Stras: CSF

Question 1

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

Answer 1

B. Producing an ultrafiltrate of plasma

Question 2

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

Answer 2

C. Arachnoid space

Question 3

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

Answer 3

B. Blood-brain barrier

Question 4

4. The CSF tube labeled 3 is sent to:
   A. The hematology department
   B. The chemistry department
   C. The microbiology department
   D. The serology department

Answer 4

A. The hematology department

Question 5

5. The CSF tube that should be refrigerated is:
   A. Tube 1
   B. Tube 2
   C. Tube 3
   D. Tube 4

Answer 5

C. Tube 3

Question 6

Even distribution of blood in all tubes

Answer 6

Intracranial hemorrhage

Question 7

Xanthochromic supernatant

Answer 7

Intracranial hemorrhage

Question 8

Concentration of blood in tube 1 is greater than in tube 3

Answer 8

Traumatic tap

Question 9

Specimen contains clots

Answer 9

Traumatic tap

Question 10

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

Answer 10

C. A recent hemorrhage

Question 11

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

Answer 11

A. Tubercular meningitis

Question 12

9. 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

Answer 12

C. 800

Question 13

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

Answer 13

C. Acetic acid

Question 14

11. 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

Answer 14

D. Counted undiluted

Question 15

12. 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

Answer 15

D. Both A and B

Question 16

13. 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

Answer 16

A. Meningitis

Question 17

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

Answer 17

B. Nucleated RBCs

Question 18

15. The presence of which of the following cells is increased when a CNS shunt malfunctions?
    A. Neutrophils
    B. Macrophages
    C. Eosinophils
    D. Lymphocytes

Answer 18

C. Eosinophils

Question 19

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

Answer 19

D. All of the above

Question 20

17. 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

Answer 20

D. Bone marrow contamination

Question 21

18. Following 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

Answer 21

D. All of the above

Question 22

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

Answer 22

B. Macrophages

Question 23

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

Answer 23

D. As a complication of acute leukemia

Question 24

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

Answer 24

A. Lymphoma cells

Question 25

22. The normal value of CSF protein is: A. 6–8 g/dL B. 15–45 g/dL C. 6–8 mg/dL D. 15–45 mg/dL

Answer 25

D. 15–45 mg/dL

Question 26

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

Answer 26

D. Tau transferrin

Question 27

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

Answer 27

B. Prealbumin

Question 28

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

Answer 28

C. Fluid leakage

Question 29

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

Answer 29

A. CSF/serum albumin index

Question 30

27. Given the following results, calculate the IgG index: CSF IgG, 50 mg/dL; serum IgG, 2 gm/dL; CSF albumin, 70 mg/dL; serum albumin, 5 gm/dL. A. 0.6 B. 6.0 C. 1.8 D. 2.8

Answer 30

C. 1.8

Question 31

28. The CSF IgG index calculated in Study Question 27 is indicative of: A. Synthesis of IgG in the CNS B. Damage to the blood-brain barrier C. Cerebral hemorrhage D. Lymphoma infiltration

Answer 31

A. Synthesis of IgG in the CNS

Question 32

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

Answer 32

C. Multiple sclerosis

Question 33

30. A CSF glucose of 15 mg/dL, WBC count of 5000, 90% neutrophils, and protein of 80 mg/dL is suggestive of: A. Fungal meningitis B. Viral meningitis C. Tubercular meningitis D. Bacterial meningitis

Answer 33

D. Bacterial meningitis

Question 34

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

Answer 34

C. 80 mg/dL

Question 35

32. CSF lactate will be more consistantly decreased in: A. Bacterial meningitis B. Viral meningitis C. Fungal meningitis D. Tubercular meningitis

Answer 35

B. Viral meningitis

Question 36

33. Measurement of which of the following can bereplaced by CSF glutamine analysis in children with Reye syndrome? A. Ammonia B. Lactate C. Glucose D. -ketoglutarate

Answer 36

A. Ammonia

Question 37

34. Prior to performing a Gram stain on CSF, the specimen must be: A. Filtered B. Warmed to 37C C. Centrifuged D. Mixed

Answer 37

C. Centrifuged

Question 38

35. All of the following statements are true about cryptoccocal 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

Answer 38

C. The WBC count is over 2000

Question 39

36. The test of choice to detect neurosyphilis is the: A. RPR B. VDRL C. FTA D. FTA-ABS

Answer 39

B. VDRL