AUBF Book Flashcards
serum like fluids formed as plasma ultrafiltrate which provides lubrication in the cavities they are found
serous fluid
membrane that lines the cavity
parietal membrane
membrane that covers the organ
visceral membrane
alteration to the oncotic and hydrostatic pressure can cause fluid buildup between the two membranes called
effusion
Increased hydrostatic pressure
Decreased oncotic pressure
Transudate
Increased capillary permeability
Lymphatic obstruction
Exudate
Congestive heart failure
Salt and fluid retention
Increased hydrostatic pressure
Nephrotic syndrome
Hepatic cirrhosis
Malnutrition
Protein-losing enteropathy
Decreased oncotic pressure
Microbial infections
Membrane inflammations
Malignancies
Increased capillary permeability
Malignant tumors
Lymphomas
Infection and inflammation thoracic duct injury
lymphatic obstruction
result from systemic disorders that disrupt fluid regulation
Transudates
produced by conditions that directly affect the membranes of the specific cavity
Exudates
Preferred parameters for pleural and pericardial fluid
Fluid: serum protein ration
Fluid: serum LD ratio
Appearance: Clear
Fluid : Serum Protein Ratio: <0.5
Fluid : Serum LD Ratio: <0.6
WBC Count: < 1000 WBC c/uL
Spontaneous clotting: No
Pleural fluid cholesterol: <45 to 60 mg/dL
Pleural fluid : Serum Cholesterol Ratio <0.3
Pleural Fluid: Bilirubin Ratio: <0.6
Serum Ascites Albumin Gradient: >1.1
Transudate
Appearance: Cloudy/Turbid
Fluid : Serum Protein Ratio: >0.5
Fluid : Serum LD Ratio: >0.6
WBC Count: > 1000 WBC c/uL
Spontaneous clotting: Possible
Pleural fluid cholesterol: >45 to 60 mg/dL
Pleural fluid : Serum Cholesterol Ratio >0.3
Pleural Fluid: Bilirubin Ratio: >0.6
Serum Ascites Albumin Gradient: <1.1
Exudate
Collection tube for serous fluid:
cell counts, morphology, and differential count
EDTA
Collection tube for serous fluid:
chemistry
clotted specimens
Collection tube for serous fluid:
microbiology and cytology
sterile heparin
SPS
Collection tube for serous fluid:
pH analysis
anaerobically on ice
Turbid appearance of Pleural Fluid indicates:
presence of WBC (indicates infection like TB)
Bloody appearance of pleural fluid
Hemothorax/Hemmorhagic exudate
test to differentiate hemothorax and hemorrhagic exudate
Hematocrit
> 50% hemothorax
<50% hemorrhagic exudate
Presence is caused by traumatic injury in pleural fluid
Hemothorax
Caused by malignancies in pleural fluid
Hemorrhagic exudate
Pleural fluid appearance:
rupture of amebic liver abscess
brown
Pleural fluid appearance:
Black
aspergillosis
Pleural fluid appearance:
viscous
Malignant mesothelioma (increased hyaluronic acid)
Pleural fluid appearance:
Milky
Chylous
Pseudochylous
Chylous and Pseudochylous appearance can be differentiated by
TAG determination
Pleural fluid appearance:
milky and white
chylous
Pleural fluid appearance:
milky and green
pseudochylous
> 110 mg/dL TAG
no cholesterol crystals
Lymphocytes are predominant
Chylous pleural fluid
<50 mg/dL
Cholesterol crystals are present
Mixed cells
Pseudochylous
Cells in plural fluid:
Pneumonia, Pancreatitis, Pulmonary infarction
Neutrophils
Cells in plural fluid:
Tuberculosis, viral infection, autoimmune disorders, malignancy
lymphocytes
Cells in plural fluid:
normal, reactive forms, have no significance, decreased in cases of tuberculosis
mesothelial cells
Substances in pleural fluid
Glucose, Lactate, TAG, ADA, Amylase, pH
Substances in pleural fluid:
Normally parallel to plasma level
Glucose
Substances in pleural fluid:
Decreased in rheumatoid inflammation, TB, malignancy, and infections
<60 mg/dl
GLUCOSE
Substances in pleural fluid:
Increased in bacterial infections
Lactate
Substances in pleural fluid:
Increased in chylous effusions
> 110 mg/dL
TAG
Substances in pleural fluid:
Indicative of TB and also elevated in malignancy
ADA (amino deaminase)
Substances in pleural fluid:
Increased in pancreatitis, esophageal rupture, and malignancy
Amylase
pH level in pleural fluid:
Esophageal rupture allowing influx of gastric acid
6.0
pH level in pleural fluid:
Indicates need for chest tube drainage
<7.2
pH level in pleural fluid:
Malignancies
> 7.4
Autoantibodies and Tumor markers:
Immunologic vs. Non-immunologic
ANA and RF
Autoantibodies and Tumor markers:
Colorectal cancer
CEA
Autoantibodies and Tumor markers:
Metastatic uterine carcinoma
CA 125
Autoantibodies and Tumor markers:
Breast cancer
CA 15.3
CA 549
Autoantibodies and Tumor markers:
Lung cancer
Breast cancer
CYFRA 21-1
Variation in appearance of pericardial fluid:
infection and malignancy
blood-streaked
Variation in appearance of pericardial fluid:
accidental cardiac puncture, anticoagulant medications
grossly bloody
Variation in appearance of pericardial fluid:
chylous and pseudochylous
milky
Cells in pericardial fluid:
bacterial endocarditis (s. viridans, s. epidermidis, HACEK)
neutrophils
Cells in pericardial fluid:
metastatic carcinoma
malignant cells
Sensitive test for the detection of intra-abdominal bleeding
Peritoneal lavage
____ RBC count indicative of blunt trauma injuries
> 100,000 cells/uL
contains concentric striations of collagen-like material seen in ovarian and thyroid malignancies
psammona bodies
Substances in peritoneal fluid:
Glucose, ALP, Amylase, BUN, Creatinine
Substances in peritoneal fluid:
Decreased in tubercular peritonitis and malignancies
Glucose
Substances in peritoneal fluid:
Increased in intestinal perforations
ALP
Substances in peritoneal fluid:
Increased in pancreatitis and intestinal perforations
Amylase
Substances in peritoneal fluid:
requested in cases of ruptured bladder or accidental bladder puncture
BUN and Creatinine