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Q4 Clin Lab II thyroid, rheum, coag, LFT, body fluids > Body Fluids (lec 1) > Flashcards

Body Fluids (lec 1) Flashcards

1
Q

Effusion is?

Transudate?

Exudate?

A

Abn fluid in cavity

Trans:
result of pressure diff b/w compartments,
blood filt across intact vascular wall,
(U) from system dz (CHF, etc)

Exu:
results from inflamm/vascular wall damage,
(U) from infect, malig, inflamm dz

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2
Q

Total Fluid Protein tells us?

Fluid:Serum Protein tells us?

A

types of fluid

FP
< 3 = transu
> 3 = exu

F:S P
< 0.5 = transu
> 0.5 = exu

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3
Q

Lactate DH Fluid:Serum tells us?

A

types of fluid

< 0.6 = transu
> 0.6 = exu

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4
Q

Glucose level tells us?

A

transu (transu glu same as plasma glu)
or
exu (exu glu < plasma glu)

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5
Q

Appearance of transu?

WBC count/type?

A

clear, thin

< 300
mononuclear

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6
Q

Appearance of exu?

WBC count/type?

A

cloudy, thick

> 500
neutrophils

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7
Q

Amylase tells us?

A

diag of pancreatitis, bowel perf, metastases

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8
Q

Triglycerides tell us?

A

confirm chylous (fat/lymph from sm intest) effusion

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9
Q

pH of pleural fluid tells us?

A

parapneumo effusion

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10
Q

Carcinoembryonic Antigen (CEA) tells us?

A

CEA-producing tumor

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11
Q

Types of cells in normal serous fluid? (4)

A

lymphocytes
monocytes
macrophages
mesothelial lining

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12
Q

Nonmalig cells from disease states? (3)

A

neutrophils (inflamm/infect),
eosinophils (hypersens, malig, MI, infect),
RBCs (hemorr, malig)

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13
Q

Exudates requires what further testing? (4)

A

Cytology (for malig)
Culture (for infect)
Cell count/diff
Chemistry

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14
Q

Exudative Pleural Effusion values:

Specif Gravity?

Fluid Protein?

Fluid:Serum Protein?

Fluid:Serum LDH?

A

SG > 1.016

FP > 3

F:S P > 0.5

LDH > 0.6

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15
Q

Hemothorax:

RBCs?

Hct?

A

RBC > 100k

Hct of fluid ≥ 50% of peripheral blood

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16
Q

Hemothorax caused by? (3)

A

Trauma
Malig
PE

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17
Q

Empyema is?

WBC count?

if >50% neutro = ?

if >50% lympho = ?

if eosino = ?

A

pus in pleural space

WBC > 50k

if >50% neutro = inflam/infect

if >50% lympho = neoplasm, TB

if eosino = collagen-vasc dz, drug-induced pleuritis, neoplasm, TB

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18
Q

Add’l Pleural Effusion tests:

pH?

Glucose?

Amylase?

Triglycerides?

A

pH < 7.2 = infect, neopl, RA, esoph rupture

Glu < 60 = infect, neopl, RA

Amylase = pancreatitis, esoph rupture

Trigly = chylous effusion from trauma, neopl or obstructed lymph

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19
Q

PE cause what effusions?

A

transu or exu

20
Q

Exu Pleural Effusions caused by? (2)

A

1) parapneumo from bacterial PNA, lung abscess, bronchiectasis
2) Malignancy (U) lung, breast, lymphoma

21
Q

Pericardial fluid obtained how?

A

Subxiphoid Needle Aspiration:
Echo-guided (preferred)
Alligator clip EKG (emergent)

22
Q

Peritoneal fluid (Ascites) obtained how?

A

4 quad abdom tap

23
Q

Ascites labs/significance?

A

same as pleural fluid

Post trauma -> r/o intraabdominal bleed

Tenderness -> r/o peritonitis

Malignant -> check cytology

Infection -> G-stain, acid-fast, C/S, biopsy

24
Q

Ascites method of classification?

