CHAPTER 14: BRONCHOALVEOLAR LAVAGE FLUID

Question 1

A method for obtaining cellular, immunologic, and microbiological information from the lining fluid of the lower respiratory tract.

Answer 1

Bronchoalveolar lavage

Question 2

Desired fluid volume for analysis

Answer 2

10-20 mL (min. 5 mL)

Question 3

Transport temperature for BAL

Answer 3

Room temp.

Question 4

Transport temperature when delivery to the lab is delayed for longer than 30 minutes.

Answer 4

4C (on ice)

Question 5

Cell counts for BAL should be performed within _____hour.

Answer 5

1 hour (but stable up to 3 hours)

Question 6

1) indicates acute diffuse alveolar
hemorrhage

2) older hemorrhagic syndrome evaluated for intracellular iron content by cytochemistry

3) indicates an accumulation of phospholipid–protein complexes derived from pulmonary surfactant in the lung alveoli

a. orange-red BAL
b. milky light brown-beige BAL
c. bloody BAL

Answer 6

1) indicates acute diffuse alveolar
hemorrhage
- bloody

2) older hemorrhagic syndrome evaluated for intracellular iron content by cytochemistry
- orange-red

3) indicates an accumulation of phospholipid–protein complexes derived from pulmonary surfactant in the lung alveoli
- milky light brown-beige BAL

Question 7

Increased in cases of interstitial lung disease, drug reactions, pulmonary lymphoma, and nonbacterial infections.

Answer 7

Lymphocytes

Question 8

The primary granulocyte seen, with a normal value of less than 3%. They are elevated in patients who are cigarette smokers and in cases of bronchopneumonia, toxin exposure, and diffuse alveolar damage.

Answer 8

Neutrophils

Question 9

Usually less than 1% to 2% of the total cells, are elevated in cases of asthma, drug-induced lung disease, infections
(parasitic, mycobacterial, or fungal), hypersensitivity, pneumonitis, and pneumonia.

Answer 9

Eosinophils

Question 10

Indicates an acute alveolar hemorrhage

Answer 10

Erythrocytes

Question 11

More numerous in bronchial wash specimens than in bronchial lavage specimens because of the more vigorous washing technique

Answer 11

Epithelial cells

Question 12

Seen in actinomyces infection

Answer 12

sulfur granules

Question 13

Seen in cigarette smokers

Answer 13

Langerhans cells

Question 14

a significant opportunistic pathogen in patients with AIDS

Answer 14

Cryptococcus neoformans

Question 15

indicate pneumoconioses or asbestos exposure

Answer 15

Dust particle inclusions

Question 16

Procedure is used for bronchoalveolar lavage

Answer 16

Bronchoscopy