Urina 4.2

Question 1

Which of the following statements is false regarding the use of albumin as a reference protein to monitor permeability of the blood-brain barrier?
• Albumin is not synthesized in the CNS.
• Presence of albumin in CS indicates passage across the blood-brain barrier.
• Albumin presence in CS is not affected by the puncture procedure.
• All of the above are true.

Answer 1

Albumin presence in CS is not affected by the puncture procedure.

Question 2

Which of the following statements regarding CSF microscopic examinations is false?
1. At room temperature 40% of WBCs in CSF will lyse in 2 hours.
2. RBCs are typically present in CS due to recent cerebral hemorrhage.
3. Keeping specimen at body temperature can significantly reduce WBC lysis to about 15%.
4. Cell counts should be refrigerated if there is a delay in counting.
•1, 2, and 3
•1, 2, and 4
•2 and 3
2 and 4

Question 3

Which of the following serves as evidence that CSF is produced by selective secretion from plasma and not an ultrafiltrate?
• Higher CSF concentrations of Na, Cl, and Mg** and lower concentrations of K+ and Cat+
•Lower CSF concentrations of Na+, K, and Mg** and lower concentrations of Cat+
and CI
•Higher CSF concentrations of K* and Ca** and lower concentrations of Na, Cl, and Mg++
•Higher CSF concentrations of Nat, K, and Cl and lower concentrations of Mg*+ and Cat+

Answer 3

Higher CSF concentrations of Na*, Cl, and Mg** and lower concentrations of K+ and Cat+

Question 4

Cerebrospinal fluid circulates in and/or around all of the following except
• brainstem.
• subarachnoid space.
• dura mater.
• spinal cord.

Answer 4

dura mater.

Question 5

Hydrocephalus is a condition that results in the excess accumulation of CSF as a result of

•overproduction of CSF.
•mental retardation.
•an obstruction that blocks reabsorption.
•increased flow between the ventricles.

Answer 5

an obstruction that blocks reabsorption.

Question 6

Cerebrospinal fluid formation, circulation, and reabsorption into the blood is a dynamic process in which how many milliliters of CSF are turned over per hour?
•10
• 20
•85
•150

Answer 6

20

Question 7

All of the following are functions of CSF except
• neural communication.
•transport of nutrients.
•removal of metabolic wastes.
•protection of the central nervous system (CNS).

Answer 7

neural communication

Question 8

The blood-brain barrier modulates the interface of the blood and CS via tight junctures between

•dura mater and arachnoid.
•adjacent endothelial cells.
•single-layer epithelial cells.
•arachnoid granulations.

Answer 8

adjacent endothelial cells.

Question 9

Upon performing a spinal tap on a 32-year-old male patient, the physician notes an
“opening” CSF pressure of 200 mm Hg. The physician proceeds to remove what amount of CSF?
•2 mL
•10 mL
•15 mL
• 20 mL

Answer 9

2 mL

Question 10

The physician removes 1 mL of CS from a 2-year-old patient and immediately puts it into a properly labeled, single sterile tube. The technologist delivers the STAT specimen to

• immunology.
• hematology.
• chemistry.
• microbiology.

Answer 10

microbiology

Question 11

All CS specimens are processed STAT because a delay in testing may result in
• decreased cell counts.
• decreased lactate levels.
•increased glucose levels.
•increased microbial growth.

Answer 11

decreased cell counts.

Question 12

CS cell counts are usually performed on tube #
1.
2.
3.
4.

Answer 12

3.

Question 13

An increase in the number of cells in CSF is referred to as
• leukocytosis.
) histiocytosis.
• pleocytosis.
erythrocytosis.

Answer 13

pleocytosis

Question 14

Turbidity may be present in CSF as a result of all of the following except
• increased protein.
• WBC count greater than 200 cells/mL.
• RBC count greater than 400 cells/mL. •increased glucose.

Answer 14

increased protein

Question 15

The physician performs a spinal tap and hands you the first tube. You note that it is extremely bloody. The second and third tubes are equally bloody. The technologist surmises that the presence of blood is most likely due to
•a subarachnoid hemorrhage.
•bacterial meningitis.
•encephalitis.
• a traumatic tap.

Answer 15

a subarachnoid hemorrhage.

Question 16

How many leukocytes are normally present in the CSF of a child?
0 to 5 cells/mL.
0 to 10 cells/mL
0 to 20 cells/mL
0 to 30 cells/mL

Answer 16

0 to 10 cells/mL

Question 17

The predominant white cell found in the CSF of healthy neonates is the
•neutrophil.
• lymphocyte.
•eosinophil.
• monocyte.

