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1
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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2
Q

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

A

c

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3
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

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4
Q

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

A

a

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5
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

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6
Q

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

A

b b a a

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7
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

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8
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

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9
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

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10
Q

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

A

c

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11
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

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12
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

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13
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

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14
Q

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

A

b

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15
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

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16
Q

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

A

d

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17
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

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18
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

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19
Q

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

A

b

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20
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

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21
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

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22
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/d

A

b

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23
Q

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

A

b

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24
Q

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

A

b

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25
Q

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

A

c

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26
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

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27
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

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28
Q

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

a

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29
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

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30
Q

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

A

d

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31
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

b

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32
Q

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

A

a

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33
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

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34
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

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35
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

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36
Q

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

A

d

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37
Q

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

A

b

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38
Q

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

a

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39
Q

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

40
Q

A. Noninflammatory
B. Inflammatory
C. Septic
D. Hemorrhagic

gout

A

b

41
Q

A. Noninflammatory
B. Inflammatory
C. Septic
D. Hemorrhagic

Neisseria gonorrhoeae infection

A

c

42
Q

A. Noninflammatory
B. Inflammatory
C. Septic
D. Hemorrhagic

Systemic lupus erythematosus

A

b

43
Q

A. Noninflammatory
B. Inflammatory
C. Septic
D. Hemorrhagic

Osteoarthritis

A

a

44
Q

A. Noninflammatory
B. Inflammatory
C. Septic
D. Hemorrhagic

Hemophilia

A

d

45
Q

A. Noninflammatory
B. Inflammatory
C. Septic
D. Hemorrhagic

Rheumatoid arthritis

A

b

46
Q

A. Noninflammatory
B. Inflammatory
C. Septic
D. Hemorrhagic

Heparin overdose

A

d

47
Q

Normal synovial fluid resembles:
A. Egg white
B. Normal serum
C. Dilute urine
D. Lipemic serum

A

a

48
Q

Before testing, very viscous synovial fluid should be
treated with:
A. Normal saline
B. Hyaluronidase
C. Distilled water
D. Hypotonic saline

A

b

49
Q

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

A

b

50
Q

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

A

b

51
Q

The highest WBC count can be expected to be seen with:
A. Noninflammatory arthritis
B. Inflammatory arthritis
C. Septic arthritis
D. Hemorrhagic arthritis

A

c

52
Q

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

a

53
Q

The lowest percentage of neutrophils would be seen in:
A. Noninflammatory arthritis
B. Inflammatory arthritis
C. Septic arthritis
D. Hemorrhagic arthritis

A

a

54
Q

All of the following are abnormal when seen in synovial
fluid except:
A. Neutrophages
B. Ragocytes
C. Synovial lining cells
D. Lipid droplet

A

c

55
Q

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

a

56
Q

Synovial fluid crystals associated with inflammation in
dialysis patients are:
A. Calcium pyrophosphate dihydrate
B. Calcium oxalate
C. Corticosteroid
D. Monosodium urate

A

b

57
Q

Crystals associated with pseudogout are:
A. Monosodium urate
B. Calcium pyrophosphate dihydrate
C. Apatite
D. Corticosteroid

A

b

58
Q

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

a

59
Q

Crystals that have the ability to polarize light are:
A. Corticosteroid
B. Monosodium urate
C. Calcium oxalate
D. All of the above

A

d

60
Q

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

A

b

61
Q

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

A

c

62
Q

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

a

63
Q
  1. The most frequently performed chemical test on synovial
    fluid is:
    A. Total protein
    B. Uric acid
    C. Calcium
    D. Glucose
A

c

64
Q

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

a

65
Q

The primary purpose of serous fluid is to:
A. Remove waste products
B. Lower capillary pressure
C. Lubricate serous membranes
D. Nourish serous membranes

A

c

66
Q

The membrane that lines the wall of a cavity is the:
A. Visceral
B. Peritoneal
C. Pleural
D. Parietal

A

d

67
Q

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

a

68
Q

Production of serous fluid is controlled by:
A. Capillary oncotic pressure
B. Capillary hydrostatic pressure
C. Capillary permeability
D. All of the above

A

d

69
Q

An increase in the amount of serous fluid is called a/an:
A. Exudate
B. Transudate
C. Effusion
D. Malignancy

A

c

70
Q

Pleural fluid is collected by:
A. Pleurocentesis
B. Paracentesis
C. Pericentesis
D. Thoracentesis

A

d

71
Q

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

A

b

72
Q

Which of the following requires the most additional
testing?
A. Transudate
B. Exudate

A

b

73
Q

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

A

c

74
Q

A milky-appearing pleural fluid indicates:
A. Thoracic duct leakage
B. Chronic inflammation
C. Microbial infection
D. Both A and B

A

d

75
Q

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

A

d

76
Q

All of the following are normal cells seen in pleural fluid
except:
A. Mesothelial cells
B. Neutrophils
C. Lymphocytes
D. Mesothelioma cells

A

d

77
Q

A differential observation of pleural fluid associated with
tuberculosis is:
A. Increased neutrophils
B. Decreased lymphocytes
C. Decreased mesothelial cells
D. Increased mesothelial cells

A

c

78
Q

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

A

b

79
Q

A pleural fluid pH of 6.0 indicates:
A. Esophageal rupture
B. Mesothelioma
C. Malignancy
D. Rheumatoid effusion

A

a

80
Q

Plasma cells seen in pleural fluid indicate:
A. Bacterial endocarditis
B. Primary malignancy
C. Metastatic lung malignancy
D. Tuberculosis infection

A

d

81
Q

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

A

b

82
Q

Another name for a peritoneal effusion is:
A. Peritonitis
B. Lavage
C. Ascites
D. Cirrhosis

A

c

83
Q

A test performed primarily on peritoneal lavage fluid is
a/an:
A. WBC count
B. RBC count
C. Absolute neutrophil count
D. Amylase

A

b

84
Q

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

A

b

85
Q

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

A

b

86
Q

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

A

c

87
Q

Detection of the CA 125 tumor marker in peritoneal fluid
indicates:
A. Colon cancer
B. Ovarian cancer
C. Gastric malignancy
D. Prostate cancer

A

b

88
Q

Chemical tests primarily performed on peritoneal fluid include all of the following except:
A. Lactose dehydrogenase
B. Glucose
C. Alkaline phosphatase
D. Amylase

A

d

89
Q

Cultures of peritoneal fluid are incubated:
A. Aerobically
B. Anaerobically
C. At 37°C and 42°C
D. Both A and B

A

d

90
Q

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

A

b

91
Q

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

A

c

92
Q

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

a

93
Q

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

A

c

94
Q

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

A

b

95
Q

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

A

aubf (3 decks)

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