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WorksheetsAUBF CSF ASSESSMENT QUIZ
Total questions: 75
Worksheet time: 3570secs
Cerebrospinal fluid (CSF) is produced primarily from
secretions by the choroid plexus
diffusion from plasma into the central nervous
system
ultrafiltration of plasma in the ventricles of the
brain.
excretions from ependymal cells lining the brain
and spinal cord.
Cerebrospinal fluid is found between the
arachnoid and dura mater
arachnoid and pia mater.
pia mater and dura mater
pia mater and choroid plexus.
Which of the following statements regarding CSF is
true?
Cerebrospinal fluid is constantly produced.
Cerebrospinal fluid is reabsorbed into the blood at the choroid plexus
Cerebrospinal fluid is essentially composed of diluted plasma.
Cerebrospinal fluid circulates through the brain and spinal cord because of active and passive diffusion processes.
Which of the following substances does not normally pass through the blood-brain barrier?
PO2
Albumin
Glucose
Fibrinogen
During a lumbar puncture procedure, the first collection tube of CSF removed should b
chemistry tests
cytologic studies
hematologic tests
microbiological studies
Which of the following is not an analytical concern when the processing and testing of CSF are delayed?
The viability of microorganism
The lability of the immunoglobulins
The lysis of leukocytes and erythrocytes
Alterations in the chemical composition
Pleocytosis is a term used to describe
an increased number of cells in the CSF
a pink, orange, or yellow CSF specimen
an increased protein content in the CSF caused by cellular lysis
inflammation and sloughing of cells from the choroid plexus
All of the following can cause xanthochromia in CSF except
high concentrations of protein.
high concentrations of bilirubin
increased numbers of leukocytes.
erythrocytes from a traumatic tap
In CSF, which of the following findings indicates a traumatic puncture?
The presence of erythrophagocytic cells in the CSF
Hemosiderin granules within macrophages in the CSF sediment
An uneven distribution of blood in the CSF collection tubes
A xanthochromic supernatant following CSF centrifugation
How many leukocytes are normally present in the CSF obtained from an adult?
0 to 5 cells/mL
0 to 10 cells/mL
0 to 20 cells/mL
0 to 30 cells/m
Which of the following cells can be present in small numbers in normal CSF?
Erythrocytes
Lymphocytes
Macrophages
Plasma cells
Which of the following cell types predominate in CSF during a classic case of bacterial meningitis?
Lymphocytes
Macrophages
Monocytes
Neutrophils
Which of the following cell types predominate in CSF during a classic case of viral meningitis?
Lymphocytes
Macrophages
Monocytes
Neutrophils
When choroid plexus cells and ependymal cells are present in CSF, they
are often clinically significant
represent the demyelination of nerve tissue
can closely resemble clusters of malignant cells
. indicate breakdown of the blood-brain barrier.
All of the following proteins are normally present in the CSF except
albumin
fibrinogen
transthyretin
transferrin
Which of the following events does not result in an increased CSF total protein?
A traumatic puncture procedure
Alterations in the blood-brain barrier
Trauma to the central nervous system, resulting in fluid loss
Decreased reabsorption of CSF into the peripheral blood
Which of the following proteins in the CSF is used to monitor the integrity of the blood-brain barrier?
Albumin
Transthyretin
Transferrin
Immunoglobulin G
An immunoglobulin G index greater than 0.70
indicates
intrathecal synthesis of immunoglobulin G
a compromised blood-brain barrier
active demyelination of neural proteins
increased transport of immunoglobulin G from plasma into the CSF
An unknown fluid can be positively identified as CSF by determining the
lactate concentration
albumin concentration
presence of oligoclonal banding on electrophoresis
presence of carbohydrate-deficient transferrin on electrophoresis
Which of the following statements about oligoclonal bands is false?
In the CSF, these bands indicate increased intrathecal concentrations of immunoglobulin G
The bands usually correlate with the stage of disease and can be used to predict disease progression
The bands are often present in the CSF and serum of individuals with a lymphoproliferative disease
The bands are often present in the CSF but not in the serum of individuals with multiple sclerosis
Which of the following statements about CSF glucose is false?
