MLT 142_Week 10_Chapter 10

A xanthochromic CSF specimen will appear: A. Crystal clear B. White and turbid C. Yellow and clear D. Red and turbid

A xanthochromic CSF specimen will appear: C. Yellow and clear

Damage to the blood-brain barrier by Mycobacterium tuberculosis may cause the CSF to: A. Appear blood-streaked B. Appear xanthochromic C. Contain a pellicle or clot D. Contain decreased protein

Damage to the blood-brain barrier by Mycobacterium tuberculosis may cause the CSF to: C. Contain a pellicle or clot

Three tubes of CSF are submitted to the laboratory. They are numbered 1, 2, and 3 and show blood in all tubes but decreasing in amount as one inspects tubes 1 through 3. This observation should be interpreted as: A. The tubes were numbered in the wrong sequence, as one would expect increasing amounts of blood B. A traumatic or bloody tap is suspected and, in all likelihood, no pathogenic significance should be attached to the presence of the blood C. The pathologic presence of RBCs and reported to the supervisor immediately D. A pathologic presence of RBCs, but because the RBC morphology is normal there is minimal importance

Three tubes of CSF are submitted to the laboratory. They are numbered 1, 2, and 3 and show blood in all tubes but decreasing in amount as one inspects tubes 1 through 3. This observation should be interpreted as: B. A traumatic or bloody tap is suspected and, in all likelihood, no pathogenic significance should be attached to the presence of the blood

Using a 1:10 dilution, 120 cells are counted in the four large corner squares on one side of the hemocytometer. What is the cell count? Show your math for full credit.

Using a 1:10 dilution, 120 cells are counted in the four large corner squares on one side of the hemocytometer. What is the cell count? Show your math for full credit. count x depth factor x dilution factor/# of large squares 120 x 10 x 10 / 4 = 3,000 ANSWER: 120*10/4*0.1=3000 cells/uL

(See above) Based on the information provided, what type of meningitis would most probably be suspected in this patient?________

(See above) Based on the information provided, what type of meningitis would most probably be suspected in this patient?________ Fungal or Cryptococcal

A CSF protein report of 32 g/dL: A. Is normal B. Indicates possible multiple sclerosis C. Is an erroneous report D. Should be followed by electrophoresis

A CSF protein report of 32 g/dL: C. Is an erroneous report

A CSF specimen, in which there is uneven distribution of blood among the three tubes and clots are detected, is an indication of: A. Meningitis B. Cerebral hemorrhage C. Multiple sclerosis D. Traumatic tap

A CSF specimen, in which there is uneven distribution of blood among the three tubes and clots are detected, is an indication of: D. Traumatic tap

A broad spectrum of reactive and nonreactive lymphocytes in the CSF is associated with: A. Bacterial meningitis B. Allergic reactions C. Cerebral hemorrhage D. Viral meningitis

A broad spectrum of reactive and nonreactive lymphocytes in the CSF is associated with: D. Viral meningitis

A patient previously diagnosed with acquired immunodeficiency arrives in the emergency room with symptoms of meningitis. A lumbar puncture is performed.Using the information provided, in addition to Gram stain, what additional testing should be performed? A. VDRL B. Electrophoresis C. Cryptococcal antigen test D. Differential of peripheral blood

A patient previously diagnosed with acquired immunodeficiency arrives in the emergency room with symptoms of meningitis. A lumbar puncture is performed.Using the information provided, in addition to Gram stain, what additional testing should be performed? C. Cryptococcal antigen test

A positive fluorescent treponemal antibody absorption test (FTA-ABS) and a positive CSF venereal disease research laboratory test (VDRL) indicate: A. A false-positive reaction B. Neurosyphilis C. Failure to inactivate the CSF D. The need to perform a rapid plasma reagin test

A positive fluorescent treponemal antibody absorption test (FTA-ABS) and a positive CSF venereal disease research laboratory test (VDRL) indicate: B. Neurosyphilis

A questionable India ink preparation on the CSF from an immunocompromised patient should be further tested using: A. A cryptococcal antigen test B. A bacterial antigen panel C. Counterimmunoelectrophoresis D. An anaerobic culture

A questionable India ink preparation on the CSF from an immunocompromised patient should be further tested using: A. A cryptococcal antigen test

A report of many gram-positive cocci on a clear CSF sample with a normal cell count may be the result of: A. An incorrect cell count B. Effective antibiotic treatment C. Use of contaminated albumin in the cytocentrifuge D. Use of recycled cytocentrifuge chambers

A report of many gram-positive cocci on a clear CSF sample with a normal cell count may be the result of: C. Use of contaminated albumin in the cytocentrifuge

A slightly hazy CSF specimen is diluted 1:10 with acetic acid. An average of 50 cells are counted in five large squares on both sides of the Neubauer counting chamber (10 squares total 49 on one side and 51 on the other). The count is reported as: ______ Show your math for full credit.

