csf.pptx
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This document discusses the examination and composition of cerebrospinal fluid (CSF). It outlines the various techniques used to collect CSF samples, including lumbar puncture. The document then lists different conditions that can cause increased levels of certain cells in the CSF, such as neutrophils, lymphocytes, plasma cells, and malignant cells. These conditions include various types of meningitis, infections, and cancers. Finally, the document notes several immunological examination techniques that can be used to identify viruses, tuberculosis, syphilis, and other pathogens in CSF samples.
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Modified from Koch’s Postulates (proof of bacterial diseases)
Isolate virus from diseased hosts.
Cultivation of virus in host cells.
Proof of filterability.
Production of a comparable disease when the cultivated virus is used to infect experimental animals.
Reisolation of the same virus from the infected experimental animal.
Detection of a specific immune response to the virus.
Much more expensive and difficult to study animal viruses than bacteriophages
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Over 60% of all infectious disease cases seen by a physician are due to viral infections.
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Vesicular rash: vesicle fluid, skin scrapings
Maculopapular rash: throat, stool, and rectal swabs
CNS (encephalitis and meningitis cases): stool, tissue, saliva, brain biopsy, cerebrospinal fluid
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Blood borne infections: blood
Sterile, leak proof container
Minimal interval
Transport media
Viral infusion broth (VIB)
Sucrose-phosphate-glutamate (SPG)
Storage temperature:
4 deg C for up to 96 hours
Minus 70 deg C beyond 96 hours
Repeated cycles of freezing and thawing to be avoided
106 virus particles per ml required for visualization,
50,000 - 60,000 magnification normally used.Specimens are negatively stained by Potassium phosphotungstate and scanned under EM
Viruses may be detected in the following specimens.
Virus particles are detected and identified on the basis of morphology.
A) Shape
Rabiesvirus –bullet shaped
Rotavirus –Cart wheel
Coronavirus –petal shaped peplomers
Adenovirus –space vehicle shaped
Astrovirus ---Star shaped
B) Direct detection from specimens
For viruses that are difficult to cultivate ,EM can be used as primary tool for diagnosis
Faeces Rotavirus, Adenovirus
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Astrovirus, Calicivirus
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As tissues culture is time consuming and technically demanding ,EM is used as an alternative :-
1) Vesicular rashes –HSV and VZV detection from vesicular fluid
2) Meningitis—Detection of enterovirus and mumps from CSF.
Virus detection from tissue cultures EM can be used for detection of viral growth in tissue culture
The sensitivity and specificity of EM can be improved by adding specific antiviral antibody to the specimen to aggregate the virus particles which can be centrifuged
The sediment is negatively stained and viewed under EM
Direct immumofluroscence
General Characteristics of Viruses
Obligate intracellular, unable to self-replicate.
Once inside living cells, viruses induce the host cell to synthesize virus particles.
The genome is either DNA or RNA (single or double stranded).
Viruses do not have a system to produce ATP.
Viruses range in size from 25 to 270 nm.
Viral tropism!!
The classification of viruses is based on nucleic acid type, size and shape of virion, and presence or absence of an envelope.
Viral Structure
I . Virion is the entire viral particle.
2. Capsid is the protein coat that encloses the genetic material.
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4. Nucleocapsid is composed of the capsid and genetic material.
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Reisolation of the same virus from the infected experimental animal.
Detection of a specific immune response to the virus.
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Types of specimens:-
Respiratory tract infections: Nasal and bronchial washings, throat and nasal swabs, sputum
Eye infections: throat and Conjunctival swab/scraping
Gastrointestinal tract infections: stool and rectal swabs
Vesicular rash: vesicle fluid, skin scrapings
Maculopapular rash: throat, stool, and rectal swabs
CNS (encephalitis and meningitis cases): stool, tissue, saliva, brain biopsy, cerebrospinal fluid
Genital infections: vesicle fluid or swab
Urinary tract infections: urine
Blood borne infections: blood
Sterile, leak proof container
Minimal interval
Transport media
Viral infusion broth (VIB)
Sucrose-phosphate-glutamate (SPG)
Storage temperature:
4 deg C for up to 96 hours
Minus 70 deg C beyond 96 hours
Repeated cycles of freezing and thawing to be avoided
106 virus particles per ml required for visualization,
50,000 - 60,000 magnification normally used.Specimens are negatively stained by Potassium phosphotungstate and scanned under EM
Viruses may be detected in the following specimens.
