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Liz's Hematology Module 2 > Body Fluids > Flashcards

Body Fluids Flashcards

1
Q

Where is cerebrospinal fluid located?

A

Brain and spinal cord

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2
Q

Where is pleural fluid found?

A

Lungs

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3
Q

Where is pericardial fluid found?

A

Heart

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4
Q

Where is peritoneal fluid found?

A

Abdominal organs

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5
Q

Where is synovial fluid found?

A

Joints

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6
Q

Normal volume of CSF in an adult

A

90-150 mL in adults

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7
Q

What is the name given to the change in color of a supernatant, caused by the breakdown of hemoglobin?

A

Xanthochromia

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8
Q

CSF for neonates

  • WBC count
  • Lymphs vs. monos
A
  • WBC count: 0-274 cells/cumm
  • Monos > Lymphs
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9
Q

CSF for adults

  • WBC count
  • Lymphs vs. monos
A
  • WBC count: 0-5 cells/cumm
  • 70% lymphs vs. 30% monos
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10
Q

An increased cell count, particularly an increase in WBC count, in a bodily fluid, such as CSF

A

Pleocytosis

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11
Q

Bacterial meningitis leads to an increase in ____

A

Neutrophils

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12
Q

Viral meningitis leads to an increase in ____

A

Lymphocytes

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13
Q

Acute leukemias lead to an increase in ____

A

Blasts

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14
Q

Lymphomas lead to an increase in ____

A

Lymphoma cells

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15
Q

Cerebral hemorrhage (including strokes) lead to an increase in ____

A

Segs, monos, and macrophages

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16
Q

Correcting for a traumatic tap (formula 1)

A

True WBCCSF = subtract 1 WBC per 500 RBCs counted

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17
Q

Correcting for a traumatic tap (formula 2)

A

WBCcsf count - [WBCblood x (RBCCSF/RBCblood)}

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18
Q

Cytospin preps are made on all ____ specimens regardless of ____ ____

A

CSF; cell count

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19
Q

How do you make a cytopsin slide?

A

Add one drop of 22% albumin and 5 drops of fluid to make the cytospin prep

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20
Q

What type of serous body fluid accumulates due to a pathologic state such as infection or malignancy?

A

Exudate

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21
Q

Abnormal collection of fluid in a cavity?

A

Effusion

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22
Q

Accumulation due to a systemic disease state

A

Transudates

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23
Q

Causes of transudates

A

Congestive heart failure, ↓ plasma COP, hypoproteinemia of the nephrotic syndrome, liver failure

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24
Q

Accumulation due to a primary pathologic state

A

Exudate

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25
Q

Examples of exudates

A

Bacterial infections, viral infections, neoplasms, trauma, noninfectious inflammatory conductions (RA), collagen vascular disease (SLE)

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26
Q

Serous fluids are ultrafiltrates of what?

A

Plasma

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27
Q

Systemic causes of effusions and the underlying mechanism

A
  • ↑ capillary HP - ↓ plasma COP
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28
Q

Local causes of effusions and the underlying mechanism

A
  • ↑ capillary permeability - ↓ lymphatic resorption
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29
Q

Transudate

  • Appearance
  • Specific gravity
  • Total protein
  • LDH
  • LDH activity ratio (BF: Serum)
  • Cell count
  • Spontaneous clotting
A
  • Appearance: Clear
  • Specific gravity: < 1.015
  • Total protein: < 3.0 g/dL
  • LDH: < 200 IU
  • LDH activity ratio (BF: Serum): < 0.6
  • Cell count: < 1000/uL
  • Spontaneous clotting: No
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30
Q

Exudate

  • Appearance
  • Specific gravity
  • Total protein
  • LDH
  • LDH activity ratio (BF: Serum)
  • Cell count
  • Spontaneous clotting
A
  • Appearance: Cloudy
  • Specific gravity: > 1.015
  • Total protein: > 3.0 g/dL
  • LDH: > 200 IU
  • LDH activity ratio (BF: Serum): > 0.6
  • Cell count: > 1000/uL
  • Spontaneous clotting: Possible
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31
Q

Chylous effusion

A

Triglycerides > 110 mg/dL

32
Q

If chylomicrons are present that = ____ If cholesterol crystals are present = ____

A

Chylous effusion; pseudochylous effusion

33
Q

Chylous effusions are obstructions of the ____ ____ from lymphoma, neoplasm, or surgery

A

Lymphatic system

34
Q

Pseudochylous effusions are ____ conditions such as RA and often have higher concentration of ____ than serum

A

Inflammatory; cholesterol

35
Q

Normal cells in serous fluids

A
  • Lymphs
  • Mono-histiocytes (macrophages)
  • Siderophages
  • Erythrophages
  • Signet Ring cells/Lipophages
  • Mesothelial cells
36
Q

Serous fluid is straw colored to yellow to clear, what does that mean?

A

Normal

37
Q

Serous fluid is cloudy to hazy, what does that mean?

A

Infectious process

38
Q

Serous fluid is bloody, what does that mean?

A

Malignancy or trauma

39
Q

Serous fluid is milky, what does that mean?

