comp Flashcards
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
B. Producing an ultrafiltrate of plasma
The CSF flows through the:
A. Choroid plexus
B. Pia mater
C. Arachnoid space
D. Dura mater
c
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
b
What department is the CSF tube labeled 3 routinely
sent to?
A. Hematology
B. Chemistry
C. Microbiology
D. Serology
a
The CSF tube that should be kept at room temperature is:
A. Tube 1
B. Tube 2
C. Tube 3
D. Tube 4
b
Place the appropriate letter in front of the statement that
best describes CSF specimens in these two conditions:
A. Traumatic tap
B. Intracranial hemorrhage
____ Even distribution of blood in all tubes
____ Xanthochromic supernatant
____ Concentration o
b b a a
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
c
A web-like pellicle in a refrigerated CSF specimen
indicates:
A. Tubercular meningitis
B. Multiple sclerosis
C. Primary CNS malignancy
D. Viral meningitis
a
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
c
A CSF WBC count is diluted with:
A. Distilled water
B. Normal saline
C. Acetic acid
D. Hypotonic saline
c
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
d
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
d
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
Neutrophils with pyknotic nuclei may be mistaken for:
A. Lymphocytes
B. Nucleated RBCs
C. Malignant cells
D. Spindle-shaped cells
b
The presence of which of the following cells is increased
in a parasitic infection?
A. Neutrophils
B. Macrophages
C. Eosinophils
D. Lymphocytes
c
Macrophages appear in the CSF after:
A. Hemorrhage
B. Repeated spinal taps
C. Diagnostic procedures
D. All of the above
d
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
d
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
d
Hemosiderin granules and hematoidin crystals are seen in:
A. Lymphocytes
B. Macrophages
C. Ependymal cells
D. Neutrophils
b
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
d
Cells resembling large and small lymphocytes with cleaved nuclei
represent:
A. Lymphoma cells
B. Choroid cells
C. Melanoma cells
D. Medulloblastoma cells
a
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/d
b
CSF can be differentiated from serum by the presence of:
A. Albumin
B. Globulin
C. Prealbumin
D. Tau transferrin
b
In serum, the second most prevalent protein is IgG; in
CSF, the second most prevalent protein is:
A. Transferrin
B. Prealbumin
C. IgA
D. Ceruloplasmin
b
Elevated CSF protein values can be caused by all of the
following except:
A. Meningitis
B. Multiple sclerosis
C. Fluid leakage
D. CNS malignancy
c
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
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
The CSF IgG index calculated in Study Question 27
indicates:
A. Synthesis of IgG in the CNS
B. Damage to the blood–brain barrier
C. Cerebral hemorrhage
D. Lymphoma infiltration
a
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
A CSF glucose of 15 mg/dL, WBC count of 5000,
90% neutrophils, and protein of 80 mg/dL suggests:
A. Fungal meningitis
B. Viral meningitis
C. Tubercular meningitis
D. Bacterial meningitis
d
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
b
CSF lactate will be more consistently decreased in:
A. Bacterial meningitis
B. Viral meningitis
C. Fungal meningitis
D. Tubercular meningitis
a
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
Before performing a Gram stain on CSF, the specimen
must be:
A. Filtered
B. Warmed to 37°C
C. Centrifuged
D. Mixed
c
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 test of choice to detect neurosyphilis is the:
A. RPR
B. VDRL
C. FAB
D. FTA-ABS
d
The functions of synovial fluid include all of the following
except:
A. Lubrication for the joints
B. Removal of cartilage debris
C. Cushioning joints during jogging
D. Providing nutrients for cartilage
b
The primary function of synoviocytes is to:
A. Provide nutrients for the joints
B. Secrete hyaluronic acid
C. Regulate glucose filtration
D. Prevent crystal formation
a
Which of the following is not a frequently performed test
on synovial fluid?
A. Uric acid
B. WBC count
C. Crystal examination
D. Gram stain
a
A. Noninflammatory
B. Inflammatory
C. Septic
D. Hemorrhagic
gout
b
A. Noninflammatory
B. Inflammatory
C. Septic
D. Hemorrhagic
Neisseria gonorrhoeae infection
c
A. Noninflammatory
B. Inflammatory
C. Septic
D. Hemorrhagic
Systemic lupus erythematosus
b
A. Noninflammatory
B. Inflammatory
C. Septic
D. Hemorrhagic
Osteoarthritis
a
A. Noninflammatory
B. Inflammatory
C. Septic
D. Hemorrhagic
Hemophilia
d
A. Noninflammatory
B. Inflammatory
C. Septic
D. Hemorrhagic
Rheumatoid arthritis
b
A. Noninflammatory
B. Inflammatory
C. Septic
D. Hemorrhagic
Heparin overdose
d
Normal synovial fluid resembles:
A. Egg white
B. Normal serum
C. Dilute urine
D. Lipemic serum
a
Before testing, very viscous synovial fluid should be
treated with:
A. Normal saline
B. Hyaluronidase
C. Distilled water
D. Hypotonic saline
b
Addition of a cloudy, yellow synovial fluid to acetic acid
produces a/an:
A. Yellow-white precipitate
B. Easily dispersed clot
C. Solid clot
D. Opalescent appearance
b
Which of the following could be the most significantly
affected if a synovial fluid is refrigerated before testing?
