Body Cavity/Joint Effusion Flashcards
Is fluid normal in horse abdomen?
Yes, RI available
Is fluid normal in small animal abdomen
No - always abnormal!
What is ‘third spacing’
Fluid in abdomen of small animals (abnormal finding)
Lab analysis of cavitary effusion
- Gross findings: (color, transparency, turbidity)
- Protein concentration
- TNCC
- Smear –> direct or sediment
- Tests (urea, creatinine, etc)
T/F - fluid accumulation is evidence of a pathologic process
True
Pure transudates (gross, protein, TNCC, microscop)
Gross: clear, colorless, watery
Protein: low (<2g/dl)
TNCC: low (1.5 x 103)
Micropscop: mixed cells, macs/lymphs/mesothelial cells
4 causes of pure transudates
- 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*
You remove some fluid from a cat’s abdomen. It looks like this. How would you classify it?
Pure exudate
- small mixed cell population, some macs and lymphs
Obstructive (modified) transudates (gross, protein, TNC, microscopic)
Gross: serosanguinous, hazy, bloody
Protein: high (>2g/dl)
TNCC: variable
Microscop: large mixed cell population, non-degen. neuts, some macs/lymphs, reacitve mesothelial cells
Causes of obstructive/modifed transudate
- 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
Your transudate sample contains these cells. What are they?
Mesothelial cells (i think these are normal)
- Line body wall/organs
When reactive: basophilic cytoplasm, binucleated (sometimes)
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
Obstructive
- non-degen neuts, macs.
- could be exudate (both are mixed cell populations) but gross appearance = obstructive
Exudate (gross, protein, TNCC, microscop)
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
Cause of exudate effusions
- Cytokines (increased permeability)
- High TNCC, high protein –> reduced COP - Increased hydraulic pressure
- Increased blood to inflammed tissue
You take a sample from a cat’s abdomen and it is cloudy and turbid. This is its smear - what is it
Exudate
- mixed cells, gross appearnace
Causes of reactive mesothelial cells
- Chronic irritation by inflammatory effusions
- Chronic irritation by neoplastic effusions
Whats an equine inflammatory exudate called
Equiine peritonitis
Causes:
- devitaliation of intestines
Appearance of FIP effusion
Gross: yellow
Protein: very high
TNCC: variable
Microscopic: neuts, macs
Bile peritonitis appearance, cytology, cause
Gross: green/brown
Protein: high
TNCC: high
Microscopic: neuts, macs
cause: rupture of biliary system, liver, intestine
What type of effusion? label a and b
Bile peritonits
A: free bile
B: macrophage with bile
Uroperitoneum appearance, cytology, cause
gross: serosanguinonus, smells like urine
protein: variable
tncc: variable
microscopic: transudate to exudate
urea, creatine > than blood
cause: rupture bladder, ureter, kidney etc
What’s this?
Ureoperitoneum (urea crystals formed by heating fluid)
hemoperitoneum appearance, cytology, cause
gross; blood-like, doesnt clot
protein: variable
TNCC: variable
microscopic: erythophagia, hemosiderphagia
cause: splenic rupture, warfarin, hemorrhagic effuson
whats this? what type of effusion?
a: erythrophage
b: hemosiderophage
* hemoperitoneum/thorax*
how can you tell the difference between blood and hemoperitoneum
Platelets: absent in hemoperiotneum
Erythrophagia/hemosiderophagia: absent in blood
Chylous effusion appearnace, cytology, cause
gross: white
protein: variable
tncc: variable
microscopic: small mature lymphs
cause: leakage from thoracic duct
neoplastic effusion appearance, cytology,
gross: bloody, turbid protein rich exudate
protein: high
tncc: variable
microscopic: criteria for malignancy, inflammatory cells
What effusion type would this smear likely come from
chylous - lots of lymphs
effusion type?
neoplastic
