Recognition and analysis of bodily fluids Flashcards
Name the 3 types of BCE based on protein levels and cell numbers
Transudate
Modified transudate
Exudate
Name the three body cavity spaces fluid can accumulate
Peritoneum (abdomen)
Pleura (thorax)
Pericardium
Which tube/s do I use to collect body cavity effusions
EDTA
Plain tube
Name types of sample processing and fluid anaylsis
Protein concentration
Nucleated cell count
Colour & turbidity
Cytologic analysis
Transudate effusions often result from
Decreased plasma oncotic pressure(Severe hypoalbuminemia)
Increased hydrostatic pressure
Colour of transudate
colourless to straw-coloured
Nucleated cell count of transudate and exception in horses
<1.5 x 10^9 cells/L
Exception is the horse – may have up to 10 cells x109/L with up to 75-80% non-degenerate neutrophils and still be considered a transudate
Protein level of transudate
<25 g/L
Expected cells in transudate
Macrophages, mesothelial cells, and rare non-degenerate neutrophils
What is the main cause of exudate
Inflammation
Why does inflammation cause exudate
Increased capillary permeability
Chemotaxis of leukocytes
Protein level of exudate
> 25 g/L
Cell count of exudate and in horses
5 x 10^9 cells/L
Horses: >5
Definition of modified transudate
Nucleated cell count or protein concentration is increased but does not fit with the exudate range
Cause of chyle
Leakage of chyle from the lymphatic system into the body cavity (usually thorax)
What gives chyle its milky appearance
Chylomicrons
Causes of chylous effusion
Idiopathic (~70% of feline chylothorax cases)
Mediastinal mass (neoplasia, less commonly inflammation)
Cardiovascular disease
Diaphragmatic hernia, lung lobe torsion
Trauma (thoracic duct rupture – rare), others
What should you expect to see of a chyle cytology
Small mature lymphocytes should predominate
Colour of FIP effusions
Odourless, straw-coloured to gold
Protein level of FIP effusion
> 35 g/L
Cell count of FIP effusion
with variable, often low, cell counts (neutrophils usually predominate)
Additional test for FIP effusions
FCoV antibody titre
- Confirm exposure to FCoV (enteric or FIP?)
Alpha 1-AGP and A:G ratio
- Evidence of inflammation
PCR
- Detecting FCoV RNA
- Does not differentiate between enteric FCoV and FIP
What do you expect to see of a microscopic view of FIP fluid
Tthick protein background with granular precipitates. Low numbers of non-degenerate neutrophils are often present, though other cell types (macrophages, lymphocytes) can also be present.
Term used for urine in peritoneum
Uroperitoneum
Confirmatory test to test for chyle
Triglyceride: Fluid > Serum
Confirmatory test to test for Neutrophilic inflammation (Septic)
Bacterial Culture
Confirmatory test to test for urinary tract rupture
Creatinine: Fluid > Serum
Cerebrospinal fluid test is a useful test in patients with
Neurological disease
Neck or limb pain
Fever of unknown origin
Type of test used to collect cerebrospinal fluid
Plain serum tube
Outline sample processing of cerebrospinal fluid
Requires prompt analysis
If volume allows send two aliquots
One unaltered for protein
One with 10% autologous serum for better cell preservation
What is the healthy level of Total protein & nucleated cell count in cerebrospinal fluid
Low in healthy animals
What is the stain used to stain cereobrospinal fluid
Romanowsky stain
Synovial fluid test is a useful test in patients with
Joint swelling
Limping
Monoarthropathy
Polyarthropathy
Fever of unknown origin
Generalised pain
Weakness
Colour of Synovial fluid
Normally transparent to colourless
Note any turbidity
Blood (iatrogenic or haemorrhage?)
Haemarthrosis vs Iatrogenic Haemorrhage
Haemarthrosis (Natural Bleeding): The fluid is consistently bloody throughout, giving it a uniform appearance.
Iatrogenic Haemorrhage (Bleeding from Medical Procedures):The fluid starts off clear and becomes bloody over time.
List common causes of transudate
Congestive Heart Failure (CHF): A weakened heart may lead to fluid retention and transudate in the pleural or abdominal cavity.
Cirrhosis of the Liver: Liver disease can result in decreased production of proteins, leading to decreased oncotic pressure and transudate.
Nephrotic Syndrome: A kidney disorder where increased permeability of the glomerular basement membrane can result in the loss of proteins in the urine, leading to transudate.
Hypoalbuminemia: Low levels of albumin in the blood (hypoalbuminemia) can reduce oncotic pressure, contributing to transudate.
Malnutrition: Inadequate intake of proteins can lead to a decrease in oncotic pressure and the formation of transudate.
List common causes of exudate
Infection: Bacterial, viral, or fungal infections can cause an inflammatory response, leading to the production of exudate. Examples include pneumonia, cellulitis, and abscesses.
Inflammatory Conditions: Inflammatory diseases, such as rheumatoid arthritis can lead to the formation of exudate in joints or other affected tissues.
Malignancy: Some cancers can cause inflammation and the production of exudate.
Trauma or Injury: Physical trauma or injury to tissues can result in inflammation and the release of exudate as part of the healing process.