A

Serum:Acites Albumin Gradient (SAAG) =

serum albumin - ascitic fluid albumin

25
Q

SAAG tells us?

A

> 1.1 = transudate ascites from portal HTN

< 1.1 = exudate ascites from non-portal HTN (e.g. malig, infection)

26
Q

Ascites cell counts tell us?

A

(most useful test)

WBC < 500 = uncomplicated cirrhosis

WBC count ↑ w/ inflamm (e.g. infect, TB, CA)

27
Q

Spontaneous Bacterial Peritonitis caused by?

Presentation?

Tx?

A

cirrhosis, ascites

No obvious source of infect,
Abrupt fever/chills, abd pain,
Rebound tender,
Fluid WBC > 500 w/ neutro > 50%

Abx, NO surgery

28
Q

Synovial Fluid Categories? (4)

A

Group I = non-inflamm (OA)

Group II = mild inflamm (SLE, scleroderma)

Group III = severe inflamm (gout, RA)

Group IV = infection (bacterial, TB)

29
Q

Next tests for septic synovial?

Tx?

A

(URGENT CONDITION)
G-stain
Cx

Abx

30
Q

Birefringence is?

A

polarized light test for crystals

shine on dark background = crystal
direction of shine determined (+ or -)

31
Q

Crystal properties for Gout?

A

monoNa+ urate
strong negative bifringence,
needle-shaped

32
Q

Crystal properties for Pseudogout?

A

Ca2+ pyrophosphate
weakly positive bifringence
rhomboid

33
Q

Cerebrospinal Fluid collected how?

A

lumbar puncture

L3-4 or 4-5

34
Q

CSF analysis detects what dzs?

A

Hemorr
Infect
Malig

35
Q

CSF analyzed for?

A

Chemistry: protein, glu, immuno

Micro: G/Acid-stains, C/S

Hemato: count, diff

Plasma prot/glu drawn for comparison

36
Q

CSF Glucose tells us?

A

N = 2/3 of plasma glu, 50-80 mg/dl

High = hyperglycemia

Low = bact meningitis, fungal inf

37
Q

CSF Protein tells us?

A

N = 20-50 mg/dl

High = bleed, hemolysis, infect

Oligoclonal bands = multiple sclerosis

Myelin basic proteins = MS and other demyelinating dz

38
Q

CSF RBCs tell us?

A

Present = cerebral hemorr or traumatic tap

Spin CSF:
If xanthochromic supernatant = hemorr
If clear = traum tap

39
Q

CSF WBCs tell us:

Normal?

↑ neutrophils?

↑ lymphocytes?

Eosinophils?

Plasma cells?

A

N = 1-5 mononuclear cells

↑ neutro = bact meningitis

↑ lympho = virus, fungus, TB

Eosino = parasitic, fungus

Plasma cells = MS, chronic inflamm

40
Q

Meningitis presentation?

A

HA
N/V
Photophobia
(P) altered mental status

41
Q

Blood Cultures used when?

Best time to draw?

A

assess for bacteremia

during episode of fever/chills

42
Q

Intermittent/Transient Bacteremia possible when?

A

during manipulation of infected tissue (e.g. dental procedures)

at onset of infection

43
Q

Continuous Bacteremia likely when?

A

endovascular infection (e.g. endocarditis)

44
Q

Blood Culture collected how?

A

drawn by syringe from at least 2 diff sites

NOT thru existing catheter

inject into BC media bottles (O2 and

45
Q

Blood Cx results tell us?

A

If growth in both Cxs = indicative of bacteremia

If one Cx set + = (P) contamination (esp if N skin flora)
Or
(P) true + if strep A, pneumo, h. flu, pseudo, candidia

Q4 Clin Lab II thyroid, rheum, coag, LFT, body fluids (14 decks)

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