Serous and Synovial Fluids Flashcards
If you only have one tube and you need to test Heme, Chem and Micro, what order do you test?
Do microbiology first, then hem and then chem, I forget why but thats the order
Where is serous fluid found?
Serous fluid is found between membranes of body cavities
What kind of fluid is collected in a Thoracentesis?
Pleural fluids
What are Pericardial fluid procedures called?
Pericardiocentesis duh
What is the purpose of serous fluid?
How is it produced?
lubricate membranes (2)
Ultrafiltrate of plasma through capillary endothelial
Produced by hydrostatic + oncotic pressure
small fluid absorbed
What is Effusion?
abnormal accumulation of fluids (ex. low protein, inflam, obstructions..etc)
Describe Transudate, what is the protein level?
secondary to disease, ex congestive heart failure
Prt : <3 g/dL
Describe Exudate, what is its protein levels?
damage to the mesothelial lining
ex. infections, SLE trauma
prt: >3 g/dL
Describe Hemorrhage
result of malignancy or trauma, may clot, HCT similar to plasma
Describe Hemothorax
pleural fluid with >50% of blood HCT (blood causes EFFUSION)
blood is from a chronic membrane, the disease will contain BOTH blood+pleural fluid = lower HCT
Describe Chylous
damage to the thoracic duct w/ result of Chyle (lymph fluid+fats) escaping into pleural cavity. Milky white due to fat droplets. STAIN WITH SUDAN III
What does chyle consist of?
lymph fluid and fats
Describe pseudochylous
caused by effusion that has remained in the body for a long time - destruction of Cellular Lipids, Cholesterol crystals, Milky green tinge
SUDAN III Stain - Neg TO weak positive
True or false: Exudate is worse with higher numbers of protein
True
What is the number associated with trauma for RBCs?
> 10,000/mm3 rbcs
Describe mesothelial cells
cells line serous cavitites
provides slippery non adhesive protective surface
HAVE the ability to convert to Macros
What are LE Cells?
First noted in SLE pt but not diagnostic, may be seen in BM or BF and associated with AnAb
(nucleus is very smooth and homogeneous)
What factors are needed to have LE cells?
1.) LE factor (AnAb)
2.) Bare nucleus - hematoxylin body
3.) phagocytic cells
What are tart cells?
similar to LE cells but have some defined chromatin, no AnAb and not a hematoxylin body
What is a sample gathered from a bronchoscopy called?
Bronchoalveolar levage
What is synovial fluid? what does it do?
joint fluid, provides lubrication, nutrients and lessens shock
Describe the formation of synovial fluid
ultrafiltrate of plasma across the membrane, synoviocytes secrete hyaluronic acid which makes the fluid viscous
describe
I. noninflammatory joint disorder
degeneration of joints, example osteoarthritis
Describe
II. inflammatory joint disorder
Autoimmune disorders including RA, Lupus and Lyme disease
Describe
III. Crystal induced joint disorder
Gout + Pseudogout
Describe
IV. Septic joint disorders
caused by microbial infections
Describe
V. Hemorrhage joint disorders
caused from traumatic injuries
What is the collection of synovial fluid called and what is the normal amount of fluid present?
Arthrocentesis
normal knee joint: 3.5 mL does not clot (diseases will have clots)
T/F normal joint fluid is clear or pale yellow or the color of egg whites
true
Describe the color of joint fluid in an inflammatory disease, infection or crystal induced
Inflam/non inflam: Deep yellow
Infection: Green
Crystal Induced: Milky
What causes the viscosity of synovial fluid?
polymerization of hyaluronic acids, essential for movement
T/F arthritis increases polymerization in synovial fluid
false, it decreases polymerization
What is the approx length for synovial fluid in a String Test?
4 - 6 cm long
T/F acetic acid may be used to ID synovial fluid
true
T/F the only time that viscosity/mucin dot test is different is with traumatic effusion
True
Synovial fluid cell counts: what is used in these counts? what is the normal range for WBC and RBC?
saline or methylene blue is used, can also be treated with hyaluronidase
WBC <200/mm3
RBC <1/mm3
T/F in a synovial fluid cell count >100,000 means septic
true
Synovial fluid: Differential cell count approximates
Monos: 65%
Synovial tissue cells occ
PMN <25%
lymph 20-40%
(all cells appear vacuolated)
What is a Reiter Cell? Ragocyte (RA) cell?
vacuolated macrophage with neut eaten
RA cell: PMN with IgM (dark granules)
T/F macrophages, plasma, LE and Eos are uncommon in joint fluid
false, they are common in joint fluid
Describe where MSU (monosodium urate) crystals are normally found
Describe where CPPD crystals are normally found (calcium pyrophosphate..etc)
MSU: in gout, high purine foods
CPPD: degenerative arthritis
T/F initial analysis of crystals is wet prep unstained under low/high power, then compensated polarized light
True
What shape is MSU crystals? CPPD crystals? which polarize?
MSU: needle shaped, intra/extracellular
CPPD: rhombic/square shaped
Both polarize
T/F CPPD is highly birefringent and brighter than MSU
false, MSU is highly birefringent and is brighter than CPPD
What does compensated polarized light do?
separates light into slow/fast vibration
crystals align on the slow vibrations
What colors are MSU/CPPD when parallel?
MSU: Yellow (uric..urine…yellow)
CPPD: Blue
