M4: Serous Fluids (Part 4: Peritoneal Fluid) Flashcards

1
Q

Peritoneal Fluid

clear and pale yellow

Identify what significance/condition based on appearance

A

Normal

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2
Q

turbid with bacterial or fungal infections

Identify what significance/condition based on appearance

A

Exudates

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3
Q

Green or dark-brown bile

Identify what significance/condition based on appearance

A

bilirubin

Check for chemical test for bilirubin

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4
Q

Peritoneal Fluid

Blood-streaked fluid

Identify what significance/condition based on appearance

A

after trauma, tuberculosis, intestinal disorders, and malignancy

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5
Q

Peritoneal Fluid

Chylous or pseudochylous material

Identify what significance/condition based on appearance

A

trauma or blockage of lymphatic vessels

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6
Q

Peritoneal Fluid

Trauma

a. blood streaked fluid
b. chylous/psuedochylous material
c. both
d. NOTA

A

c. both

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7
Q

Peritoneal Fluid: Laboratory Tests

accumulation of fluid between the peritoneal membranes

A

Ascites

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8
Q

Peritoneal Fluid: Laboratory Tests

This is accumulation of fluid and is of hepatic origin

A

Ascitic fluid

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9
Q

Peritoneal Fluid: Laboratory Tests

Indicate Hepatic Disorders

accumulation of fluid

A

Ascitic transudate

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10
Q

Peritoneal Fluid: Laboratory Tests

  • Intestinal Perforation
  • Ruptured Appendix
  • Malignancy

conditions listed are associated with what infection?

A

Peritonitis (bacterial infection)

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11
Q

Peritoneal Fluid: Laboratory Tests

  • Specimen used for diagnostic
    procedure used to detect intra-abdominal bleeding in blunt trauma cases
  • Indicates patient needs surgery
A

Peritoneal lavage

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12
Q

Peritoneal Fluid: Laboratory Tests

Volume of peritoneal lavage needed which indicates blunt trauma injuries causes internal bleeding (also indicates patient needs surgery)

A

> 100,000/μL RBC count

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13
Q

Peritoneal Fluid: Laboratory Tests

Peritoneal lavage

a. Intra-abdominal bleeding
b. >100,000/mL RBC count
c. both
d. NOTA

A

a. Intra-abdominal bleeding

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14
Q

Peritoneal Fluid: Laboratory Tests

tests used in detection of peritoneal fluid laternative to using peritoneal lavage

A
  • FAST
  • CT
  • Cell counts and differential

FAST - Focused Assessment with Sonography for Trauma

CT - Computed Tomography

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15
Q

Peritoneal Fluid: Laboratory Tests

WBC count of < 500
cells/μL
indicate what condition?

Cell counts and differential

A

None, normal

>500 cells/ul ang abnormal

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16
Q

Peritoneal Fluid: Laboratory Tests

Increased WBC Count involves what (2) conditions

Cell counts and differential

A
  • Bacterial peritonitis
  • Cirrhosis
17
Q

Peritoneal Fluid: Laboratory Tests

T or F

Absolute neutrophil count of < 250 cells/uL or WBC count of < 50% of indicates infection

Cell counts and differential

A

F (Absolute neutrophil count of >250 cells/uL or WBC count of >50% of indicates infection)

18
Q

Peritoneal Fluid: Laboratory Tests

Tuberculosis and Peritoneal Carcinomatosis indicates presence of?

a. Neutrophil
b. Eosinophil
c. Lymphocyte
d. ALL
e. NOTA

Cell counts and differential

A

c. Lymphocyte

19
Q

Peritoneal Fluid: Transudates Versus Exudates

  • Is recommended than the fluid: serum total protein and LD ratios
  • Detect Transudates of Hepatic Origin
A

SAAG

Serum–ascites albumin gradient

20
Q

T or F

In SAAG, you also get the blood serum of patient

A

T

21
Q

After peritoneal fluid and serum albumin are measured. What should be done?

A

Subtract fluid albumin level from serum albumin

22
Q

A difference (gradient) of 1.1 or greater = ?

A difference (gradient) less than 1.1 = ?

Levels of fluid and serum albumin

A

A difference (gradient) of 1.1 or greater = Transudate effusion of hepatic origin

A difference (gradient) less than 1.1 = Exudative Effusions

23
Q

Peritoneal Fluid: Cellular Examination

These are examined to:
* detects tumors of primary and metastatic origin
* Gastrointestinal, prostate, or ovarian origin
* Doctor expecting maglignancy
* Leukocytes, abundant, mesothelial cells, and macrophages, lipophages

A

Ascitic Exudates Malignant Cells

24
Q

Peritoneal Fluid: Cellular Examination

seen in Acscitic fluid except

a. Bacteria
b. RTE
c. Yeast
d. Toxoplasma gondii

A

b. RTE

25
Q

Peritoneal Fluid: Cellular Examination

Malignant cells of ovarian, prostatic, and colonic origin, often containing?

A

mucin-filled vacuoles

26
Q

Peritoneal Fluid: Cellular Examination

  • containing concentric striations of collagen like material
  • benign conditions and associated with ovarian and thyroid malignancies
A

Psammoma bodies

27
Q

Peritoneal Fluid: Chemical Testing

Parameters observed in chemical testing of peritoneal fluid

A
  • Glucose
  • Amylase
  • Alkaline phosphatase
  • BUN and creatinine
  • Bilirubin
28
Q

Peritoneal Fluid: Chemical Testing

This analyte is decreased below serum levels in bacterial and tuberculous peritonitis and malignancy

A

Glucose

29
Q

Peritoneal Fluid: Chemical Testing

This presence of analyte indicates pancreatitis, gastrointestinal perforations

A

Amylase

30
Q

Peritoneal Fluid: Chemical Testing

This presence of analyte indicates increased in intestinal perforations

A

Alkaline phosphatase

31
Q

Peritoneal Fluid: Chemical Testing

This presence of analyte indicates ruptured bladder or accidental puncture of the bladder

A

BUN and creatinine

32
Q

Peritoneal Fluid: Chemical Testing

This presence of analyte indicates leakage of bile into the peritoneum

due to trauma or accidents duirng surgery

A

Bilirubin

33
Q

Peritoneal Fluid: Microbiology Tests

are performed when bacterial peritonitis is suspected

A

Gram stains and bacterial cultures

34
Q

Peritoneal Fluid: Microbiology Tests

What other microbiology tests may be requested aside from gram stain and culture for detecting TB

A

AFS, Adenosine Deaminase, Cultures for TB

35
Q

Peritoneal Fluid: Microbiology Tests

  • more sensitive and specific
  • done when doctor suspects TB
A

PCR

36
Q

Peritoneal Fluid: Serological Tests

is a valuable- ID of primary source of tumors producing ascitic exudates

tumor markers ‘to beh

2

A

CEA and CA 125

37
Q

Peritoneal Fluid: Serological Tests

Presence of this tumor markers means the source are ovaries, fallopian tubes, or endometrium

A

CA 125 (NEGATIVE CEA)