Urine,CSF, Other Fluids

Question 1

The bladder must be emptied first in

Answer 1

morning urine specimen

Question 2

In a random urine specimen

Answer 2

There is a single collection of urine specimen that day at any period of time

Question 3

In a fasting specimen

Answer 3

The urine is collected more than 4hrs after ingestion of food and water.

Question 4

Specimen of urine passed during defaecation must be included in a

Answer 4

24hr urine sample

Question 5

Urinalysis is useful for screening

Answer 5

UTI
Kidney disease 
Liver disease with bilirubinuria
Pregnancy
Drug screening 
Diabetes mellitus

Question 6

Volume of urine per hr

Answer 6

1-2 liters

Question 7

Yellow colour of urine is due to

Answer 7

Urobilin, Urochrome ,porphyrins

Question 8

When normal urine is left to stand a _ may form if urine is alkaline and _ if urine is highly acidic

Answer 8

White phosphate

Pink Uric acid

Question 9

Normal PH of urine is between

Answer 9

4.5-8.0

Question 10

Urine osmolality is used in determining

Answer 10

Concentration capabilities of Renal tubules

Question 11

Range of specific gravity of urine

Answer 11

1.010-1.020

Question 12

Polyuria
Oligouria
Anuria

Answer 12

1. Seen in diabetes mellitus and insipidus, volume greater than 3.0L in adults and 2.0L/m2 in children
2. Urine volume less than 400ml per day. Due to reduced RBF and or GFR. Seen in acute tubular necrosis, Dehydration
3. Anuria:- output less than 100ml per day. Due to severe damage to renal tubules

Question 13

Cloudy urine colour is associated with

Answer 13

Bacteria and pus cells

Question 14

Red and cloudy urine

Answer 14

Hematuria

Question 15

Brown and cloudy ruins suggests

Answer 15

Hemoglobinuria

Question 16

Yellowish brown / greenish brown urine is suggestive of

Answer 16

Urine that contains bile pigments

Question 17

Urine that is milky white contains

Answer 17

Chyme

Question 18

Nitrite test

Answer 18

Used to confirm that bacteria which reduces urinary nitrate to nitrite is present

Question 19

CSF fluid is produced in adults at a rate of

Answer 19

20ml/hr

Question 20

A volume of what CSF is maintained in the Sub Arachnoid space

Answer 20

90-150ml

Question 21

CSF composition has the same composition as the blood. T/F

Answer 21

False

Question 22

Function of analysis of CSF fluid

Answer 22

• To confirm diagnosis of viral, fungi or bacteria meningitis
• Encephalitis
• Evaluation for intracranial haemorrhage
• SAH
• spinal canal block leading to increased ICP
• diagnosing malignant infiltrates like lymphoma and acute leukemia

Question 23

Lumbar puncture is done between

Answer 23

3rd and 4th or 4th and 5th lumbar vertebrae

Question 24

Opening pressure above 250mmHg is suggestive of an

Answer 24

Intracranial hypertension

Question 25

Elevated intracranial hypertension is seen in

Answer 25

Meningitis Intracranial haemorrhage Tumors

Question 26

Idiopathic intracranial hypertension is seen in

Answer 26

Obese women during their childbearing years

Question 27

Macroscopic appearance of CSF is

Answer 27

Clear and colourless

Question 28

CSF is usually acellular. T/F A 5 mononuclear WBC/ul and 5 RBC/ul in adults while 20 WBC/ul in newborns is normal. T/F

Answer 28

True | True

Question 29

A turbid CSF is indicative of

Answer 29

WBC>>200/ul RBC>>400/ul Increased proteins Increased microorganisms

Question 30

Bloody CSF is indicative of

Answer 30

Traumatic tap Hypertensive intracerebral haemorrhage into ventricles Rupture of berry aneurysm into sub-arachnoid space. Bleeding from vascular malformations >>6000rbcs/uL

Question 31

Delicate clots resembling a cobweb(pellicle) is seen in

Answer 31

Tuberculous meningitis

Question 32

Increased protein level is seen in what type of meningitis

Answer 32

Pyogenic

Question 33

Fibrin clot is seen in

Answer 33

Traumatic taps

Question 34

Xanthochromic CSF has what colourations

Answer 34

Yellow, Orange, or pink

Question 35

Xanthochromia is caused by

Answer 35

Breakdown of RBC forming haemoglobin which is broken down to form, oxyhaemoglobin(pink colour), methemoglobin and Bilirubin(yellow)

Question 36

Yellow CSF supernatant is pathological for

Answer 36

Hyperbilirubinemia

Question 37

Brown CSF is seen in

Answer 37

Meningeal melanomatosis

Question 38

Discolouration of CSF begins after RBC has been in been in CSF for

Answer 38

>>2hrs

Question 39

Eighty seven percent of patients with Bacteria meningitis have a WBC count higher than

Answer 39

1000 per mm3

Question 40

99% of patients with bacterial | meningitis will have WBC higher than

Answer 40

100 per mm3

Question 41

Having less than 100WBC per mm3 is seen in patients with

Answer 41

viral meningitis

Question 42

CSF in bacterial meningitis is typically dominated by the presence of

Answer 42

PMNs

Question 43

WBC count in adult is typically composed of

Answer 43

70% lymphocytes | 30% monocytes

Question 44

One of the most sensitive indicators of pathology in the CNS is

Answer 44

CSF protein concentration

Question 45

Newborn protein level

Answer 45

150mg/dL

Question 46

Adult protein level and time it is attained

Answer 46

15-45mg/dL at 6-12 months

Question 47

Pathological cause of elevated CSF protein

Answer 47

Increased BBB permeability(infection) Multiple sclerosis Gillian Barre syndrome Obstruction from tumour Froin’s syndrome Intracranial haemorrhage Traumatic trap situations( due to increased RBC)

Question 48

CSF protein level falls in hypoproteinemia.

Answer 48

False- it remains unchanged

Question 49

CSF protein levels reduces in

Answer 49

Intracranial hypertension Acute water intoxication Loss of CSF(leak)

Question 50

What is a major component of myelin

Answer 50

Myelin basic protein

Question 51

IgG increase is see in what disease

Answer 51

MS

Question 52

CSF values of what protein is useful in diagnosing Alzheimer’s disease from other dementia

Answer 52

Tau’s protein

Question 53

CSF glucose is about what the value of serum’s

Answer 53

Half to two-third

Question 54

CSF glucose is reduced in all infections except

Answer 54

Viral

Question 55

CSF normal lactate values

Answer 55

11-22mg/dL

Question 56

Lactate values is increased in

Answer 56

Hypoxia Bacteria meningitis Epilepsy Xanthochromia

Question 57

Polymerase chain reaction is seen in

Answer 57

Viral and tuberculos meningitis

Question 58

Pleura fluid accumulates when

Answer 58

Decreased removal due to decreased pleural pressure like bronchial obstruction or impaired lymphatic drainage Increased production in hypoproteinemia Increased capillary vessel permeability(infection) Increased hydrostatic pressure in cardiac failure

Question 59

Trans USA tube and exudative pleural effusions is differentiated by measuring

Answer 59

Lactate dehydrogenase and protein level

Question 60

Aetioligical cause of Ascitic fluid increase is

Answer 60

Liver cirrhosis- 75% Malignancies- 10% Cardiac failure- 5% Remaining-10%

Question 61

Diagnosis of Ascitis due to portal hypertension is by

Answer 61

SAAG-Serum Ascitis Albumin gradient