CAP Pro Course - Urinalysis - Cerebrospinal Fluid Analysis (2025 & 2026)

Author: Marjorie Di Lorenzo, MLS(ASCP)SH
Reviewer: Laurie Bjerklie, MA, MLS(ASCP)CM

Continuing Education Credits

Objectives

  • Describe the appearance of normal cerebrospinal fluid (CSF) and list causes of abnormal CSF color and clarity.
  • List diagnostic reasons for hematologic testing of CSF and describe CSF handling procedures that will provide quality specimens to ensure proper patient diagnosis and treatment.
  • Describe methods for obtaining accurate RBC and nucleated cell counts in CSF.
  • Describe slide preparation and staining techniques necessary to obtain optimal microscopic cellular morphology and list possible causes of artifact.
  • Identify cell types and microscopic structures seen in CSF and associate abnormal hematologic CSF findings with known pathologies.

Course Outline

  • Describe the appearance of normal cerebrospinal fluid and list causes of abnormal CSF color and clarity.
      • Normal CSF Appearance
      • Causes of Abnormal Color and Clarity in CSF Samples
      • Causes of Abnormal Color and Clarity in CSF Samples, continued
      • Differentiation of Traumatic Tap and Subarachnoid Hemorrhage (SAH)
      • Table 2: Differentiation of Traumatic Tap and Subarachnoid Hemorrhage (SAH)
      • Differentiation of Traumatic Tap and SAH, continued
      • The medical laboratory scientist received three tubes of CSF containing unevenly distributed blood with the concentration of blood in tube 1 greater t...
      • A disoriented 60-year-old patient was seen in the emergency department. A lumbar puncture was performed to obtain cerebrospinal fluid (CSF). Four tube...
  • List diagnostic reasons for hematologic testing of CSF and describe CSF handling procedures that will provide quality specimens to ensure proper patient diagnosis and treatment.
      • Detection of Meningitis
      • Detection of Malignant Cells
      • Detection of Intracranial Bleed
      • Cerebrospinal Fluid Stability, Preservation, and Distribution
      • A 6-year-old child is taken to the emergency department because of a 104°F temperature, lethargy, complaints of severe headaches, and a stiff nec...
      • Identification of nucleated cells in a child's CSF is critical because of which of the following?
  • Describe methods for obtaining accurate RBC and nucleated cell counts in CSF.
      • Manual Cell Count
      • Manual Cell Count, continued
      • Manual Cell Count Calculation
      • Automated Cell Count
      • A medical laboratory scientist had difficulty counting the WBCs in a CSF specimen on a hemocytometer. The specimen appeared to be contaminated with pe...
      • Which statements are correct regarding normal CSF nucleated cell counts and patient age?
  • Describe slide preparation and staining techniques necessary to obtain optimal microscopic cellular morphology and list possible causes of artifact.
      • Slide Preparation For Microscopic Analysis of CSF
      • Slide Preparation for Microscopic Analysis of CSF, continued
      • Artifacts Seen in CSF Slide Preparations
      • Which of the following images of representative microscopic fields from three CSF cytocentrifuge preparations correlates with a nucleated cell count o...
      • A recent medical laboratory science graduate was assigned to the microbiology laboratory. The assignment for the day was to prepare the Gram stains an...
  • Identify cell types and microscopic structures seen in cerebrospinal fluid (CSF) and associate abnormal hematologic CSF findings with known pathologies.
      • Nucleated Cells and Other Microscopic Elements Seen in CSF
      • Abnormal and Immature Cells in CSF
      • Malignant Cells in CSF
      • Additional Abnormal Microscopic Findings in CSF
      • Abnormal Hematologic Findings in CSF and Associated Pathologies
      • A 19-year-old college student who lives in the dormitory complained of being tired all the time, with a severe headache and stiff neck. They were take...
      • A 32-year-old patient with AIDS is admitted to the hospital with a fever of 104°F and rigidity of the neck. The doctor ordered blood drawn and pe...
  • References
      • References

Additional Information

Level of Instruction: Intermediate
Intended Audience: This program is designed as an educational and training tool for laboratory personnel including medical laboratory scientists and medical laboratory technicians, medical laboratory students and interns, pathology residents, and practicing pathologists.
Author Information: Marjorie Di Lorenzo, MLS(ASCP)SH, is a medical technologist with 40 years of laboratory experience. She has assumed many roles in her career, first as a staff technologist and moving into roles of laboratory management and education in CLS and MLT programs. She is the co-author for several textbooks and articles on the topics of urinalysis and body fluids. Marjorie is currently the Phlebotomy Technician Program Coordinator at Nebraska Methodist College and an Adjunct Instructor in the Division of Laboratory Sciences at the University of Nebraska Medical Center, Omaha, Nebraska.
Reviewer Information: Laurie Bjerklie, MA, MLS(ASCP)CM, is currently an Education Developer. She earned a B.S. in Medical Laboratory Science from the University of North Dakota and an M.A. in Curriculum and Instruction from Saint Xavier University. She has over 15 years of experience in higher education and has held program director and faculty positions in both MLT and MLS programs.

This course is part of the CAP Competency Assessment Hub.

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