Body Fluids Flashcards
Where is cerebrospinal fluid located
brain and spinal cord
Where is pleural fluid found
lungs
Where is pericardial fluid found
heart
Where is peritoneal fluid found
abdominal organs
Where is synovial fluid found
joints
normal volume of CSF in an adult
90-150 mL in adults
What is the name given to the change in color of a supernatant, caused by the breakdown of hemoglobin
Xanthochromia
CSF for neonates
- white blood cell count
- lymphs v.s. monos
- 0-27 cells/cumm
- more monos then lymphs
CSF white blood cell count for adults
0-5/cumm
- 70% lymphs and 30% monos
an increased cell count, particularly an increase in white blood cell (WBC) count, in a bodily fluid, such as cerebrospinal fluid (CSF)
pleocytosis
Bacterial meningitis leads to increase in
neutrophils
Viral meningitis leads to an increase in
lymphocytes
Acute leukemias lead to increase in
blasts
Lymphomas lead to an increase in
lymphoma cells
Cerebral hemorrhage (including strokes) lead to increase in
pollys, monos, macrophages
Correcting for a traumatic tap (formula 1)
subtract 1 WBC per 500 RBCs counted
Correcting for a traumatic tap (formula 2)
WBC count - [WBCblood x (RBCcsf/RBCblood)]
Cytospin preps are made on all ______ specimen regardless of _______ ________
CSF
Cell Count
How do you make a Cytospin slide?
add one drop of 22% albumin and 5 drops of fluid to make the cytospin prep
What type of serous body fluid accumulates due to a pathologic state such as infection or malignancy
Exudate
abnormal collection of fluid in a cavity
Effusion
accumulate due to a systemic disease state
transudates
Causes of transudates (4)
Congestive Heart Failure
Decreased plasma oncotic pressure
Hypoproteinemia of the nephrotic syndrome
Liver failure
Accumulate due to a primary pathologic state
Exudates
Examples of causes of Exudates
bacterial infections, viral infections, neoplasms, trauma, noninfectious inflammatory conductions (RA), collagen vascular disease (SLE)
Serous fluids are ultra filtrate of what?
plasma
systemic causes of effusions and the underlying mechanism
- increase capillary HP
2. decrease plasma oncotic pressure
local causes of effusions and the underlying mechanism
- increased capillary permeability
2. decreased lymphatic resorption
Specific gravity for transudates and exudates
T is < E is >
1.015
Total protein for transudates and exudates
T is < E is >
3.0 g/dL
LDH for transudates and exudates
T is < E is >
200 IU
LDH activity ratio for transudates and exudates
T is < E is >
0.6
cell count for transudates and exudates
T is < E is >
1000/microL
Chylous Effusion
Trigs >110mg/dl
If chylomicrons are present that = ______
If cholesterol crystals are present = ______
Chylous Effusion
Pseudochylous Effusion
Chylous Effusions are obstruction of ____ ____ from lymphoma, neoplasm, or surgery
Lymphatic system
Pseudochylous effusions are ______ conditions such as RA and often have higher concentration of ____ than serum
inflammatory
cholesterol
Normal Cells in serous fluids
- lymphocytes
- mono-histocytes (macrophages)
- siderophages
- erythrophages
- Signet Ring Cells
- mesothelial cells
Serous Fluid is straw colored to yellow clear, what does that mean?
normal
Serous fluid is cloudy to hazy, what does that mean?
Infectious process
Serous fluid is bloody, what does that mean?
malignancy or trauma
Serous fluid is milky what does that mean?
chyle (lipids)
macrophages containing siderotic (iron) granules
Siderophages
macrophages that have phagocytize RBCs
Erythrophages
macrophages that have phagocytize large amounts of lipids
signet ring cells
These cells are neutrophils that have phagocytized a naked nucleus showing a homogenous, smooth chromatin pattern
LE Cells
Malignant cell facts (4)
- form clusters
- irrecgular or jagged
- chromatin is unevenly distributed
- unclear to cytoplasmic ratio is higher than normal
Normal cells found in synovial fluid (7)
- monos/macs (60%)
- lymphocytes (30%)
- neutrophils (10%)
- LE Cells
- Cartilaginous cells
- Malignant
- Synoviocytes
Purpose of hyaluronidase when analyzing synovial fluid
Synovial fluid is viscous, containing hyaluronic acid, adding hyaluronidase fixes that?
What are the groups of the synovial fluid classification?
- Normal
- Group 1 - Noninflammatory
- Group 2- Inflammatory
- Group 3 - Septic
- Group 4 - Hemorrhagic
How do you perform a BAL?
Warm saline introduced into the lungs and then withdrawn
BAL cell findings
- Histiocytes
may have carbonaceous material from smokers (black, brown, or blue-black)
BAL cell findings
- Pneumocystic jiroveci
common in specimens from HIV patients (may look like amorphous material)
Cells found in BAL (8)
- Neutrophils
- macrophages
- no mesothelial
- pneumocytes
- ciliated epithelial cells
- histocytes
- pneumocystis jiroveci
Cells found in CSF
- lymphocytes
Lymphocytes found in all body fluids but what?
BAL
Neutrophils are abnormal in all body fluids but what?
BAL
Monocytes are normal in all body fluids but what?
NONE! normal in all
Leukemia/Lymphoma cells are most common in what?
ALL and some AML
Rice bodies are found where and are made of what?
in synovial fluids and composed of collagen covered by fibrinous tissue
Monosodium Urate see in what?
gout
Calcium Pyrophosphate crystals seen in what?
pseudo-gout
MSU look on polarizer
bright needles strongly birefringent
CPP look on polarizer
rhomboidal and weakly birefringent
Red compensator is used MSU crystals appear yellow when ____ to axis and blue when ______
parallel
perpendicular
If the opening pressure is low in collection of spinal fluid, it leads to__________,_________
Reduced volume and block above the puncture site
If the opening pressure is high in collection of spinal fluid, it leads to__________,_________,_______,_______,______
High volume CNS hemorrhage Malignancy Hydrocephalus Meningitis
