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Hematology II > Serous and Synovial Fluids > Flashcards

Serous and Synovial Fluids Flashcards

1
Q

If you only have one tube and you need to test Heme, Chem and Micro, what order do you test?

A

Do microbiology first, then hem and then chem, I forget why but thats the order

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2
Q

Where is serous fluid found?

A

Serous fluid is found between membranes of body cavities

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3
Q

What kind of fluid is collected in a Thoracentesis?

A

Pleural fluids

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4
Q

What are Pericardial fluid procedures called?

A

Pericardiocentesis duh

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5
Q

What is the purpose of serous fluid?
How is it produced?

A

lubricate membranes (2)
Ultrafiltrate of plasma through capillary endothelial

Produced by hydrostatic + oncotic pressure
small fluid absorbed

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6
Q

What is Effusion?

A

abnormal accumulation of fluids (ex. low protein, inflam, obstructions..etc)

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7
Q

Describe Transudate, what is the protein level?

A

secondary to disease, ex congestive heart failure
Prt : <3 g/dL

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8
Q

Describe Exudate, what is its protein levels?

A

damage to the mesothelial lining
ex. infections, SLE trauma
prt: >3 g/dL

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9
Q

Describe Hemorrhage

A

result of malignancy or trauma, may clot, HCT similar to plasma

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10
Q

Describe Hemothorax

A

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

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11
Q

Describe Chylous

A

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

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12
Q

What does chyle consist of?

A

lymph fluid and fats

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13
Q

Describe pseudochylous

A

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

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14
Q

True or false: Exudate is worse with higher numbers of protein

A

True

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15
Q

What is the number associated with trauma for RBCs?

A

> 10,000/mm3 rbcs

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16
Q

Describe mesothelial cells

A

cells line serous cavitites
provides slippery non adhesive protective surface
HAVE the ability to convert to Macros

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17
Q

What are LE Cells?

A

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)

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18
Q

What factors are needed to have LE cells?

A

1.) LE factor (AnAb)
2.) Bare nucleus - hematoxylin body
3.) phagocytic cells

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19
Q

What are tart cells?

A

similar to LE cells but have some defined chromatin, no AnAb and not a hematoxylin body

20
Q

What is a sample gathered from a bronchoscopy called?

A

Bronchoalveolar levage

21
Q

What is synovial fluid? what does it do?

A

joint fluid, provides lubrication, nutrients and lessens shock

22
Q

Describe the formation of synovial fluid

A

ultrafiltrate of plasma across the membrane, synoviocytes secrete hyaluronic acid which makes the fluid viscous

23
Q

describe
I. noninflammatory joint disorder

A

degeneration of joints, example osteoarthritis

24
Q

Describe
II. inflammatory joint disorder

A

Autoimmune disorders including RA, Lupus and Lyme disease

25
Q

Describe
III. Crystal induced joint disorder

A

Gout + Pseudogout

26
Q

Describe
IV. Septic joint disorders

A

caused by microbial infections

27
Q

Describe
V. Hemorrhage joint disorders

A

caused from traumatic injuries

28
Q

What is the collection of synovial fluid called and what is the normal amount of fluid present?

A

Arthrocentesis
normal knee joint: 3.5 mL does not clot (diseases will have clots)

29
Q

T/F normal joint fluid is clear or pale yellow or the color of egg whites

A

true

30
Q

Describe the color of joint fluid in an inflammatory disease, infection or crystal induced

A

Inflam/non inflam: Deep yellow
Infection: Green
Crystal Induced: Milky

31
Q

What causes the viscosity of synovial fluid?

A

polymerization of hyaluronic acids, essential for movement

32
Q

T/F arthritis increases polymerization in synovial fluid

A

false, it decreases polymerization

33
Q

What is the approx length for synovial fluid in a String Test?

A

4 - 6 cm long

34
Q

T/F acetic acid may be used to ID synovial fluid

A

true

35
Q

T/F the only time that viscosity/mucin dot test is different is with traumatic effusion

A

True

36
Q

Synovial fluid cell counts: what is used in these counts? what is the normal range for WBC and RBC?

A

saline or methylene blue is used, can also be treated with hyaluronidase

WBC <200/mm3
RBC <1/mm3

37
Q

T/F in a synovial fluid cell count >100,000 means septic

A

true

38
Q

Synovial fluid: Differential cell count approximates

A

Monos: 65%
Synovial tissue cells occ
PMN <25%
lymph 20-40%

(all cells appear vacuolated)

39
Q

What is a Reiter Cell? Ragocyte (RA) cell?

A

vacuolated macrophage with neut eaten

RA cell: PMN with IgM (dark granules)

40
Q

T/F macrophages, plasma, LE and Eos are uncommon in joint fluid

A

false, they are common in joint fluid

41
Q

Describe where MSU (monosodium urate) crystals are normally found
Describe where CPPD crystals are normally found (calcium pyrophosphate..etc)

A

MSU: in gout, high purine foods
CPPD: degenerative arthritis

42
Q

T/F initial analysis of crystals is wet prep unstained under low/high power, then compensated polarized light

A

True

43
Q

What shape is MSU crystals? CPPD crystals? which polarize?

A

MSU: needle shaped, intra/extracellular
CPPD: rhombic/square shaped
Both polarize

44
Q

T/F CPPD is highly birefringent and brighter than MSU

A

false, MSU is highly birefringent and is brighter than CPPD

45
Q

What does compensated polarized light do?

A

separates light into slow/fast vibration
crystals align on the slow vibrations

46
Q

What colors are MSU/CPPD when parallel?

A

MSU: Yellow (uric..urine…yellow)
CPPD: Blue

Hematology II (8 decks)

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