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Liz's Clinical Chemistry Module 2 > Body Fluids > Flashcards

Body Fluids Flashcards

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1
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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2
Q

Define pleural fluid

A

Fluid from thoracic area (thoracic, chest, or lung fluid)

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3
Q

This fluid is found in its highest concentration in the eyes and joints

A

Hyaluronic acid

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4
Q

List two conditions which cause neutrophils to be present in stool specimens

A
  • Ulcerative colitis - Bacillary dysentery - Ulcerative diverticulitis - Intestinal TB - Abscesses or fistulae
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5
Q

Clinical signifance of abnormal synovial fluid glucose

A

If markedly decreased, indicates Group II or III disorders

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6
Q

Define peritoneal fluid

A

Fluid secreted by cells of teh peritoneum (ascitic or abdominal fluid)

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7
Q

CNS neoplasm

  • Clarity
  • CSF Cell count
  • CSF protein
  • CSF glucose
  • Microbiology data
A
  • Clarity: clear or xanthochromic
  • CSF cell count: Normal or ↓ lymphocytes/blasts
  • CSF protein: normal or ↓
  • CSF glucose: normal or ↓
  • Microbiology data: N/A
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8
Q

Clinical significance of abnormal synovial fluid total protein

A

Increased in inflammatory or hemorrhage disorders

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9
Q

Clinical significance of pleural fluid glucose

A

Decreased in tubercular and rhematoid inflammations

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10
Q

Urine vs. 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 (negative) levels in urine; plasma levels in amniotic fluid - Protein: normal (negative) for urine; plasma levels for amniotic fluid
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11
Q

Possible cause for the appearance of red stool

A

Lower gastrointestinal bleeding

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12
Q

Exudates

  • Appearance
  • Specific gravity
  • Total protein
  • LD
  • Cell count
  • Presence of spontaneous clotting
  • Associated condition
A
  • Appearance: Cloudy
  • Specific gravity: > 1.015
  • Total protein: > 3.0 g/dL
  • LD: > 200 IU
  • Cell count: >1000/uL
  • Presence of spontaneous clotting: Possible
  • Associated condition: Pneumonia, malignancy, inflammation, infection
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13
Q

Define chylous effusion

A

Accumulation of lymph (chyle) in the body cavities

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14
Q

Tubercular meningitis

  • Clarity
  • CSF Cell count
  • CSF protein
  • CSF glucose
  • Lactate
  • Microbiology data
A
  • Clarity: Cloudy
  • CSF cell count: ↑ neutrophils (early); ↑ lymphocytes (later)
  • CSF protein: > 45 mg/dL (~75 mg/dL)
  • CSF glucose: < 50 mg/dL (~35 mg/dL)
  • Lactate: increased
  • Microbiology data: positive acid-fast stain and culture
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15
Q

Define parietal membrane

A

Surface membrane which lines the body wall

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16
Q

Clinical significance of an increased CSF IgG index calculation

  • Equation?
A

Calculated to determine if there is a compromised BBB or increased endogenous production of Igs; > 0.7 indicates Multiple Sclerosis (MS)

(IgGCSF x ALBserum) ÷ (IgGserum x ALBCSF)

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17
Q

Aspects of a CSF protein

  • Two most common specific causes of its increase
A
  • Damage to the BBB (increased capillary permeability or hemorrhage) - Bacterial meningitis
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18
Q

Diagnostic use and principle for fecal occult blood analysis

A

To detect hidden blood; screening for colorectal cancer and for GI bleed

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19
Q

Clinical significance of pleural fluid amylase determinations

A

Elevated in pancreatic disorders

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20
Q

Specific clinical significance of CSF lactate measurements

A

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

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21
Q

Define thoracentesis

A

Surgical puncture of the chest wall, done to obtain pleural fluid

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22
Q

Fecal occult blood

  • Principle of the test
A

To detect color change in samples positive for WBCs

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23
Q

Fecal occult blood - Reagents used

A

Peroxidase and pseudoperoxidase; guaiac used as the most common indicator

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24
Q

Clinical significance of abnormal pericardial fluid CEA determinations

A

Indicates malignancy

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25
Q

Pleural fluid pH < 7.2

A

Indicates need for ATB’s and chest tube drainage

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26
Q

Define hemorrhagic fluid

A

Bloody fluid which can come from a traumatic tap, malignancy, pulmonary infarction, trauma, pancreatitis, TB, but usually malignancy

