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Chemistry Module 1 > Body Fluids > Flashcards

Body Fluids Flashcards

1
Q

Explain the routing of a three-tube cerebrospinal fluid collection

A

Tube 1: Chemistry Serology
Tube 2: Microbiology
Tube 3: Hematology (Microbiology)
Tube 4: Additional Tests

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2
Q

What is the clinical significance of abnormal CSF appearance?

A

If its ever bloody, something is wrong

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3
Q

What is the typical appearance of CSF from a traumatic tap?

A

Blood decreases as more tubes of blood are taken

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4
Q

What is the typical appearance of a CSF from a patient with subarachnoid hemorrhage?

A

All tube will be equally bloody with xanthochromia

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5
Q

Aspects of a CSF protein:

- fraction that is in greatest concentration

A

albumin

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6
Q

Aspects of a CSF protein:

- 4 general conditions that cause its increase

A
  • inflammatory diseases
  • intracranial tumors
  • subarachnoid hemorrhage,
  • cerebral infarction
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7
Q

Aspects of a CSF protein:

- two most common specific causes of its increase

A
  • Damage to the blood brain barrier (meningitis and hemorrhage)
  • Bacterial meningitis
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8
Q

Aspects of a CSF protein:

- reason for its supurious elevation

A

spurious elevations occur when fluid is contaminated with serum or blood cells during traumatic tap

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9
Q

Clinical significance of an increased CSF IgG index calculation

A

Multiple sclerosis (MS)

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10
Q

Normal proportion of CSF glucose related to concomitant blood glucose measurements

A

Should be 60-70% of concomitant blood glucose

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11
Q

Specific clinical significance of CSF lactate measurements

A

Increased in any condition that decreases oxygen blood flow to the brain
- >25 mg/dL indicate bacterial, tubercular, or fungal meningitis, with a better predictive value than CSF glucose

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12
Q

Clincal significance of CSF lactate dehydrogenase isoenzyme measurements *

A

LD-1 and LD-2 are found in brain tissue
LD-2 and LD-3 are found in lymphocytes
LD-4 and LD-5 are found in neutrophils

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13
Q

Clinical significance of CSF creatine kinase isoenzyme measurements

A

CK-BB

- If elevated post cardiac arrest, a poor prognosis is indicated

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14
Q

BACTERIAL MENINGITIS

  • Clarity
  • CSF cell count
  • CSF protein
  • CSF glucose
  • Microbiological data
A
  • Clarity: Cloudy
  • CSF cell count: Mk’d increased neutrophils
  • CSF protein: much greater than 45 mg/dL
  • CSF glucose: (Mk’d decreased) much less than 50mg/dl
  • Microbiological data: possible positive gram stain; positive bacterial culture
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15
Q

VIRAL MENINGITIS

  • Clarity
  • CSF cell count
  • CSF protein
  • CSF glucose
  • Microbiological data
A
  • Clarity: Clear to cloudy
  • CSF cell count: Increased lymphocytes
  • CSF protein: > 45 mg/dL, NOT Mk’d increased
  • CSF glucose: Normal to slight decrease
  • Microbiological data: negative Gram stain for organisms or polys
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16
Q

FUNGAL MENINGITIS

  • Clarity
  • CSF cell count
  • CSF protein
  • CSF glucose
  • Microbiological data
A
  • Clarity: Clear to cloudy
  • CSF cell count: increased monocytes
  • CSF protein: > 45 mg/dL
  • CSF glucose: slightly decreased < 50 mg/dL
  • Microbiological data: positive gram stain and fungal culture; possibly positive India Ink if organism is encapsulated
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17
Q

Normal formation of serous fluid

- colloid osmotic pressure

A

COP is the pressure caused by protein. If protein is higher on one side of semi-permeable membrane, water tends to flow there to dilute it

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18
Q

Normal formation of serous fluid

- hydrostatic pressure

A

HP exerted by the pumping heart drives fluid OUT of the capillaries into tissue spaces and the serous cavity

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19
Q

Normal formation of serous fluid

- Capillary permeability

A

refers to the normal ability of water, protein, and particular matter from the extravascular space to be absorbed by the lymphatic system

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20
Q

Increased or decreased will cause the formation of effusions
- colloid osmotic pressure

A

DECREASED

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21
Q

Increased or decreased will cause the formation of effusions
- hydrostatic pressure

22
Q

Increased or decreased will cause the formation of effusions

- capillary permeability

23
Q

Increased or decreased will cause the formation of effusions

- lymphatic absorption

24
Q

Transudates

  • appearance
  • Specific gravity
A
  • Clear

- <1.015

25
Q

Transudates

- Total protein

A

< 3.0 g/dL

26
Q

Transudates

- Lactate Dehydrogenase

27
Q

Transudates

- Cell Count

A

< 1000/micro L

28
Q

Transudates

- presence of spontaneous clotting

29
Q

Exudates

- Appearance

30
Q

Exudates

- Specific gravity

31
Q

Exudates

- Total Protein

A

> 3.0 g/dL

32
Q

Exudates

- Lactate dehydrogenase

33
Q

Exudates

- Cell count

A

> 1000/micro L

34
Q

Exudates

- Presence of spontaneous clotting

35
Q

Clinical significance of pleural fluid glucose

A

Decreased in tubercular and rheumatoid inflammations

36
Q

Clinical significance of pleural fluid amylase determinations

A

Elevated in pancreatic disorders

37
Q

Pleural Fluid pH < 7.2

A

Indicates need for ATB’s and chest tube drainage

38
Q

Pleural Fluid pH > 7.4

A

Commonly noted in malignancy

39
Q

Pleural Fluid pH < 6.0

A

*Indicative of esophageal rupture (influx of gastric fluid)

40
Q

Clinical significance of abnormal pericardial fluid glucose

A

Decreased in bacterial infections and malignancy

41
Q

Clinical significance of abnormal pericardial fluid CEA determinations

A

Indicates malignancy

42
Q

Clinical significance of abnormal peritoneal fluid glucose

A

Decreased in tubercular peritonitis and malignancy

43
Q

Clinical significance of abnormal peritoneal fluid amylase

A

Increased in pancreatitis and GI perforations

44
Q

Clinical significance of abnormal peritoneal fluid alkaline phosphatase

A

Increased in intestinal perforations

45
Q

Clinical significance of abnormal peritoneal fluid BUN and creatinine

A

Indicates a ruptured bladder or accidental puncture of bladder during paracentesis

46
Q

Clinical significance of abnormal peritoneal fluid CEA and CA 125

A

Elevated in malignancy

48
Q

Clinical significance of abnormal synovial fluid glucose

A

If markedly decreased, indicates Group II or III disorders

49
Q

Clinical significance of abnormal synovial fluid lactate

A

If < 7.5 mmol/L, sptic arthritis is excluded; if > 7.5 mmol/L, septic or rheumatoid arthritis are indicated

50
Q

Clinical significance of abnormal synovial fluid total proein

A

Increased in inflammatory or hemorrhagic disorders

51
Q

Clinical significance of abnormal synovial fluid uric acid

A

May indicate crystal-induced joint disorder when uric acid crystals are not seen on crystal examination

52
Q

Urine v.s. amniotic fluid

  • urea
  • creatine
  • glucose
  • protein levels
A
  • Urea: high in urine; plasma (normal) levels in amniotic fluid
  • Creatine: high in urine; Plasma levels in amniotic fluid
  • glucose: normal levels in urine; plasma levels in amniotic fluid
  • protein: normal for urine; plasma levels for amniotic fluid

Chemistry Module 1 (18 decks)

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