Serous fluid Flashcards

1
Q

Three cavities that contain serous fluid

A

Pleural, pericardial, peritoneal

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2
Q

what are the two serous membranes

A

parietal (cavity) and visceral (organ in cavity)

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3
Q

Collection names for each of the cavities

A

Thoracentesis=pleural fluid
Pericardiocentesis=pericardial fluid
Paracentesis=peritoneal fluid

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4
Q

What are serous fluids ultrafiltrates of?

A

Plasma

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5
Q

4 forces that effect production and reabsorption rate

A

hydrostatic, oncotic, intrapleural, lymphatic

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6
Q

Effusion

A

increase in serous fluid due to disruption in formation or reabsorption of fluid

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7
Q

effusion causes

A
  • increased capillary hydrostatic pressure (chronic heart failure)
  • Decreased oncotic pressure (nephrotic syndromes)
  • increased capillary permeability (infection/inflammation)
  • lymphatic obstruction (tumor/lymphoma)
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8
Q

Type 1: Transudate

A

secondary to a systemic disease process. No further testing, resolved when disorder is resolved

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9
Q

Type 2: Exudate

A

Primary or local inflammation in the closed cavity. Infection or malignancies, further testing is necessary

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10
Q

Pleural fluid colors

A

Normal=clear or pale yellow
Turbid/white=microbial infection
Bloody=hemothorax, hemorrhagic effusion, embolism, TB
Milky=chylous/pseudochylous material
Brown=rupture of liver abscess
Black=aspergillus
Viscous=malignant mesothelioma (increased hyaluronic acid)

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11
Q

Chylous

A

thoracic duct leakage. High [triglycerides]. Lots of lymphocytes, sudan III stain=+

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12
Q

Pseudo

A

chronic inflammatory conditions. High [cholesterol]. Mix of cells, sudan III stain=-

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13
Q

Normal pleural cells

A

macrophages=64-80%
lymphocytes=18-30%
neutrophils=1-2%
mesothelial cells are decreased when TB

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14
Q

Reactive mesothelial cells

A

very bad

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15
Q

Glucose

A

decreased in infection and rheumatoid inflammation. Lactate may also be measured

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16
Q

pH

A

decreased in pneumonia <7.2. esophageal rupture <6, lung abcess is <7.2

17
Q

Adenosine deaminase (ADA)

A

Increased=TB/malignancy

18
Q

Amylase

A

Increased=pancreatitis, esophageal rupture, malignancy

19
Q

Triglycerides

A

increased=chylous effusion

20
Q

Microbiology testing

A

gram stain and culture (aerobic and anaerobic) or acid fast stain. Autoimmune markers
- SLE = antinuclear antibodies
- RA = rheumatoid factor
Malignancy= uterine/ovarian cancer=CEA and CA125

21
Q

Pericardial fluid

A

10-15mL. Increased volume due to infection, malignancy, trauma, metabolic disorder, autoimmune disorder.

22
Q

pericardial fluid colors

A

normal=clear or pale yellow
turbid=infection and malignancy
bloody=malignancy/cardiac puncture, anticoag
milky=chylous, pseudochylous

23
Q

Testing of pericardial fluid

A

serum protein/LDH ratio

24
Q

Peritoneal fluid

A

ascites=accumulation of fluid btwn peritoneal membranes. could be from cirrhosis, peritonitis, malignancy

25
Q

Appearance of peritoneal fluid

A

normal=clear/pale yellow
Turbid=micro infection
Green=bile duct or gall bladder or pancreatic disorder
bloody=trauma, infection, malignancy
milky=lymph block/trauma

26
Q

Serum ascites albumin gradient (SAAG)

A

> 1.1 = transudate effusion of hepatic origin
<1.1 = exudative effusion