ch. 17 & 9 Urinalysis

All of these statements are true with regard to the presence of malignant cells in CSF except:1. The cells may be from metastatic tumors2. The cells resemble choroid plexus and ependymal cells3. The cells appear singly or in clumps4. The cells are the result of leukemic infiltration5. The result should be reported if more than 10 cells are observed Select one: a. 1, 2, and 3 b. 2, 4, and 5 c. 5 d. All of the above

C. 5

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? Select one: a. 2 mL b. 10 mL c. 15 mL d. 20 mL

a. 2 mL

All of the following diluents can be used for a WBC count on synovial fluid except: Select one: a. 3% acetic acid. b. hypotonic saline. c. hyaluronidase buffer. d. 0.85% saline.

a. 3% acetic acid.

A nucleated cell count of 0 to 100 cells/µL requires how many drops of body fluid when preparing a slide by cytocentrifugation? Select one: a. 2 b. 3 or 4 c. 5 or 6 d. 10

d. 10

What is the cell count on a slightly cloudy CSF that was performed using a 1:2 dilution, counting the five large squares and giving duplicate counts of 45 cells for each count? Select one: a. 22.5 × 106 WBCs/L b. 45 × 106 WBCs/L c. 90 × 106 WBCs/L d. 180 × 106 WBCs/L

d. 180 × 106 WBCs/L

All of the following cellular distortions are associated with cytocentrifugation except: Select one: a. nuclear lobes of PMNs take on a pyknotic appearance. b. cells at the center of the cell button may be small and have denser nuclear chromatin. c. cytoplasmic vacuoles and/or granules localize along the cell periphery. d. irregular cytoplasmic processes form.

A. Nuclear lobes of PMNs take on a pyknotic appearance.

A slightly cloudy body fluid is submitted for a cell count. The technologist will make which of the following recommended WBC dilutions for slightly cloudy specimens before performing the cell count? Select one: a. Undiluted b. 1:2 c. 1:10 d. 1:20

B. 1:2

Semen that fails to liquefy after 60 minutes must be pretreated using which of the following before performing sperm counts, motility assessment, and chemical tests? Select one: a. Sodium bicarbonate/formalin mixture b. Bromelain c. Turk's solution d. Warming in a 37°C water bath for 30 minutes

B. Bromelain

Which pathologic condition(s) demonstrate(s) oligoclonal bands in the CSF?1. Panencephalitis2. Multiple sclerosis3. Neurosyphilis4. Bacterial meningitis5. Viral meningitis Select one: a. 1 and 4 b. 2 c. 4 and 5 d. All of the above

D. All of the above

What color does xanthochromia appear as in the supernatant of CFS? Select one: a. Yellow b. Orange c. Pink d. All of the above

D. All of the above

Which of the following ensures an accurate cell count when using a hemacytometer?1. Avoiding high dilutions on body fluids2. Counting additional squares if the count is low3. Adjusting calculations based on the volume of body fluid counted4. Performing and analyzing dilutions in duplicate Select one: a. 1 and 2 b. 1, 2, and 4 c. 3 and 4 d. All of the above

D. All of the above

Which of the following serves as evidence that CSF is produced by selective secretion from plasma and not an ultrafiltrate? Select one: a. Higher CSF concentrations of Na+, Cl-, and Mg++ and lower concentrations of K+ and Ca++ b. Lower CSF concentrations of Na+, K+, and Mg++ and lower concentrations of Ca++ and Cl- c. Higher CSF concentrations of K+ and Ca++ and lower concentrations of Na+, Cl-, and Mg++ d. Higher CSF concentrations of Na+, K+, and Cl- and lower concentrations of Mg++ and Ca++

a. Higher CSF concentrations of Na+, Cl-, and Mg++ and lower concentrations of K+ and Ca++

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: Select one: a. a subarachnoid hemorrhage. b. bacterial meningitis. c. encephalitis. d. a traumatic tap.

a. a subarachnoid hemorrhage.

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: Physical ExaminationMicroscopic ExaminationChemical ExaminationColor: ColorlessClarity: Cloudy (2+)Gram stain: NegativeCulture: PendingLeukocyte count: 5500 cells/mLDifferential count: Monocytes: 5%Lymphocytes: 5%Neutrophils: 90%Total protein: 100 mg/dLGlucose: 35 mg/dLLactate: 50 mg/dL Based on the CSF report and the clinical symptoms, the physician suspects the child has: Select one: a. bacterial meningitis. b. viral stomach flu. c. Reye's syndrome. d. viral meningitis

a. bacterial meningitis

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: Physical ExaminationMicroscopic ExaminationChemical ExaminationColor: ColorlessClarity: Cloudy (2+)Gram stain: NegativeCulture: PendingLeukocyte count: 5500 cells/mLDifferential count: Monocytes: 5%Lymphocytes: 5%Neutrophils: 90%Total protein: 100 mg/dLGlucose: 35 mg/dLLactate: 50 mg/dL Based on the CSF report and the clinical symptoms, the physician suspects the child has: Select one: a. bacterial meningitis. b. viral stomach flu. c. Reye's syndrome. d. viral meningitis.

a. bacterial meningitis.

