Question 1

Which of the following is a feature of malignant cells in fluids?&#10;A)small size&#10;B)three-dimensional clumps with no &#34;windows&#34;&#10;C)low nuclear-to-cytoplasmic (N:C) ratio&#10;D)uniformity

Accepted Answer

Mesothelial cells are the lining cells of body cavities and are shed into these cavities.They can be confused with malignant cells.However,when mesothelial cells appear in clumps (a frequent occurrence),usually windows are noted between the cells.This is not true of malignant cells that are also commonly found in clumps.

Question 2

Which of the following is normal in a CSF?&#10;A)ependymal cells&#10;B)100 white cells per mm3&#10;C)blasts&#10;D)mesothelial cells

Accepted Answer

Ependymal cells,along with choroids plexus cells,are lining cells of the central nervous system and are seen in CSF.None of the other findings would be normal in CSF.

Question 3

Three CSF tubes are received in the laboratory numbered 1 through 3 based on the order in which they were obtained,with 1 being the first.The first tube is cloudy pink,but this color diminishes and clearing occurs with each successive tube.What does this suggest?

A)Internal bleeding into the CSF has occurred.
B)This is blood contaminating the CSF fluid from a traumatic puncture.
C)Bacterial infection is likely present.
D)Metastatic tumor is likely present.

Accepted Answer

The turbid and pink color is due to the presence of red cells in the fluid.Because each succeeding tube becomes clearer and the pink color diminishes,a traumatic tap is most likely the cause.If there had been internal bleeding into the CSF,each tube would appear the same.The presence of bacterial infection or metastatic tumor cells cannot be determined by simply a gross examination of the fluid.

Question 4

Which of the following is true regarding bronchoalveolar lavage (BAL)fluids?&#10;A)The differential is not done on these fluids.&#10;B)It is often received from patients suspected of having asthma.&#10;C)Moving ciliated cells suggest that the patient has Pneumocystis carinii.&#10;D)A mask should be worn when performing tests.

Accepted Answer

BAL examination is performed on patients with severe lung dysfunction.They may contain airborne organisms because they are taken from the interior of the lung;they often contain bacteria and/or yeast when cytocentrifuge slides are examined.Aerosol production is a real risk;thus it is critical to wear a mask when working with these specimens.

Question 5

What determines whether or not body fluids are diluted before counting?&#10;A)appearance of the fluid&#10;B)type of fluid&#10;C)patient's diagnosis&#10;D)whether or not the fluid needs to go to other sections of the laboratory for additional testing

Accepted Answer

The appearance of the fluid is used to determine whether or not a body fluid is diluted before counting.If the fluid is clear,no dilution is made.If it is hazy or cloudy,an appropriate dilution is made.

Question 6

Nucleated red blood cells (NRBCs)and immature white cells in a CSF most likely mean&#10;A)bacterial meningitis.&#10;B)patient has NRBCs in the peripheral blood.&#10;C)subarachnoid hemorrhage.&#10;D)bone marrow contamination.

Accepted Answer

When immature bone marrow cells are seen in the CSF,it most likely means that bone marrow contamination of the specimen has occurred.If a significant number exist,the CSF differential will be a reflection of what is in the marrow,not the CSF.

Question 7

A synovial fluid has a high white cell count and large intracellular needlelike crystals that are yellow when the crystals are parallel to the y-axis of a red compensator.What is the likely diagnosis?&#10;A)pseudo-gout&#10;B)gout&#10;C)lupus erythematosus&#10;D)bacterial infection

Accepted Answer

These are monosodium urate crystals and are seen in gout.

Question 8

What determines the amount of fluid used for a cytocentrifuge preparation?&#10;A)type of fluid&#10;B)desired speed of centrifugation&#10;C)number of cells&#10;D)amount of fluid collected

Accepted Answer

The number of cells,determined when the cell count is done on the body fluid,determines how much fluid should be used in making the cytocentrifuge preparation.This preparation concentrates the cells so that a representative number of them can be morphologically evaluated.

