Cerebrospinal Fluid (CSF) Analysis – Exam Review

Fill-in-the-blank flashcards covering key facts on CSF anatomy, physiology, collection, chemistry, hematology, and microbiology to aid exam preparation.

CSF was first recognized by in 1764.

Cotugno

CSF is considered the major fluid of the body.

third (3rd)

CSF is produced chiefly by the .

choroid plexus

The outermost meningeal layer is the mater.

dura

The middle, spider-web-like meningeal layer is the mater.

arachnoid

The innermost, delicate meningeal layer adhering to neural tissue is the mater.

pia

CSF flows through the space between the arachnoid and pia mater.

subarachnoid

Reabsorption of CSF occurs via

arachnoid villi/granulations.

Normal adult CSF volume is approximately mL.

140–170

Normal neonatal CSF volume ranges from mL.

10–60

The Barrier consists of tight endothelial junctions that restrict passage of molecules into CSF.

blood-Brain

Disruption of the BBB is commonly seen in meningitis and (two-word disease).

multiple sclerosis

Routine CSF collection is by lumbar puncture where

between L3–L4 or L4–L5.

CSF collected from the cisterna magna is called a .

cisternal puncture

A xanthochromic CSF supernatant indicates the presence of degraded .

blood (hemoglobin)‏

A classic web-like (pine-tree) clot without RBCs suggests meningitis.

tubercular

Remaining CSF after testing should be if further tests are pending.

frozen

Normal adult CSF total protein is

15–45 mg/dL.

Newborn CSF protein is higher, normally ____ mg/dL.

75–150

In CSF, is the major protein fraction.

albumin

The second most abundant CSF protein fraction is .

prealbumin

The beta-globulin that is major in CSF is .

transferrin

Tau protein is found in CSF but not in .

serum

Proteins normally ABSENT from CSF include

fibrinogen IgM, , and beta-lipoproteins.

it is the reagent of choice in precipitating (turbidimetric) protein assays.

Trichloroacetic acid

changes from red to blue in the dye-binding protein method.

Coomassie Brilliant Blue G-250

Electrophoresis showing oligoclonal bands in CSF but not serum is characteristic of .

multiple sclerosis

A CSF/Serum Albumin Index greater than indicates a damaged BBB.

9

A CSF/Serum IgG Index above suggests intrathecal IgG production.

0.77

Normal CSF glucose is about of plasma glucose in adults.

60–70 %

Markedly low CSF glucose with neutrophilic pleocytosis points to meningitis.

bacterial

Markedly low CSF glucose with lymphocytic pleocytosis suggests meningitis.

tubercular

Normal CSF glucose with increased lymphocytes indicates meningitis.

viral

CSF lactate above 35 mg/dL favors meningitis.

bacterial

CSF lactate 25–35 mg/dL may indicate tubercular or _______ meningitis.

fungal

CSF lactate below 25 mg/dL is typical of meningitis.

viral

Glutamine levels above mg/dL are associated with disturbances of consciousness.

35

Reye’s syndrome shows elevated CSF in about 75 % of cases.

glutamine

LD₁ and LD₂ isoenzymes in CSF indicate

brain tissue destruction.

LD₄ and LD₅ predominance in CSF points to meningitis.

bacterial

A CSF CK-BB level _____ after cardiac arrest predicts poor prognosis.

> 17 mg/dL

Normal adult CSF contains up to WBC/µL.

5

Normal neonatal CSF may contain up to mononuclear cells/µL.

30

An increased number of normal cells in CSF is termed .

pleocytosis

For every 700 contaminating RBCs, subtract WBC in traumatic tap correction.

1

The diluent for CSF WBC counts is to lyse RBCs.

3 % glacial acetic acid

Cytocentrifugation with what diluent improves cell yield for differential counts.

30% albumin

The most frequent Gram-positive cocci causing meningitis in adults is .

Streptococcus pneumoniae

In newborns, Gram-positive bacillus monocytogenes is an important pathogen.

Listeria

A star-burst pattern on Gram stain suggests .

Cryptococcus neoformans

is primarily used to detect encapsulated C. neoformans.

India ink

Acid-fast staining of CSF is performed when meningitis is suspected.

tubercular

Reverse latex agglutination is a sensitive test for detecting

Cryptococcus neoformans antigen

VDRL testing on CSF aids in diagnosing .

neurosyphilis

The most sensitive serologic test for syphilis in CSF is the .

FTA-ABS

Latex agglutination/ELISA kits can rapidly detect antigens of

Haemophilus influenzae type B.

CSF specimens for culture are concentrated by centrifugation at

1500 × g for 15 min.