Virus particles are detected and identified on the basis of morphology.
A) Shape
Rabiesvirus –bullet shaped
Rotavirus –Cart wheel
Coronavirus –petal shaped peplomers
Adenovirus –space vehicle shaped
Astrovirus ---Star shaped
B) Direct detection from specimens
For viruses that are difficult to cultivate ,EM can be used as primary tool for diagnosis
Faeces Rotavirus, Adenovirus
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As an alternative to tissue culture
As tissues culture is time consuming and technically demanding ,EM is used as an alternative :-
1) Vesicular rashes –HSV and VZV detection from vesicular fluid
2) Meningitis—Detection of enterovirus and mumps from CSF.
Virus detection from tissue cultures EM can be used for detection of viral growth in tissue culture
The sensitivity and specificity of EM can be improved by adding specific antiviral antibody to the specimen to aggregate the virus particles which can be centrifuged
The sediment is negatively stained and viewed under EM
Direct immumofluroscence
General Characteristics of Viruses
Obligate intracellular, unable to self-replicate.
Once inside living cells, viruses induce the host cell to synthesize virus particles.
The genome is either DNA or RNA (single or double stranded).
Viruses do not have a system to produce ATP.
Viruses range in size from 25 to 270 nm.
Viral tropism!!
The classification of viruses is based on nucleic acid type, size and shape of virion, and presence or absence of an envelope.
Viral Structure
I . Virion is the entire viral particle.
2. Capsid is the protein coat that encloses the genetic material.
3. Capsomer is the protein subunit that makes up the capsid.
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This document provides an overview of meningitis, including:
- Bacterial meningitis is an infection of the membranes surrounding the brain and spinal cord that is commonly caused by bacteria and has high mortality rates in developing countries.
- Common bacterial causes in children include E. coli, Group B Strep in neonates and H. influenzae, N. meningitidis, Strep pneumoniae in older children.
- Diagnosis is made through lumbar puncture to examine cerebrospinal fluid for signs of infection like increased white blood cells and decreased glucose. Treatment involves administering antibiotics like ceftriaxone for 5-7 days.
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This document contains 27 multiple choice questions about various microorganisms and diseases. Question 1 asks about causes of secondary immunodeficiency, with options including infectious mononucleosis and AIDS. Question 2 asks which pathogen could remain in an old cattle burial ground for over 50 years, with options including Bacillus anthracis. Question 3 asks about a process by which a Corynebacterium diphtheriae isolate could become toxigenic, with an option being phage conversion.
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A man with a history of blood transfusions 10 years ago has elevated liver enzymes and tests positive for hepatitis C antibodies. A liver biopsy shows portal inflammation, indicating he has chronic hepatitis C. The incidence of this complication from HCV infection is 20%.
Dengue fever is the only viral haemorrhagic fever listed that has not been reported in Saudi Arabia.
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This document discusses the diagnostic approach for meningitis. It outlines the most common etiological agents which can cause meningitis including bacteria like Neisseria meningitidis, viruses like enteroviruses and herpes viruses, fungi such as Cryptococcus neoformans, and parasites including Entamoeba histolytica. The diagnostic approach involves clinical presentation, laboratory examination of cerebrospinal fluid including analysis of cell count, biochemistry, culture and microscopy, as well as blood tests and molecular methods if initial tests are negative. Lumbar puncture to obtain CSF is the mainstay of diagnosis, allowing for analysis of physical characteristics, biochemical features and cytological examination of the fluid.
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This document discusses the diagnosis and management of various types of intracranial infections. It covers topics such as acute bacterial meningitis, viral meningitis, tuberculous meningitis, post-neurosurgical procedure meningitis, post-cranial trauma meningitis, brain abscesses, and more. For each topic, it discusses causes, clinical presentation, diagnosis, and treatment approaches. The goal is to provide an overview of different intracranial infections and guidelines for clinicians on evaluating and managing these conditions.