A. Glucose
B. Crystal examination
C. Mucin clot test
D. Differential
b
The highest WBC count can be expected to be seen with:
A. Noninflammatory arthritis
B. Inflammatory arthritis
C. Septic arthritis
D. Hemorrhagic arthritis
c
When diluting a synovial fluid WBC count, all of the
following are acceptable except:
A. Acetic acid
B. Isotonic saline
C. Hypotonic saline
D. Saline with saponin
a
The lowest percentage of neutrophils would be seen in:
A. Noninflammatory arthritis
B. Inflammatory arthritis
C. Septic arthritis
D. Hemorrhagic arthritis
a
All of the following are abnormal when seen in synovial
fluid except:
A. Neutrophages
B. Ragocytes
C. Synovial lining cells
D. Lipid droplet
c
Synovial fluid crystals that occur as a result of purine
metabolism or chemotherapy for leukemia are:
A. Monosodium urate
B. Cholesterol
C. Calcium pyrophosphate
D. Apatite
a
Synovial fluid crystals associated with inflammation in
dialysis patients are:
A. Calcium pyrophosphate dihydrate
B. Calcium oxalate
C. Corticosteroid
D. Monosodium urate
b
Crystals associated with pseudogout are:
A. Monosodium urate
B. Calcium pyrophosphate dihydrate
C. Apatite
D. Corticosteroid
b
Synovial fluid for crystal examination should be examined
as a/an:
A. Wet preparation
B. Wright’s stain
C. Gram stain
D. Acid-fast stain
a
Crystals that have the ability to polarize light are:
A. Corticosteroid
B. Monosodium urate
C. Calcium oxalate
D. All of the above
d
In an examination of synovial fluid under compensated
polarized light, rhomboid-shaped crystals are observed.
What color would these crystals be when aligned parallel
to the slow vibration?
A. White
B. Yellow
C. Blue
D. Red
b
Negative birefringence occurs under red-compensated polarized light when:
A. Slow light is impeded more than fast light
B. Slow light is less impeded than fast light
C. Fast light runs against the molecular grain of the
crystal
D. Both B and C
c
Synovial fluid cultures are often plated on chocolate agar
to detect the presence of:
A. Neisseria gonorrhoeae
B. Staphylococcus agalactiae
C. Streptococcus viridans
D. Enterococcus faecalis
a
- The most frequently performed chemical test on synovial
fluid is:
A. Total protein
B. Uric acid
C. Calcium
D. Glucose
c
Serologic tests on patients’ serum may be performed to
detect antibodies causing arthritis for all of the following
disorders except:
A. Pseudogout
B. Rheumatoid arthritis
C. Systemic lupus erythematosus
D. Lyme arthritis
a
The primary purpose of serous fluid is to:
A. Remove waste products
B. Lower capillary pressure
C. Lubricate serous membranes
D. Nourish serous membranes
c
The membrane that lines the wall of a cavity is the:
A. Visceral
B. Peritoneal
C. Pleural
D. Parietal
d
During normal production of serous fluid, the slight excess
of fluid is:
A. Absorbed by the lymphatic system
B. Absorbed through the visceral capillaries
C. Stored in the mesothelial cells
D. Metabolized by the mesothelial cells
a
Production of serous fluid is controlled by:
A. Capillary oncotic pressure
B. Capillary hydrostatic pressure
C. Capillary permeability
D. All of the above
d
An increase in the amount of serous fluid is called a/an:
A. Exudate
B. Transudate
C. Effusion
D. Malignancy
c
Pleural fluid is collected by:
A. Pleurocentesis
B. Paracentesis
C. Pericentesis
D. Thoracentesis
d
Fluid:serum protein and lactic dehydrogenase ratios are
performed on serous fluids:
A. When malignancy is suspected
B. To classify transudates and exudates
C. To determine the type of serous fluid
D. When a traumatic tap has occurred
b
Which of the following requires the most additional
testing?