Increased CSF glucose values are diagnostically significant.
Glucose enters the CSF by active transport and simple diffusion.
Decreased CSF glucose values reflect a defective blood-brain barrier and increased glycolysis.
CSF glucose values reflect the plasma glucose concentration 30 to 90 minutes preceding collection
Normal CSF lactate levels (less than 25 mg/dL) are commonly found in patients with
bacterial meningitis
fungal meningitis
tuberculous meningitis
viral meningitis
Which of the following procedures frequently provides a rapid presumptive diagnosis of bacterial meningitis?
A blood culture
A CSF culture
A CSF Gram stain
Immunologic tests on CSF for microbial antigens
India ink preparations and microbial antigen tests on CSF can aid in the diagnosis of
bacterial meningitis
fungal meningitis.
tuberculous meningitis.
viral meningitis
The functions of the CSF include all of the following
except:
Removing metabolic wastes
Producing an ultrafiltrate of plasma
Supplying nutrients to the CNS
Protecting the brain and spinal cord from trauma
The CSF flows through the:
Choroid plexus
Pia mater
Arachnoid space
Dura mater
Substances present in the CSF are controlled by the:
Arachnoid granulations
Blood–brain barrier
Presence of one-way valves
Blood–CSF barrier
What department is the CSF tube labeled 3 routinely sent to?
Hematology
Chemistry
Microbiology
Serology
The CSF tube that should be kept at room temperature is:
Tube 1
Tube 2
Tube 3
Tube 4
The CSF tube that should be kept at ref temperature is:
Tube 1
Tube 2
Tube 3
Tube 4
Even distribution of blood in all tubes is a characteristic of?
Traumatic tap
Intracranial hemorrhage
Specimen contains clots is a characteristic of?
Traumatic tap
Intracranial hemorrhage
Concentration of blood in tube 1 is greater
than in tube 3 is a characteristic of?
Traumatic tap
Intracranial hemorrhage
Xanthochromic supernatant is a characteristic of?
Traumatic tap
Intracranial hemorrhage
The presence of xanthochromia can be caused by all of
the following except:
Immature liver function
RBC degradation
A recent hemorrhage
Elevated CSF protein
A web-like pellicle in a refrigerated CSF specimen indicates:
Tubercular meningitis
Multiple sclerosis
Primary CNS malignancy
Viral meningitis
A CSF WBC count is diluted with:
Distilled water
Normal saline
Acetic acid
Hypotonic saline
A total CSF cell count on a clear fluid should be:
Reported as normal
Not reported
Diluted with normal saline
Counted undiluted
The purpose of adding albumin to CSF before cytocentrifugation is to
Increase the cell yield only
Decrease cellular distortion only
Improve the cellular staining only
Increase the cell yield and decrease cell distortion
The primary concern when pleocytosis of neutrophils and
lymphocytes is found in the CSF is:
Meningitis
CNS malignancy
Multiple sclerosis
Hemorrhage
Neutrophils with pyknotic nuclei may be mistaken for:
Lymphocytes
Nucleated RBCs
Malignant cells
Spindle-shaped cells
The presence of which of the following cells is increased
in a parasitic infection?
Neutrophils
Macrophages
Eosinophils
Lymphocytes
Macrophages appear in the CSF after:
Hemorrhage
Repeated spinal taps
Diagnostic procedures
All the given choices
Nucleated RBCs are seen in the CSF as a result of:
Elevated blood RBCs
Treatment of anemia
Severe hemorrhage
Bone marrow contamination
After a CNS diagnostic procedure, which of the following might be seen in the CSF?