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27
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 (~75 mg/dL)
  • CSF glucose: slightly decreased <50 mg/dL (~35 mg/dL)
  • Microbiological data: positive gram stain and fungal culture; possibly positive India ink if organism is encapsulated
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28
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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29
Q

Clinical significance of abnormal peritoneal fluid CEA and CA 125

A

Elevated in malignancy

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30
Q

Clinical significance of abnormal synovial fluid lactate

A

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

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31
Q

Define serous cavity

A

Formed by the visceral and parietal membranes; area b/w them contains the serous fluid

32
Q

Aspects of a CSF protein

  • Fraction that is in greatest concentration?
A

Albumin Reference range: 15-45 mg/dL

33
Q

Clinical significance of abnormal peritoneal fluid alkaline phosphatase

A

Increased in intestinal perforations

34
Q

Pleural fluid pH > 7.4

A

Commonly noted in malignancy

35
Q

Possible cause for the appearance of mucus in stool

A
  • Malignancy - Colitis
36
Q

Define pericardial fluid

A

Fluid around the heart

37
Q

Transudates

  • Appearance
  • Specific gravity
  • Total protein
  • LD
  • Cell count
  • Presence of spontaneous clotting
  • Associated condition
A
  • Appearace: clear
  • Specific gravity: < 1.015
  • Total protein: < 3.0 g/dL
  • LD: <200 IU
  • Cell count: <1000/uL
  • Presence of spontaneous clotting: No
  • Associated condition: cardiovascular, hypoalbuminaemia, hypothyroidism
38
Q

Define ascites

A

Comes from the Latin for “bag” and describes the bloated abdomen from patient affected w/ massive accumulation of peritoneal fluid

39
Q

Aspects of a CSF protein

  • Reason for its spurious elevation
A

Spurious elevations occur when fluid is contaminated w/ serum or blood cells during traumatic tap

40
Q

Possible cause for the appearance of ribbon-like stool

A

Intestinal constriction

41
Q

Bacterial meningitis

  • Clarity
  • CSF cell count
  • CSF protein
  • CSF glucose
  • Lactate
  • LD
  • Microbiological data
A
  • Clarity: Cloudy
  • CSF cell count: Mk’d increased neutrophils ‘
  • CSF protein: much greater than 45 mg/dL (~100 mg/dL; may rise to 500 mg/dL)
  • CSF glucose: (Mk’d decrease) much less than 50 mg/dL (~25 mg/dL)
  • CSF lactate: increased
  • LD: increased LD4 and LD5
  • Microbiological data: possible positive Gram stain; positive bacterial culture
42
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

43
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 (< 100 mg/dL)
  • CSF glucose: Normal to slight decrease (~50 mg/dL)
  • Microbiological data: negative Gram stain for oraganisms or polys (segs)
44
Q

Increased or decreased will cause the formation of effusions

  • Colloid osmotic pressure
A

Decreased - Hypoproteinemia - Cirrhosis - Nephrotic syndrome

45
Q

Intracranial hemorrhage

  • Clarity
  • CSF Cell count
  • CSF protein
  • CSF glucose
  • Microbiology data
  • Differential
A
  • Clarity: Bloody w/ xanthochromia
  • CSF cell count: ↑ due to PB
  • CSF protein: > 45 mg/dL (due to PB protein)
  • CSF glucose: Normal or ↓
  • Microbiology data: negative Gram stain and culture
  • Differential: PB percentages
46
Q