A. Transudate
B. Exudate
b
An additional test performed on pleural fluid to classify
the fluid as a transudate or exudate is the:
A. WBC count
B. RBC count
C. Fluid:cholesterol ratio
D. Fluid-to-serum protein gradient
c
A milky-appearing pleural fluid indicates:
A. Thoracic duct leakage
B. Chronic inflammation
C. Microbial infection
D. Both A and B
d
Which of the following best represents a hemothorax?
A. Blood HCT: 42 Fluid HCT: 15
B. Blood HCT: 42 Fluid HCT: 10
C. Blood HCT: 30 Fluid HCT: 10
D. Blood HCT: 30 Fluid HCT: 20
d
All of the following are normal cells seen in pleural fluid
except:
A. Mesothelial cells
B. Neutrophils
C. Lymphocytes
D. Mesothelioma cells
d
A differential observation of pleural fluid associated with
tuberculosis is:
A. Increased neutrophils
B. Decreased lymphocytes
C. Decreased mesothelial cells
D. Increased mesothelial cells
c
All of the following are characteristics of malignant cells
except:
A. Cytoplasmic molding
B. Absence of nucleoli
C. Mucin-containing vacuoles
D. Increased nucleus:cytoplasm ratio
b
A pleural fluid pH of 6.0 indicates:
A. Esophageal rupture
B. Mesothelioma
C. Malignancy
D. Rheumatoid effusion
a
Plasma cells seen in pleural fluid indicate:
A. Bacterial endocarditis
B. Primary malignancy
C. Metastatic lung malignancy
D. Tuberculosis infection
d
A significant cell found in pericardial or pleural fluid that
should be referred to cytology is a:
A. Reactive lymphocyte
B. Mesothelioma cell
C. Monocyte
D. Mesothelial cell
b
Another name for a peritoneal effusion is:
A. Peritonitis
B. Lavage
C. Ascites
D. Cirrhosis
c
A test performed primarily on peritoneal lavage fluid is
a/an:
A. WBC count
B. RBC count
C. Absolute neutrophil count
D. Amylase
b
The recommended test for determining whether peritoneal fluid is a transudate or an exudate is the:
A. Fluid:serum albumin ratio
B. Serum ascites albumin gradient
C. Fluid:serum lactic dehydrogenase ratio
D. Absolute neutrophil count
b
Given the following results, classify this peritoneal fluid:
serum albumin, 2.2 g/dL; serum protein, 6.0 g/dL; fluid
albumin, 1.6 g/dL.
A. Transudate
B. Exudate
b
Differentiation between bacterial peritonitis and cirrhosis
is done by performing a/an:
A. WBC count
B. Differential
C. Absolute neutrophil count
D. Absolute lymphocyte count
c
Detection of the CA 125 tumor marker in peritoneal fluid
indicates:
A. Colon cancer
B. Ovarian cancer
C. Gastric malignancy
D. Prostate cancer
b
Chemical tests primarily performed on peritoneal fluid include all of the following except:
A. Lactose dehydrogenase
B. Glucose
C. Alkaline phosphatase
D. Amylase
d
Cultures of peritoneal fluid are incubated:
A. Aerobically
B. Anaerobically
C. At 37°C and 42°C
D. Both A and B
d
Which of the following is not a function of amniotic fluid?
A. Allows movement of the fetus
B. Allows carbon dioxide and oxygen exchange
C. Protects fetus from extreme temperature changes
D. Acts as a protective cushion for the fetus
b
What is the primary cause of the normal increase in amniotic fluid as a pregnancy progresses?
A. Fetal cell metabolism
B. Fetal swallowing
C. Fetal urine
D. Transfer of water across the placenta
c
Which of the following is not a reason for decreased
amounts of amniotic fluid?
A. Fetal failure to begin swallowing
B. Increased fetal swallowing
C. Membrane leakage
D. Urinary tract defects
a
Why might a creatinine level be requested on an amniotic
fluid?
A. Detect oligohydramnios
B. Detect polyhydramnios
C. Differentiate amniotic fluid from maternal urine
D. Evaluate lung maturity
c
Amniotic fluid specimens are placed in amber-colored tubes
prior to sending them to the laboratory to prevent the
destruction of:
A. Alpha-fetoprotein
B. Bilirubin
C. Cells for cytogenetics
D. Lecithin
b
How are specimens for FLM testing delivered to and stored
in the laboratory?
A. Delivered on ice and refrigerated
B. Immediately centrifuged
C. Kept at room temperature
D. Delivered in a vacuum tube