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Here are the key points about albumin and Bence Jones proteins in urine:
- Albumin is the main protein normally found in small amounts in urine. Increased albumin is called albuminuria or proteinuria.
- Bence Jones proteins are light chains of immunoglobulins that can be excreted in the urine in certain plasma cell dyscrasias like multiple myeloma.
- Albumin can be detected by routine urine protein tests like heat test, sulfosalicylic acid test, or reagent strips.
- Bence Jones proteins are detected by a special heat test - a coagulum forms on heating urine to 50-60°C that dissolves at 80°C and re
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(1) The document discusses heart failure, including its definition, signs and symptoms, and classification systems.
(2) It describes the pathophysiology of heart failure, including factors that affect cardiac output and the ways the body compensates, such as neurohormonal changes that increase heart rate and blood volume.
(3) The causes, progression, and complications of heart failure are explained, such as venous congestion, edema, and pulmonary edema. The document also covers cardiac pathology seen in heart failure.
Actinomycetes
1) Actinomyces are gram-positive bacteria that normally inhabit the mouth and intestines.
2) Actinomycosis occurs when these bacteria invade tissues, usually through breaks in the mucosa.
3) It most commonly affects the cervicofacial region due to dental infections or procedures. Symptoms include abscesses and draining sinuses.
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Neoplasia is defined as abnormal, uncontrolled cell proliferation that continues even after stimulus for growth has stopped. Key characteristics include growth rate, cancer phenotypes and stem cells, clinical features, microscopic features, local invasion, and metastasis. Benign neoplasms are generally well-encapsulated masses that are spherical, movable, and firm. Microscopic examination is important for classification, looking at patterns, cell morphology, angiogenesis, stroma, and inflammation. Benign tumors differ from malignant in their uncontrolled growth and ability to invade surrounding tissue and metastasize.
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The document discusses innate immunity, adaptive immunity, cells of the immune system, mechanisms of humoral and cellular immunity, major histocompatibility complex, and types of hypersensitivity reactions. It defines innate immunity as non-specific and the first line of defense, consisting of humoral components like complement and cellular components like neutrophils and macrophages. Adaptive immunity is antigen-specific and consists of humoral immunity mediated by B cells and antibodies, and cellular immunity mediated by T cells. It also describes the four types of hypersensitivity reactions - Type I is an immediate hypersensitivity mediated by IgE and mast cells, Type II involves IgG and antigen on cell surfaces, Type III is immune complex-mediated, and Type IV is T cell
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Autoimmune diseases result from the immune system failing to distinguish self from non-self and reacting against the body's own tissues. This loss of tolerance can be caused by immunological, genetic, and microbial factors interacting. There are two main types of autoimmune diseases: organ-specific diseases where autoantibodies form against a specific organ like the thyroid; and organ non-specific or systemic diseases where multiple autoantibodies form against many tissues causing systemic issues. Examples of both organ-specific and systemic autoimmune diseases are then provided.
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Edema is defined as the abnormal accumulation of free fluid in the interstitial tissue spaces and body cavities. There are two main types: localized edema affecting a single organ or limb, and generalized edema affecting the entire body. Edema can occur due to decreased plasma oncotic pressure, increased capillary hydrostatic pressure, lymphatic obstruction, or increased capillary permeability. Renal edema, cardiac edema, pulmonary edema, and cerebral edema are some common types discussed in the document, along with their causes and pathogenesis.
12- Blood Groups and Blood Transfusion 2018-converted.pptx
Blood typing involves determining the presence of antigens on red blood cells. The ABO and Rh blood group systems are most important for blood transfusions. Karl Landsteiner discovered the ABO blood groups in 1901 and was awarded the Nobel Prize for this work. The ABO blood groups are determined by the presence of A and B antigens, and antibodies against antigens not present. Type O blood lacks both antigens and can be donated to all groups, while Type AB has both antigens and is a universal recipient. Compatible blood typing and cross-matching between donor and recipient prevents transfusion reactions.
