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AUBF Lecture Final Term > SEROUS FLUIDS > Flashcards

SEROUS FLUIDS Flashcards

1
Q

are those which surround various organs (heart, lungs, and abdomen) and are lined with serous membranes.

A

Serous body cavities

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2
Q

What portion of the serous membrane covers the organ

A

Visceral portion

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3
Q

What portion of the serous membrane lines the body wall

A

Parietal portion

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4
Q

is an ultrafiltrate of plasma contained within the pleural, pericardial, and peritoneal cavities with NO ADDITIONAL MATERIAL FROM MEMBRANE CELLS

A

Serous fluid

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5
Q

collection of serous fluid (pleural, pericardial, peritoneal)

A

Paracentesis

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6
Q

SPECIMEN CONSIDERATIONS
3 Collection Techniques

A
  • Thoracentesis
  • Pericardiocentesis
  • Paracentesis
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7
Q

SPECIMEN CONSIDERATIONS
Volume collected

A

> 100 mL

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8
Q

SPECIMEN CONSIDERATIONS
3 Collection tubes

A

EDTA - Cell counts and differential
Sterile Heparinized - Microbiology and cytology procedures
Non-anticoagulated or Heparinized - Chemistry tests

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9
Q

Accumulation of serous fluid

Results from disruption in the balance of pressure or in response to infection and inflammatory processes.

A

Effusion

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10
Q

Effusion is Further classified into?

A

transudates or exudates

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11
Q

Occur during various systemic disorders that disrupt fluid filtration, fluid reabsorption, or both.

A

TRANSUDATE EFFUSIONS

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12
Q

Medical Conditions associated with TRANSUDATE EFFUSIONS

A

Medical conditions.
o Congestive heart failure
o Hepatic cirrhosis
o Nephrotic syndrome.

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13
Q

Occur during inflammatory processes that result in damage to blood vessel walls, body cavity membrane damage, or decreased reabsorption by the lymphatic system.

A

EXUDATE EFFUSIONS

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14
Q

(4) pathologic processes caused by EXUDATE EFFUSIONS

A

o Infections
o Inflammations
o Hemorrhages
o Malignancies

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15
Q

TRANSUDATE or EXUDATE
Clarity: Clear

A

TRANSUDATE

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16
Q

TRANSUDATE or EXUDATE
Clarity: Bloody, Cloudy, Purulent, Turbid

A

EXUDATE

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17
Q

TRANSUDATE or EXUDATE
Color: Colorless to Pale Yellow

A

TRANSUDATE

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18
Q

TRANSUDATE or EXUDATE
Color: Any abnormal color:
- Brown
- Cream
- Green
- Milky
- Pink
- Red
- Yellow

