Friday, 3 September 2010

MCRP revision battle 1.2: CSF

Analysis of CSF

Questions involving CSF are common, and there are just some facts and lists that you have to 'suck it up' and learn...

Normal values 
  • normal protein 0.2-0.4 g/l
  • red cells 0
  • WCC <5/mm3
  • glucose >2/3 plasma

CSF in meningitis
  • Bacterial: cloudy appearence, high protein, low glucose, polymorphs
  • Viral: clear or cloudy appearence, normal protein, normal glucose, lymphocytes
  • TB: fibrin webs, high protein, low glucose, lymphocytes

Causes of very high protein in CSF (>2g/l)

Remember as BLOCK TB with FUNGAL GBS 
= spinal block, TB meningitis, fungal meningitis and GBS.

Causes of high protein in CSF
Remember as ABCDE... and an N
= abscess, bacterial meningitis, cancer, subDural, viral Encephalitis and neurosyphillis.

Causes of Low glucose in CSF

bacterial/fungal/TB meningitis, 20% mumps meningitis, 20% herpes encephalis and occasionally SAH.

Lymphocytosis in CS

Remember as HB HVLLS (a bit like the front of a ship made of pencil lead...)
= 'half bacteria' (ie partially treated bacterial meningitis), HIV, viral meningitis/encephalitis, lymphoma/leukaemia, Lyme disease, SLE.

Oligoclonal bands in CSF 

Remember as MS, NS NS, S S, GBS
MS, neurosarcoid, neurosyphillis, SLE, rarely SAH, GBS.

If you're still up for battle 1.3, click here!