Pediatric autopsy.pptx
This document provides guidance on performing autopsies on pediatric cases. It discusses the purpose of pediatric autopsies which is to determine the cause of death and identify any developmental abnormalities or organ pathology. It outlines the preparation, external examination, internal examination and dissection of organs that should be conducted. Key steps include external measurements, examining features of the head, skin, chest, abdomen and extremities. The internal examination involves inspecting organs in-situ before removal and dissection of the heart, lungs, brain and other organs. Tissue sampling and imaging may also be utilized.
Kidney failure.pptx
1. Renal failure can be acute or chronic and is classified based on the underlying cause and pathology. Acute renal failure (ARF) is characterized by a rapid decline in renal function and accumulation of waste products in the blood. Common causes of ARF include decreased blood flow to the kidneys, direct kidney damage, or urinary tract obstruction.
2. Chronic renal failure (CRF) is an irreversible deterioration of renal function that develops slowly over time. It can be caused by diseases affecting the glomeruli or tubulointerstitial tissues. CRF results in fluid and electrolyte imbalances as well as metabolic abnormalities that manifest as uraemic symptoms.
3. Laboratory findings in renal
special stain
This document discusses various special stains used in pathology to identify different tissue components. It describes stains for carbohydrates like Periodic acid-Schiff (PAS), mucins like Alcian blue and mucicarmine, collagen and elastic fibers like reticulin and trichrome stains, amyloid with Congo red, lipids, melanin, calcium, iron, and microorganisms. It provides details on the principles, reagents, controls, and uses of these important special stains.
NEOPLASIA.pptx
Benign and malignant neoplasms can be differentiated based on their gross and microscopic features. Benign neoplasms are generally well-circumscribed masses that are spherical or ovoid in shape and are often encapsulated. They are freely movable and uniform in appearance unless changes like hemorrhage or infarction have occurred. Microscopically, benign tumors show characteristic growth patterns and differentiated tumor cells, as well as tumor angiogenesis and stroma formation. In contrast, malignant neoplasms exhibit features of invasion and metastasis.
Autopsy techniques.ppt
- Autopsies date back to ancient Greece and have evolved significantly over time, with early contributors including Herophilus, Galen, Vesalius, and Virchow.
- The main objectives of autopsy are to determine the cause of death, identify hereditary diseases, rule out infectious diseases, and provide information for education, research, and national statistics.
- There are various techniques for performing autopsies including en masse, en bloc, and in situ methods. Special techniques are also used for situations like postoperative autopsies.
Bilirubin &jaundice.pptx
Bilirubin metabolism involves its source from the breakdown of heme, transport to the liver, hepatic uptake and conjugation then secretion into bile, and intestinal elimination. The document discusses bilirubin metabolism, the etiology and pathogenesis of jaundice, and the distinction between direct and indirect hyperbilirubinemia.
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- 3. Normal Composition of CSF
- 4. Sample collection CSF is obtained by the following techniques: • Lumbar puncture • Cisternal puncture • Ventricular cannulas or shunts • Lateral cervical puncture
- 5. CSF findings in health & meningitis.
- 6. Conditions causing increased neutrophils in CSF • Bacterial meningitis • Brain abscess • Brain infarct • Repeated lumbar puncture
- 7. • Conditions causing increased lymphocytes in CSF i. Viral meningitis ii. Tuberculous meningitis iii. Parasitic meningitis iv. Fungal infections Conditions causing plasma cells in CSF i. Tuberculous meningitis ii. ii. Syphilitic meningoencephalitis iii. Multiple myeloma iv. Malignant brain tumours
- 8. Conditions causing malignant cells in CSF i. Metastatic cancers ii. Leukaemias iii. Lymphomas iv. Medulloblastoma v. Ependymoma
- 9. Immunological Examination CSF i. Viral inclusions by immunostains ii. PCR for viral DNA and tuberculosis iii. ELISA for tuberculosis iv. VDRL for syphilis.
Editor's Notes
- To demonstrate the following: