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1
Q

The functions of the CSF include all of the following
except:
A. Removing metabolic wastes
B. Producing an ultrafiltrate of plasma
C. Supplying nutrients to the CNS
D. Protecting the brain and spinal cord

A

B. Producing an ultrafiltrate of plasma

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2
Q

The CSF flows through the:
A. Choroid plexus
B. Pia mater
C. Arachnoid space
D. Dura mater

A

c

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3
Q

Substances present in the CSF are controlled by the:
A. Arachnoid granulations
B. Blood–brain barrier
C. Presence of one-way valves
D. Blood–CSF barrier

A

b

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4
Q

What department is the CSF tube labeled 3 routinely
sent to?
A. Hematology
B. Chemistry
C. Microbiology
D. Serology

A

a

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5
Q

The CSF tube that should be kept at room temperature is:
A. Tube 1
B. Tube 2
C. Tube 3
D. Tube 4

A

b

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6
Q

Place the appropriate letter in front of the statement that
best describes CSF specimens in these two conditions:
A. Traumatic tap
B. Intracranial hemorrhage
____ Even distribution of blood in all tubes
____ Xanthochromic supernatant
____ Concentration o

A

b b a a

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7
Q

The presence of xanthochromia can be caused by all of
the following except:
A. Immature liver function
B. RBC degradation
C. A recent hemorrhage
D. Elevated CSF protein

A

c

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8
Q

A web-like pellicle in a refrigerated CSF specimen
indicates:
A. Tubercular meningitis
B. Multiple sclerosis
C. Primary CNS malignancy
D. Viral meningitis

A

a

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9
Q

Given the following information, calculate the CSF WBC
count: cells counted, 80; dilution, 1:10; large Neubauer
squares counted, 10.
A. 8
B. 80
C. 800
D. 8000

A

c

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10
Q

A CSF WBC count is diluted with:
A. Distilled water
B. Normal saline
C. Acetic acid
D. Hypotonic saline

A

c

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11
Q

A total CSF cell count on a clear fluid should be:
A. Reported as normal
B. Not reported
C. Diluted with normal saline
D. Counted undiluted

A

d

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12
Q

The purpose of adding albumin to CSF before cytocentrifugation is to:
A. Increase the cell yield
B. Decrease the cellular distortion
C. Improve the cellular staining
D. Both A and B

A

d

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13
Q

The primary concern when pleocytosis of neutrophils and
lymphocytes is found in the CSF is:
A. Meningitis
B. CNS malignancy
C. Multiple sclerosis
D. Hemorrhage

A

a

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14
Q

Neutrophils with pyknotic nuclei may be mistaken for:
A. Lymphocytes
B. Nucleated RBCs
C. Malignant cells
D. Spindle-shaped cells

A

b

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15
Q

The presence of which of the following cells is increased
in a parasitic infection?
A. Neutrophils
B. Macrophages
C. Eosinophils
D. Lymphocytes

A

c

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16
Q

Macrophages appear in the CSF after:
A. Hemorrhage
B. Repeated spinal taps
C. Diagnostic procedures
D. All of the above

A

d

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17
Q

Nucleated RBCs are seen in the CSF as a result of:
A. Elevated blood RBCs
B. Treatment of anemia
C. Severe hemorrhage
D. Bone marrow contamination

A

d

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18
Q

After a CNS diagnostic procedure, which of the following
might be seen in the CSF?
A. Choroidal cells
B. Ependymal cells
C. Spindle-shaped cells
D. All of the above

A

d

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19
Q

Hemosiderin granules and hematoidin crystals are seen in:
A. Lymphocytes
B. Macrophages
C. Ependymal cells
D. Neutrophils

A

b

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20
Q

Myeloblasts are seen in the CSF:
A. In bacterial infections
B. In conjunction with CNS malignancy
C. After cerebral hemorrhage
D. As a complication of acute leukemia

A

d

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21
Q

Cells resembling large and small lymphocytes with cleaved nuclei
represent:
A. Lymphoma cells
B. Choroid cells
C. Melanoma cells
D. Medulloblastoma cells

A

a

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22
Q

The reference range for CSF protein is:
A. 6 to 8 g/dL
B. 15 to 45 g/dL
C. 6 to 8 mg/dL
D. 15 to 45 mg/d

