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Analysis of Urine and Other Body Fluids > Chapter 15 - Serous Fluid > Flashcards

Chapter 15 - Serous Fluid Flashcards

1
Q

The fluid between parietal and visceral membranes

A

Serous fluid

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2
Q

Fxn of serius fluid: to provide ____ between the 2 membranes as the surfaces move against each other

A

Lubrication

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3
Q

Accumulation of fluid bet membranes

A

Effusion

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4
Q

Effusion may be classified as ___ or ____

A

Exudate or transudate

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5
Q

Effusion that is caused by a direct dmg to the membrane of a particular cavity

A

Exudate

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6
Q

Effusion that is caused by a disruption of fluid production and regulation bet membranes

A

Transudate

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7
Q

Transudate may be caused by changes in ____ pressure and ____ pressure

A

Hydrostatic or oncotic

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8
Q

Identify whether the ff are transudate or exudate

  1. Congestive heart failure
  2. Malignancy
  3. Hypoproteinemia
  4. Inflammation
  5. Nephrotic syndrome
  6. Infection
  7. Liver cirrhosis
  8. Malnutrition
  9. Empyema
A
  1. T
  2. E
  3. T
  4. E
  5. T
  6. E
  7. T
  8. T
  9. E
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9
Q

Identify whether the ff transudate have inc oncotic pressure, dec OP, inc hydrostatic pressure or dec HP

  1. Congestive heart failure
  2. Hypoproteinemia
  3. Nephrotic syndrome
A
  1. Dec OP
  2. Inc HP
  3. Dec OP
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10
Q

Transudate vs exudate

  1. Appearance
  2. Fluid:serum protein ratio
  3. Fluid:serum LD ratio
  4. WBC ct
  5. Spontaneous clotting
  6. Pleural fluid chole
  7. Pleural fluid:serum chole ratio
  8. Pleural fluid:bilirubin ratio
  9. Serum-ascites albumin gradient
  10. Glucose
  11. Protein
  12. Rivalta’s test
A
  1. Clear;cloudy
  2. <0.5;>0.5
  3. <0.6;>0.6
  4. <1000/uL;>1000/uL
  5. No;possible
  6. <45-60;>45-60
  7. <0.3;>0.3
  8. <0.6;>0.6
  9. > /=1.1;<1.1
  10. Equal to serum;possible low
  11. <3.0;>3.0
  12. Neg;pos
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11
Q

Other name for rivalta’s test

A

Serosamucin clot test

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12
Q

Positive rxn for Rivalta’s test

A

Heavy precipitation

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13
Q

Recommended test to detect transudate of hepatic origin

A

SAAG

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14
Q

Most reliable tests for diff trans from exu

A

Fluid:serum protein ratio and fluid:serum LD ratio

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15
Q

How to get SAAG value

A

Serum albumin minus peritoneal fluid albumin

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16
Q

SAAG value for transudate

A

> or = 1.1

17
Q

SAAG value for exudates

A

<1.1

18
Q

Normal appearance of serous fluid

A

Clear, pale yellow

19
Q

Method of collection for each of the ff

  1. Pleural f
  2. Pericardial f
  3. Peritoneal fluid / ascitic fluid
A
  1. Thoracentesis
  2. Pericardiocentesis
  3. Paracentesis
20
Q

Normal volumes of each of the ff:

  1. Pleural f
  2. Pericardial f
  3. Peritoneal f
A
  1. <30mL
  2. <50mL
  3. <100mL
21
Q

Serous fluid spx is distributed in what tube given the ff purposes:

  1. For microbio and cytology
  2. For chem
  3. For cell counts and differential
A
  1. Sterile heparin or SPS
  2. Plain or heparin tubes
  3. EDTA
22
Q

Expected appearance/color of the ff pleural fluid conditions

  1. Aspergillosis
  2. Rupture of amoebic liver abscess
  3. Microbial infection (TB)
  4. Malignant mesothelioma (inc hyaluronic acid)
  5. Chylous material
  6. Hemorrhagic effusion
  7. Hemothorax
  8. Pseudochylous material
A
  1. Black
  2. Brown
  3. Turbid white
  4. Viscous
  5. milky
  6. Bloody
  7. Bloody
  8. Milky
23
Q