Answer 17

monocyte

Question 18

The presence of hemosiderin in macrophages in the CS is characteristic of
bacterial meningitis.
• viral meningitis.
• cerebral hemorrhage.
traumatic puncture.

Answer 18

cerebral hemorrhage.

Question 19

All of these statements are true with regard to the presence of malignant cells in CSF except
1. the cells may be from metastatic tumors.
2. the cells resemble choroid plexus and ependymal cells.
3. the cells appear singly or in clumps.
4. the cells are the result of leukemic infiltration.
5. the result should be reported if more than 10 cells are observed.
•1, 2, and 3
• 2, 4, and 5
•5
• All of the above

Answer 19

5

Question 20

All of these conditions result in an increase in CSF protein except
•pneumoencephalography.
•cerebral infarction.
• viral meningitis.
•endocrine disorders.

Answer 20

pneumoencephalography

Question 21

The technologist is diligently performing culture identifications in microbiology when he has a horrific sneeze. From that point on, he is bothered by a clear liquid that continues to drip from his nose. This continues for several days, without any other nasal symptoms. He sees his physician and reports having a slight headache that improves when he lies down but worsens when he sits up. He has some slight photosensitivity. Based on the physical examination and patient self-reporting, the physician collects a sample of the drainage and sends it to the laboratory, along with a blood sample for electrophoretic testing. The test identifies the fluid as CSF based on the presence of which of the following?
mation
•Transthyretin
•Albumin
• T-Transferrin
• Myelin

Answer 21

T-Transferrin

Question 22

The CSF/serum albumin index is useful in determining which of the following?
• Albumin gradient between blood plasma and CSF
• Breach in the blood-brain barrier
•Presence of bacteria in the meninges
• Normal production of CSF

Answer 22

Breach in the blood-brain barrier

Question 23

An IgG index less than 0.30 is indicative of
• multiple sclerosis.
• inflammatory disorder.
• compromised blood-brain barrier. •autoimmune disease.

Answer 23

• compromised blood-brain barrier.

Question 24

A 30-year-old female who complains of weakness, tingling, and numbness of her legs and arms, along with an inability to move around normally at times over the past month, is being evaluated for multiple sclerosis. Test results reveal an IgG index greater than 0.70, but her CSF electrophoresis results are negative for oligoclonal bands and positive for myelin basic protein. Based on these results and the patient’s clinical signs and symptoms, the physician
• diagnoses multiple sclerosis.
• determines that the patient has a pinched nerve.
•indicates that the patient is in the convalescent phase of viral meningitis.
•suspects encephalitis.

Answer 24

diagnoses multiple sclerosis.

Question 25

Which pathologic condition(s) demonstrate(s) oligoclonal bands in the CSF?
1. Panencephalitis
2. Multiple sclerosis
3. Neurosyphilis
4. Bacterial meningitis
5. Viral meningitis
•1 and 4
•2
•4 and 5
•all of the above

Answer 25

•all of the above

Question 26

All of the following are associated with low CSF glucose values except
• traumatic puncture.
•metastatic tumor cell infiltration.
• increased glycolysis in the CNS.
• meningitis.

Answer 26

• traumatic puncture

Question 27

A 5-year-old female presents to the ED with a fever of 102.8 °F, confusion, and sleepiness. The mother reports that the child had been feeling nauseous and had vomited yesterday but not today. The examination further reveals that the child has photosensitivity. A lumbar puncture is performed, and the test results are as follows:

• bacterial meningitis.
• viral stomach flu.
Reye’s syndrome.
viral meningitis.

Answer 27

bacterial meningitis.

Question 28

If tuberculous meningitis is suspected, which type of stain is ordered?
Gram stain
Acid-fast stain
India ink
Eosin stain

Answer 28

Acid-fast stain

Question 29

The most common causes of bacterial meningitis include all of the following except
Neisseria meningitidis:
Streptococcus pneumoniae.
Haemophilus influenzae.
influenza virus.

Answer 29

influenza virus

Question 30

What color does xanthochromia appear as in the supernatant of CFS?
Yellow
Orange
• Pink
• All of the above

Answer 30

• All of the above

Question 31

All of the following can cause xanthochromic CSF except
normal neonate.
• intracerebral hemorrhage.
• protein concentration exceeding 150 mg/dL.
• bacterial meningitis.

Answer 31

• bacterial meningitis.