A

b

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23
Q

CSF can be differentiated from serum by the presence of:
A. Albumin
B. Globulin
C. Prealbumin
D. Tau transferrin

A

b

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24
Q

In serum, the second most prevalent protein is IgG; in
CSF, the second most prevalent protein is:
A. Transferrin
B. Prealbumin
C. IgA
D. Ceruloplasmin

A

b

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25
Elevated CSF protein values can be caused by all of the following except: A. Meningitis B. Multiple sclerosis C. Fluid leakage D. CNS malignancy
c
26
The integrity of the blood–brain barrier is measured using the: A. CSF/serum albumin index B. CSF/serum globulin ratio C. CSF albumin index D. CSF IgG index
a
27
Given the following results, calculate the IgG index: CSF IgG, 50 mg/dL; serum IgG, 2 g/dL; CSF albumin, 70 mg/dL; serum albumin, 5 g/dL. A. 0.6 B. 6.0 C. 1.8 D. 2.8
c
28
The CSF IgG index calculated in Study Question 27 indicates: A. Synthesis of IgG in the CNS B. Damage to the blood–brain barrier C. Cerebral hemorrhage D. Lymphoma infiltration
a
29
The finding of oligoclonal bands in the CSF and not in the serum is seen with: A. Multiple myeloma B. CNS malignancy C. Multiple sclerosis D. Viral infections
c
30
A CSF glucose of 15 mg/dL, WBC count of 5000, 90% neutrophils, and protein of 80 mg/dL suggests: A. Fungal meningitis B. Viral meningitis C. Tubercular meningitis D. Bacterial meningitis
d
31
A patient with a blood glucose of 120 mg/dL would have a normal CSF glucose of: A. 20 mg/dL B. 60 mg/dL C. 80 mg/dL D. 120 mg/dL
b
32
CSF lactate will be more consistently decreased in: A. Bacterial meningitis B. Viral meningitis C. Fungal meningitis D. Tubercular meningitis
a
33
Measurement of which of the following can be replaced by CSF glutamine analysis in children with Reye syndrome? A. Ammonia B. Lactate C. Glucose D. α -Ketoglutarate
a
34
Before performing a Gram stain on CSF, the specimen must be: A. Filtered B. Warmed to 37°C C. Centrifuged D. Mixed
c
35
All of the following statements are true about cryptococcal meningitis except: A. An India ink preparation is positive B. A starburst pattern is seen on Gram stain C. The WBC count is over 2000 D. A confirmatory immunology test is available
c
36
The test of choice to detect neurosyphilis is the: A. RPR B. VDRL C. FAB D. FTA-ABS
d
37
The functions of synovial fluid include all of the following except: A. Lubrication for the joints B. Removal of cartilage debris C. Cushioning joints during jogging D. Providing nutrients for cartilage
b
38
The primary function of synoviocytes is to: A. Provide nutrients for the joints B. Secrete hyaluronic acid C. Regulate glucose filtration D. Prevent crystal formation
a
39
Which of the following is not a frequently performed test on synovial fluid? A. Uric acid B. WBC count C. Crystal examination D. Gram stain
a
40
A. Noninflammatory B. Inflammatory C. Septic D. Hemorrhagic gout
b
41
A. Noninflammatory B. Inflammatory C. Septic D. Hemorrhagic Neisseria gonorrhoeae infection
c
42
A. Noninflammatory B. Inflammatory C. Septic D. Hemorrhagic Systemic lupus erythematosus
b
43
A. Noninflammatory B. Inflammatory C. Septic D. Hemorrhagic Osteoarthritis
a
44
A. Noninflammatory B. Inflammatory C. Septic D. Hemorrhagic Hemophilia
d
45
A. Noninflammatory B. Inflammatory C. Septic D. Hemorrhagic Rheumatoid arthritis
b
46
A. Noninflammatory B. Inflammatory C. Septic D. Hemorrhagic Heparin overdose
d
47
Normal synovial fluid resembles: A. Egg white B. Normal serum C. Dilute urine D. Lipemic serum
a
48
Before testing, very viscous synovial fluid should be treated with: A. Normal saline B. Hyaluronidase C. Distilled water D. Hypotonic saline
b
49
Addition of a cloudy, yellow synovial fluid to acetic acid produces a/an: A. Yellow-white precipitate B. Easily dispersed clot C. Solid clot D. Opalescent appearance
b
50
