CM LEC - Pleural Fluid Flashcards
(112 cards)
1
Q
Closed cavities
A
Pleural, pericardial, peritoneal cavities
2
Q
Closed cavities
A
Pleural, pericardial, peritoneal cavities
3
Q
type of serous membrane
lines the cavity wall
A
Parietal membrane
4
Q
type of serous membrane
covers the organs within the cavity
A
Visceral membrane
5
Q
– fluid between the membranes
A
serous fluid
6
Q
why small amount of serous fluid is normally present
A
because production and reabsorption take place at a constant rate
7
Q
function of serous fluid
A
provides lubrication
8
Q
production and reabsorption of serous fluid subject to
A
hydrostatic pressure colloidal pressure (oncotic pressure)
9
Q
needle aspiration procedures for pleural fluid
A
Thoracentesis
10
Q
needle aspiration procedures for pericardial fluid
A
Pericardiocentesis
11
Q
needle aspiration procedures for peritoneal fluid
A
Paracentesis
12
Q
volume of serous fluid to be collected
A
> 100 ml
13
Q
type of tube for cell counts and diff count
A
EDTA
14
Q
type of tube for microbiology and cytology
A
sterile heparinized or sodium polyanethol sulfonate (SPS)
15
Q
done for better recovery of microorganisms and abnormal cells
A
Centrifugation
16
Q
what type of tests are performed on clotted specimens in plain tubes or in heparin tubes
A
chemistry tests
17
Q
results of chemistry tests compared with __ chemical concentrations
A
plasma
18
Q
Specimens for pH must be ___
A
maintained anaerobically in ice
19
Q
Cause of an effusion may be
A
transudate or exudate
20
Q
cause of an effusion
formed because of a systemic disorder that disrupts the balance in the regulation of fluid filtration and reabsorption (ex of systemic disorder: changes in hydrostatic pressure created by congestive heart failure or the hypoproteinemia associated with the nephrotic syndrome)
A
transudates
21
Q
cause of an effusion
produced by conditions that directly involve the membranes of the particular cavity, including infections and malignancies
A
exudates
22
Q
- most reliable differentiation between transudate and exudate
A
Fluid: blood ratios for protein and lactic dehydrogenase
23
Q
• Serous fluid cell counts can be performed manually by using a ____ counting chamber
A
Neubauer
24
Q
fluid obtained from the pleural cavity
A
pleural fluid
25
additional procedures helpful when analyzing pleural fluid
- -pleural fluid cholesterol and fluid:serum cholesterol ratio
- -pleural fluid:serum total bilirubin ratio
26
when is a pleural fluid/effusion classified as an exudate
- - pleural fluid cholesterol >60 mg/dL
- -pleural fluid:serum cholesterol ratio >0.3
- -fluid:serum total bilirubin ratio of 0.6 or more
27
used to differentiate between hemothorax and hemorrhage exudate
Hematocrit
28
Hct > 50% = ?
hemothorax, effusion comes from the inpouring of blood from injury
29
Hct
chronic membrane disease effusion (has both blood and increased pleural fluid)
30
milky pleural fluid may be due to (2)
chylous
| pseudochylous
31
most diagnostically significant hematology test performed on serous fluids
Differential count
32
what type of WBC increases in pulmonary infarction
neutrophils
33
what type of WBC increases in
- Presence of air or blood (pneumothorax and hemothorax)
- Allergic reactions
- Parasitic infections
eosinophil
34
– pleomorphic: resemble lymphocytes, plasma cells, and malignant cells, frequently making identification difficult
Mesothelial cells
35
what type of mesothelial cells: single small or large round cells with abundant blue cytoplasm and round nuclei with uniform dark purple cytoplasm
normal mesothelial cells
36
what type of mesothelial cells: in clusters; have varying amounts of cytoplasm, eccentric nuclei, and prominent nucleoli; and be multinucleated, thus more closely resembling malignant cells
reactive mesothelial cells
37
lack of mesothelial cells is due to
exudate covering pleural membranes
38
lack of mesothelial cells associated with
TB
39
What type of cells
| nuclear and cytoplasmic irregularities
malignant cells
40
What type of cells
| hyperchromatic nucleoli
malignant cells
41
What type of cells
| cellular clumps with cytoplasmic molding (community borders)
malignant cells
42
What type of cells
| abnormal nucleus:cytoplasm ratios
malignant cells
43
most common chemical tests for pleural fluid (4)
glucose
pH
Adenine deaminase (ADA)
Amylase
44
Decreased value for glucose in pleural fluid
45
Decreased value for glucose in pleural fluid (
TB
RA
Purulent infections
46
if pH reaches
chest-tube drainage
47
if pH reaches
antibiotics
48
what is considered significant pH in pleural fluid
at least 0.30 degrees lower than blood pH
49
pH of 6.0 associated with
esophageal rupture
50
ADA > 40 U/L associated with
TB or malignancy
51
elevated first in the pleural fluid
Amylase
52
Amylase elevated first in what type of serous fluid
pleural
53
increased amylase associated with (3)
pancreatitis, esophageal rupture, malignancy
54
used to confirm the presence of chylous effusion
triglyceride levels
55
- Staphylococcus aureus
- Enterobacteriaceae
- Anaerobes
- Mycobacterium tuberculosis
Microorganisms primarily associated with pleural effusions include:
56
most frequent serologic tests for pleural fluid
o antinuclear antibody (ANA)
| o rheumatoid factor (RA)
57
tests for pleural effusions of malignant origin (5)
