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CLINICAL MICROSCOPY > Serous Fluid > Flashcards

Serous Fluid Flashcards

1
Q

The closed cavities of the body are lined by two membranes referred to as the

A

Serous membranes

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2
Q

Membrane that lines the cavity wall

A

Parietal membrane

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3
Q

Membrane that covers the organs within the cavity

A

Visceral membrane

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4
Q

The fluid between the membranes is called

A

Serous fluid

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5
Q

Function of serous fluid

A

Provides lubrication to prevent the friction between the parietal and visceral membranes

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6
Q

Serous fluids are formed as ultrafiltrates of plasma. True or False?

A

True

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7
Q

Production and reabsorption of serous fluids are subject to

A

Hydrostatic pressure
Colloidal pressure

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8
Q

Increase in fluid between the membranes

A

Effusion

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9
Q

Needle aspiration of the lungs

A

Thoracentesis

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10
Q

Needle aspiration of the heart

A

Pericardiocentesis

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11
Q

Needle aspiration of the abdominal organs

A

Paracentesis

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12
Q

Normal appearance of serous fluid

A

Clear, pale yellow

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13
Q

Volume of serous fluid to be collected

A

> 100 mL

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14
Q

Anticoagulant used to collect specimen and their corresponding tests

A

EDTA tube: cell counts and the differential

Sterile heparinized or sodium polyanethol sulfonate (SPS): microbiology and cytology

Clotted specimens in plain tubes or in heparin tubes: chemistry and serology tests

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15
Q

How to maintain pH of serous fluid specimen?

A

Must be maintained anaerobically in ice

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16
Q

Performed for better recovery of microorganisms and abnormal cells

A

Centrifugation

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17
Q

Effusions caused by a systemic disorder that disrupts the balance in the regulation of fluid filtration and reabsorption

A

Transudate

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18
Q

Effusions caused by conditions that directly involve the membranes of the particular cavity

A

Exudate

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19
Q

Appearance of a transudate

A

Clear

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20
Q

Appearance of an exudate

A

Cloudy

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21
Q

Fluid:serum protein ratio of transudate

A

<0.5

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22
Q

Fluid:serum protein ratio of exudate

A

> 0.5

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23
Q

Fluid:serum LD ratio of transudate

A

<0.6

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24
Q

Fluid:serum LD ratio of exudate

A

> 0.6

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25
Q

Rivaltas’s Test for transudate

A

Negative

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26
Q

Rivaltas’s Test for exudate

A

Positive (heavy precipitation)

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27
Q

The most reliable differentiation between transudates and exudates

A

Fluid: blood ratios for protein and lactic dehydrogenase

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28
Q

Serous fluid examination is performed in the same manner on all serous fluids. True or False?

A

True

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29
Q

Serous fluid cell counts can be performed manually by using

A

Neubauer counting chamber

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30
Q

Pleural fluid is obtained from the

A

Pleural cavity

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31
Q

Pleural fluid cholesterol

A

≥60 mg/d

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32
Q

Pleural fluid:serum cholesterol ratio

A

≥0.3

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33
Q

Pleural fluid:serum total bilirubin ratio

A

≥0.6

34
Q

Provides reliable information that the fluid is an exudate

A

Pleural fluid:serum cholesterol ratio
Pleural fluid:serum total bilirubin ratio

35
Q

Normal appearance of pleural fluid

A

Clear, pale yellow

36
Q

Turbid, white appearance of pleural fluid

A

Presence of WBCs

37
Q

Bloody appearance of pleural fluid

A

Hemothorax (traumatic injury)
Hemorrhagic effusion, pulmonary embolus, tuberculosis, malignancy

38
Q

Difference between Hemothorax (traumatic injury) and Hemorrhagic effusion in terms of hematocrit

A

Hemothorax (traumatic injury) = >50% of the whole blood hematocrit

Hemorrhagic effusion = <50% of the whole blood hematocrit

39
Q

Milky appearance of pleural fluid

A

Chylous material from thoracic duct leakage
Pseudochylous material from chronic inflammation

