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
Cells resembling large and small lymphocytes with cleaved nuclei represent: A. Lymphoma cells B. Choroid cells C. Melanoma cells D. Medulloblastoma cells
A. Lymphoma cells
26
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
B. 15 to 45 g/dL
27
CSF can be differentiated from serum by the presence of: A. Albumin B. Globulin C. Transthyretin D. Tau transferrin
D. Tau transferrin
28
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
C. Prealbumin
29
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
C. Fluid leakage
30
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. CSF/serum albumin index
31
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
C. 1.8
32
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. Synthesis of IgG in the CNS
33
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
C. Multiple sclerosis
34
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
D. Bacterial meningitis
35
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
C. 80 mg/dL
36
CSF lactate will be more consistently decreased in: A. Bacterial meningitis B. Viral meningitis C. Fungal meningitis D. Tubercular meningitis
B. Viral meningitis
37
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. Ammonia
38
Before performing a Gram stain on CSF, the specimen must be: A. Filtered B. Warmed to 37°C C. Centrifuged D. Mixed
C. Centrifuged
39
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
C. The WBC count is over 2000
40
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
D. PCR assay
41
The test of choice to detect neurosyphilis is the: A. RPR B. VDRL C. FAB D. FTA-ABS
B. VDRL