A slightly hazy CSF specimen is diluted 1:10 with acetic acid. An average of 50 cells are counted in five large squares on both sides of the Neubauer counting chamber (10 squares total 49 on one side and 51 on the other). The count is reported as: ______ Show your math for full credit. 50*10/5*0.1=1000 WBCs/uL

All of the following are functions of the cerebrospinal fluid (CSF) except: A. Nutritional enrichment of nervous tissue B. Transmission of neurologic impulses C. Removal of metabolic waste products D. Protection of neurologic tissue from trauma

All of the following are functions of the cerebrospinal fluid (CSF) except: B. Transmission of neurologic impulses

Bacterial antigen tests have replaced the Gram stain as the method of choice for detecting meningitis. True or False

Bacterial antigen tests have replaced the Gram stain as the method of choice for detecting meningitis. False

CSF electrophoresis can be used to confirm the diagnosis of multiple sclerosis and would be expected to show which of the following? A. Increased IgG with oligoclonal bands not seen on serum electrophoresis B. Increased IgG with oligoclonal bands similar to those seen on serum electrophoresis C. Decreased IgG with antibody-specific oligoclonal bands D. Decreased IgG with oligoclonal bands resembling those seen on serum electrophoresis

CSF electrophoresis can be used to confirm the diagnosis of multiple sclerosis and would be expected to show which of the following? A. Increased IgG with oligoclonal bands not seen on serum electrophoresis

CSF is formed in the _______________ and reabsorbed by the _______________. A. Ventricles, spinal cord B. Choroid plexus, arachnoid granulations C. Arachnoid space, blood-brain barrier D. Blood-brain barrier, arachnoid granulations

CSF is formed in the _______________ and reabsorbed by the _______________. B. Choroid plexus, arachnoid granulations

CSF is produced primarily by: A. Secretion by cells of the arachnoid villi B. Diffusion from the plasma into the central nervous system (CNS) C. Selective filtration of plasma in the choroid plexus D. Excretions from the ependymal cells lining the central nervous system

CSF is produced primarily by: C. Selective filtration of plasma in the choroid plexus

Cell counts on CSF are performed on: A. Cells as they are counted in the hemocytometer B. Cover-slipped wet preparations C. Stained smears prepared from the undiluted specimen D. Stained smears prepared from a concentrated specimen

Cell counts on CSF are performed on: A. Cells as they are counted in the hemocytometer

Chemical analysis of CSF shows that the fluid contains: A. Plasma chemicals in the same concentration as in the plasma B. Plasma chemicals in concentrations different from those in the plasma C. More chemicals than are found in plasma D. Fewer chemicals than are found in plasma

Chemical analysis of CSF shows that the fluid contains: B. Plasma chemicals in concentrations different from those in the plasma

Conditions that produce elevated CSF protein include all of the following except: A. Fluid leakage B. Meningitis C. Multiple sclerosis D. Hemorrhage

Conditions that produce elevated CSF protein include all of the following except: A. Fluid leakage

Define xanthochromia:

Define xanthochromia: Yellowish, pink, or orange supernatant discoloration of the cerebrospinal fluid.

Dilution of CSF prior to performing a total cell count should be made using: A. Normal saline B. Deionized water C. Acetic acid D. Acetic acid containing methylene blue

Dilution of CSF prior to performing a total cell count should be made using: A. Normal saline

Examination of a CSF shows 1000 WBCs, of which 75% are lymphocytes and 25% are monocytes. This finding is consistent with: A. Normal spinal fluid B. Bacterial meningitis C. Viral meningitis D. Multiple sclerosis

Examination of a CSF shows 1000 WBCs, of which 75% are lymphocytes and 25% are monocytes. This finding is consistent with: C. Viral meningitis

Gram stains performed on CSF specimens are helpful in the: A. Diagnosis of tubercular meningitis B. Diagnosis of bacterial meningitis C. Detection of viral meningitis D. Detection of bacterial and fungal meningitis

