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Cytodiagnostics > Body Cavity Effusion Analysis > Flashcards

Body Cavity Effusion Analysis Flashcards

1
Q

What are the cells lining the body cavities?

A

mesothelial cells

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2
Q

What are the common causes of body effusions?

A

trauma

CV dz/altered starling forces

hemorrhage

neoplasia

infection/inflammation

ruptured organs

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3
Q

What is the most common clinical sign associated with severe effusions?

A

dyspnea

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4
Q

If you know there will be a delay in assessing the effusion sample, what should be done?

A

Make a direct smear at collection

store fluid in fridge

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5
Q

If performing an estimate of the cell count in an effusion, how can it be determined?

A

Average number of cells in at least 10 representative fields is multiplied by the square of the objective used to perform the count

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6
Q

What are the normal findings in a body cavity effusion for small animals?

A

minimal reactive mononuclear cells

low # of small lymphocytes & mesothelial cells

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7
Q

Normal effusion cellular makeup in the horse?

A

 Low numbers of mesothelial cells
 Minimally reactive mononuclear phagocytes
 Low number of small lymphocytes
Mature non-degenerate neutrophils often predominate

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8
Q

What are the cell # present in small animal & equine exudative effusions?

A

horse >10,000

small animals >5,000

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9
Q

What is a transudate?

A

Diffusion of plasma water from the vessels

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10
Q

What causes transudate effusions?

A

Reduced plasma oncotic pressure

Increased hydrostatic pressure

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11
Q

What clinical conditions result in transudate effusions?

A

Liver dz ( Portal hypertension
 Shunting
 Malnutrition
 Hepatic insufficiency)

Intestinal Dz (malabsorption/digestion, PLE)

Renal dz (PLN)

Iatrogenic fluid overload and dilution of plasma albumin

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12
Q

With acute transudates, what is the predominant cell type in small animals? In chronic transudates? Why?

A

acute: mononuclear
chronic: NT (fluid irritates mesothelial cells that release cytokines that recruit NT)

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13
Q

What causes exudate effusions?

A

inflammation results in increased vascular permeability

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14
Q

Clinical conditions that result in non-septic exudates?

A

chronic modified transudates

Chemical peritonitis: uroperitoneum, bile peritonitis

FIP

Misc: sterile FB, neoplasia, pancreatitis, abscessed organs

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15
Q

What question is critical to ask when assessing an exudate as being septic or not and you do not see any intracellular organisms but you do see degenerate NT?

A

did the animal receive abx?

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16
Q

What is the major difference between septic & non-septic exudates?

A

septic: degenerate NT with intracell organisms

non-septic: non-degenerate NT

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17
Q

What clinical condition could result in a septic exudate?

A

puncture/bite wound

perforation of the GI tract

abscessed organs

Iatrogenic

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18
Q

Abdominal effusion in a horse- protein >5 mg/dL, 30,000 cells

Type?

A

septic exudate

19
Q

How large would the difference in BG and effusion glucose have to be to indicate exudate?

A

>20 mg/dL

20
Q

What is the difference in vascular permeability in transudates vs. exudates?

A

transudates: normal
exudates: increased

21
Q

Clinical conditions that result in modified transudate effusions?

A

CHF (peritoneal in dogs, pleural in cats)

thrombosis of CVC

Misc: diaphragmatic/ peritoneal/pericardial hernias, organ torsion (acute), neoplasia

22
Q

Main difference between modified transudate & transudate?

A

MT: higher protein and cells

23
Q

Main reason for modified transudates to occur?

A

increased hydrostatic pressure

24
Q

How does a chylous effusion appear grossly and cytologically?

A

gross: pale, turbid, white
cytology: lymphocytes dominant, macrophages/NT with lipid vacuoles

25
Q

What causes chylous effusions?

A

blockage of the lymphatics

26
Q

What levels of triglycerides would make you suspicious for a chylous effusion?

A

>100 mg/dL

27
Q

Clinical conditions that result in chylous effusions?

A

lymphangiectasia: physical vs. functional obstructions

physical (congenital, fungal, neoplasia, venous thrombus)

functional (cardiac dz (common in cat)/HW dz)

Idiopathic (dogs)

diaphragmatic hernia, lung lobe torsion, thoracic duct rupture

28
Q

Where do chylous effusions typically occur?

A

thoracic cavity

29
Q

What test would you like to run on this effusion obtained from the thorax of a cat to confirm your suspicion? What is the most likely dx?

A

TG (if >100= chylous)

Cardiac dz

30
Q

What is the component of pseudochylous effusions that makes it appear chylous?

A

cholesterol from breakdown products in chronic effusions

31
Q

A foal presents with lethargic and dyspnea. An amber colored fluid is removed from the abdomen. On chemistry, the foal has a ____ & _____. What is the diagnostic test result that will confirm your suspicion of uroperitoneum?

A

hyperK & hypoNa

fluid: Creatinine ration >2:1

32
Q

A yellow/green/brown colored fluid is removed from the abdomen of a dog. The cytology indicate what likely dx? What test can confirm your suspicion?

A

Bile peritonitis

Fluid:Serum bilirubin concentration >2:1

33
Q

A feline presents with a light amber color fluid from the abdomen. TP >5 g/dL. What is the likely dx? What on the cytology indicated that?

A

FIP

granular eosinophilic background, protein crescents

34
Q

What Albumin:Globulin ratio in effusions with a
total protein >3.5 g/dL and neutrophilic and
macrophagic inflammation would exclude FIP? Include FIP?

A

Exclude: >0.8

Include: <0.45

35
Q

Acute or chronic hemorrhage?

A

Chronic (hemosiderin breakdown products in macrophage)

36
Q

Type of effusion? Characteristics? Acute or chronic?

A

Hemorrhagic (erythrophagia & hemosiderin breakdown products, PCV 10-25% of peripheral blood)

Acute (erythrophagia), chronic (hemosiderin breakdown products)

37
Q

True hemorrhage or iatrogenic? How do you know?

A

True hemorrhage (erythrophagia)

iatrogenic: would have PLT

38
Q

True hemorrhage or iatrogenic?

A

Iatrogenic

39
Q

Clinical conditions that can cause hemorrhagic effusions?

A
  1. Trauma
  2. Acquired clotting disorder (Rodenticide)
  3. Inherited clotting disorders
  4. Idiopathic/benign (dogs & horses)
  5. Neoplasia (hemangiosarcoma, adrenal tumors, thyroid carcinoma)
40
Q

Most common clinical condition associated with chylous and hemorrhagic effusions in dogs?

A

Idiopathic

41
Q

If you are concerned fro lymphoma vs. chylous effusion, what test can be run?

A

PPAR

42
Q

Type of effusion?

A

Neoplastic (carcinoma)

43
Q

Most common type of neoplasia seen with neoplastic effusions?

A

hemangiosarcoma

adrenal tumors

thyroid carcinoma

mesothelioma

Cytodiagnostics (9 decks)

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