Body Fluid Analysis (Chapter 23)

What are the three functions of Cerebrospinal Fluid?

• Physical support & protection

• Provides a controlled chemical environment to supply nutrients to the tissues & remove wastes

• Intracerebral & extracerebral transport

CSF is formed mostly at the ____

Choroid plexus

What are the two reasons that blood shows up in CSF?

• Traumatic tap

• Subarachnoid hemorrhage

What are some common CSF tests?

• Glucose

• Protein

• Lactate

• Glutamine

_____ is about 2/3rds that of plasma

CSF glucose

Selective ultrafiltration

The blood-brain barrier filters proteins from blood into the CSF selectively; only allows specific proteins to pass through

Diagnostically more sensitive information can be obtained by analysis of the _____ present

Protein fractions 

If total CSF protein is high or a neurological disease is suspected, what test may be done to separate the proteins?

Electrophoresis

Oligoclonal bands

Small number of clones of IgG from the same cell type with nearly identical electrophoretic properties

Oligoclonal bands are usually associated with inflammatory diseases and:

Multiple sclerosis (MS) or SSP (Subacute sclerosing pancephalitis)

Increased CSF protein levels usually indicates the need of:

Electrophoretic separation

High levels of lactate in CSF can indicate:

Bacterial meningitis

Glutamine is formed by:

combining ammonia & glutamate in the brain

Glutamate elevations can be frequently seen in:

Patients with hepatic encephalopathy & other metabolic disorders

Serous membranes

Thin layers of tissues that line cavities of the body & cover the organs in these cavities

Serous fluid

Fluid found between the parietal & visceral membranes in the pleural, pericardial & peritoneal cavities

Pleural Fluid

Surrounds the lungs

Pericardial Fluid

Surrounds the heart

Peritoneal Fluid

Surrounds the abdominal organs

Over-accumulation of serous fluids is known as an:

Effusion

Transudate Effusions are due to

Systemic issues (Heart failure, low protein states)

Exudate effusions are due to:

Local disease (Infection, inflammation, cancer)

Low glucose levels in pleural fluid can suggest:

Inflammation or infection

High lactate levels in pleural fluid can indicate

Inflammation or infection

Elevated pleural fluid amylase levels suggests:

Pancreatitis

Very high levels of triglyceride (2-10X serum) in pleural fluid means that:

Lymphatic fluid is leaking into the pleural space

Pericardiocentesis

Medical procedure to remove excess pericardial fluid from around the heart

When >50 mL of peritoneal fluid is present in the peritoneal cavity, it indicates disease. What is the fluid called?

Ascitic fluid

Ascitic transudate fluid is caused by:

A disturbance in fluid balance due to conditions like hypertension (often related to liver disease)

Ascitic exudate fluid is caused by:

Primary disease of the peritoneal membrane itself, such as metastatic cancer (ovarian, prostate, or colon) or infective peritonitis (infection of the peritoneum)

What is the formula for Serum Ascites Albumin Gradient (SAAG)

Serum Albumin - Ascites Albumin

High SAAG indicates:

Transudate ascitic fluid

Low SAAG inidcates:

Exudate ascitic fluid

Amniotic sac provides an:

Enclosed environment for fetal development

Amniotic fluid is collected via:

Transabdominal amniocentesis

Hemolytic Disease of the Newborn (HDN) is also known as:

Erythroblastosis Fetalis

Erythroblastosis Fetalis

COndition where the mother’s immune system attacks the RBCs of the fetus, leading to hemolysis

High levels of bilirubin in the amniotic fluid indicates:

Hemolysis, suggesting HDN

High levels of alpha-fetoprotein (AFP) in maternal serum are associated with ____

Neural Tube Defects (NTDs)

As the lungs of a fetus mature, levels of certain phospholipids rise, especially:

Lecithin & phosphatidylglycerol (PG)

Lecithin & phosphatidylglycerol acts as:

Surfactants

Bubble/Shake Test

Measures surfactant presence by observing bubble formation when amniotic fluid is shaken

Foam Stability Index (FSI)

Involves the formation of a foam layer after shaking a mixture of ethanol & amniotic fluid

Lecithin-Sphingomyelin (L/S) Ratio

An L/S ration of 2.0 or higher suggests lung maturity

Phophatidylglycerol (PG)

Presence in AF indicates lung maturity

Sweat Chloride Test

Most notable clinical use of sweat analysis is measuring chloride levels to diagnose cystic fibrosis

Individuals with CF have elevated levels of ____ in their sweat

Chloride

Pilocarpine Nitrate Iontophoresis

Method that uses a small electric current to stimulate sweating

Synovial fluid is found in cavities of:

Movable joints