CSF Textbook Questions Flashcards

1
Q

Cerebrospinal fluid (CSF) is produced primarily from
A. secretions by the choroid plexus.
B. diffusion from plasma into the central nervous system.
C. ultrafiltration of plasma in the ventricles of the brain.
D. excretions from ependymal cells lining the brain and spinal cord.

A

A. secretions by the choroid plexus.

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2
Q
Cerebrospinal fluid is found between the
A. arachnoid and dura mater.
B. arachnoid and pia mater.
C. pia mater and dura mater.
D. pia mater and choroid plexus.
A

B. arachnoid and pia mater.

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3
Q

Which of the following statements regarding CSF is true?
A. Cerebrospinal fluid is constantly produced.
B. Cerebrospinal fluid is reabsorbed into the blood at the choroid plexus.
C. Cerebrospinal fluid is essentially composed of diluted plasma.
D. Cerebrospinal fluid circulates through the brain and spinal cord because of active and passive diffusion processes.

A

A. Cerebrospinal fluid is constantly produced.

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4
Q
Which of the following substances does not normally pass through the blood-brain barrier? 
A. PO2
B. Albumin
C. Glucose
D. Fibrinogen
A

D. Fibrinogen

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5
Q
During a lumbar puncture procedure, the first collection tube of CSF removed should be used for 
A. chemistry tests.
B. cytologic studies.
C. hematologic tests.
D. microbiological studies
A

A. chemistry tests.

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6
Q

Which of the following is not an analytical concern when the processing and testing of CSF are delayed?
A. The viability of microorganisms
B. The lability of the immunoglobulins
C. The lysis of leukocytes and erythrocytes
D. Alterations in the chemical composition

A

B. The lability of the immunoglobulins

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7
Q

Pleocytosis is a term used to describe
A. an increased number of cells in the CSF
B. a pink, orange, or yellow CSF specimen.
C. an increased protein content in the CSF caused by cellular lysis.
D. inflammation and sloughing of cells from the
choroid plexus.

A

A. an increased number of cells in the CSF

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8
Q
All of the following can cause xanthochromia in
CSF except
A. high concentrations of protein.
B. high concentrations of bilirubin. 
C. increased numbers of leukocytes. 
D. erythrocytes from a traumatic tap.
A

C. increased numbers of leukocytes.

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9
Q

In CSF, which of the following findings indicates a traumatic puncture?
A. The presence of erythrophagocytic cells in the CSF
B. Hemosiderin granules within macrophages in the CSF sediment
C. An uneven distribution of blood in the CSF collection tubes
D. A xanthochromic supernatant following CSF
centrifugation

A

C. An uneven distribution of blood in the CSF collection tubes

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10
Q
How many leukocytes are normally present in the
CSF obtained from an adult? 
A. 0 to 5 cells/mL
B. 0 to 10 cells/mL
C. 0 to 20 cells/mL
D. 0 to 30 cells/mL
A

A. 0 to 5 cells/mL

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11
Q
Which of the following cells can be present in small numbers in normal CSF? 
A. Erythrocytes
B. Lymphocytes
C. Macrophages
D. Plasma cells
A

B. Lymphocytes

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12
Q

Which of the following cell types predominate in
CSF during a classic case of bacterial meningitis? A. Lymphocytes
B. Macrophages
C. Monocytes
D. Neutrophils

A

D. Neutrophils

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13
Q

Which of the following cell types predominate in
CSF during a classic case of viral meningitis?
A. Lymphocytes
B. Macrophages
C. Monocytes
D. Neutrophils

A

A. Lymphocytes

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14
Q

When choroid plexus cells and ependymal cells are present in CSF, they
A. are often clinically significant.
B. represent the demyelination of nerve tissue.
C. can closely resemble clusters of malignant cells.
D. indicate breakdown of the blood-brain barrier.

A

C. can closely resemble clusters of malignant cells.

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15
Q
All of the following proteins are normally present in the CSF except 
A. albumin.
B. fibrinogen. 
C. transthyretin. 
D. transferrin.
A

B. fibrinogen.

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16
Q

Which of the following events does not result in an increased CSF total protein?
A. A traumatic puncture procedure
B. Alterations in the blood-brain barrier
C. Trauma to the central nervous system, resulting in fluid loss
D. Decreased reabsorption of CSF into the peripheral blood

A

C. Trauma to the central nervous system, resulting in fluid loss

17
Q
Which of the following proteins in the CSF is used to monitor the integrity of the blood-brain barrier? 
A. Albumin
B. Transthyretin
C. Transferrin
D. Immunoglobulin G
A

A. Albumin

18
Q

An immunoglobulin G index greater than 0.70
indicates
A. intrathecal synthesis of immunoglobulin G.
B. a compromised blood-brain barrier.
C. active demyelination of neural proteins.
D. increased transport of immunoglobulin G from
plasma into the CSF.

A

A. intrathecal synthesis of immunoglobulin G.

19
Q

An unknown fluid can be positively identified as CSF by determining the
A. lactate concentration.
B. albumin concentration.
C. presence of oligoclonal banding on electrophoresis.
D. presence of carbohydrate-deficient transferrin on electrophoresis

A

D. presence of carbohydrate-deficient transferrin on electrophoresis

20
Q

Which of the following statements about oligoclonal bands is false?
A. In the CSF, these bands indicate increased intrathecal concentrations of immunoglobulin G.
B. The bands usually correlate with the stage of disease and can be used to predict disease progression.
C. The bands are often present in the CSF and
serum of individuals with a lymphoproliferative
disease.
D. The bands are often present in the CSF but
not in the serum of individuals with multiple sclerosis.

A

B. The bands usually correlate with the stage of disease and can be used to predict disease progression.

21
Q

Which of the following statements about CSF glucose is false?
A. Increased CSF glucose values are diagnostically significant.
B. Glucose enters the CSF by active transport and simple diffusion.
C. Decreased CSF glucose values reflect a defective blood-brain barrier and increased glycolysis.
D. CSF glucose values reflect the plasma glucose concentration 30 to 90 minutes preceding collection.

A

A. Increased CSF glucose values are diagnostically significant.

22
Q
Normal CSF lactate levels (less than 25 mg/dL) are commonly found in patients with 
A. bacterial meningitis.
B. fungal meningitis.
C. tuberculous meningitis.
D. viral meningitis.
A

D. viral meningitis.

23
Q

Which of the following procedures frequently provides a rapid presumptive diagnosis of bacterial meningitis?
A. A blood culture
B. A CSF culture
C. A CSF Gram stain
D. Immunologic tests on CSF for microbial antigens

A

C. A CSF Gram stain

24
Q
India ink preparations and microbial antigen tests on CSF can aid in the diagnosis of 
A. bacterial meningitis.
B. fungal meningitis.
C. tuberculous meningitis.
D. viral meningitis.
A

B. fungal meningitis.