Body Cavity Fluids Flashcards

1
Q

what cavities are often known as serous cavities because they contain a small amount of clear watery fluid in health?

A

pleural
peritoneal
pericardial

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2
Q

which animals have enough cavitary fluid in health for collection and analysis?

A

horses
other large animals

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3
Q

how is body cavity fluid formed?

A

plasma filtrate: leaves capillaries and diffuses

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4
Q

how are fluids removed from the body cavities?

A

lymphatic system: returns to plasma

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5
Q

what are the constituents and amount of fluid in body cavities dependent upon?

A

starling forces
vascular permeability
mesothelial lining integrity
lymphatic drainage

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6
Q

what determines which molecules enter the extravascular space?

A

molecular size

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7
Q

how many cells and how much protein is in a healthy body cavity fluid?

A

very few cells
very little protein

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8
Q

is an increased amount of fluid in body cavities a disease?

A

no

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9
Q

what does fluid accumulation indicate?

A

a pathologic process of fluid production/removal system

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10
Q

what can cause effusions?

A

an imbalance in what is entering and leaving through the normal mechanisms
ectopic sources such as ruptured hollow organs

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11
Q

what are the mechanisms of body cavity effusions?

A

alteration in one of the components of Starling equilibrium
impaired fluid drainage
increased vascular permeability
hemorrhage
less common: trauma to hollow organ

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12
Q

what might you see on a physical exam of a patient with body cavity effusions?

A

muffled heart and lung sounds
abdominal effusion
palpable fluid wave
cough
pulsus paradoxus

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13
Q

what is the most common sign of severe effusion?

A

dyspnea (any type of effusion)

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14
Q

what are some indications for abdominocentesis or thoracocentesis?

A

underlying etiology of the effusion can bee characterized
determine presence of inflammation and/or neoplasia
therapeutic centesis

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15
Q

which tubes should you collect effusions into?

A

purple top
red top

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16
Q

what can you use fluid from a red top tube for?

A

culture
biomedical analysis

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17
Q

what might be the color of an effusion with nucleated cells?

A

straw
yellow
gray
green

18
Q

which effusions often coagulate to some extent?

A

inflammatory effusions

19
Q

can an EDTA sample be used for bacterial culture?

20
Q

how is protein in effusions measured?

A

chemistry analyzer
total solids on refractometer

21
Q

to estimate the cell count from a direct smear, count the number of cells in 5-10 fields, and multiply thee average of cells by _____________________

A

objective power squared

22
Q

what effective solutes actively change the refractive index of light?

A

glucose
sodium
BUN
lipemic fluids often do not clear enough with routine centrifugation

23
Q

how can you prepare a slide of low-cellularity fluids?

A

concentrated smears
always do a direct smear too

24
Q

should you fix body cavity effusion slides?

A

yes: need it to be super well fixed

25
when looking at an effusion with a microscope, what should you do if there are a lot of neutrophils?
pay close attention to morphology
26
how much of an effusion should be neutrophils?
<10% except for horses
27
are eosinophils and mast cells normal in effusions?
no increased in some inflammatory and neoplastic conditions
28
what are toxic neutrophils?
cytoplasmic changes happen in bone marrow in response to inflammation
29
what are degenerate neutrophils?
nuclear changes happen at site of inflammation in response to infection
30
what is the main purpose of mesothelial cells?
produce lubricating fluid
31
what does accumulation of fluid in body cavities result in with mesothelial cells?
hyperplasia and eexfoliation
32
what is classification of body cavity effusions based upon?
protein concentration/total solids total nucleated cell count
33
what are some normal findings in small animals of body cavity effusions?
predominance of minimally reactive macrophages low number of small lymphocytes low number of mesothelial cells
34
how much protein does transudate have in small animals?
<2.5g/dL
35
how is nonseptic exudate distinguished from septic exudate in small animals?
nonseptic: non-degenerate neutrophils septic: degenerate neutrophils with intracellular bacteria or other visible pathogens
36
what characterizes exudate in large animals?
protein >3.0g/dL cell count/microliter >10,000
37
what are the possible mechanisms of transudates?
reduced plasma oncotic pressure: passive fluid shifting, decreased albumin increased hydrostatic pressure
38
what clinical conditions can result in transudate?
liver disease intestinal disease renal disease iatrogenic: relative decrease in plasma albumin
39
how do protein-rich transudates occur?
transudative mechanisms modified by addition of protein and/or cells may result from variety of clinical conditions
40
how do exudates occur?
increased vascular permeability and inflammation: active process septic or non-septic
41
what clinical conditions can result in non-septic exudates?
long-standing transudates chemical peritonitis feline infectious peritonitis miscellaneous causes
42
what are some clinical conditions that can result in septic exudates?
puncture wounds bite wounds perforation of intestinal tract abscessation of internal organs iatrogenic