Body Cavity Fluids

Question 1

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

Answer 1

pleural
peritoneal
pericardial

Question 2

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

Answer 2

horses
other large animals

Question 3

how is body cavity fluid formed?

Answer 3

plasma filtrate: leaves capillaries and diffuses

Question 4

how are fluids removed from the body cavities?

Answer 4

lymphatic system: returns to plasma

Question 5

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

Answer 5

starling forces
vascular permeability
mesothelial lining integrity
lymphatic drainage

Question 6

what determines which molecules enter the extravascular space?

Answer 6

molecular size

Question 7

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

Answer 7

very few cells
very little protein

Question 8

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

Answer 8

no

Question 9

what does fluid accumulation indicate?

Answer 9

a pathologic process of fluid production/removal system

Question 10

what can cause effusions?

Answer 10

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

Question 11

what are the mechanisms of body cavity effusions?

Answer 11

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

Question 12

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

Answer 12

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

Question 13

what is the most common sign of severe effusion?

Answer 13

dyspnea (any type of effusion)

Question 14

what are some indications for abdominocentesis or thoracocentesis?

Answer 14

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

Question 15

which tubes should you collect effusions into?

Answer 15

purple top
red top

Question 16

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

Answer 16

culture
biomedical analysis

Question 17

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

Answer 17

straw
yellow
gray
green

Question 18

which effusions often coagulate to some extent?

Answer 18

inflammatory effusions

Question 19

can an EDTA sample be used for bacterial culture?

Answer 19

no

Question 20

how is protein in effusions measured?

Answer 20

chemistry analyzer
total solids on refractometer

Question 21

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 _____________________

Answer 21

objective power squared

Question 22

what effective solutes actively change the refractive index of light?

Answer 22

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

Question 23

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

Answer 23

concentrated smears
always do a direct smear too

Question 24

should you fix body cavity effusion slides?

Answer 24

yes: need it to be super well fixed

Question 25

when looking at an effusion with a microscope, what should you do if there are a lot of neutrophils?

Answer 25

pay close attention to morphology

Question 26

how much of an effusion should be neutrophils?

Answer 26

<10%
except for horses

Question 27

are eosinophils and mast cells normal in effusions?

Answer 27

no
increased in some inflammatory and neoplastic conditions

Question 28

what are toxic neutrophils?

Answer 28

cytoplasmic changes
happen in bone marrow
in response to inflammation

Question 29

what are degenerate neutrophils?

Answer 29

nuclear changes
happen at site of inflammation
in response to infection

Question 30

what is the main purpose of mesothelial cells?

Answer 30

produce lubricating fluid

Question 31

what does accumulation of fluid in body cavities result in with mesothelial cells?

Answer 31

hyperplasia and eexfoliation

Question 32

what is classification of body cavity effusions based upon?

Answer 32

protein concentration/total solids
total nucleated cell count

Question 33

what are some normal findings in small animals of body cavity effusions?

Answer 33

predominance of minimally reactive macrophages
low number of small lymphocytes
low number of mesothelial cells

Question 34

how much protein does transudate have in small animals?

Answer 34

<2.5g/dL

Question 35

how is nonseptic exudate distinguished from septic exudate in small animals?

Answer 35

nonseptic: non-degenerate neutrophils
septic: degenerate neutrophils with intracellular bacteria or other visible pathogens

Question 36

what characterizes exudate in large animals?

Answer 36

protein >3.0g/dL
cell count/microliter >10,000

Question 37

what are the possible mechanisms of transudates?

Answer 37

reduced plasma oncotic pressure: passive fluid shifting, decreased albumin
increased hydrostatic pressure

Question 38

what clinical conditions can result in transudate?

Answer 38

liver disease
intestinal disease
renal disease
iatrogenic: relative decrease in plasma albumin

Question 39

how do protein-rich transudates occur?

Answer 39

transudative mechanisms
modified by addition of protein and/or cells
may result from variety of clinical conditions

Question 40

how do exudates occur?

Answer 40

increased vascular permeability and inflammation: active process
septic or non-septic

Question 41

what clinical conditions can result in non-septic exudates?

Answer 41

long-standing transudates
chemical peritonitis
feline infectious peritonitis
miscellaneous causes

Question 42

what are some clinical conditions that can result in septic exudates?

Answer 42

puncture wounds
bite wounds
perforation of intestinal tract
abscessation of internal organs
iatrogenic