A

EXUDATE

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19
Q

TRANSUDATE or EXUDATE
Spontaneous Clotting: No

A

TRANSUDATE

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20
Q

TRANSUDATE or EXUDATE
Spontaneous Clotting: Possible

A

EXUDATE

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20
Q

TRANSUDATE or EXUDATE
pH: Alkaline

A

TRANSUDATE

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21
Q

TRANSUDATE or EXUDATE
pH: Acidic

A

EXUDATE

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22
Q

TRANSUDATE or EXUDATE
Specific Gravity: <1.015

A

TRANSUDATE

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23
Q

TRANSUDATE or EXUDATE
Specific Gravity: >1.015

A

EXUDATE

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24
Q

TRANSUDATE or EXUDATE
Glucose: As in Plasma Level

A

TRANSUDATE

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25
Q

TRANSUDATE or EXUDATE
Glucose: Lower than Plasma Level

A

EXUDATE

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26
Q

TRANSUDATE or EXUDATE
Total Protein: <3 g/dl

A

TRANSUDATE

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27
Q

TRANSUDATE or EXUDATE
Total Protein: >3 g/dl

A

EXUDATE

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28
Q

TRANSUDATE or EXUDATE
LDH:<200 IU/L

A

TRANSUDATE

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29
Q

TRANSUDATE or EXUDATE
LDH:>200 IU/L

A

EXUDATE

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30
Q

TRANSUDATE or EXUDATE
Pleural Fluid Cholesterol: <45 mg/dl

A

TRANSUDATE

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31
Q

TRANSUDATE or EXUDATE
Pleural Fluid Cholesterol: >45 mg/dl

A

EXUDATE

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32
Q

TRANSUDATE or EXUDATE
PF Serum Cholesterol Ratio: <0.3

A

TRANSUDATE

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33
Q

TRANSUDATE or EXUDATE
PF Serum Cholesterol Ratio: >0.3

A

EXUDATE

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34
Q

TRANSUDATE or EXUDATE
PF Serum bilirubin Ratio: <0.6

A

TRANSUDATE

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35
Q

TRANSUDATE or EXUDATE
PF Serum bilirubin Ratio: >0.6

A

EXUDATE

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36
Q

TRANSUDATE or EXUDATE
Fluid Serum protein Ratio: <0.5

A

TRANSUDATE

37
Q

TRANSUDATE or EXUDATE
Fluid Serum protein Ratio: >0.5

38
Q

TRANSUDATE or EXUDATE
Fluid Serum LD Ratio:<0.6

A

TRANSUDATE

39
Q

TRANSUDATE or EXUDATE
Fluid Serum LD Ratio:>0.6

40
Q

TRANSUDATE or EXUDATE
Serum Ascites Albumin Gradient: >1.1

A

TRANSUDATE

41
Q

TRANSUDATE or EXUDATE
Serum Ascites Albumin Gradient: <1.1

42
Q

TRANSUDATE or EXUDATE
WBC Count:<1000/ul

A

TRANSUDATE

43
Q

TRANSUDATE or EXUDATE
WBC Count:>1000/ul

44
Q

(6) Laboratory Tests for SF

A

Macroscopic
Microscopic
Cell Count/Diff Count
Chemical Analysis
Culture
Immunologic and Molecular Analysis

45
Q

Gross Exam
APPEARANCE:

A
  • NORMAL: Clear and colorless to pale yellow
  • “SEROUS” because it resembles SERUM
46
Q

Gross Exam
VARIATIONS:

A
  • Turbid, white – microbial infection
  • Bloody or milky
47
Q

Clinical Significance of bloody and milky effusions

A

HEMOTHORAX or HEMORRHAGIC EXUDATES

48
Q

HEMOTHORAX or HEMORRHAGIC EXUDATES
Distribution of blood: Uneven/Streaked

A

HEMOTHORAX

49
Q

HEMOTHORAX or HEMORRHAGIC EXUDATES
Distribution of blood: Even

A

HEMORRHAGIC EXUDATES

50
Q

HEMOTHORAX or HEMORRHAGIC EXUDATES
Hct:>50% of Blood HCT

A

HEMOTHORAX

51
Q

HEMOTHORAX or HEMORRHAGIC EXUDATES
Hct:<50% of Blood HCT

A

HEMORRHAGIC EXUDATES

52
Q

HEMOTHORAX or HEMORRHAGIC EXUDATES
Milky: Chylous

A

HEMOTHORAX

53
Q

HEMOTHORAX or HEMORRHAGIC EXUDATES
Milky: Pseudochylous

A

HEMORRHAGIC EXUDATES

54
Q

HEMOTHORAX or HEMORRHAGIC EXUDATES
Appearance: Milky/White

A

HEMOTHORAX

55
Q

HEMOTHORAX or HEMORRHAGIC EXUDATES
Appearance: Milky/Green Tinge

A

HEMORRHAGIC EXUDATES

56
Q

HEMOTHORAX or HEMORRHAGIC EXUDATES
Leukocytes: Predominantly lymphocytes

A

HEMOTHORAX

57
Q

HEMOTHORAX or HEMORRHAGIC EXUDATES
Leukocytes: Mixed Cells

A

HEMORRHAGIC EXUDATES

58
Q

HEMOTHORAX or HEMORRHAGIC EXUDATES
Cholesterol Crystals: Absent

A

HEMOTHORAX

59
Q

HEMOTHORAX or HEMORRHAGIC EXUDATES
Cholesterol Crystals: Present

A

HEMORRHAGIC EXUDATES

60
Q

HEMOTHORAX or HEMORRHAGIC EXUDATES
Triglycerides: >110 mg/dl

A

HEMOTHORAX

61
Q

HEMOTHORAX or HEMORRHAGIC EXUDATES
Triglycerides: <50 mg/dl

A

HEMORRHAGIC EXUDATES

62
Q

HEMOTHORAX or HEMORRHAGIC EXUDATES
Sudan III Staining: Strongly Positive

A

HEMOTHORAX

63
Q

HEMOTHORAX or HEMORRHAGIC EXUDATES
Sudan III Staining: Negative/Weakly Positive

A

HEMORRHAGIC EXUDATES

64
Q

Abnormal Gross Presentations
(3) Serous Fluid Pleural Appearance

A
  • Brown
  • Black
  • Viscous
65
Q

Abnormal Gross Presentations
(3) Serous Fluid Pleural Disease

A
  • Rupture of Amoebic Liver Abscess
  • Aspergillus Infection
  • Malignant Mesothelioma
66
Q

