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CLS 304 > Chapter 15 Serous Fluids > Flashcards

Chapter 15 Serous Fluids Flashcards

1
Q

Fluid between the membranes of closed body cavities

A

Serous fluid

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2
Q

Lines the cavity walls

A

Parietal membrane

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3
Q

Covers the organs within the cavity

A

Visceral membrane

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4
Q

Provides lubrication to prevent friction between 2 membranes when organs move

A

Serous fluid

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5
Q

Label the missing visceral and parietal membranes

A
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6
Q

Space between each lung and the chest wall

A

Pleural cavities

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7
Q

A thin membrane lines the pleural cavities

  • composed of thin layer of mesothelial cells
  • provides a moist surface to minimize friction
A

Pleura

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8
Q

Surrounds the heart

A

Pericardial cavity

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9
Q

Thin membrane that covers the pericardial party

- composed of a single layer of mesothelial cells

A

Pericardium

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10
Q

Pericardial fluid reactions

A
  • Fluid can accumulate

- can restrict the normal heart beat (cardiac tamponade)

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11
Q

Name the cavity or cells

A
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12
Q

Space between the abdominal wall and outside of the stomach, small and large intestine, liver, and superior aspect of the urinary bladder and uterus

A

Peritoneal cavity

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13
Q

Consists of one layer of mesothelial cells

A

Peritoneal lining

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14
Q

Accumulation of peritoneal fluid

A

Ascites

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15
Q

3 types of body fluids

A

Pleural, pericardial, peritoneal

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16
Q

Similar findings for all 3 fluids (6)

A
  • Minimal amount of fluid
  • produced by the parietal lining
  • absorbed by the visceral lining
  • fluid is produced by plasma filtration through capillary endothelial cells
  • amount produced depends on 4 factors
  • pathological state results in effusion - abnormal fluid collection
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17
Q

What 4 factors does the amount produced depend on

A
  • Increased capillary hydrostatic pressure
  • decreased plasma oncotic pressure
  • decreased lymphatic resorption
  • increased capillary permeability
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18
Q

Types of effusion

A

Transudate and exudate

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19
Q

Contain a small amount of fluids to lubricate and cushion organ movement

A

Body cavities

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20
Q

Amount of fluid is maintained by an equilibrium between

A

The fluid, capillaries, and lymphatic vessels of an organ

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21
Q

Any compromise can cause an escape and buildup of fluids into the body cavity called

A

Effusion

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22
Q

Needle puncture for aspiration of fluids from body cavities

A

Centesis

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23
Q

Thoracentesis

A

Pleural

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24
Q

Pericardiocentesis

A

Pericardial

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25
Q

Paracentesis or peritoneocentesis also known as ascitic fluid

A

Peritoneal

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26
Q

Intermittent drainage of excess fluid through a catheter that remains in the pleural space

A

Pleural catheter

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27
Q

Repeated fluid removal via a syringe or temporary external catheter connected to a vacuum container

A

Serial thoracenteses

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28
Q

Creation of scar tissue in pleural space

A

Pleurodesis

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29
Q

Increased capillary hydrostatic pressure causes

A

Congestive heart failure

Salt and fluid retention

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30
Q

Decreased oncotic pressure causes

A

Nephrotic syndrome
hepatic cirrhosis
Malnutrition
Protein-losing enteropathy

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31
Q

Increased capillary permeability causes

A

Microbial infections
Membrane inflammations
Malignancy

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32
Q

Lymphatic obstruction causes

A

Malignant tumors
Lymphomas
Infection and inflammation
Thoracic duct injury

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33
Q

Causes of exudate

A

Increased capillary permeability

Decreased lymphatic absorption

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34
Q

Causes of transudate

A

Increased hydrostatic pressure

Decreased oncotic pressure

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35
Q

Conditions of exudate

A

Infections, inflammatory, neoplasms

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36
Q

Conditions of transudate

A

Congestive heart failure, renal disease, cirrhosis, malnutrition

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37
Q

Specific gravity: >1.015
Protein: >3.0 g/dL
Fluid:serum ratio: >0.5
Lactic dehydrogenase fluid:serum ratio: >0.6
WBC: >1000 per microliter
Diff: >25% PMN, many mesothelial cells, malignant cells
Fibrinogen: cause clotting

A

Exudate

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38
Q 
Specific gravity: <1.015
Protein: <3.0 g/dL
Fluid:serum ratio: <0.5
Lactic dehydrogenase fluid:serum ratio: <0.6
WBC: <1000 per microliter
Diff: <25% PMN and lymphs
Fibrinogen: none
A

Transudate

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39
Q

Decreased in infection, tuberculosis, rheumatoid inflammation

A

Glucose

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40
Q

Elevated in bacterial infections

A

Lactate

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41
Q

Increased in pancreatitis, esophageal rupture and malignancy

A

Amylase

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42
Q

Decreased in pneumonia resistant to antibiotics and esophageal rupture

A

pH

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43
Q

Increased in tuberculosis and malignancy

A

Adenosine deaminase

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44
Q

Infections: bacteria, tuberculosis, fungal and viral

A

Microbiological studies

45
Q

Malignancies

A

Cytology studies

46
Q

Normal appearance

A

Clear, pale, yellow

47
Q

Microbial infection appearance

A

Turbid, cloudy

48
Q

Hemothorax, hemorrhagic effusion, pulmonary embolism, TB, cardiac puncture, anticoagulants, malignancy appearance

A

Bloody (hematocrit is run >50% indicates hemothorax)

