CSF and Semen Analysis Overview
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Questions and Answers

What should be done if a semen specimen fails to liquefy within 60 minutes?

  • Ask the patient for recollection following another proper specimen collection method and criteria.
  • Add enzymes such as Dulbeco's Phosphate-Buffered Saline and Bromelain that can induce liquefaction.
  • Report the case and it should appear on the patient result. (correct)
  • Wait for another 30 minutes until specimen liquefies.

What is the expected change in pH value of a semen specimen that fails to liquefy?

  • pH is neutral.
  • It will be within the normal range.
  • pH will increase given that decreased liquefaction is tantamount to decreased prostatic fluid. (correct)
  • It will become acidic due to increased prostatic fluid concentration.

In the case of Sarah, what is likely to be observed in the vaginal swab specimen under the microscope?

  • Motile and moving sperm cells indicating recent assault.
  • Lethargic sperm head suggesting the assault occurred recently.
  • Immotile sperm cells observed due to the time elapsed since the assault. (correct)
  • Remnants of the sperm tail given the time elapsed before testing.

Which of the following incorrectly matches with the inability to collect the last portion of a semen specimen?

<p>Coagulation: Not possible (B), Volume: Increased (C), pH: Acidic (D)</p> Signup and view all the answers

The presence of 2 or more oligoclonal bands in CSF but not in serum indicates the following, except for?

<p>Neoplastic Disorder (B), Inflammatory Bowel Disease (C), Guillain-Barre Syndrome (D)</p> Signup and view all the answers

What type of sperm movement is considered ideal for successful fertilization?

<p>4.0 a (A)</p> Signup and view all the answers

Which of the following statements about WBC counting in a CSF specimen is true?

<p>Manual counting uses large squares in Neubauer Counting Chamber. (B)</p> Signup and view all the answers

Which of the following is a common characteristic of a semen specimen that has liquefied?

<p>It is thin and watery. (B)</p> Signup and view all the answers

Which factor does not generally affect fertility?

<p>Abstinence (A)</p> Signup and view all the answers

What is the purpose of the forensic medical exam for Sarah?

<p>To gather evidence for potential legal action. (B)</p> Signup and view all the answers

If a patient's semen sample had a higher pH than normal, what could this indicate?

<p>Infection or inflammation in the reproductive tract. (D)</p> Signup and view all the answers

Which must not be observed in the handling of semen specimens?

<p>Semen specimens can be frozen for later testing. (A), Specimens should be submitted within a 1-hour turnaround time. (B), Home collected specimens should be maintained at room temperature. (C)</p> Signup and view all the answers

Which test detects anti-sperm antibodies in Immunoglobulins G, M, and A?

<p>Mixed Agglutination Reaction (C)</p> Signup and view all the answers

What should be a primary concern when collecting a vaginal swab following an assault?

<p>To avoid contamination of the collected specimen. (C)</p> Signup and view all the answers

Which statement regarding sperm count and specimen volume is incorrect?

<p>Sperm count will falsely increase with a partial sample. (C)</p> Signup and view all the answers

Which condition does the presence of oligoclonal bands in CSF typically indicate?

<p>Multiple Sclerosis (B)</p> Signup and view all the answers

Which of the following can occur in Traumatic Tap CSF specimens?

<p>Progressive clarity of blood from first to last tube (C), CSF may form clots (D)</p> Signup and view all the answers

What role does 30% albumin play in the cytocentrifugation process?

<p>Improves cell yield by reducing distortion (C)</p> Signup and view all the answers

Which of the following is indicative of an acidic pH in semen?

<p>Infection (A), Increased Prostatic Fluid (B)</p> Signup and view all the answers

Which statement regarding sperm structure is incorrect?

<p>Tail measures 45 cm (B)</p> Signup and view all the answers

Which WHO criteria relate to abstinence for fertility testing?

<p>Abstinence should last 2-3 days, not exceeding 7 days (D)</p> Signup and view all the answers

How is the IgG index calculated given the following values: CSF IgG: 50 mg/dL, Serum IgG: 2 g/dL, CSF Albumin: 70 mg/dL, Serum Albumin: 5 mg/dL?

<p>1.8 (B)</p> Signup and view all the answers

What does an elevated IgG index indicate?

<p>Synthesis of IgG in the CNS (A)</p> Signup and view all the answers

What abnormal condition is associated with an increase of normal cells in cerebrospinal fluid?

<p>Pleocytosis (C)</p> Signup and view all the answers

Flashcards

Pleocytosis

A condition where there are more normal cells in the cerebrospinal fluid. It can be a sign of inflammation or infection within the central nervous system.

Albumin Addition in CSF Cytocentrifugation

The process in which albumin is added to a cerebrospinal fluid (CSF) specimen before cytocentrifugation. This helps improve the quality of the specimen by decreasing cellular distortion.