40
Q

Predominant lipid present in chylous effusion

A

Triglycerides

41
Q

Predominant lipid present in pseudochylous effusion

A

Cholesterol

42
Q

Appearance of chylous effusion

A

Milky/white

43
Q

Appearance of pseudochylous effusion

A

Milky/green tinge

44
Q

Brown appearance of pleural fluid

A

Rupture of amoebic liver abscess

45
Q

Black appearance of pleural fluid

A

Aspergillus

46
Q

Viscous appearance of pleural fluid

A

Malignant mesothelioma (increased hyaluronic acid)

47
Q

Hematology differential count on serous fluid

A

Macrophages = 64%-80%
Lymphocytes = 18%-30%
Neutrophils = 1%-2%
Eosinophil = <10%

48
Q

Normal mesothelial cells: appear

A

Singly

49
Q

Reactive mesothelial cells: appear

A

In cluster

50
Q

Decreased level of pleural fluid glucose

A

<60 mg/dL

51
Q

pH level indicating the need for chest-tube drainage

A

<7.2

52
Q

pH level indicating esophageal rupture allowing the influx of gastric fluid

A

<6.0

53
Q

Microorganisms primarily associated with pleural effusions

A

Staphylococcus aureus
Enterobacteriacea
Mycobacterium tuberculosis

54
Q

Test used to differentiate effusions of immunologic origin from noninflammatory processes

A

Serologic testing

55
Q

Most frequently performed serologic test for pleural fluid

A

Antinuclear antibody (ANA)
Rheumatoid factor (RF)

56
Q

Normal amount of pericardial fluid

A

10-50 mL

57
Q

Primarily the result of changes in the membrane permeability due to infection (pericarditis), malignancy, and trauma-producing exudates

A

Pericardial effusions

58
Q

Primary causes of pericardial fluid transudate

A

Metabolic disorders such as uremia, hypothyroidism, and autoimmune disorders

59
Q

Clear, pale yellow pericardial fluid indicates

A

Normal, transudate

60
Q

Grossly bloody pericardial fluid indicates

A

Cardiac puncture, misuse of anticoagulant medications

61
Q

Effusion between the peritoneal membranes is

A

Ascites

62
Q

The fluid in the effusion between the peritoneal membrane

A

Ascitic fluid

63
Q

Causes of ascitic transudates

A

Hepatic disorders

64
Q

Causes of ascitic exudates

A

Bacterial infections

65
Q

Recommended ratio to detect transudates of hepatic origin

A

Serum-ascites albumin gradient (SAAG)

66
Q

Gradient of ≥1.1 indicates

A

Transudate effusion

67
Q

Gradient of <1.1 indicates

A

Exudative effusions

68
Q

Normal appearance of peritoneal fluid

A

Clear, pale yellow

69
Q

Normal WBC count in peritoneal fluid

A

< 350 cells/µL

70
Q

How to distinguish between bacterial peritonitis and cirrhosis?

A

Perform absolute neutrophil count

71
Q

Predominant cell in tuberculosis

A

Lymphocytes

72
Q

Decreased below serum levels in bacterial and tubercular peritonitis and malignancy

A

Glucose

73
Q

Increased in pancreatitis, and in patients with gastrointestinal perforations

A

Amylase

74
Q

Increased level is also highly diagnostic of intestinal perforation

A

Alkaline phosphatase

75
Q

Requested when a ruptured bladder or accidental puncture of the bladder during the paracentesis is of concern

A

Blood urea nitrogen and creatinine

76
Q

Measured when leakage of bile into the peritoneum is suspected following trauma or surgery

A

Bilirubin

77
Q

Bile primarily contains

A

Conjugated bilirubin

78
Q

Test for malignancy of gastrointestinal origin

A

Carcinoembryonic antigen (CEA)

79
Q

Test for malignancy of ovarian, fallopian tubes, or endometrium origin

A

CA 125

80
Q

Contains concentric striations of collagen-like material

A

Psammoma bodies

81
Q

Macrophage containing fat droplets

A

Lipophages

CLINICAL MICROSCOPY (20 decks)

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