Abnormal Gross Presentations
Serous Fluid Pericardial Appearance

A

Grossly Bloody

67
Q

Abnormal Gross Presentations
(2) Serous Fluid Pericardial Disease

A

Cardiac Puncture
Anticoagulant Medications

68
Q

Abnormal Gross Presentations
Serous Fluid Peritoneal Appearance

69
Q

Abnormal Gross Presentations
(2) Serous Fluid Peritoneal Disease

A

Gallbladder Disorders
Pancreatic Disorders

70
Q

Chemical Examination
(2) Pleural Test Glucose SIGNIFICANCE

A

Rheumatoid Inflammation and Purulent Infection

71
Q

Chemical Examination
Pleural Test Lactate SIGNIFICANCE

A

Bacterial Infection

72
Q

Chemical Examination
Pleural Test Triglyceride SIGNIFICANCE

A

Chylous Effusions

73
Q

Chemical Examination
(2) Pleural Test pH SIGNIFICANCE

A

Pneumonia, Esophageal Rupture

74
Q

Chemical Examination
(2) Pleural Test Adenosine Deaminase SIGNIFICANCE

A

Tuberculosis and Malignancy

75
Q

Chemical Examination
(3) Pleural Test Amylase SIGNIFICANCE

A

Pancreatitis, Esophageal Rupture and Malignancy

76
Q

Chemical Examination
Pericardial Test Adenoside Deaminase SIGNIFICANCE

A

Tubular Pericarditis

77
Q

Chemical Examination
(2) Peritoneal Test Glucose SIGNIFICANCE

A

Tubercular Peritonitis and Malignancy

78
Q

Chemical Examination
(2) Peritoneal Test Amylase SIGNIFICANCE

A

Pancreatitis and Gastrointestinal Perforation

79
Q

Chemical Examination
Peritoneal Test Alkaline Phosphatase SIGNIFICANCE

A

Gastrointestinal Perforation

80
Q

Chemical Examination
Peritoneal Test Bun and Creatinine SIGNIFICANCE

A

Ruptured or Punctured Bladder

81
Q

Chemical Examination
Peritoneal Test Adenosine Deaminase SIGNIFICANCE

A

Tubercular Peritonitis

82
Q

Routinely performed to examine WBC and demonstrate malignant cells of SF

A

DIFFERENTIAL COUNT

83
Q

Microscopic Examination
Pleural Tests Mesothelial cells SIGNIFICANCE

A

Decreased in TB

84
Q

Microscopic Examination
(2) Peritoneal Tests WBC >500 cells/ul SIGNIFICANCE

A

Bacterial Peritonitis
Cirrhosis

85
Q

Microscopic Examination
Pleural Tests Plasma cells SIGNIFICANCE

A

Increased in TB

86
Q

Microscopic Examination
Peritoneal Tests RBC > 100,000/ul SIGNIFICANCE

A

Intraabdominal bleeding

87
Q

Microscopic Examination
Peritoneal Tests Absolute granulocyte count >250 cells/ul SIGNIFICANCE

A

Bacterial peritonitis

88
Q

5 Microbiologic and Serologic Examinations

A
  1. Gram Staining and Culture
  2. PCR
  3. Acid Fast Staining
  4. Tumor Markers and Cytologic Examination
  5. Measurement of RF/SLE Titer and Complement Levels
89
Q

(2) Bacteria commonly seen in Pleural Fluid Effusions

A

Staphylococcus aureus
Mycoplasma tuberculosis

90
Q

(2) Bacteria commonly seen in Pericardial Fluid Effusions

A

Haemophilus influenzae
Mycobacterium tuberculosis

91
Q

(2) Bacteria commonly seen in Peritoneal Fluid Effusions

A

Escherichia coli
Pneumococci

AUBF Lecture Final Term (5 decks)

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