Question 9

Why should spinal fluid tests be performed within 30 minutes of collection?&#10;A)Cells begin to deteriorate quickly.&#10;B)The conditions detected by the tests are often life threatening.&#10;C)They are often ordered &#34;stat.&#34;&#10;D)All of the above are true.

Accepted Answer

Spinal fluid tests should be performed within 30 minutes of collection for all the reasons listed.

Question 10

A CSF is equally bloody in all tubes collected and has a yellowish supernatant.On the differential,macrophages with hemosiderin are noted.Which of the following is most likely?&#10;A)bacterial meningitis&#10;B)viral meningitis&#10;C)subarachnoid hemorrhage&#10;D)traumatic tap

Accepted Answer

All tubes being equally bloody indicates hemorrhage.If it had been a traumatic tap,there should have been a gradual decrease in the number of red cells in successive tubes with gradual clearing.The yellow tinge to the supernatant suggests a subarachnoid hemorrhage.

Question 11

A cloudy cerebrospinal fluid (CSF)is diluted 1:20.In nine large squares,99 white cells are counted.What is the total white blood count/mm&#179; or /mL?&#10;A)99&#10;B)1980&#10;C)2200&#10;D)22,000

Accepted Answer

The answer of A cloudy cerebrospinal fluid (CSF)is diluted 1:20.In...

Question 12

A patient has a pleural fluid with 2000 WBCs per mL.Seventy percent of the cells are neutrophils.Which of the following is most likely?&#10;A)normal fluid&#10;B)transudate on a patient with a pleural bacterial infection&#10;C)exudate on a patient with a pleural bacterial infection&#10;D)exudate on a patient with heart failure

Accepted Answer

The answer of A patient has a pleural fluid with...

Question 13

Which of the following is true regarding malignant cells in serous fluids?&#10;A)All clumps of large cells should be considered malignant.&#10;B)Malignant cells in serous fluids are rarely seen.&#10;C)Malignant cells categorize the fluid as a transudate.&#10;D)Care must be taken to distinguish malignant cells from clumps of mesothelial cells.

Accepted Answer

The answer of Which of the following is true regarding...

Question 14

If most of the white cells are neutrophils on the previously discussed CSF,what additional test should be performed?&#10;A)cytology&#10;B)flow cytometry&#10;C)lactate dehydrogenase&#10;D)Gram stain and bacterial cultures

Accepted Answer

The answer of If most of the white cells are...

Question 15

How must synovial fluids be handled differently than other fluids?&#10;A)Perform a Gram stain if bacteria are seen.&#10;B)Dilute the fluid if the cell counts are high.&#10;C)Add hyaluronidase to overcome the viscous nature of fluid.&#10;D)Carefully search the whole cytospin preparation for malignant cells.

Accepted Answer

The answer of How must synovial fluids be handled differently...

Question 16

One clinical laboratory scientist is covering the "manual bench" in the hematology laboratory,which is where body fluid examinations are done.Just as she is preparing to go on break,she simultaneously receives two specimens,one a CSF and one a BAL fluid.Both are marked "stat." What should she do first?

A)Analyze the BAL.
B)Analyze the CSF.
C)Go on break and then return and do the BAL.
D)Go on break and then return and do the CSF.

Accepted Answer

The answer of One clinical laboratory scientist is covering the...

Question 17

A hazy spinal fluid has 400 white cells per mm&#179; that are mostly lymphocytes and reactive lymphocytes.Which of the following is most likely?&#10;A)bacterial meningitis&#10;B)viral meningitis&#10;C)infectious mononucleosis&#10;D)multiple myeloma

Accepted Answer

The answer of A hazy spinal fluid has 400 white...

Question 18

Which of the following are normal in serous fluids?&#10;A)macrophages&#10;B)bacteria&#10;C)eosinophils (EOs)&#10;D)LE cells

Accepted Answer

The answer of Which of the following are normal in...

Deck 18: Body Fluid Analysis in the Hematology Laboratory