Body Cavity/Joint Effusion

Question 1

Is fluid normal in horse abdomen?

Answer 1

Yes, RI available

Question 2

Is fluid normal in small animal abdomen

Answer 2

No - always abnormal!

Question 3

What is ‘third spacing’

Answer 3

Fluid in abdomen of small animals (abnormal finding)

Question 4

Lab analysis of cavitary effusion

Answer 4

• Gross findings: (color, transparency, turbidity)
• Protein concentration
• TNCC
• Smear –> direct or sediment
• Tests (urea, creatinine, etc)

Question 5

T/F - fluid accumulation is evidence of a pathologic process

Answer 5

True

Question 6

Pure transudates (gross, protein, TNCC, microscop)

Answer 6

Gross: clear, colorless, watery

Protein: low (<2g/dl)

TNCC: low (1.5 x 10³)

Micropscop: mixed cells, macs/lymphs/mesothelial cells

Question 7

4 causes of pure transudates

Answer 7

• Due to protein loss - reduced COP –> fluid moves out*
  1. protein loss nephropathy
  2. protein loss enteropathy
  3. protein loss dermatrophaty (burns)
  4. liver cirrhosis (no albumin made)
• Also due to increased hydraulic pressure and lymphatic obstruction*

Question 8

You remove some fluid from a cat’s abdomen. It looks like this. How would you classify it?

Answer 8

Pure exudate

• small mixed cell population, some macs and lymphs

Question 9

Obstructive (modified) transudates (gross, protein, TNC, microscopic)

Answer 9

Gross: serosanguinous, hazy, bloody

Protein: high (>2g/dl)

TNCC: variable

Microscop: large mixed cell population, non-degen. neuts, some macs/lymphs, reacitve mesothelial cells

Question 10

Causes of obstructive/modifed transudate

Answer 10

• Increased permeability of capillaries in liver, lungs*
• Protein rich b/c more proteins pass through
• Increased hydraulic pressure*
• -* Hepatic congestion
• CHF
• Lymphatic obstruction*
• Leakage from thoracic duct

Question 11

Your transudate sample contains these cells. What are they?

Answer 11

Mesothelial cells (i think these are normal)

• Line body wall/organs

When reactive: basophilic cytoplasm, binucleated (sometimes)

Question 12

You take an effusion sample from a dog’s abdomen. Grossly, it is serousanguinous and blood. You stick it under a microscope - identify the transudate

Answer 12

Obstructive

• non-degen neuts, macs.
• could be exudate (both are mixed cell populations) but gross appearance = obstructive

Question 13

Exudate (gross, protein, TNCC, microscop)

Answer 13

Gross: turbidy, bloody or yellow/white

Protein: high (>3.5g/dl) - due to high cell #

TNCC: high (>8 x 10³)

Microscop: mixed cell pop., non-degens or degens, some macs/lymphs, some reactive mesothelial

Question 14

Cause of exudate effusions

Answer 14

1. Cytokines (increased permeability)
   - High TNCC, high protein –> reduced COP
2. Increased hydraulic pressure
   - Increased blood to inflammed tissue

Question 15

You take a sample from a cat’s abdomen and it is cloudy and turbid. This is its smear - what is it

Answer 15

Exudate

• mixed cells, gross appearnace

Question 16

Causes of reactive mesothelial cells

Answer 16

1. Chronic irritation by inflammatory effusions
2. Chronic irritation by neoplastic effusions

Question 17

Whats an equine inflammatory exudate called

Answer 17

Equiine peritonitis

Causes:

• devitaliation of intestines

Question 18

Appearance of FIP effusion

Answer 18

Gross: yellow

Protein: very high

TNCC: variable

Microscopic: neuts, macs

Question 19

Bile peritonitis appearance, cytology, cause

Answer 19

Gross: green/brown

Protein: high

TNCC: high

Microscopic: neuts, macs

cause: rupture of biliary system, liver, intestine

Question 20

What type of effusion? label a and b

Answer 20

Bile peritonits

A: free bile

B: macrophage with bile

Question 21

Uroperitoneum appearance, cytology, cause

Answer 21

gross: serosanguinonus, smells like urine

protein: variable

tncc: variable

microscopic: transudate to exudate

urea, creatine > than blood

cause: rupture bladder, ureter, kidney etc

Question 22

What’s this?

Answer 22

Ureoperitoneum (urea crystals formed by heating fluid)

Question 23

hemoperitoneum appearance, cytology, cause

Answer 23

gross; blood-like, doesnt clot

protein: variable

TNCC: variable

microscopic: erythophagia, hemosiderphagia

cause: splenic rupture, warfarin, hemorrhagic effuson

Question 24

whats this? what type of effusion?

Answer 24

a: erythrophage
b: hemosiderophage
* hemoperitoneum/thorax*

Question 25

how can you tell the difference between blood and hemoperitoneum

Answer 25

Platelets: absent in hemoperiotneum

Erythrophagia/hemosiderophagia: absent in blood

Question 26

Chylous effusion appearnace, cytology, cause

Answer 26

gross: white

protein: variable

tncc: variable

microscopic: small mature lymphs

cause: leakage from thoracic duct

Question 27

neoplastic effusion appearance, cytology,

Answer 27

gross: bloody, turbid protein rich exudate

protein: high

tncc: variable

microscopic: criteria for malignancy, inflammatory cells

Question 28

What effusion type would this smear likely come from

Answer 28

chylous - lots of lymphs

Question 29

effusion type?

Answer 29

neoplastic