How to diff chylous effusion and pseudochylous effusion:

  1. Cause
  2. Appearance
  3. Leukocytes
  4. Chole crystals
  5. Triglycerides
  6. Sudan III staining
A
  1. Thoracic duct leakage ; chronic inflammation
  2. Milky/white ; milky/green tinge/‘gold paint’
  3. Inc lympho ; mixed cells
  4. Absent ; present
  5. > 110 mg/dL ; <50 mg/dL
  6. +++ ; - / weakly +
24
Q

How to diff hemothorax from hemorrhagic effusion based on the ff:

  1. Distribution of blood
  2. Hematocrit
A
  1. Uneven ; even

2. Pleural fluid hct is > or = 1/2 of whole blood hct ; pleural fluid hct is <1/2 of whole blood hct

25
Q

Identify whether the ff is hemothorax or hemorrhagic effusion

  1. WB hct = 50% , PF hct = 25%
  2. WB hct = 50% , PF hct = 35%
  3. WB hct = 50% , PF hct = 35%
A
  1. Hemothorax
  2. Hemothorax
  3. Hemorrhagic diffusion
26
Q

Significance of the ff cell in PF

  1. Neutrophil
  2. Mesothelial cell
  3. Plasma cells
A
  1. Pancreatitis (pneumonia, pulmonary infarction)
  2. Decreased in TB
  3. TB
27
Q

Identify the tumor markers for the ff:

  1. Colon cancer
  2. Ovarian/metastatic uterine cancer
  3. Breast cancer
  4. Lung cancer
  5. Urinary bladder cancer
  6. Breast cancer
A
  1. CEA
  2. CA 125
  3. CA 15-3, CA 549
  4. CYFRA 21-1
28
Q

Significance of testing pleural fluid:

  1. Glucose
  2. Lactate
  3. Trigly
  4. pH
  5. Adenosine deaminase (ADA)
  6. Amylase
A
  1. Dec in rheumatoid inflammation, purulent infection
  2. Inc in Bacterial infection
  3. Inc in Chylous effusions
  4. dec in pneumonia, super dec in esophageal rupture, dec in complicated parapneumonic effusion
  5. TB, malignancy
  6. Inc in pacreatitis, esophageal rupture, malignancy
29
Q

Pericardial fluid appearance for the ff significances

  1. Cardiac puncture
  2. Normal, transudate
  3. Infection
  4. Chylous and pseudochylous material
  5. Anticoag medications
  6. Malignancy
A
  1. Grossly bloody
  2. Clear, pale yellow
  3. Blood-streaked
  4. Milky
  5. Grossly bloody
  6. Blood-streaked
30
Q

Appearance of the ff peritonela fluid significances

  1. Microbial infection
  2. Lymphatic trauma
  3. Pancreatic disorders
  4. Blockage
  5. Trauma
  6. Infection
  7. Malignancy
  8. Gall bladder disorders
A
  1. Turbid
  2. Milky
  3. Green
  4. Milky
  5. Blood-streaked
  6. Blood-streaked
  7. Blood-streaked
  8. Green
31
Q

Normal WBC ct in peritoneal fluid

A

<500 cells/uL

32
Q

Peritoneal lavage containing _____ RBCs/uL indicates blunt trauma injury (intra-abdominal bleeding)

A

> 100,000

33
Q

Contain concentric striations of collagen-like material

A

Psammoma bodies

34
Q

____ mesothelial cells appear in clusters, have varying amt of cytoplasm, eccentric nuclei, and prominent nucleoli

A

Reactive

35
Q

_____ mesothelial cells appear as single small or large round cells with abundant blue cytosplasm and round nuclei with uniform dark purple cytoplasm

A

Normal

36
Q

Pleural fluid neutrophils are ____ (inc or dec) in effusions due to pancreatitis and pulmonary infarction

A

Inc

Analysis of Urine and Other Body Fluids (18 decks)

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