All CSF specimens are processed STAT because a delay in testing may result in: Select one: a. decreased cell counts. b. decreased lactate levels. c. increased glucose levels. d. increased microbial growth.

a. decreased cell counts.

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: Select one: a. diagnoses multiple sclerosis. b. determines that the patient has a pinched nerve. c. indicates that the patient is in the convalescent phase of viral meningitis. d. suspects encephalitis.

a. diagnoses multiple sclerosis.

All of the following are functions of CSF except: Select one: a. neural communication. b. transport of nutrients. c. removal of metabolic wastes. d. protection of the central nervous system (CNS).

a. neural communication.

All of these conditions result in an increase in CSF protein except: Select one: a. pneumoencephalography. b. cerebral infarction. c. viral meningitis. d. endocrine disorders.

a. pneumoencephalography.

All of the following are associated with low CSF glucose values except: Select one: a. traumatic puncture. b. metastatic tumor cell infiltration. c. increased glycolysis in the CNS. d. meningitis.

a. traumatic puncture.

How many leukocytes are normally present in the CSF of a child? Select one: a. 0 to 5 cells/mL b. 0 to 10 cells/mL c. 0 to 20 cells/mL d. 0 to 30 cells/mL

b. 0 to 10 cells/mL

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? Select one: a. 10 b. 20 c. 85 d. 150

b. 20

If tuberculous meningitis is suspected, which type of stain is ordered? Select one: a. Gram stain b. Acid-fast stain c. India ink d. Eosin stain

b. Acid-fast stain

The CSF/serum albumin index is useful in determining which of the following? Select one: a. Albumin gradient between blood plasma and CSF b. Breach in the blood-brain barrier c. Presence of bacteria in the meninges d. Normal production of CSF

b. Breach in the blood-brain barrier

Viscous body fluids require the use of which type of pipette? Select one: a. Sterile transfer pipette b. Positive displacement pipette c. Air displacement pipette d. Serologic pipette

b. Positive displacement pipette

The blood-brain barrier modulates the interface of the blood and CSF via tight junctures between: Select one: a. dura mater and arachnoid. b. adjacent endothelial cells. c. single-layer epithelial cells. d. arachnoid granulations.

b. adjacent endothelial cells.

CSF cell counts are usually performed on tube #: Select one: a. 1. b. 2. c. 3. d. 4.

c. 3

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

c. Albumin presence in CSF is not affected by the puncture procedure.

Hydrocephalus is a condition that results in the excess accumulation of CSF as a result of: Select one: a. overproduction of CSF. b. mental retardation. c. an obstruction that blocks reabsorption. d. increased flow between the ventricles.

c. an obstruction that blocks reabsorption.

The presence of hemosiderin in macrophages in the CSF is characteristic of: Select one: a. bacterial meningitis. b. viral meningitis. c. cerebral hemorrhage. d. traumatic puncture.

c. cerebral hemorrhage.

An IgG index less than 0.30 is indicative of: Select one: a. multiple sclerosis. b. inflammatory disorder. c. compromised blood-brain barrier. d. autoimmune disease.

c. compromised blood-brain barrier.

Cerebrospinal fluid circulates in and/or around all of the following except: Select one: a. brainstem. b. subarachnoid space. c. dura mater. d. spinal cord.

c. dura mater

All of the following characteristics are true about the preparation of slides using centrifugation except: Select one: a. preserves cellular morphology. b. easiest to perform. c. good cellular recovery. d. least expensive to use.

c. good cellular recovery.

An increase in the number of cells in CSF is referred to as: Select one: a. leukocytosis. b. histiocytosis. c. pleocytosis. d. erythrocytosis.

c. pleocytosis

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? Select one: a. Transthyretin b. Albumin c. ô-Transferrin d. Myelin

c. ô-Transferrin

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 CSF 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. Select one: a. 1, 2, and 3 b. 1, 2, and 4 c. 2 and 3 d. 2 and 4

d. 2 and 4

All of the following can cause xanthochromic CSF except: Select one: a. normal neonate. b. intracerebral hemorrhage. c. protein concentration exceeding 150 mg/dL. d. bacterial meningitis.

d. bacterial meningitis.

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

d. increased glucose.

The most common causes of bacterial meningitis include all of the following except: Select one: a. Neisseria meningitidis. b. Streptococcus pneumoniae. c. Haemophilus influenzae. d. influenza virus.

d. influenza virus.

The physician removes 1 mL of CSF from a 2-year-old patient and immediately puts it into a properly labeled, single sterile tube. The technologist delivers the STAT specimen to: Select one: a. immunology. b. hematology. c. chemistry. d. microbiology.

d. microbiology.

The predominant white cell found in the CSF of healthy neonates is the: Select one: a. neutrophil. b. lymphocyte. c. eosinophil. d. monocyte.

d. monocyte