Choroidal cells
Ependymal cells
Spindle-shaped cells
All of the choices given
Hemosiderin granules and hematoidin crystals are seen in:
Lymphocytes
Macrophages
Ependymal cells
Neutrophils
Myeloblasts are seen in the CSF
In bacterial infections
In conjunction with CNS malignancy
After cerebral hemorrhage
As a complication of acute leukemia
Cells resembling large and small lymphocytes with cleaved nuclei represent
Lymphoma cells
Choroid cells
Melanoma cells
Medulloblastoma cells
The reference range for CSF protein is:
6 to 8 g/dL
15 to 45 g/dL
6 to 8 mg/dL
15 to 45 mg/dL
CSF can be differentiated from serum by the presence of:
Albumin
Globulin
Prealbumin
Tau transferrin
In serum, the second most prevalent protein is IgG; in CSF, the second most prevalent protein is
Transferrin
Prealbumin
IgA
Ceruloplasmin
Elevated CSF protein values can be caused by all of the following except:
Meningitis
Multiple sclerosis
Fluid leakage
CNS malignancy
The integrity of the blood–brain barrier is measured using the:
CSF/serum albumin index
CSF/serum globulin ratio
CSF albumin index
CSF IgG index
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
0.6
6.0
1.8
2.8
The finding of oligoclonal bands in the CSF and not in
the serum is seen with:
Multiple myeloma
CNS malignancy
Multiple sclerosis
Viral infections
A CSF glucose of 15 mg/dL, WBC count of 5000, 90% neutrophils, and protein of 80 mg/dL suggests:
Fungal meningitis
Viral meningitis
Tubercular meningitis
Bacterial meningitis
A patient with a blood glucose of 120 mg/dL would have
a normal CSF glucose of
20 mg/dL
60 mg/dL
80 mg/dL
120 mg/dL
Measurement of which of the following can be replaced by
CSF glutamine analysis in children with Reye syndrome?
Ammonia
Lactate
Glucose
α -Ketoglutarate
Before performing a Gram stain on CSF, the specimen must be:
Filtered
Warmed to 37°C
Centrifuged
Mixed
All of the following statements are true about cryptococcal meningitis except:
An India ink preparation is positive
A starburst pattern is seen on Gram stain
The WBC count is over 2000
A confirmatory immunology test is available
The test of choice to detect neurosyphilis is the:
RPR
VDRL
FAB
FTA-ABS
Presence of this protein indicates recent destruction of the myelin sheath that protects the axons of the neurons in case of Multiple Sclerosis.
Myelin Basic Protein
Bence Jones Protein
Tau transferrin
Immunoglobulin
Decreased result of CSF protein is due to the following except?
Myxedema
Water Intoxication
Recent puncture
CSF leakage/trauma
This is the major beta globulin present in the CSF.
IgA
IgG
Pre-albumin
Albumin
Tau protein
Increased eosinophils are usually seen in the CSF in association with fungal infections particularly infection with __________________________.
N. meninigitidis
Coccidioides immitis
C. albicans
Cryptococcus Neoformans
Stain used for WBCs during WBC count.
Methylene Blue
Gram Stain
India Ink stain
Hansel Stain
What dilution factor should be used if the collected CSF is bloody or turbid?
1:10
1:20
1:200
1:1000
1:10, 000
How many cells should be counted when performing CSF WBC differential?
100
200
1000
2000
Just count and report only the number of WBC seen
CSF protein is how many percent of the serum protein?
60-70%
1%
15-45%
10-20%
What type of meningitis shows markedly decreased glucose level but has elevated WBC count.
Bacterial
Fungal
Viral
Tubercular
What type of meningitis shows normal glucose level and normal lactate level.
Bacterial
Fungal
Viral
Tubercular
It is a “brain-eating amoeba” that can invade the brain via nasal passages causing primary amebic meningoencephalitis.
C. immitis
C. neoformans
N. fowleri
M. tuberculosis
What is the ratio of monocyte to lymphocyte in children?
70:30
30:70
What is the pH of CSF?
7.30-7.45
7.30-7.35
7.40-7.45
7.0-7.40
When there is extra tube collected, this tube is usually used to the ________________.
Hematology section
Clinical Chemistry section
Immunoserology section
Microbiology section
