Serous Fluid

Question 1

Serous Fluid

Answer 1

Located between the parietal and visceral membranes

Question 2

Production of Serous Fluids

Answer 2

Ultrafiltrate of plasma (mirrors plasma)
Continuous process
- hydrostatic and osmotic pressure
- produced through parietal
- reabsorbed through visceral

Question 3

Function of Serous Fluids

Answer 3

Lubrication between moving surfaces
Protection

Question 4

Collection Tubes

Answer 4

Sterile (culture) for micro
Anticoagulated - cell count (EDTA preferred)
Non-anticoagulated - Chemistry

Question 5

Pleural Fluid

Answer 5

Chest fluid
Lung fluid
Thorocentesis

Question 6

Pericardial

Answer 6

Heart fluid
Pericardiocentesis

Question 7

Peritoneal

Answer 7

Abdominal
Ascitic fluid
Ascites
Paracentesis

Question 8

Lavage

Answer 8

Saline wash of cavity

Question 9

Classification to Determine Cause of Effusion

Answer 9

Transudates
Exudates

Question 10

Transudates

Answer 10

Systemic Disorders
Specific gravity - <1.015
Total protein - <3.0 g/dL
Fluid:Serum TP - <0.5
LDH - <200 IU
Fluid:Serum LDH - <0.6

Question 11

Exudates

Answer 11

Membrane Disorders
Specific gravity - >1.015
Total Protein - >3.0 g/dL
Fluid:Serum TP - >0.5
LDH - >200 IU
Fluid:Serum LDH - >0.6

Question 12

Transudates Disease

Answer 12

Systemic Disorders
Mechanical Processes
- Chronic Heart Failure (alters pressure in entire system)
- Cirrhosis
- Nephrotic Syndrome

Question 13

Exudates Disease

Answer 13

Membrane Disorders
- Infection (only affects one location not entire body)
- Inflammation
- Malignancy

Question 14

STAT Serous Fluid

Answer 14

45 minutes

Question 15

Serous Fluid Appearance

Answer 15

Color
Clarity
Volume

Question 16

Normal color

Answer 16

Pale yellow
Colorless
Resembles Plasma

Question 17

Normal Clarity

Answer 17

Clear

Question 18

Volume

Answer 18

Varies
- Pleural cavity = <20 mL
- Pericardial cavity = 10-50 mL
- Peritoneal cavity = <50 mL

Question 19

Analysis of Serous Fluids

Answer 19

Cell Count and Differential
- Count same as CSF

Question 20

Normal TNC/cumm

Answer 20

<200 - <1,000

Question 21

Normal RBC/cumm

Answer 21

<2,000

Question 22

Diagnosis

Answer 22

Based on cell count
Predominate Cell
Clinical Information

Question 23

Serous Fluid Chemical Analysis

Answer 23

Normal is the same as plasma values

Question 24

Serous Fluid Red, Pink, Bloody

Answer 24

Hemorrhage
Trauma
Traumatic Tap
Hemthorax

Question 25

Serous Fluid Green

Answer 25

Presence of bile
- Perforated gall bladder, duodenal ulcer, pancreatitis

Question 26

Serous Fluid Milky

Answer 26

Chylous (thoracic duct leakage, lymphoid obstruction)
Pseudochylous (chronic inflammation)

Question 27

Increased RBCs

Answer 27

Hemorrhage
Trauma
Traumatic Tap

Question 28

Increased TNCs - Predom Neutrophils

Answer 28

Inflammation
Infection
Acute Process

Question 29

Increased WBCs - Predom Lymph

Answer 29

Viral Process
TB
Chronic Process
Lymphoproliferative Disease

Question 30

Increased TNCs - Predom Eosin

Answer 30

Blood Eos >10%
Parasitic Infection
Allergy

Question 31

Increased TNCs - Predom Macro

Answer 31

Post hemoorhage
Clean Up cells
TB

Question 32

Increased TNCs - Predom Mesothelial

Answer 32

Lining Cells

Question 33

Tumor Cells Present

Answer 33

Rare in serous fluids with cell counts
<100/cumm

Question 34

Tumor Morphs Seen

Answer 34

Clumps
Molding
Large
High N:C ratio
3D
Abnormal mitosis
Mucin Vacuoles

Question 35

Decreased Glucose

Answer 35

Infection
Malignancy

Question 36

Total Protein and LDH

Answer 36

Determination of transudate vs exudate

Question 37

Increased Alkaline Phosphatase

Answer 37

Intestinal Perforation

Question 38

Increased Amylase

Answer 38

Pancreatic Disease
GI Perforation

Question 39

Other Chemicals

Answer 39

CEA
ANA
Immunoglobulins