Which of the following could be the most significantly affected if a synovial fluid is refrigerated before testing? A. Glucose B. Crystal examination C. Mucin clot test D. Differential
b
51
The highest WBC count can be expected to be seen with: A. Noninflammatory arthritis B. Inflammatory arthritis C. Septic arthritis D. Hemorrhagic arthritis
c
52
When diluting a synovial fluid WBC count, all of the following are acceptable except: A. Acetic acid B. Isotonic saline C. Hypotonic saline D. Saline with saponin
a
53
The lowest percentage of neutrophils would be seen in: A. Noninflammatory arthritis B. Inflammatory arthritis C. Septic arthritis D. Hemorrhagic arthritis
a
54
All of the following are abnormal when seen in synovial fluid except: A. Neutrophages B. Ragocytes C. Synovial lining cells D. Lipid droplet
c
55
Synovial fluid crystals that occur as a result of purine metabolism or chemotherapy for leukemia are: A. Monosodium urate B. Cholesterol C. Calcium pyrophosphate D. Apatite
a
56
Synovial fluid crystals associated with inflammation in dialysis patients are: A. Calcium pyrophosphate dihydrate B. Calcium oxalate C. Corticosteroid D. Monosodium urate
b
57
Crystals associated with pseudogout are: A. Monosodium urate B. Calcium pyrophosphate dihydrate C. Apatite D. Corticosteroid
b
58
Synovial fluid for crystal examination should be examined as a/an: A. Wet preparation B. Wright's stain C. Gram stain D. Acid-fast stain
a
59
Crystals that have the ability to polarize light are: A. Corticosteroid B. Monosodium urate C. Calcium oxalate D. All of the above
d
60
In an examination of synovial fluid under compensated polarized light, rhomboid-shaped crystals are observed. What color would these crystals be when aligned parallel to the slow vibration? A. White B. Yellow C. Blue D. Red
b
61
Negative birefringence occurs under red-compensated polarized light when: A. Slow light is impeded more than fast light B. Slow light is less impeded than fast light C. Fast light runs against the molecular grain of the crystal D. Both B and C
c
62
Synovial fluid cultures are often plated on chocolate agar to detect the presence of: A. Neisseria gonorrhoeae B. Staphylococcus agalactiae C. Streptococcus viridans D. Enterococcus faecalis
a
63
23. The most frequently performed chemical test on synovial fluid is: A. Total protein B. Uric acid C. Calcium D. Glucose
c
64
Serologic tests on patients’ serum may be performed to detect antibodies causing arthritis for all of the following disorders except: A. Pseudogout B. Rheumatoid arthritis C. Systemic lupus erythematosus D. Lyme arthritis
a
65
The primary purpose of serous fluid is to: A. Remove waste products B. Lower capillary pressure C. Lubricate serous membranes D. Nourish serous membranes
c
66
The membrane that lines the wall of a cavity is the: A. Visceral B. Peritoneal C. Pleural D. Parietal
d
67
During normal production of serous fluid, the slight excess of fluid is: A. Absorbed by the lymphatic system B. Absorbed through the visceral capillaries C. Stored in the mesothelial cells D. Metabolized by the mesothelial cells
a
68
Production of serous fluid is controlled by: A. Capillary oncotic pressure B. Capillary hydrostatic pressure C. Capillary permeability D. All of the above
d
69
An increase in the amount of serous fluid is called a/an: A. Exudate B. Transudate C. Effusion D. Malignancy
c
70
Pleural fluid is collected by: A. Pleurocentesis B. Paracentesis C. Pericentesis D. Thoracentesis
d
71
Fluid:serum protein and lactic dehydrogenase ratios are performed on serous fluids: A. When malignancy is suspected B. To classify transudates and exudates C. To determine the type of serous fluid D. When a traumatic tap has occurred
b
72
Which of the following requires the most additional testing? A. Transudate B. Exudate
b
73
An additional test performed on pleural fluid to classify the fluid as a transudate or exudate is the: A. WBC count B. RBC count C. Fluid:cholesterol ratio D. Fluid-to-serum protein gradient
