Misc Fluid Flashcards
Vaginal secretion collection
Non lubricated speculum, swab or loop, saline
Room temp
pH of vaginal fluid
and changes
Before saline: 3.8-4.5
Acidic from lactobacilli
>4.5: bacterial and trich
Clue cells
SECs covered in bacteria, usually G. vaginalis or P. bivia
Time frame for reading motile trichomonas?
within 30 mins
Blood cells
WBCs: usually normal
RBCs: NONE unless menstruation?
Significance of lactobacilli
large motile GPR
if decreased = opportunisitc infection possible
Abnormal epithelial cells
Parabasal: increased in vaginitis or natural inflammation
Basal: desquamative vaginitis, cancer
KOH prep and amine test
Happens at the same time
- Drop KOH onto slide for yeast or fungus
- If there is a fishy odor, amine is released, strong with bacterial vaginosis
Clues for bacterial vaginosis
Usually no WBCs
Lack of lactobacilli giving other opportunity
- Clue cells
- Amine test +
- ph >4.5
- gray yellow stank discharge
Candidiasis
Candida albicans: normal flora but gets out of control without normal flora or immunocomp
Clues
- Increased WBCs, yeast hyphae
- Amine -, KOH +
- White curd discharge
Trichomoniasis
Vaginal inflammation
- Green/yellow
- Culture or DNA probe
- pH 5-6
- Increased WBCs and sometimes altered flora
- Amine sometimes +
Atrophic vaginitis
Epithelium thinning
- Decrease estrogen + lactobacilli
- Dryness, soreness
- pH >5
- WBCs and RBCs up, parabasal cells
- Amine KOH neg because no yeast or bacteria
Bronchoalveolar lavage and collection
Lower respr. tract
- Saline inijected into alveolar space then mixed and aspirated
- 10-20 mls
- Discard 1st aliquot
BAL transport and storage
Room temp transport
- >30mins then ice
- no testing after 24hrs
What causes milky or beige BAL fluid
Phospholipid proteins or pulmonary alveolar proteinosis