SPT, BAL, SWEAT, CSF Flashcards

1
Q

A mixture of plasma, electrolytes, mucin and water

A

Tracheobronchial secretions

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2
Q

Acceptable sputum specimen

A

<10 SEC/LPF and >25 WBCs/LPF

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3
Q

Sputum is produced by

A

Tracheobronchial tree

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4
Q

Most preferred sample for routine analysis

A

First morning

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5
Q

Collection method for unconscious or debilitated patients

A

Tracheal aspiration

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6
Q

Yellow or gray PIN HEAD sized material and produces foul odor when crushed

A

Dittrich’s plugs

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7
Q

Color of sputum for old blood, pneumonia, gangrene

A

Anchovy sauce or rusty brown

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8
Q

Color of sputum of cancer patient

A

Olive green or grass green

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9
Q

Color of sputum with lobar pneumonia ( S. Pneumonia)

A

Rusty with pus

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10
Q

Color of sputum of patient with congestive heart failure

A

Rusty without pus

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11
Q

Color of sputum of patient with Klebsiella pneumoniae infection

A

Currant, jelly-like

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12
Q

Hard concretions in a bronchus (LUNG STONE)
Yellow white calcified TB structures/ foreign material

A

Pneumoliths or broncholiths

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13
Q

Coiled mucus strands and appear as fluff balls macroscopically

A

Curschmann spiral

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14
Q

Colorless hexagonal, double pyramid, often NEEDLE LIKE, arise from disintegrations of eosinophils

A

Charcot Leyden crystals

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15
Q

Seen in bronchial asthma

A

Charcot leyden crystals
creola bodies
Curschmanns spiral

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16
Q

Pigmented cell: hemosiderin-laden macrophage

A

Heart failure cells

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17
Q

Pigmented cells: angular black granules

A

Carbon-laden cells

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18
Q

Colorless globules occurring in a variety of sizes and bizarre formations

A

Myelin globules

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19
Q

It has no significance and MISTAKEN AS BLASTOMYCES

A

MYELIN GLOBULES

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20
Q

Clusters of columnar epithelial cells

A

Creola bodies

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21
Q

Bronchoalveolar lavage is an important disgnostic test for what parasite in immunocompromised patients

A

Pneumocystis jiroveci/carinii

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22
Q

A BAL stain that is best for delineating the cysts of pneumocystis jiroveci

A

Grocott’s methenamine silver stain

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23
Q

Most predominant cells seen in BAL

A

ALVEOLAR MACROPHAGE

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24
Q

Percentage of lymphocytes seen in BAL

A

1-15%

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25
Q

These cells are increased in BAL among cigarette smokers

A

Neutrophil

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26
Q

Specimen used to diagnose cystic fibrosis

A

Sweat

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27
Q

Pilocarpine + mild current = induce sweat production

A

Gibson and Cooke Pilocarpine iontophoresis

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28
Q

Sweat sodium and chloride values that is diagnostic for Cystic fibrosis

A

> 70 mEq/L

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29
Q

Sweat sodium and chloride values that is BORDERLINE for Cystic fibrosis

A

40 mEq/L

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30
Q

Most important single component of sputum viscosity

A

Sialic acid

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31
Q

Produces CSF by selective filtration at a rate of 20 mL//hour

A

Choroid plexus

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32
Q

Reabsorbs CSF

A

ARACHNOID VILLI/GRANULATIONS

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33
Q

Protects brain from chemicals and other substances circulating in the blood that can harm the brain tissue

A

Blood brain barrier

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34
Q

Up to ___ mL CSF can be collected using a manometer attached to a spinal needle

A

20 mL

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35
Q

Method of CSD collection

A

Lumbar tap

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36
Q

Location of collection of CSF in adults

A

Between L3-L4

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37
Q

Location of CSF collection in infants

A

Between L4-L5

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38
Q

CSF tube 1 is used for what section ; storage temp

A

Chemistry or serology ; freezer

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39
Q

CSF TUBE 2 IS FOR WHAT SECTION ; storage temp

A

MICROBIOLOGY ; room temp for 30 mins

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40
Q

Tube 3 is for what section

A

Hematology ; ref temp for fours

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41
Q

CSF TUBE 4 is for what section

A

microbiology or serology (best)

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42
Q

If 1 CSF tube 1 only what is the order for each section

A

Micro > hema > chemistry

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43
Q

Normal CSF volume in adults

A

90-150 mL

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44
Q

Normal CSF volume in infants

A

10-60 mL

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45
Q

Puncture of blood vessels

A

Traumatic tap

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46
Q

Bleeding within the brain case

A

Intracranial hemorrhage

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47
Q

Uneven distribution of blood on 3 tubes

A

Traumatic tap

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48
Q

Even distribution of blood on 3 tubes

A

Intracranial hemorrhage

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49
Q

Positive for clot formation

A

Traumatic tap

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50
Q

Negative for clot formation

A

Intracranial hemorrhage

51
Q

D-dimer positive

A

Intracranial hemorrhage

52
Q

Supernatant of traumatic tap

A

Clear

53
Q

Supernatant of intracranial hemorrhage

A

Xanthochromic (rbcs lyse in CSF after 2 hrs

54
Q

Erythrophages are absent

A

Traumatic tap

55
Q

Erythrophages are present
= hematite in and hemosiderin

A

Intracranial hemorrhage

56
Q

Pellicle CSF appearance is indicative of what type of meningitis

A

Tubercular meningitis

57
Q

CSF cell count must be performed _____

A

Within 1 hour Orr immediately

58
Q

Normal wbc count in CSF in adults

A

0-5 WBCs/uL

59
Q

Normal wbc count in CSF in neonates

A

0-30 WBCs/uL

60
Q

Clear CSF dilution

A

Undiluted

61
Q

Slightly hazy CSF dilution

A

1:10

62
Q

Hazy CSF dilution

A

1:20

63
Q

Slightly cloudy CSF dilution

A

1:100

64
Q

Bloody or turbid CSF dilution

A

1:10,000

65
Q

WBC diluting fluid

A

3% acetic acid with methylene blue

66
Q

This is done only in traumatic tap

A

Rbc count

67
Q

To correct WBC count and total protein concentration

A

-1 wbc for every 700 rbcs seen

68
Q

In CSF differential count, specimen should be ______ before smearing by using ____

