle-shaped cells

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Hemosiderin granules and hematoidin crystals

Seen in macrophages

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Myeloblasts in CSF

Complication of acute leukemia

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Lymphoma cells

Cells resembling large and small lymphocytes with cleaved nuclei

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Normal value of CSF protein

15 to 45 mg/dL

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Differentiation of CSF from plasma

By the presence of Tau transferrin and Prealbumin (transthyretin)

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Second most prevalent protein in CSF

lgG

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Elevated CSF protein causes

Damage to the blood-brain barrier, Ig production within the CNS, Decreased normal protein clearance from the fluid, Neural tissue degeneration

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Conditions causing elevated CSF protein

Meningitis and hemorrhage conditions that damage the blood-brain barrier are the most common causes

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Integrity of the blood-brain barrier measurement

Using the CSF/serum albumin index

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lgG index calculation

lgG index=CSF IgG (mg/dL)/serum lgG (g/dL) / CSF albumin (mg/dL)/ serum albumin (g/dL)

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lgG index values greater than 0.70

Indicates IgG production within the CNS

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Finding of oligoclonal bands in CSF

Seen with MULTIPLE SCLEROSIS and other conditions: encephalitis, neurosyphilis, Guillain-Barré syndrome and neoplastic disorders

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CSF glucose and WBC count indicative of bacterial meningitis

CSF glucose of 15 mg/dL, WBC count of 5,000 with 90% neutrophils, and protein of 80 mg/dL

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Normal CSF glucose

Range of 72 to 84 mg/dL

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CSF glucose

60 to 70% of blood glucose

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CSF lactate

Consistently decreased (NORMAL) in viral meningitis

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CSF glutamine analysis

Measurement that can replace ammonia in children with Reye syndrome

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Gram stain on CSF

Specimen must be centrifuged prior to staining

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Cryptococcal meningitis

India ink preparation is positive; starburst pattern is seen on Gram stain

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WBC count in cryptococcal meningitis

Over 2,000

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Test of choice to detect neurosyphilis

VDRL (RECOMMENDED BY CDC, page 197)

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Spermatogenesis location

Takes place in seminiferous tubules of testes

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Maturation of spermatozoa

Takes place in epididymis

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Enzymes for coagulation and liquefaction

Produced by the prostate gland

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Major component of seminal fluid

Fructose

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First portion of a semen specimen not collected

Semen analysis will have abnormal sperm concentration

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Failure to document semen sample time

Primarily affects the interpretation of semen viscosity

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Liquefaction of a semen specimen

Within 30 to 60 minutes after collection

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Increased semen pH causes

Prostatic infection, decreased prostatic secretions, increased bulbourethral gland secretions

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Normal sperm concentration

Above 20 million per milliliter

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Sperm concentration calculation

83x20x1,000=83 Millions/mL

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Primary reason to dilute a semen specimen

Immobilize the sperm

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Sperm motility evaluations timing

Well mixed, liquefied semen within 1 hour of specimen collection

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Normal sperm motility percentage

50%

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Grading criteria for sperm motility

EXCEPT lateral movement

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Purpose of the acrosomal cap

Ovum penetration

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Morphologic shape of a normal sperm head

Oval

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Normal sperm morphology criteria

>30% normal forms (routine criteria)

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Synovial fluid functions

Lubrication for the joints, cushioning joints during jogging, providing nutrients for cartilage

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Primary function of synoviocytes

Secrete hyaluronic acid

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Procedure for collection of synovial fluid

Arthrocentesis

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Normal synovial fluid appearance

Resembles egg white

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Most frequently performed chemical test on synovial fluid

Glucose

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Primary purpose of serous fluid

Lubrication of serous membranes

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Membrane covering organs within a cavity

Visceral membrane

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Increase in the amount of serous fluid

Effusion

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Mesothelial cells

Normal cells seen in pleural fluid.

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Neutrophils

A type of white blood cell involved in the body's response to infection.

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Lymphocytes

A type of white blood cell that is part of the immune system.

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Mesothelioma cells

Abnormal cells associated with mesothelioma, a type of cancer.

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Differential observation of pleural fluid

Involves assessing the types and quantities of cells in pleural fluid.

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Presence of plasma cells

Associated with tuberculosis.

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Cytoplasmic molding

A characteristic of malignant cells.

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Mucin-containing vacuoles

A characteristic of malignant cells.

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Increased nucleus: cytoplasm ratio

A characteristic of malignant cells.

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Absence of nucleoli

Characteristic of malignant cells except.

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Pleural fluid pH of 6.0

Indicates esophageal rupture.

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Mesothelioma cell

Seen in pleural fluid and indicates primary malignancy.

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Ascites

Another name for a peritoneal effusion.

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RBC count

Test performed on peritoneal lavage fluid.

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Peritoneal lavage RBCs>100,000/μL

Indicate blunt trauma injury.

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Serum ascites albumin gradient

Recommended test for determining if peritoneal fluid is a transudate or an exudate.

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Serum albumin, 2.2 g/dL

Fluid albumin, 1.6 g/dL; indicates peritoneal fluid is exudate.

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SAAG≥1.1

Indicates transudate; SAAG <1.1 indicates exudate.

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Absolute neutrophil count

Used to differentiate between bacterial peritonitis and cirrhosis.

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Normal WBC counts

Less than 350 cells/μL; increases with bacterial peritonitis and cirrhosis.

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CA 125 tumor marker

Detection in peritoneal fluid is indicative of ovarian cancer.

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Glucose↓

Indicates bacterial, tubercular peritonitis, malignancy.

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ALP↑

Indicates gastrointestinal perforations.

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Amylase ↑

Indicates pancreatitis, gastrointestinal perforations.

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Lactose dehydrogenase

Not a chemical test primarily performed on peritoneal fluid.

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Amniotic fluid

Provides a protective cushion for the fetus.

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Fetal urine

Primary cause of the normal increase in amniotic fluid as pregnancy progresses.

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Oligohydramnios

Decreased amount of amniotic fluid.

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Creatinine level

Requested on amniotic fluid to differentiate amniotic fluid from maternal urine.

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Bilirubin

Destruction is prevented by placing amniotic fluid specimens in amber-colored tubes.

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FLM testing specimens

Delivered on ice and refrigerated or frozen.

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Cytogenetic analysis

Amniotic specimens incubated at 37 °C prior to analysis.

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Phospholipids

Filtration of amniotic fluid is required to avoid decreased values in test results.