Gram stains performed on CSF specimens are helpful in the: D. Detection of bacterial and fungal meningitis

If CSF tubes numbered 2 and 3 cannot be analyzed within 1 hour, the correct procedure is to: A. Refrigerate both tubes B. Leave both tubes at room temperature C. Refrigerate tube 2 and freeze tube 3 D. Refrigerate tube 3 and leave tube 2 at room temperature

If CSF tubes numbered 2 and 3 cannot be analyzed within 1 hour, the correct procedure is to: D. Refrigerate tube 3 and leave tube 2 at room temperature

Increased CSF eosinophils are associated with: A. Multiple sclerosis B. Introduction of foreign material C. Human immunodeficiency virus D. Viral meningitis

Increased CSF eosinophils are associated with: B. Introduction of foreign material

India ink preparations are useful in the diagnosis of:________

India ink preparations are useful in the diagnosis of:________ Cryptococcal meningitis or Fungal meningitis

Measurement of CSF lactate is useful for monitoring cases of: A. Multiple sclerosis B. Bacterial meningitis C. Reye's syndrome D. Tertiary syphilis

Measurement of CSF lactate is useful for monitoring cases of: B. Bacterial meningitis

Myelin basic protein is measured in the CSF to assess the condition of patients with: A. Cerebral hemorrhage B. Multiple sclerosis C. Bacterial meningitis D. Neurosyphilis

Myelin basic protein is measured in the CSF to assess the condition of patients with: B. Multiple sclerosis

Nucleated red blood cells (RBCs) seen in the CSF indicate: A. Recent cerebral hemorrhage B. Acute leukemia C. A ventricular rather than a lumbar puncture D. Bone marrow contamination from the puncture

Nucleated red blood cells (RBCs) seen in the CSF indicate: D. Bone marrow contamination from the puncture

Oligoclonal bands are significant in the diagnosis of multiple sclerosis when: A. They are seen in both the serum and CSF B. At least five bands are seen in the CSF C. They are seen in the CSF and not in the serum D. They appear in both the albumin and globulin fractions of serum and CSF

Oligoclonal bands are significant in the diagnosis of multiple sclerosis when: C. They are seen in the CSF and not in the serum

Specimens from patients suspected of having fungal meningitis should be tested with: A. Gram stain, acid-fast stain, and India ink B. Gram stain and India ink C. India ink only D. Acid-fast stain and India ink

Specimens from patients suspected of having fungal meningitis should be tested with: B. Gram stain and India ink

The CSF circulates through the brain and spinal cord in the: A. Arachnoid mater B. Choroid plexuses C. Dura mater D. Subarachnoid space

The CSF circulates through the brain and spinal cord in the: D. Subarachnoid space

The CSF glucose in a patient with a blood glucose of 90 mg/dL is 60 mg/dL. These results are representative of: A. An improperly preserved specimen B. Bacterial meningitis C. Normal CSF D. Damage to the blood-brain barrier

The CSF glucose in a patient with a blood glucose of 90 mg/dL is 60 mg/dL. These results are representative of: C. Normal CSF

The CSF/serum albumin index is performed to determine: A. The amount of albumin in the CSF B. Synthesis of IgG within the CNS C. The integrity of the blood-brain barrier D. If an unknown fluid is in the CSF

The CSF/serum albumin index is performed to determine: C. The integrity of the blood-brain barrier

The average range of volume of CSF in an adults is: _____

The average range of volume of CSF in an adults is: _____ 90-150 mls

The formation of clots does not occur in CSF that does not contain blood. False/True

The formation of clots does not occur in CSF that does not contain blood. False

The normal CSF glucose is: A. 25 to 50 mg/dL B. 80 to 120 mg/dL C. 60% to 70% of the blood glucose D. 10% to 20% higher than the blood glucose

The normal CSF glucose is: C. 60% to 70% of the blood glucose

The normal CSF protein range is:

The normal CSF protein range is: 15-45 mg/dL

The presence of xanthochromia and an increased D-dimer test in the CSF is indicative of: A. A traumatic tap B. Multiple sclerosis C. A cerebral hemorrhage D. Viral meningitis

The presence of xanthochromia and an increased D-dimer test in the CSF is indicative of: C. A cerebral hemorrhage

The primary cause of a decreased CSF glucose in bacterial meningitis is: A. Utilization of glucose by the microorganisms present in the fluid B. Rapid glycolysis C. Utilization of glucose by leukocytes present in the fluid D. Alteration of blood-brain glucose transport

