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2A STRASINGER CHAPTER QUESTIONS > 10 CEREBROSPINAL FLUID > Flashcards

10 CEREBROSPINAL FLUID Flashcards

1
Q

CSF is produced mainly in the:
A. Bone marrow
B. Peripheral blood
C. Choroid plexuses
D. Subarachnoid space

A

C. Choroid plexuses

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2
Q

The functions of the CSF include all of the following except:
A. Removing metabolic wastes
B. Producing an ultrafiltrate of plasma
C. Supplying nutrients to the CNS
D. Protecting the brain and spinal cord

A

B. Producing an ultrafiltrate of plasma

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3
Q

The CSF flows through the:
A. Choroid plexus
B. Pia mater
C. Subarachnoid space
D. Dura mater

A

C. Subarachnoid space

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4
Q

Substances present in the CSF are controlled by the:
A. Arachnoid granulations
B. Blood–brain barrier
C. Presence of one-way valves
D. Blood–CSF barrier

A

B. Blood–brain barrier

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5
Q

What department is the CSF tube labeled 3 routinely sent to?
A. Hematology
B. Chemistry
C. Microbiology
D. Serology

A

A. Hematology

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6
Q

The CSF tube that should be kept at room temperature is:
A. Tube 1
B. Tube 2
C. Tube 3
D. Tube 4

A

B. Tube 2

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7
Q

Choose which of these two conditions best describe the following statement:
(A) Traumatic tap
(B) Intracranial hemorrhage

Even distribution of blood in all tubes

A

(B) Intracranial hemorrhage

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8
Q

Choose which of these two conditions best describe the following statement:
(A) Traumatic tap
(B) Intracranial hemorrhage

Xanthochromic supernatant

A

(B) Intracranial hemorrhage

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9
Q

Choose which of these two conditions best describe the following statement:
(A) Traumatic tap
(B) Intracranial hemorrhage

Concentration of blood in Tube 1 is greater than in Tube 3

A

(A) Traumatic tap

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10
Q

Choose which of these two conditions best describe the following statement:
(A) Traumatic tap
(B) Intracranial hemorrhage

Specimen contains clots

A

(A) Traumatic tap

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11
Q

The presence of xanthochromia can be caused by all of
the following except:
A. Immature liver function
B. RBC degradation
C. A recent hemorrhage
D. Elevated CSF protein

A

C. A recent hemorrhage

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12
Q

A web-like pellicle in a refrigerated CSF specimen indicates:
A. Tubercular meningitis
B. Multiple sclerosis
C. Primary CNS malignancy
D. Viral meningitis

A

A. Tubercular meningitis

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13
Q

Given the following information, calculate the CSF WBC count: cells counted, 80; dilution, 1:10; large Neubauer
squares counted, 10.
A. 8
B. 80
C. 800
D. 8000

A

C. 800

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14
Q

A CSF WBC count is diluted with:
A. Distilled water
B. Normal saline
C. Acetic acid
D. Hypotonic saline

A

C. Acetic acid

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15
Q

A total CSF cell count on a clear fluid should be:
A. Reported as normal
B. Not reported
C. Diluted with normal saline
D. Counted undiluted

A

D. Counted undiluted

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16
Q

The purpose of adding albumin to CSF before
cytocentrifugation is to:
A. Increase the cell yield
B. Decrease the cellular distortion
C. Improve the cellular staining
D. Both A and B

A

D. Both A and B

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17
Q

The primary concern when pleocytosis of neutrophils and lymphocytes is found in the CSF is:
A. Meningitis
B. CNS malignancy
C. Multiple sclerosis
D. Hemorrhage

A

A. Meningitis

18
Q

Neutrophils with pyknotic nuclei may be mistaken for:
A. Lymphocytes
B. Nucleated RBCs
C. Malignant cells
D. Spindle-shaped cells

A

B. Nucleated RBCs

19
Q

The presence of which of the following cells is increased in a parasitic infection?
A. Neutrophils
B. Macrophages
C. Eosinophils
D. Lymphocytes

A

C. Eosinophils

20
Q

Macrophages appear in the CSF after:
A. Hemorrhage
B. Repeated spinal taps
C. Diagnostic procedures
D. All of the above

A

D. All of the above

21
Q

Nucleated RBCs are seen in the CSF as a result of:
A. Elevated blood RBCs
B. Treatment of anemia
C. Severe hemorrhage
D. Bone marrow contamination

