Deck 18: Body Fluid Analysis in the Hematology Laboratory

Question 1

Which of the following is a feature of malignant cells in fluids?

A)small size
B)three-dimensional clumps with no "windows"
C)low nuclear-to-cytoplasmic (N:C) ratio
D)uniformity

Answer 1

three-dimensional clumps with no "windows"

Question 2

Which of the following is normal in a CSF?

A)ependymal cells
B)100 white cells per mm3
C)blasts
D)mesothelial cells

Answer 2

ependymal cells

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.

Answer 3

This is blood contaminating the CSF fluid from a traumatic puncture.

Question 4

Which of the following is true regarding bronchoalveolar lavage (BAL)fluids?

A)The differential is not done on these fluids.
B)It is often received from patients suspected of having asthma.
C)Moving ciliated cells suggest that the patient has Pneumocystis carinii.
D)A mask should be worn when performing tests.

Question 5

What determines whether or not body fluids are diluted before counting?

A)appearance of the fluid
B)type of fluid
C)patient's diagnosis
D)whether or not the fluid needs to go to other sections of the laboratory for additional testing

Question 6

Nucleated red blood cells (NRBCs)and immature white cells in a CSF most likely mean

A)bacterial meningitis.
B)patient has NRBCs in the peripheral blood.
C)subarachnoid hemorrhage.
D)bone marrow contamination.

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?

A)pseudo-gout
B)gout
C)lupus erythematosus
D)bacterial infection

Question 8

What determines the amount of fluid used for a cytocentrifuge preparation?

A)type of fluid
B)desired speed of centrifugation
C)number of cells
D)amount of fluid collected

Question 9

Why should spinal fluid tests be performed within 30 minutes of collection?

A)Cells begin to deteriorate quickly.
B)The conditions detected by the tests are often life threatening.
C)They are often ordered "stat."
D)All of the above are true.

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?

A)bacterial meningitis
B)viral meningitis
C)subarachnoid hemorrhage
D)traumatic tap

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/mm³ or /mL?

A)99
B)1980
C)2200
D)22,000

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?

A)normal fluid
B)transudate on a patient with a pleural bacterial infection
C)exudate on a patient with a pleural bacterial infection
D)exudate on a patient with heart failure

Question 13

Which of the following is true regarding malignant cells in serous fluids?

A)All clumps of large cells should be considered malignant.
B)Malignant cells in serous fluids are rarely seen.
C)Malignant cells categorize the fluid as a transudate.
D)Care must be taken to distinguish malignant cells from clumps of mesothelial cells.

Question 14

If most of the white cells are neutrophils on the previously discussed CSF,what additional test should be performed?

A)cytology
B)flow cytometry
C)lactate dehydrogenase
D)Gram stain and bacterial cultures

Question 15

How must synovial fluids be handled differently than other fluids?

A)Perform a Gram stain if bacteria are seen.
B)Dilute the fluid if the cell counts are high.
C)Add hyaluronidase to overcome the viscous nature of fluid.
D)Carefully search the whole cytospin preparation for malignant cells.

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.

Question 17

A hazy spinal fluid has 400 white cells per mm³ that are mostly lymphocytes and reactive lymphocytes.Which of the following is most likely?

A)bacterial meningitis
B)viral meningitis
C)infectious mononucleosis
D)multiple myeloma

Question 18

Which of the following are normal in serous fluids?

A)macrophages
B)bacteria
C)eosinophils (EOs)
D)LE cells