A

Chyle (lipids)

40
Q

Macrophages containing siderotic (iron) granules

A

Siderophages

41
Q

Macrophages that have phagocytized RBCs

A

Erythrophage

42
Q

Macrophages that have phagocytized large amounts of lipids

A

Signet ring cells

43
Q

These cells are neutrophils that have phagocytized a naked nucleus showing a homogenous, smooth chromatin pattern

A

LE cells

44
Q

Five clues to identifying malignant cells

A
  • Form clusters
  • Nuclear membrane is irregular or jagged
  • Contain prominent, frequently multiple nucleoli w/ irregular membranes
  • Chromatin is unevenly distributed
  • N/C ratio is higher than normal
45
Q

Normal cells found in synovial fluid

A
  • Monos/macrophages (60%)
  • Lymphs (30%)
  • Neutrophils (10%)
  • LE cells
  • Cartilaginous cells
  • Malignant cells
  • Synoviocytes
46
Q

**Purpose of hyaluronidase when analyzing synovial fluid

A

Synovial fluid is viscous, containing hyaluronic acid, adding hyaluronidase fixes that**

47
Q

What are the groups of the synovial fluid classification?

A
  • Normal
  • Group 1 (Noninflammatory)
  • Group 2 (Inflammatory)
  • Group 3 (Septic)
  • Group 4 (Hemorrhagic)
48
Q

How do you perform a bronchoalveolar lavage?

A

Warm saline is introduced into the lungs and then withdrawn

49
Q

What is the purpose of a BAL?

A

To determine the types of organisms and cells in areas of lung inaccessible by other means

50
Q

BAL cell findings

  • Histiocytes
A

May have carbonaceous material from smokers (black, brown, ro blue-black)

51
Q

BAL cell findings

  • Pneumocystic jiroveci
A

Common in specimens from HIV patients (may look like amorphous material)

52
Q

Normal cells found in BAL

A
  • Neutrophils
  • Macrophages
  • Pneumocytes (alveolar)
  • Ciliated epithelial cells
  • Histocytes
  • Pneumocystis jiroveci
53
Q

What do ciliated epithelial cells in a BAL indicate?

A

Indicates that sample was collected from upper respiratory tract instead of the lung

54
Q

Normal cells found in CSF

A

Lymphs

  • Neutrophils should be absent or rare regardless of age
55
Q

Lymphs are found in all body fluids except for ____

A

BAL

56
Q

Neutrophils are abnormal in all body fluids except for ____

A

BAL

57
Q

Monocytes are normal in all body fluids except for ____

A

NONE!! Normal in ALL!!

58
Q

Leukemia/Lymphoma cells are most common in what?

A

ALL and some AML

59
Q

Rice bodies are found where and are made of what?

A

In synovial fluids; composed of collagen covered by fibrinous tissue

60
Q

Monosodium Urate is seen in ____

A

Gout

61
Q

Calcium pyrophosphate crystals are seen in ____

A

Pseudo-gout

62
Q

How do MSU crystals look on a polarizer?

A

Bright needles strongly birefringent

63
Q

How do CPP crystlas look on a polarizer?

A

Rhomboidal and weakly birefringent

64
Q

How do MSU crystals look using a red compensator?

A

MSU crystals appear yellow when parallel to the axis and blue when perpendicular

65
Q

How do CPP crystlas look using a red compensator?

A

CPP crystals appear blue when parallel to the axis and yellow when perpendicular

66
Q

If the opening pressure is low in collection of spinal fluid, it leads to…

A
  • Reduced volume
  • Blocks the above puncture site
67
Q

If the opening pressure is high in collection of spinal fluid, it leads to…

A
  • High volume
  • CNS hemorrhage
  • Malignancy
  • Hydrocephalus
  • Meningitis
68
Q

Describe how to differentiate a traumatic tap from a hemorrhage

A
  • Amount of blood decreases b/w each successive tube
  • Clotting
  • Clear supernatant
69
Q

Describe how to differentiate a hemorrhage from a traumatic tap

A
  • Tubes are equally bloody
  • Clotting is rare
  • Pink, orange, or yellow supernatant
70
Q

Significance of increased lymphs in body fluids

A
  • Viral infections
  • Mycobacterial, syphilitc, and leptospiral meningitis
  • MS
  • Guillian-Barre (autoimmune)
  • Polyarteritis (autoimmune)
71
Q

Found in tissues from hemoglobin and is chemically similar to bilirubin

A

Hematoidin

72
Q

Rare finding the CSF; drug used for prophylaxis and treatment of meningeal leukemias; crystallized in a liposome which is destroyed by staining

A

Cytarabine crystals

73
Q

Benign cells

  • Size
  • Staining
  • Mitotic figures
  • Nuclei shape
  • Nucleoli
  • Clumping
A
  • Size: occasionally large; low N/C ratio
  • Staining: light to dark
  • Mitotic figures: Rare
  • Nuclei shape: round to oval; nuclei uniform size w/ various amts of cytoplasm
  • Nucleoli: Small if present
  • Clumping: may have “windows”
74
Q

Malignant cells

  • Size
  • Staining
  • Mitotic figures
  • Nuclei shape
  • Nucleoli
  • Clumping
A
  • Size: Very large; high N/C ratio
  • Staining: very basophilic
  • Mitotic figures: Several
  • Nuclei shape: irregular or even bizarre nuclear shape; disintegrated at edges; various sizes and shapes of nuclei
  • Nucleoli: Large and prominent
  • Clumping: no “windows”
75
Q

Advantages of cytocentrifuge preparations for body fluids

A
  • Concentrates cells when only a few WBC present
  • Provides small area to search for tumor cells or indication of infection
  • Provides permanent slide for file
76
Q

Disadvantages of cytocentrifuge preparations for body fluids

A
  • Requires special equipment - Cell integrity often compromised

Liz's Hematology Module 2 (13 decks)

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