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

A
  • No xanthochromia b/c there is fresh blood - Blood decreases as more tubes of CSF are collected
47
Q

Pleural fluid < 6.0

A

Indicative of esophageal rupture (influx of gastric fluid)

48
Q

Define empyema

A

Pus in the pleural cavity

49
Q

Define visceral membrane

A

Surface membrane which lines the organs; aka peritoneum

50
Q

Clinical significance of abnormal peritoneal fluid amylase

A

Increased in pancreatitis and GI perforations

51
Q
A

There is a sharp peak at 450nm which indicates bilirubin in the amniotic fluid; this will tell us how bad HDN is

52
Q

Clinical significance of abnormal peritoneal fluid glucose

A

Decreased in tubercular peritonitis and malignancy

53
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

54
Q

Define effusion

A

Escape of fluid into a part of the body

55
Q

What is the clinical significance of abnormal CSF appearance?

A

If its very bloody, something is wrong

56
Q

Increased or decreased will cause the formation of effusions

  • Capillary permeability
A

Increased - Infection - Inflammation

57
Q

Purpose of pilocarpine

A

Purpose is to induce sweat on electrodes in order to analyze chloride

58
Q

List two conditions which cause the presence of muscle fibers in stool specimens

A
  • Impaired digestion - Rapid intestinal transit time
59
Q

Increased or decreased will cause the formation of effusions

  • Hydrostatic pressure
A

Increased - Congestive heart failure, impaired venous return, constrictive pericarditis → generalized edema - Venous obstruction, deep vein thrombosis, external pressure (mass), arteriolar dilation, heat, neurohormonal dysregulation → localized edema

60
Q

Diagnositc usefulness of sweat analysis

A

Performed to diagnose cystic fibrosis, a value of > 60 mEq/L is bad

61
Q

Possible cause for the appearance of pale yellow/white gray stool

A

Bile duct obstruction

62
Q

Normal formation of serous fluid

  • Capillary permeability
A

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

63
Q

Describe the clinical use of bronchoalveolar lavage (BAL) analysis

A

Used to detect organisms at the alveolar level; usually Pneumocystis jirovecii (carinii) in HIV patients

64
Q

Possible cause for the appearance of black stool

A

Upper gastrointestinal bleed

65
Q

Clinical significance of CSF lactate dehydrogenase isoenzyme measurements

A

LD-1 adn 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

66
Q

Principle and diagnostic usefulness of fecal Clinitest assays

A

To detect increased reducing substances indicating CHO malabsorption (intolerance)

67
Q

Clinical significance of abnormal synovial fluid uric acid

A

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

68
Q

Possible cause for the appearance of bulky/frothy stool

A

Steatorrhea (in pancreatic dysfunction or fat malabsorption)

69
Q

Clinical significance of abnormal peritoneal fluid BUN and creatinine

A

Indicates a ruptured bladder or accidental puncture of bladder during paracentesis

70
Q

Define hemothorax

A

Whole blood in the pleural cavities

71
Q

Clinical significance of abnormal pericardial fluid glucose determinations

A

Decreased in bacterial infections and malignancy

72
Q

Aspects of a CSF protein

  • 4 general conditions that cause its increase (150-200 mg/dL)
A
  • Inflammatory disease - Intracranial tumors - Subarachnoid hemorrhage - Cerebral infarction
73
Q

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

A

All tubes will be equally bloody w/ xanthochromia

74
Q

Normal proportion of CSF glucose related to concomitant blood glucose measurements

A

Should be 60-70% of concomitant blood glucose

75
Q

Define paracentesis

A

Aspiration of fluid from a cavity (in general)

76
Q

Increased or decreased will cause the formation of effusions

  • Lymphatic absorption
A

Decreased - Tumors - Leukemias/Lymphomas - Superior vena cava obstruction

Liz's Clinical Chemistry Module 2 (9 decks)

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