LAB 7 Body cavity fluids + CSF

Question 1

Body cavity fluids

Answer 1

Pericardial cavity
Peritonial cavity (abdominal)
Pleural cavity (thorax) + mediastinum

Question 2

Causes of accumulation in different cavities?

Answer 2

1. Increased permeability of vessels due to non-inflammatory causes
2. Increased permeability due to inflammation

Question 3

Non-inflammatory causes of fluid accumulation, due to increased permeability of vessels?

Answer 3

• Increase hydrostatic pressure of blood:
  righ side heart failure, liver failure, blockage of vessel
• Decrease of plasma colloid oncotic pressure:
  decreased albumin levels
• Impeded lymphatic flow
• Hormonal effects: aldosterone, ADH

Question 4

Inflammatory causes of fluid accumulation, due to increased permeability of vessels?

Answer 4

Bacterial (endotoxins, exotoxins)
Viral (immune complexes)
Parasitic toxins
Inflammatory mediators (histamine, immune complexes)

Question 5

Types of fluids in body cavities?

Answer 5

• Transudate (hydro-): due to systemic faults
• Excudate (pyo-): due to inflammation
• Modified transudate: between transudate and excudate
• Blood
• Chylus (lymph)

Question 6

How should the samples be taken?

Answer 6

Sterile enviorment: syringe, IV catheter, vacuum bottles into glass tube and Na(K)2EDTA (anticoagulant) containing tubes.

Question 7

What is the Rivalta test? Process

Answer 7

3% acetic acid into non-centrifuged sample.
Coagulation –> smokey appearance = exudate
No coagulation –> transudate
Honey-like –> sample contains high glubin amount

Question 8

Albumin/globulin ratio of fluids suggests:

Answer 8

Important in cats!
If more than 50% of TP are globulins –> suggest FIP (feline infectious peritonitis, virus)
TP (total protein) - albumin = globulin

Question 9

Creatinine, urea concentration of fluids suggests:

Answer 9

If levels are higher in fluid than in plasma –> suggest urinary bladder rupture, kidney rupture or rupture of the urether(s)

Question 10

Alpha-amylase, lipase activity of fluids suggest:

Answer 10

If higher in fluid than in plasma –> suggest duodenal perforation, gall bladder rupture, pancreatitis.

If collected from pleural cavity + highly inflammatory + high alpha-amylase activity –> suggest esophageal rupture.

Question 11

LDH activity (lactate dehydrogenase) in fluids suggest:

Answer 11

Increased value –> suggest neoplastic origin (tumours)

Question 12

Triglycerol / cholesterol ratio in fluids suggest:

Answer 12

To evaluate whether the fluid is lymphatic or not.

More TG than Chol –> chylus (lymph)

Question 13

Major causes of septic exudates

Answer 13

• Trauma of pleural, peritoneal or pericardeal wall
• Overgrowth of bacteria through wall of organs (e.g. pneumonia)
• Rupture of organs (e.g. gastric perfuration)
• Haematogenous or lymphatic spreading of bacteria (e.g. mycobacteriosis)

Question 14

Major causes of non-septic exudates

Answer 14

• Viruses (e.g. FIP)
• Parasites
• Rupture of gall bladder and urinary bladder
• Neoplasm or necrosis (e.g. from pancreatitis)
• Trauma caused to lymphatic organs (nodes, spleen and lymph vessels)

Question 15

Causes of modified transudates

Answer 15

Long-term stasis –> tissue necrosis on neighbouring tissues –> secondary inflammatory response

Question 16

When to we take CSF samples and where?

Answer 16

When the patient shows central nervous signs.
Lumbusacral and occipital zone.

Make sure to perform retina observation to check the intracranial pressure. If it is high, it is necessary to reduce it!

Question 17

What kind of tubes must the sample go into?

Answer 17

Na(K)2 EDTA-containing tubes

Question 18

Physical examination of CSF:

Answer 18

• Colour: red (fresh bleeding), yellow (old bleeding), opaque (highly inflammatory or neuplastic conditions)
• Turbidity: slightly (cell count 100-300/ul), severe (2000-3000/ul)
• Coagulation: in higly inflammatory processes

Question 19

Major cell types in CSF

Answer 19

Small lymphocytes, macrophages and some epithelial cells.

Nr. of neutrophil granulocytes must not exceed 10%

Question 20

Causes of neutrophil pleocytosis (increased neutrophils in CSF)?

Answer 20

• Bacterial + parasitic menginitis
• GME
• Steroid-responsive meningitis-arthritis

Question 21

Cause of high eosinophil granulucyte count in CSF?

Answer 21

Eosinophilic meningoencephalitis

Question 22

Glucose concentration of CSF

Answer 22

60-80% of plasma glucose

In case of inflammation –> decreased

Question 23

Lactate concentration in CSF

Answer 23

< 2.2 mmol/l
Increased lactate conc:
- bacterial menginitis
- subarachnoid bleeding
- ischemic attacks