A

Concentrated ; cytocentrifuge

69
Q

What is being added in cytocentrifuge that increases cell yield or recovery and also decrease cellular distortion

A

30% albumin

70
Q

Predominant cells in CSF

A

Lymphocytes and monocytes

71
Q

Ratio of lymphocytes to monocytes in adult CSF

A

70:30

72
Q

Number of monocytes in neonate CSF

A

80% monocytes

73
Q

Abnormal condition with increased number normal cells in the CSF

A

PLEOCYTOSIS

74
Q

Increased neutrophil in the CSF in indicative of what type meningitis

A

Bacterial meningitis

75
Q

Increased wbc seen in cases of viral meningitis, TB, and fungal meningitis

A

Lymphocytes and monocytes

76
Q

Normal CSF protein in adult

A

15-45 mg/dL

77
Q

Normal CSF protein in infants

A

150 mg/dL

78
Q

Normal CSF protein in immature

A

500 mg/dL

79
Q

Increased CSF protein in seen in

A

Meningitis and hemorrhage

80
Q

Most common cause of increased CSF protein

A

Damage to the BBB result

81
Q

This is increased in CSF in the case of multiple sclerosis

A

CSF protein

82
Q

Major CSF protein

A

ALBUMIN

83
Q

2nd most prevalent protein in the CSF

A

Prealbumin / transtyrethin

84
Q

Alpha globulins seen in CSF

A

Haptoglobin and ceruloplasmin

85
Q

Beta globulin seen in CSF

A

Beta 2 transferrin (tau)

86
Q

Carbohydrate deficient transferrin

A

Beta 2 transferrin

87
Q

Found in the CSF but not in serum

A

Beta 2 transferin

88
Q

Not found in normal CSF

A

Fibrinogen
Lipids
IgM

89
Q

Gamma globulins found in CSF

A

IgA and IgG

90
Q

Preferred turbidimetric method that precipitates both albumin and globulins

A

TRICHLOROACETIC ACID

91
Q

turbidimetric method that precipitates albumin only

A

3% Sulfosalicyclic acid

92
Q

A dye binding technique for CSF protein determination wherein the dye turns from red to blue

A

Coumadin brilliant blue

93
Q

CSF/ serum albumin index normal value

A

<9

94
Q

IgG index normal value in CSF protein

A

<0.70 or 0.30 to 0.70

95
Q

Abnormal IgG index in CSF protein

A

> 0.70 or 0.77

96
Q

Used to the detection of oligoclonal band

A

CSF electrophoresis

97
Q

(+) 2 or more oligoclonal bands in CSF but not in serum is valuable for the diagnosis of ____

A

Multiple sclerosis

98
Q

Better resolution is obtained using CSF immunofixation electrophoresis and isoelectric focusing followed by ________

A

Silver staining

99
Q

Oligoclonal banding in CSF but not in serum (MNENG)

A

Multiple sclerosis
Neurosyphilis
Encephalitis
Neoplastic disorders
Guillain-Barré syndrome

100
Q

Oligoclonal banding in serum but not in CSF (LLV)

A

Leukemia
Lymphoma
Viral infections

101
Q

Oligoclonal banding BOTH in serum and CSF

A

HIV

102
Q

Demyelinating disorder

A

Multiple scelrosis

103
Q

Protein component of the lipid protein complex that insulate the nerve fibers

A

MYELIN BASIC PROTEIN

104
Q

Presence of _____ in CSF indicates destruction of myelin sheath

A

Myelin basic protein

105
Q

Specimen for blood glucose should be drawn _____ hrs prior to spinal tap

A

2 hours

106
Q

Normal CSF glucose is seen in what type of meningitis

A

Viral meningitis

107
Q

Sensitive method for evaluating the effectiveness of antibiotic therapy

A

CSF lactate

108
Q

Inversely proportional to glucose

A

CSF LACTATE

109
Q

Indirect test for the presence of excess AMMONIA in the CSF

A

CSF Glutamine

110
Q

CSF glutamine is increased in

A

Reye’s syndrome

111
Q

Serum LDH normal pattern

A

2>1>3>4>5

112
Q

Flipped pattern of LDH seen in acute myocardial infarction

A

1>2

113
Q

CSF LDH isoenzyme in Brain tissue

A

LD 1 and LD 2

114
Q

CSF LDH isoenzyme : lymphocytes

A

LDH 2 and 3

115
Q

CSF LDH isoenzyme : NEUTROPHILS

A

LD 4 and 5

116
Q

CSF LDH normal patterns

A

1>2>3>4>5

117
Q

CSF LDH neurological abnormalities

A

2>1

118
Q

CSF LDH pattern in bacterial meningitis

A

5>4>3>2>1

119
Q

Recommended by CDC for the detection of neurosyphilis

A

VDRL

120
Q

Increased lymph and mono, protein and lactate and decreased glucose

(+) pellicle or weblike clot formation

A

TB meningitis

121
Q

Limulus lysate test detects ___________ in the body fluids and surgical instrument

A

Gram negative endotoxin

122
Q

Limulus lysate test reagent

A

Blood of horse shoe crab

123
Q

Positive result if limulus lysate test

A

Clot formation