Recognition and analysis of bodily fluids

Question 1

Name the 3 types of BCE based on protein levels and cell numbers

Answer 1

Transudate
Modified transudate
Exudate

Question 2

Name the three body cavity spaces fluid can accumulate

Answer 2

Peritoneum (abdomen)
Pleura (thorax)
Pericardium

Question 3

Which tube/s do I use to collect body cavity effusions

Answer 3

EDTA
Plain tube

Question 4

Name types of sample processing and fluid anaylsis

Answer 4

Protein concentration
Nucleated cell count
Colour & turbidity
Cytologic analysis

Question 5

Transudate effusions often result from

Answer 5

Decreased plasma oncotic pressure(Severe hypoalbuminemia)
Increased hydrostatic pressure

Question 6

Colour of transudate

Answer 6

colourless to straw-coloured

Question 7

Nucleated cell count of transudate and exception in horses

Answer 7

<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

Question 8

Protein level of transudate

Answer 8

<25 g/L

Question 9

Expected cells in transudate

Answer 9

Macrophages, mesothelial cells, and rare non-degenerate neutrophils

Question 10

What is the main cause of exudate

Answer 10

Inflammation

Question 11

Why does inflammation cause exudate

Answer 11

Increased capillary permeability
Chemotaxis of leukocytes

Question 12

Protein level of exudate

Answer 12

> 25 g/L

Question 13

Cell count of exudate and in horses

Answer 13

5 x 10^9 cells/L
Horses: >5

Question 14

Definition of modified transudate

Answer 14

Nucleated cell count or protein concentration is increased but does not fit with the exudate range

Question 15

Cause of chyle

Answer 15

Leakage of chyle from the lymphatic system into the body cavity (usually thorax)

Question 16

What gives chyle its milky appearance

Answer 16

Chylomicrons

Question 17

Causes of chylous effusion

Answer 17

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

Question 18

What should you expect to see of a chyle cytology

Answer 18

Small mature lymphocytes should predominate

Question 19

Colour of FIP effusions

Answer 19

Odourless, straw-coloured to gold

Question 20

Protein level of FIP effusion

Answer 20

> 35 g/L

Question 21

Cell count of FIP effusion

Answer 21

with variable, often low, cell counts (neutrophils usually predominate)

Question 22

Additional test for FIP effusions

Answer 22

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

Question 23

What do you expect to see of a microscopic view of FIP fluid

Answer 23

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.

Question 24

Term used for urine in peritoneum

Answer 24

Uroperitoneum

Question 25

Confirmatory test to test for chyle

Answer 25

Triglyceride: Fluid > Serum

Question 26

Confirmatory test to test for Neutrophilic inflammation (Septic)

Answer 26

Bacterial Culture

Question 27

Confirmatory test to test for urinary tract rupture

Answer 27

Creatinine: Fluid > Serum

Question 28

Cerebrospinal fluid test is a useful test in patients with

Answer 28

Neurological disease
Neck or limb pain
Fever of unknown origin

Question 29

Type of test used to collect cerebrospinal fluid

Answer 29

Plain serum tube

Question 30

Outline sample processing of cerebrospinal fluid

Answer 30

Requires prompt analysis
If volume allows send two aliquots
One unaltered for protein
One with 10% autologous serum for better cell preservation

Question 31

What is the healthy level of Total protein & nucleated cell count in cerebrospinal fluid

Answer 31

Low in healthy animals

Question 32

What is the stain used to stain cereobrospinal fluid

Answer 32

Romanowsky stain

Question 33

Synovial fluid test is a useful test in patients with

Answer 33

Joint swelling
Limping
Monoarthropathy
Polyarthropathy
Fever of unknown origin
Generalised pain
Weakness

Question 34

Colour of Synovial fluid

Answer 34

Normally transparent to colourless
Note any turbidity
Blood (iatrogenic or haemorrhage?)

Question 35

Haemarthrosis vs Iatrogenic Haemorrhage

Answer 35

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.

Question 36

List common causes of transudate

Answer 36

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.

Question 37

List common causes of exudate

Answer 37

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.