The primary cause of a decreased CSF glucose in bacterial meningitis is: D. Alteration of blood-brain glucose transport

The primary disadvantage in using a cytocentrifuge to prepare CSF differential slides is: A. Frequent bacterial contamination B. Uneven distribution of cells C. Cellular distortion D. Increased cost

The primary disadvantage in using a cytocentrifuge to prepare CSF differential slides is: C. Cellular distortion

The recommended serologic test for the diagnosis of neurosyphilis is the rapid plasma reagin test. True or False

The recommended serologic test for the diagnosis of neurosyphilis is the rapid plasma reagin test. False

The third tube of CSF collected from a lumbar puncture should be used for: A. Chemistry tests B. Cytology examination C. Microbiology tests D. Hematology tests

The third tube of CSF collected from a lumbar puncture should be used for: D. Hematology tests

Using a 1:10 dilution, an average of 64 cells are counted in five large squares on both sides of the hemocytometer.(10 squares counted 63 in one side and 65 in the other) What is the reported cell count? Show your math for full credit.

Using a 1:10 dilution, an average of 64 cells are counted in five large squares on both sides of the hemocytometer.(10 squares counted 63 in one side and 65 in the other) What is the reported cell count? Show your math for full credit. 64*10/5*0.1=1280 cells/uL

Using an undiluted specimen, 100 cells are counted in the nine large squares on one side of the hemocytometer. What is the cell count? Show your math for full credit.

Using an undiluted specimen, 100 cells are counted in the nine large squares on one side of the hemocytometer. What is the cell count? Show your math for full credit. count x depth factor x dilution factor/# of large squares 100 x 10 x 1 / 9 111 ANSWER: 100*1/9*0.1= 111 cells/uL

Using the following laboratory results, determine whether they represent bacterial, viral, tubercular, or fungal meningitis: WBC count: 1000/uL Lymphocytes: 10% Monocytes: 0% Neutrophils: 90% Protein 150 mg/dL Glucose: 15 mg/dL (Serum 90 mg/dL) Lactate: 40 mg/dL

Using the following laboratory results, determine whether they represent bacterial, viral, tubercular, or fungal meningitis: WBC count: 1000/uL Lymphocytes: 10% Monocytes: 0% Neutrophils: 90% Protein 150 mg/dL Glucose: 15 mg/dL (Serum 90 mg/dL) Lactate: 40 mg/dL Bacterial

Using the following laboratory results, determine whether they represent bacterial, viral, tubercular, or fungal meningitis: WBC count: 300/uL Lymphocytes: 70% Monocytes: 30% Neutrophils: 0% Protein 90mg/dL Glucose: 30 mg/dL (Serum 90 mg/dL) Lactate: 30 mg/dL Pellicle formation

Using the following laboratory results, determine whether they represent bacterial, viral, tubercular, or fungal meningitis: WBC count: 300/uL Lymphocytes: 70% Monocytes: 30% Neutrophils: 0% Protein 90mg/dL Glucose: 30 mg/dL (Serum 90 mg/dL) Lactate: 30 mg/dL Pellicle formation Tubercular

Using the following laboratory results, determine whether they represent bacterial, viral, tubercular, or fungal meningitis: WBC count: 400/uL Lymphocytes: 90% Monocytes: 8% Neutrophils: 2% Glucose: 70 mg/dL (Serum 100 mg/dL) Lactate: 18 mg/dL

Using the following laboratory results, determine whether they represent bacterial, viral, tubercular, or fungal meningitis: WBC count: 400/uL Lymphocytes: 90% Monocytes: 8% Neutrophils: 2% Glucose: 70 mg/dL (Serum 100 mg/dL) Lactate: 18 mg/dL Viral

What factor is the most common reason for xanthochromia?

What factor is the most common reason for xanthochromia? Presence of RBC degradation products.

What is the advantage of cytocentrifuge of CSF specimens?

What is the advantage of cytocentrifuge of CSF specimens? Produces a more concentrated area of cells

When a CSF specimen is received in the microbiology laboratory, the first thing the technologist should do is: A. Perform a Gram stain B. Perform an India ink preparation C. Centrifuge the specimen D. Streak the fluid on chocolate agar

When a CSF specimen is received in the microbiology laboratory, the first thing the technologist should do is: C. Centrifuge the specimen

Xanthochromic CSF may appear pink, orange, or yellow. T/F

Xanthochromic CSF may appear pink, orange, or yellow. True