c
74
A milky-appearing pleural fluid indicates: A. Thoracic duct leakage B. Chronic inflammation C. Microbial infection D. Both A and B
d
75
Which of the following best represents a hemothorax? A. Blood HCT: 42 Fluid HCT: 15 B. Blood HCT: 42 Fluid HCT: 10 C. Blood HCT: 30 Fluid HCT: 10 D. Blood HCT: 30 Fluid HCT: 20
d
76
All of the following are normal cells seen in pleural fluid except: A. Mesothelial cells B. Neutrophils C. Lymphocytes D. Mesothelioma cells
d
77
A differential observation of pleural fluid associated with tuberculosis is: A. Increased neutrophils B. Decreased lymphocytes C. Decreased mesothelial cells D. Increased mesothelial cells
c
78
All of the following are characteristics of malignant cells except: A. Cytoplasmic molding B. Absence of nucleoli C. Mucin-containing vacuoles D. Increased nucleus:cytoplasm ratio
b
79
A pleural fluid pH of 6.0 indicates: A. Esophageal rupture B. Mesothelioma C. Malignancy D. Rheumatoid effusion
a
80
Plasma cells seen in pleural fluid indicate: A. Bacterial endocarditis B. Primary malignancy C. Metastatic lung malignancy D. Tuberculosis infection
d
81
A significant cell found in pericardial or pleural fluid that should be referred to cytology is a: A. Reactive lymphocyte B. Mesothelioma cell C. Monocyte D. Mesothelial cell
b
82
Another name for a peritoneal effusion is: A. Peritonitis B. Lavage C. Ascites D. Cirrhosis
c
83
A test performed primarily on peritoneal lavage fluid is a/an: A. WBC count B. RBC count C. Absolute neutrophil count D. Amylase
b
84
The recommended test for determining whether peritoneal fluid is a transudate or an exudate is the: A. Fluid:serum albumin ratio B. Serum ascites albumin gradient C. Fluid:serum lactic dehydrogenase ratio D. Absolute neutrophil count
b
85
Given the following results, classify this peritoneal fluid: serum albumin, 2.2 g/dL; serum protein, 6.0 g/dL; fluid albumin, 1.6 g/dL. A. Transudate B. Exudate
b
86
Differentiation between bacterial peritonitis and cirrhosis is done by performing a/an: A. WBC count B. Differential C. Absolute neutrophil count D. Absolute lymphocyte count
c
87
Detection of the CA 125 tumor marker in peritoneal fluid indicates: A. Colon cancer B. Ovarian cancer C. Gastric malignancy D. Prostate cancer
b
88
Chemical tests primarily performed on peritoneal fluid include all of the following except: A. Lactose dehydrogenase B. Glucose C. Alkaline phosphatase D. Amylase
d
89
Cultures of peritoneal fluid are incubated: A. Aerobically B. Anaerobically C. At 37°C and 42°C D. Both A and B
d
90
Which of the following is not a function of amniotic fluid? A. Allows movement of the fetus B. Allows carbon dioxide and oxygen exchange C. Protects fetus from extreme temperature changes D. Acts as a protective cushion for the fetus
b
91
What is the primary cause of the normal increase in amniotic fluid as a pregnancy progresses? A. Fetal cell metabolism B. Fetal swallowing C. Fetal urine D. Transfer of water across the placenta
c
92
Which of the following is not a reason for decreased amounts of amniotic fluid? A. Fetal failure to begin swallowing B. Increased fetal swallowing C. Membrane leakage D. Urinary tract defects
a
93
Why might a creatinine level be requested on an amniotic fluid? A. Detect oligohydramnios B. Detect polyhydramnios C. Differentiate amniotic fluid from maternal urine D. Evaluate lung maturity
c
94
Amniotic fluid specimens are placed in amber-colored tubes prior to sending them to the laboratory to prevent the destruction of: A. Alpha-fetoprotein B. Bilirubin C. Cells for cytogenetics D. Lecithin
b
95
How are specimens for FLM testing delivered to and stored in the laboratory? A. Delivered on ice and refrigerated B. Immediately centrifuged C. Kept at room temperature D. Delivered in a vacuum tube

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