IgG Index

A test that measures the ratio of IgG concentration in the cerebrospinal fluid (CSF) to the concentration in the serum. It helps to determine if IgG is being produced within the central nervous system.

Increased CSF Albumin

A condition where the albumin concentration in the cerebrospinal fluid (CSF) is higher than normal. This can indicate a disruption of the blood-brain barrier.

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Traumatic Tap CSF Specimen

A type of cerebrospinal fluid (CSF) sample that is obtained by a lumbar puncture and contains blood.

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Calculating the IgG Index

The process of calculating the IgG Index, which helps determine if IgG is being produced in the CNS.

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Semen Specimen pH Evaluation

The process of evaluating the quality of a semen specimen, including its pH. An acidic pH can be an indicator of certain abnormalities.

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Acrosomal Deficiency

An abnormal condition in which the head of a sperm cell contains a small or absent acrosome. This can affect fertility.

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Non-liquefying Semen

The inability of a semen specimen to liquefy within 60 minutes after collection, indicating a potential problem with the composition or function of prostatic fluid.

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Enzymatic Liquefaction

The process of adding enzymes like Dulbeco's Phosphate-Buffered Saline or Bromelain to a semen specimen that has failed to liquefy within 60 minutes, aiming to break down the thick consistency and allow for proper analysis.

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Altered Semen pH

A condition where the pH value of semen is altered due to an imbalance in the prostatic fluid, which is responsible for contributing to semen alkalinity.

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Motile Sperm in Vaginal Swab

The observation of motile or moving sperm cells in a vaginal swab, indicating the potential presence of sperm from a recent sexual assault. This observation is dependent on the time elapsed since the assault, as sperm motility decreases over time.

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Sperm Microscopic Examination

The process of examining a specimen under a microscope to determine the presence, motility, and morphology of sperm cells. This is crucial for evaluating male fertility and assessing the possibility of sexual assault.

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Sperm Movement Classification

A rating system used to describe the movement pattern of sperm cells, with '4.0 a' representing the most desirable and ideal type of movement for successful fertilization. Other types of movement are less likely to lead to pregnancy. The ideal movement is straight, fast and progressive.

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Mixed Agglutination Reaction

A test used to detect the presence of anti-sperm antibodies, particularly Immunoglobulins G, M, and A, by observing how the antibodies attach to specific areas of the sperm.

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Oligoclonal Bands in CSF

Presence of 2 or more oligoclonal bands in CSF (Cerebrospinal Fluid) but not in serum is suggestive of various neurological diseases, excluding neoplastic (cancerous) disorders.

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WBC Counting in CSF

A manual method to count white blood cells (WBCs) in cerebrospinal fluid (CSF). It involves using a Neubauer counting chamber to visualize and count WBCs in specific grid squares.

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Liquefaction of Semen

The process of breaking down the jelly-like substance that initially surrounds sperm cells after ejaculation. This is essential for sperm motility.

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Immunobead Test

A test to detect anti-sperm antibodies, particularly the detection of Immunoglobulins G, M and A. It also demonstrates what area of the sperm is specifically affected by autoantibodies.

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Acrosome Reaction

The reaction that occurs when a sperm cell releases enzymes that break down the outer layer of an egg cell, allowing the sperm to penetrate the egg.

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Resorcinol Test

A test used to determine the concentration of fructose in semen. Fructose serves as an energy source for sperm.

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Sperm Count

The process of counting the number of sperm cells in a semen sample. It is a key factor in determining male fertility.

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Study Notes

CSF Specimen Analysis

  • CSF may clot if there is an increased or clear progressive clot from the first to the last collection tube.
  • D-dimer is positive in a clotted specimen.
  • The amount of blood in a specimen is negative in a non-clotted specimen.
  • Hemosiderin is negative in a non-clotted specimen.
  • Xanthochromia is negative for non-clotted specimens.

Cytocentrifuge

  • Adding 30% albumin to CSF specimens improves the cytocentrifugation process.
  • This process often decreases cellular distortion in viewed specimens.

Semen Analysis

  • Undevloped seminiferous vesicles are an indication of a semen specimen.
  • Infection and acidity are indicators for semen analysis.

Semen Abstinence

  • Abstinence of 2-3 days is necessary for fertility testing.
  • Specimen collection should not be less than 7 days and not more than 7.

Sperm Morphology

  • Abnormally shaped sperm cells can be a problem in conception.

CSF IgG Index

  • CSF IgG is 50 mg/dL; Serum IgG: 2 g/dL; CSF Albumin: 70 mg/dL; Serum Albumin: 5 mg/dL.
    • The IgG index is 1.8

Abnormal Blood Cell Conditions

  • Pleocytosis is an abnormal condition associated with normal cells in the cerebrospinal fluid.

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Description

Explore key concepts in CSF and semen analysis, including the significance of clotting in CSF specimens, the impact of albumin on cytocentrifugation, and the importance of sperm morphology. This quiz covers essential information for understanding fertility testing and cerebrospinal fluid analysis.

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