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
ANS: D
Neutrophils increase in response to a bacterial infection. Thus if most of the cells seen in a CSF are neutrophils, then a gram stain and bacterial cultures should be performed on the CSF. It is critical that the specimen be handled in a sterile manner until these tests have been performed; often a separate CSF tube is used for culture than that for cell counts.
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