49
Q

Chylous or pseudochylous material appearance

A

Milky, opaque. Remains in the supernatant after centrifugation

50
Q

Rupture of liver abscess, bile appearance

51
Q

Gallbladder, pancreatic disorders appearance

52
Q

Aspergillous appearand

53
Q

Results from leakage of lymphatic vessels of the major thoracic duct

A

Chylous effusion in pleural cavity

54
Q

Results from blockage of the lymphatic vessel

A

Chylous effusion of peritoneal fluid

55
Q

Associated with malignancy and trauma

A

Chylous effusion

56
Q

Rich in chylomicrons, high triglycerides >110 mg/dL, lymphocyte predominant cell

A

Chylous effusion

57
Q

Results from conditions such as TB and rheumatoid pleuritis

A

Pseudochylous effusions

58
Q

Cholesterol high with crystals, chylomicrons not present, triglycerides < 50 mg/dL

A

Pseudochylous effusions

59
Q

Mixed reactive cell population

- inflammatory cells, necrotic cells

A

Psuedochylous effusions

60
Q

No question

61
Q

Bacterial endocarditis differential

A

Increased neutrophils or gram stain and culture

62
Q

Metastatic carcinoma differential

A

Malignant cells or carcinoembryonic antigen

63
Q

Tubercular effusion differential

A

Acid-fast stain or adenosine deaminase

64
Q

Best differentiation for peritoneal transudates and exudates

A

Serum-ascites

65
Q

Serum and fluid albumin levels are measured; fluid level is subtracted from serum level; difference (gradient) > than 1.1 =

A

Transudate (hepatic origin)

66
Q

Serum albumin 3.8 - fluid albumin 1.2 =2.6 =

A

Hepatic transudate

67
Q

Segmented neutrophils are found in

A

Pleural, pericardial, and peritoneal fluid

68
Q
A

Artifactual change in neutrophils

69
Q

Differences in segmented neutrophils (3)

A
  • Artifactual changes due to cytocentrifugation
  • degeneration
  • immature neutrophils
70
Q

Lymphocytes in various morphologies are present in

A

All body fluid types

71
Q

Lymphocyte difference in cytocentrifugation (3)

A
  • Nucleoli can be more prominent
  • Irregular nuclear shape
  • cytoplasmic projections
72
Q
A

Overly prominent nucleoli in lymphocytes

73
Q

Not seen in normal fluids; found in chronic inflammatory disorders

A

Plasma cells

74
Q

Small numbers in pleural, pericardial, peritoneal, joint fluid
High in various disorders

A

Eosinophils, basophils, mast cells

75
Q

Appear similar to those in PB smears

76
Q

Larger, abundant vacuolated cytoplasm

A

Histiocytes

77
Q

Has phagocytosed material

A

Macrophages, phagocyte

78
Q

Large vacuoles fuse, nucleus flattened against membrane

A

Signet ring

79
Q

Cell and fluid type

A

Monocytes in pleural fluid

80
Q

Cell and fluid type

A

Histiocyte in pleural fluid

81
Q

Cell and fluid type

A

Macrophage in pleural fluid (“signet ring” appearance)

82
Q
  • Seen in any BFs

- must be differentiated from malignant cells

A

Benign tissue cells

83
Q
  • Pleural, pericardial, peritoneal fluid
  • cytoplasm = moderate to abundant, light or dark blue, may contain granules or phagocytosed debris
  • nucleus- eccentric, homogenous chromatin pattern, nucleoli blue with smooth membrane
A

Benign mesothelial cells

84
Q

Single cell layer lines membranes; “fried egg appearance”

A

Mesothelial Cells

85
Q
A

Benign mesothelial cells

86
Q

Mesothelia cells that may be multinucleated

A

Reactive Cells

87
Q
A

Reactive mesothelial cells

88
Q

Wright’s stain of cytocentrifage prep test for what

A

Bacteria, fungi, yeast

89
Q
  • Stains blue with wright’s stain
  • intracellular establishes pathogenicity
  • gram stain
90
Q
  • CSF
  • can be seen intracellulary
  • most frequent fungal organisms: cryptococcus, histoplasma, candida albicans, candida tropicalis
91
Q
A

Intracellular and extracellular bacteria, bacilli

92
Q
A

Candida tropicalis

93
Q
  • Can contain malignant cells
  • ID critical for making correct diagnosis
  • may establish a condition of tumor metastasis
  • may be the initial diagnosis of malignancy
A

Pleural, pericardial, and peritoneal fluids

94
Q

Malignant: hematopoietic examples

A

Leukemia, lymphoma

95
Q

Malignant: nonhematopoietic examples

A

Carcinoma, sarcoma

96
Q

General malignant cell features

A
  • Irregular nuclear membrane - jagged or multiple folds
  • unevenly distributed chromatin
  • Nucleoli irregular membrane, prominent, irregular shape
  • N:C ratio varies
97
Q

Must common nonhematopoietic malignancy

A

Adenocarcinomas

98
Q
  • Larger than small cell carcinoma
  • moderate to abundant cytoplasm
  • nuclear chromatin-partially clumped, heterogeneous, prominent nucleoli
  • cytoplasmic vacuoles
A

Adenocarcinoma

99
Q

Carcinoembryonic antigen gastric cancer tumor marker

100
Q

Metastatic uterine cancer tumor marker

101
Q

Breast cancer tumor markers

A

CA15.3 and CA540

102
Q

Lung cancer tumor marker

A

CYFRA 21.1

103
Q
A

Metastatic breast carcinoma cells

104
Q
A

Small cell carcinoma

105
Q
A

Adenocarcinoma

106
Q
A

Small cell carcinoma

107
Q
A

Pancreatic carcinoma

108
Q
A

Bile pigment in macrophage due to cholangiocarcinoma

CLS 304 (8 decks)

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