Which of the following is true regarding bronchoalveolar lavage ...

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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 2

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 receives simultaneously 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.

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Answer to Question 1

ANS: D
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.

Answer to Question 2

ANS: B
A CSF fluid is always stat, and evaluation is critical for good patient care. The cells will rapidly disintegrate, just as for all body fluid specimens, and so they must be examined within 30 minutes of draw. Diagnostic information obtained from examination of CSF fluid can be extremely important for timely and appropriate patient care; therefore in this scenario the CSF must be examined first and immediately. The clinical relevance of information obtained from hematologic examination of BAL fluid is minimal, and some hematology laboratories no longer perform counts and/or cytocentrifuge preparations on these specimens because the biohazard risk outweighs the clinical usefulness.

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