A

D. Bone marrow contamination

22
Q

After a CNS diagnostic procedure, which of the
following might be seen in the CSF?
A. Choroidal cells
B. Ependymal cells
C. Spindle-shaped cells
D. All of the above

A

D. All of the above

23
Q

Hemosiderin granules and hematoidin crystals are seen in:
A. Lymphocytes
B. Macrophages
C. Ependymal cells
D. Neutrophils

A

B. Macrophages

24
Q

Myeloblasts are seen in the CSF:
A. In bacterial infections
B. In conjunction with CNS malignancy
C. After cerebral hemorrhage
D. As a complication of acute leukemia

A

D. As a complication of acute leukemia

25
Q

Cells resembling large and small lymphocytes with cleaved nuclei represent:
A. Lymphoma cells
B. Choroid cells
C. Melanoma cells
D. Medulloblastoma cells

A

A. Lymphoma cells

26
Q

The reference range for CSF protein is:
A. 6 to 8 g/dL
B. 15 to 45 g/dL
C. 6 to 8 mg/dL
D. 15 to 45 mg/dL

A

B. 15 to 45 g/dL

27
Q

CSF can be differentiated from serum by the presence of:
A. Albumin
B. Globulin
C. Transthyretin
D. Tau transferrin

A

D. Tau transferrin

28
Q

In serum, the second most prevalent protein is IgG; in CSF, the second most prevalent protein is:
A. Transferrin
B. Transthyretin
C. Prealbumin
D. Ceruloplasmin

A

C. Prealbumin

29
Q

Elevated values for CSF protein can be caused by all of the following except:
A. Meningitis
B. Multiple sclerosis
C. Fluid leakage
D. CNS malignancy

A

C. Fluid leakage

30
Q

The integrity of the blood–brain barrier is measured using the:
A. CSF/serum albumin index
B. CSF/serum globulin ratio
C. CSF albumin index
D. CSF IgG index

A

A. CSF/serum albumin index

31
Q

Given the following results, calculate the IgG index: CSF IgG, 50 mg/dL; serum IgG, 2 g/dL; CSF albumin,
70 mg/dL; serum albumin, 5 g/dL.
A. 0.6
B. 6.0
C. 1.8
D. 2.8

A

C. 1.8

32
Q

The CSF IgG index of 1.8 indicates:
A. Synthesis of IgG in the CNS
B. Damage to the blood–brain barrier
C. Cerebral hemorrhage
D. Lymphoma infiltration

A

A. Synthesis of IgG in the CNS

33
Q

The finding of oligoclonal bands in the CSF and not in the serum is seen with:
A. Multiple myeloma
B. CNS malignancy
C. Multiple sclerosis
D. Viral infections

A

C. Multiple sclerosis

34
Q

Which condition is suggested by the following results:
a CSF glucose of 15 mg/dL, WBC count of 5000, 90% neutrophils, and protein of 80 mg/dL?
A. Fungal meningitis
B. Viral meningitis
C. Tubercular meningitis
D. Bacterial meningitis

A

D. Bacterial meningitis

35
Q

A patient with a blood glucose of 120 mg/dL would have a normal CSF glucose of:
A. 20 mg/dL
B. 60 mg/dL
C. 80 mg/dL
D. 120 mg/dL

A

C. 80 mg/dL

36
Q

CSF lactate will be more consistently decreased in:
A. Bacterial meningitis
B. Viral meningitis
C. Fungal meningitis
D. Tubercular meningitis

A

B. Viral meningitis

37
Q

Measurement of which of the following can be replaced by CSF glutamine analysis in children with Reye
syndrome?
A. Ammonia
B. Lactate
C. Glucose
D. α-Ketoglutarate

A

A. Ammonia

38
Q

Before performing a Gram stain on CSF, the specimen must be:
A. Filtered
B. Warmed to 37°C
C. Centrifuged
D. Mixed

A

C. Centrifuged

39
Q

All of the following statements are true about cryptococcal meningitis except:
A. An India ink preparation is positive
B. A starburst pattern is seen on Gram stain
C. The WBC count is over 2000
D. A confirmatory immunology test is available

A

C. The WBC count is over 2000

40
Q

The most sensitive and specific method to detect the causative organism in meningitis is:
A. Gram stain
B. Culture and sensitivity
C. India ink stain
D. PCR assay

A

D. PCR assay

41
Q

The test of choice to detect neurosyphilis is the:
A. RPR
B. VDRL
C. FAB
D. FTA-ABS

A

B. VDRL

2A STRASINGER CHAPTER QUESTIONS (18 decks)

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