Question 1

What is the fluid collected from the subarachnoid space?

Accepted Answer

A) Pleural fluid 
B) Pericardial fluid 
C) Synovial fluid 
D) Cerebrospinal fluid

Question 2

What are the morphological characteristics of the following cell types that will help the technologist differentiate between them?
A)Mesothelial cell
B)Adenocarcinoma
C)Leukemic blasts
D)Small-cell carcinoma

Accepted Answer

The answer of What are the morphological characteristics of the...

Question 3

This type of fluid is milky in appearance and is formed from long standing effusions due to chronic conditions.

Accepted Answer

A) Transudate 
B) Pseudochylous 
C) Exudates 
D) Chylous

Question 4

An exudative effusion can be caused by many different pathologic processes, such as bacterial infections, viral infections, neoplasms, and collagen vascular diseases.What are the typical laboratory results of an exudate?

Accepted Answer

A) Specific gravity is less than 1.015, total protein is >3.0 g/dL, a ratio of total fluid protein to serum protein is >0.5, a ratio of fluid LD to serum LD is >0.6, and usually a total leukocyte count is >1000/µL. 
B) Specific gravity is less than 1.015, a total protein is  1.015, a total protein > 3.0 g/dL, a ratio of total fluid protein to serum protein >0.5, a ratio of fluid LD to serum LD >0.6, and usually a total leukocyte count > 1000µL.

Question 5

The ability to bend light rays against both fixed and rotating filters is:

Accepted Answer

A) Xanthochromia. 
B) Birefringence. 
C) Thermal reactivity. 
D) Nephelometry.

Question 6

A specimen labeled "ascites" is sent to the laboratory.What type of procedure was used to obtain this fluid?

Accepted Answer

A) Thoracentesis 
B) Lumbar puncture 
C) Arthrocentesis 
D) Paracentesis

Question 7

Cells found in fluids can be reactive mesothelial cells, or malignant cells.Which features are found in reactive cells but not in malignant cells?

Accepted Answer

A) Smooth nuclear membranes 
B) Chromatin unevenly distributed 
C) Nucleoli prominent and frequently multiply 
D) Nuclear molding

Question 8

An unknown crystal exhibits positive birefringence.It is rhomboid in appearance.What is the most likely identification of the unknown crystal?

Accepted Answer

A) Monosodium urate 
B) Starch particles 
C) Cholesterol crystals 
D) Calcium pyrophosphate

Question 9

The following results are obtained from a 38-year-old woman with congestive heart failure: 
-Specimen: pleural fluid
-Fluid protein = 4.5 g/dl
-Serum protein = 9.5 g/dl
-Serum LD = 110 U/L
-Fluid LD = 60 U/L
These results are most consistent with which of the following?

Accepted Answer

A) Chylous effusion 
B) Exudate 
C) Transudate 
D) Normal pleural fluid

Question 10

A patient with rheumatoid arthritis has fluid collected from his knee.The fluid has crystals that have a notched-plate shape.They are also birefringent.These crystals are most likely:

Accepted Answer

A) Calcium pyrophosphate. 
B) Monosodium urate. 
C) Steroid. 
D) Cholesterol.

Question 11

A technologist is scanning a cytospin, and notices a few solid-staining wrinkled bodies on the cytospin prep.What is the most likely identification of this?

Accepted Answer

A) Histoplasma infiltration 
B) Cryptococcus infiltration 
C) Candidiasis 
D) Bacterial contamination

Question 12

The most pathogenic yeasts are found in the CSF rather than in the other types of fluids.Which yeast is described as small and often intracellular, with a distinct nonstaining cell wall?

Accepted Answer

A) Cryptococcus 
B) Candida albicans 
C) Candida tropicalis 
D) Histoplasma

Question 13

Which of the following is responsible for the production of cerebrospinal fluid?

Accepted Answer

A) Arachnoid cells 
B) Choroid plexus cells 
C) Pia mater 
D) Ventricles

Question 14

A technologist is performing a body fluid analysis on a CSF specimen recently received in the laboratory.Four CSF tubes were sent to the body fluids bench.The tech notices that all four specimens seem moderately blood-tinged equally.Moderate xanthochromia was also noted.He performs the cytospin differential and notices many macrophages with black crystals and round, pink intracellular bodies.What is the most likely reason for the aforementioned findings?

Accepted Answer

A) Traumatic specimen collection 
B) The patient has a CNS lymphoma. 
C) The patient is suffering from a subdural hemorrhage. 
D) The wrong patient was drawn.

Question 15

Examination of joint fluid on a 60-year-old patient with right knee pain reveals many intracellular needlelike crystals that polarize yellow to blue.What is the most likely identification of the crystal?

Accepted Answer

A) Calcium pyrophosphate 
B) Cholesterol crystal 
C) Monosodium urate 
D) Talc particle

Question 16

How would the technologist differentiate between a traumatic specimen collection and a cerebral hemorrhage? Provide at least three macroscopic and three microscopic findings.

Accepted Answer

The answer of How would the technologist differentiate between a...

Question 17

Necrotic PMNs in a cytospin can be easily mistaken for which of the following?

Accepted Answer

A) Nucleated RBCs 
B) Hairy cells 
C) Leukemic blasts 
D) Hypersegmented PMNs

Question 18

Joint fluid from a patient with knee pain revealed many monosodium urate crystals.These crystals are associated with:

Accepted Answer

A) Gout. 
B) Pseudo-gout. 
C) Rheumatoid arthritis. 
D) Recent treatment with steroids.

Question 19

When evaluating a CSF for a hemorrhage or a traumatic tap, what laboratory results would be expected if it were a traumatic tap?

Accepted Answer

A) Tube 1 would have a lower red cell count than Tube 4. 
B) Tube 1 would have a higher red cell count than Tube 4. 
C) Tube 1 would show xanthochromia and Tube 4 would show no xanthochromia. 
D) Tube 1 would not have any cells but tube 4 would have many crenated cells.

Exam 27: Morphologic Analysis of Body Fluids in the Hematology Laboratory