Serous and Synovial Fluids

Question 1

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

Answer 1

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

Question 2

Where is serous fluid found?

Answer 2

Serous fluid is found between membranes of body cavities

Question 3

What kind of fluid is collected in a Thoracentesis?

Answer 3

Pleural fluids

Question 4

What are Pericardial fluid procedures called?

Answer 4

Pericardiocentesis duh

Question 5

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

Answer 5

lubricate membranes (2)
Ultrafiltrate of plasma through capillary endothelial

Produced by hydrostatic + oncotic pressure
small fluid absorbed

Question 6

What is Effusion?

Answer 6

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

Question 7

Describe Transudate, what is the protein level?

Answer 7

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

Question 8

Describe Exudate, what is its protein levels?

Answer 8

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

Question 9

Describe Hemorrhage

Answer 9

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

Question 10

Describe Hemothorax

Answer 10

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

Question 11

Describe Chylous

Answer 11

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

Question 12

What does chyle consist of?

Answer 12

lymph fluid and fats

Question 13

Describe pseudochylous

Answer 13

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

Question 14

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

Answer 14

True

Question 15

What is the number associated with trauma for RBCs?

Answer 15

> 10,000/mm3 rbcs

Question 16

Describe mesothelial cells

Answer 16

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

Question 17

What are LE Cells?

Answer 17

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)

Question 18

What factors are needed to have LE cells?

Answer 18

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

Question 19

What are tart cells?

Answer 19

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

Question 20

What is a sample gathered from a bronchoscopy called?

Answer 20

Bronchoalveolar levage

Question 21

What is synovial fluid? what does it do?

Answer 21

joint fluid, provides lubrication, nutrients and lessens shock

Question 22

Describe the formation of synovial fluid

Answer 22

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

Question 23

describe
I. noninflammatory joint disorder

Answer 23

degeneration of joints, example osteoarthritis

Question 24

Describe
II. inflammatory joint disorder

Answer 24

Autoimmune disorders including RA, Lupus and Lyme disease

Question 25

Describe III. Crystal induced joint disorder

Answer 25

Gout + Pseudogout

Question 26

Describe IV. Septic joint disorders

Answer 26

caused by microbial infections

Question 27

Describe V. Hemorrhage joint disorders

Answer 27

caused from traumatic injuries

Question 28

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

Answer 28

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

Question 29

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

Answer 29

true

Question 30

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

Answer 30

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

Question 31

What causes the viscosity of synovial fluid?

Answer 31

polymerization of hyaluronic acids, essential for movement

Question 32

T/F arthritis increases polymerization in synovial fluid

Answer 32

false, it decreases polymerization

Question 33

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

Answer 33

4 - 6 cm long

Question 34

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

Answer 34

true

Question 35

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

Answer 35

True

Question 36

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

Answer 36

saline or methylene blue is used, can also be treated with hyaluronidase WBC <200/mm3 RBC <1/mm3

Question 37

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

Answer 37

true

Question 38

Synovial fluid: Differential cell count approximates

Answer 38

Monos: 65% Synovial tissue cells occ PMN <25% lymph 20-40% (all cells appear vacuolated)

Question 39

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

Answer 39

vacuolated macrophage with neut eaten RA cell: PMN with IgM (dark granules)

Question 40

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

Answer 40

false, they are common in joint fluid

Question 41

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

Answer 41

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

Question 42

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

Answer 42

True

Question 43

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

Answer 43

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

Question 44

T/F CPPD is highly birefringent and brighter than MSU

Answer 44

false, MSU is highly birefringent and is brighter than CPPD

Question 45

What does compensated polarized light do?

Answer 45

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

Question 46

What colors are MSU/CPPD when parallel?

Answer 46

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