Body Fluids

Question 1

Cytopin preps are made on all ________ regardless of cell count.

Answer 1

CSF specimens

Question 2

Procedure of cytocentrifuge (cytospin) method of slide preparation.

Answer 2

Always add one drop of 22% albumin and then five drops of fluid to make the cytospin prep.

Question 3

When is necessary to make dilutions for cytospin?

Answer 3

If TNC/WBC is 200/cumm- dilute fluid with isotonic saline to bring total cell count to 200 TNC/cumm. Then use 1 drop of albumin & 5 drop of diluted fluid to make prep

Question 4

Important notes about cytoscentrifuge smear.

Answer 4

• slide must be prepared soon after collection to prevent nuclei of cells formed degenerating and vacuoles in cytoplasm
• may see irregular cytoplasmic processes, increased lobulation, or clefting of nucleus
• nucleoli may appear more prominent and large lymphocytes be difficult to distinguish from monocytes

Question 5

How to do differentials on body fluids.

Answer 5

Count 100 cells.
Count monocytes/macrophages/histiocytes on one key
count lining cells (mesothelial, pneumocytes, ependymal) on one key
comment on crystals, microorganisms, malignants cells, etc
differentiate WBC types.

Question 6

____slide is the preferred method of cellular concentration for differential in body fluids.

Answer 6

cytospin slide

Question 7

In synovial fluid, ____ should be added to the specimen before cell counts are performed.

Answer 7

Hyaluronidase, if crystal exam ordered, remove some fluid before adding hyaluronidase

Question 8

All body fluid cell count is performed on _____

Answer 8

Hemacytometer

Question 9

Know the procedures for body fluid cell counts (Hemacytometer).

Answer 9

This is done by forcing a small quantity of the dilution from the reservoir to flow between the chamber and coverglass. Allow the chamber to stand 1-2 minutes to permit cells to settle. Then count the cells under microscope.

Question 10

Properly setup the microscope polarizer.

Answer 10

• Place the lower polarizer on top of the light source
• rotate the lower polarizer to get to the darkest field
• use 40X objective to examine the crystals closely. Adjust the condenser light and intensity to get good contrast. Examine several fields to verify the absence of crystals. Then push in the red compensator

Question 11

______is sometimes used in conjunction with polarized light.

Answer 11

A red compensator

Question 12

Clues to identifying malignant cells.

Answer 12

-tend to form clusters, nuclear membrane is irregular or jagged, chromatin is unevenly distributed, contain prominent, frequently multiple nucleoli with irregular membranes, N:C ratio is higher than normal, cytoplasmic granules, signet ring cells, unusual homogenous populations, cell clusters

Question 13

Normal CSF fluid looks like___

Answer 13

colorless, clear, and has similar viscosity to water

Question 14

Reasons for cloudiness CSF fluid

Answer 14

cells (>200 WBC or >400 RBC)
Microorganisms
proteins

Question 15

Reason for bloody specimens of CSF fluid.

Answer 15

Traumatic tap or hemorrhages (arachnoid or intracerebral)

Question 16

Amount of blood decreases between each successive tube is ___

Answer 16

traumatic tap

Question 17

Amount of blood is consistent is ____

Answer 17

Hemorrhage

Question 18

differentiate if clotting is present in traumatic tape and hemorrhage.

Answer 18

Traumatic tape-clotting

Hemorrhage-clotting rare

Question 19

Clear supernantant

Answer 19

traumatic tap

Question 20

pink, orange, or yellow supernant

Answer 20

hemorrhage

Question 21

May see macrophages engulfing RBCs or contain hemosiderin is _____.

Answer 21

Hemorrhage

Question 22

If Neutrophil counts are increased, look closely for either _____ and _______

Answer 22

intracellular or extracellular bacteria

Question 23

Neutrophils are considered an abnormal finding in all body fluids except _____

Answer 23

BAL

Question 24

Hemosiderin from engulfed RBC will stain with _____ and appears ___ hours after a _____

Answer 24

Prussian blue stain, 24-72 hours, hemorrhage

Question 25

____cells react to foreign material such as shunts, intrathecal injections

Answer 25

Eosinophils and basophils

Question 26

This type of cells sen when vertebral body is accidentally punctured or traumatic arthritis

Answer 26

cartilage cells

Question 27

Three most common crystals in synovial fluids:

Answer 27

cholesterol
calcium pyrophosphate
monosodium urate

Question 28

Two methods to differentiate between MSU and CPP

Answer 28

polarization and use of a red compensator

Question 29

When a red compensator is used, CPP crystal are blue when the longitudinal axis is ____ to the axis of slow vibration and yellow when _____

Answer 29

parallel and perpendicular