Deck 47: Nervous System

Question 1

Which of the following are true of cerebrospinal fluid?
1)The total volume of CSF in adults is about 350 mL.
2)The total amount of CSF is replaced every 6 to 8 hours.
3)CSF is produced by the choroid plexus.

A)1, 2, 3
B)1, 2
C)2, 3
D)1, 3

Answer 1

2, 3

Question 2

Calculate the IgG index, given the data below.
IgG (CSF) = 0.2 mg/dL
IgG (serum = 0.5 g/dL
Albumin (CSF) = 1.7 mg/dL
Albumin (serum) = 3.5 g/dL

A)0.19
B)0.29
C)0.41
D)0.82

Answer 2

0.82

Question 3

CSF will develop a pink or yellow tinge with an RBC level of ______ and will become slightly cloudy at a WBC level of ______.

A)100 cells/mm3, 200 cells/mm3
B)200 cells/mm3, 100 cells/mm3
C)200 cells/mm3, 500 cells/mm3
D)500 cells/mm3, 200 cells/mm3

Answer 3

500 cells/mm3, 200 cells/mm3

Question 4

Which of the following laboratory abnormalities are identified in patients with multiple sclerosis?
1)an elevation of up to 40 white blood cells/mm³
2)an increase in serum myelin basic protein
3)a decreased spinal fluid IgG
4)observation of oligoclonal bands in the immunoglobulin region on electrophoresis

A)1, 2, 3
B)1, 2, 4
C)1, 3, 4
D)2, 3, 4

Question 5

When blood is present from a traumatic lumbar puncture or there is bleeding within the CNS, how is the CSF protein level corrected for the amount of blood present?

A)subtracting 1 mg/dL of protein for every 2000 RBCs per mm3
B)subtracting 2 mg/dL of protein for every 1000 RBCs per mm3
C)subtracting 1 mg/dL of protein for every 1000 RBCs per mm3
D)subtracting 2 mg/dL of protein for every 2000 RBCs per mm3

Question 6

Which of the following statements describe the ability of penicillin to cross the blood-brain barrier?

A)Penicillin freely crosses the intact blood-brain barrier.
B)Penicillin does not cross the intact blood-brain barrier.
C)Penicillin crosses the blood-brain barrier once the permeability of the barrier is altered by inflammation.
D)both b and c

Question 7

Which of the following occurs in Alzheimer's disease?

A)a large decrease in choline acetyltransferase activity, along with degeneration of neurons using acetylcholine
B)a degeneration of cholinergic neurons in the basal ganglia
C)dysfunction of GABA-ergic systems
D)dopaminergic neuron dysfunction

Question 8

Which of the following are characteristics of a normal spinal fluid?
1)specific gravity of 1.007
2)glucose of 50 mg/dL
3)protein of 7.0 g/dL
4)sodium of 140 mmol/L

A)1, 2, 3
B)1, 2, 4
C)1, 3, 4
D)2, 3, 4

Question 9

Which of the following compounds most readily enters the central nervous system?

A)albumin
B)calcium
C)alcohol
D)aspartic acid

Question 10

Guillain-Barré syndrome is a neuromuscular disease that has a characteristic CSF finding of an elevated ______ without an elevated ______.

A)white cell count, protein
B)protein, white cell count
C)protein, glucose
D)glucose, protein

Question 11

The following laboratory results were obtained on a patient suffering from depression, fatigue, and apathy.These data provide laboratory evidence of which disease?
Serum cortisol - decreased
Serum sodium - decreased
Serum potassium - increased

A)Addison's disease
B)hypothyroidism
C)Cushing's syndrome
D)liver failure

Question 12

Which of the following laboratory tests would be selected to assess the integrity of the blood-brain barrier?

A)CSF osmolality
B)IgG index
C)CSF lactic acid
D)kappa to lambda light chain ratio

Question 13

The normal ratio of serum protein to CSF protein is ________________.

A)150:1
B)200:1
C)250:1
D)300:1

Question 14

The following data obtained on a spinal fluid analysis provide laboratory evidence of which of the following clinical states?
CSF carcinoembryonic antigen - elevated
CSF β-glucuronidase - elevated
IgG index - decreased

A)stroke
B)hemorrhage
C)coma
D)CNS tumor

Question 15

In comparing CSF and blood, the pH of CSF is ______ than that found in the blood, and the one electrolyte found in higher concentration in CSF than in blood is ______.(answer format: blank 1, blank 2)

A)lower, sodium
B)higher, potassium
C)lower, chloride
D)higher, bicarbonate

Question 16

Which of the following statements are true of focal-onset seizures?
1)These seizures begin in a discrete region of the brain and then have varying degrees and patterns of spread.
2)These seizures begin at any point throughout the brain.
3)These seizures are usually caused by some localized abnormality of the brain that can sometimes be identified by using brain-imaging procedures such as CT or MRI.
4)Frequent causes of these seizures include stroke, brain tumors, birth injuries, or severe head injury.

A)1, 2, 3
B)1, 2, 4
C)1, 3, 4
D)2, 3, 4

Question 17

Based on electrophoretic results, prealbumin makes up what percentage of spinal fluid proteins?

A)2% to 7%
B)56% to 76%
C)3.5% to 12%
D)8% to 18%

Question 18

Which type of meningitis is most likely indicated by the following laboratory data on a spinal fluid sample?
WBC - 400 cells/mm³, primarily lymphocytes
Protein: 35 mg/dL
Glucose: 55mg/dL

A)bacterial
B)fungal
C)cryptococcal
D)viral