- CEA
- CA 125 (metastatic uterine cancer)
- CA 15.3
- CA 549 (breast cancer)
- CYFRA 21-1 (lung cancer)
58
type of serous membrane
| lines the cavity wall
Parietal membrane
59
type of serous membrane
| covers the organs within the cavity
Visceral membrane
60
– fluid between the membranes
serous fluid
61
why small amount of serous fluid is normally present
because production and reabsorption take place at a constant rate
62
function of serous fluid
provides lubrication
63
production and reabsorption of serous fluid subject to
```
hydrostatic pressure
colloidal pressure (oncotic pressure)
```
64
needle aspiration procedures for pleural fluid
Thoracentesis
65
needle aspiration procedures for pericardial fluid
Pericardiocentesis
66
needle aspiration procedures for peritoneal fluid
Paracentesis
67
volume of serous fluid to be collected
> 100 ml
68
type of tube for cell counts and diff count
EDTA
69
type of tube for microbiology and cytology
sterile heparinized or sodium polyanethol sulfonate (SPS)
70
done for better recovery of microorganisms and abnormal cells
Centrifugation
71
what type of tests are performed on clotted specimens in plain tubes or in heparin tubes
chemistry tests
72
results of chemistry tests compared with __ chemical concentrations
plasma
73
Specimens for pH must be ___
maintained anaerobically in ice
74
Cause of an effusion may be
transudate or exudate
75
cause of an effusion
formed because of a systemic disorder that disrupts the balance in the regulation of fluid filtration and reabsorption (ex of systemic disorder: changes in hydrostatic pressure created by congestive heart failure or the hypoproteinemia associated with the nephrotic syndrome)
transudates
76
cause of an effusion
produced by conditions that directly involve the membranes of the particular cavity, including infections and malignancies
exudates
77
- most reliable differentiation between transudate and exudate
Fluid: blood ratios for protein and lactic dehydrogenase
78
• Serous fluid cell counts can be performed manually by using a ____ counting chamber
Neubauer
79
fluid obtained from the pleural cavity
pleural fluid
80
additional procedures helpful when analyzing pleural fluid
- -pleural fluid cholesterol and fluid:serum cholesterol ratio
- -pleural fluid:serum total bilirubin ratio
81
when is a pleural fluid/effusion classified as an exudate
- - pleural fluid cholesterol >60 mg/dL
- -pleural fluid:serum cholesterol ratio >0.3
- -fluid:serum total bilirubin ratio of 0.6 or more
82
used to differentiate between hemothorax and hemorrhage exudate
Hematocrit
83
Hct > 50% = ?
hemothorax, effusion comes from the inpouring of blood from injury
84
Hct
chronic membrane disease effusion (has both blood and increased pleural fluid)
85
milky pleural fluid may be due to (2)
chylous
| pseudochylous
86
most diagnostically significant hematology test performed on serous fluids
Differential count
87
what type of WBC increases in pulmonary infarction
neutrophils
88
what type of WBC increases in
- Presence of air or blood (pneumothorax and hemothorax)
- Allergic reactions
- Parasitic infections
eosinophil
89
– pleomorphic: resemble lymphocytes, plasma cells, and malignant cells, frequently making identification difficult
Mesothelial cells
90
what type of mesothelial cells: single small or large round cells with abundant blue cytoplasm and round nuclei with uniform dark purple cytoplasm
normal mesothelial cells
91
what type of mesothelial cells: in clusters; have varying amounts of cytoplasm, eccentric nuclei, and prominent nucleoli; and be multinucleated, thus more closely resembling malignant cells
reactive mesothelial cells
92
lack of mesothelial cells is due to
exudate covering pleural membranes
93
lack of mesothelial cells associated with
TB
94
What type of cells
| nuclear and cytoplasmic irregularities
malignant cells
95
What type of cells
| hyperchromatic nucleoli
malignant cells
96
What type of cells
| cellular clumps with cytoplasmic molding (community borders)
malignant cells
97
What type of cells
| abnormal nucleus:cytoplasm ratios
malignant cells
98
most common chemical tests for pleural fluid (4)
glucose
pH
Adenine deaminase (ADA)
Amylase
99
Decreased value for glucose in pleural fluid
100
Decreased value for glucose in pleural fluid (
TB
RA
Purulent infections
101
if pH reaches
chest-tube drainage
102
if pH reaches
antibiotics
103
what is considered significant pH in pleural fluid
at least 0.30 degrees lower than blood pH
104
pH of 6.0 associated with
esophageal rupture
105
ADA > 40 U/L associated with
TB or malignancy
106
elevated first in the pleural fluid
Amylase
107
Amylase elevated first in what type of serous fluid
pleural
108
increased amylase associated with (3)
pancreatitis, esophageal rupture, malignancy
109
used to confirm the presence of chylous effusion
triglyceride levels
110
- Staphylococcus aureus
- Enterobacteriaceae
- Anaerobes
- Mycobacterium tuberculosis
Microorganisms primarily associated with pleural effusions include:
111
most frequent serologic tests for pleural fluid
o antinuclear antibody (ANA)
| o rheumatoid factor (RA)
112
tests for pleural effusions of malignant origin (5)
- CEA
- CA 125 (metastatic uterine cancer)
- CA 15.3
- CA 549 (breast cancer)
- CYFRA 21-1 (lung cancer)
