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MOD > All fluid analysis > Flashcards

All fluid analysis Flashcards

1
Q

Where is cavitary fluid found?

A

*Peritoneal, pleural, pericardial cavities
=ultrafiltrate of blood

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2
Q

What does volume of fluid depend on?

A

*Hydrostatic pressure of blood
*Oncotic pressure of blood
*Permeability of vessels

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3
Q

What is an effusion?

A

*Accumulation of fluid in body cavity
*rate of fluid formation > rate of fluid removal

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4
Q

How can effusions be classified?

A

*Transudate = effusion by imbalance of hydrostatic / oncotic pressure
*Exudate = effusion by increased vascular permeability due to inflammation

*Classify by aetiology of composition = Haemorrhagic, chylous, pseudochylous, neoplastic

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5
Q

How can you analyse effusion?

A

*Appearance = colour, turbidity
*Odour
*Cell counts +TP
*Microscopic examination
*Biochemistry

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6
Q

What causes haemorrhagic effusions?

A

*True cavity haemorrhage - vessel disruption
*Iatrogenic blood contamination
*Splenic tap

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7
Q

What is iatrogenic contamination?

A

*Clear then blood or vice-versa
*Swirling of blood - should form clot
*Clear supernatant - can see platelets

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8
Q

What is true body cavity haemorrhage?

A

*Fluid does not clot - haemolysed supernatant
*Due to RBC degradation in cavity
*No platelets

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9
Q

What are differential diagnosis of true body cavity haemorrhage?

A

*Bleeding tumours
*Coagulopathy
*Trauma
*Lung lobe torsion

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10
Q

How would you diagnosed haemorrhagic effusions?

A

*Coagulation profile
*Ultrasound of abdomen for masses
*Look for neoplastic cells on cytology

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11
Q

What is chylous effusions?

A

*Chylomicron-rich lymph
*Milky fluid
*Protein >25g/l
*High triglyceride content

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12
Q

What are causes of chylous effusions?

A

*Heart failure
*Trauma / surgery
*Neoplasia
*Idiopathic

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13
Q

What is pseudochyle?

A

*Looks similar, but not high in triglycerides

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14
Q

What is pure (low protein) transudate?

A

*Clear, colourless, protein <25g/l
*Few cells - mainly monocytes + macrophages

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15
Q

What causes low protein transudate?

A

*Decreased oncotic pressure - severe hypoalbuminaemia (protein loss)
*Increased hydrostatic pressure - portal hypertension, over hydration, cardiac failure+ thrombi in major vessels

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16
Q

What is modified (high protein) Transudate?

A

*Modified - more protein + cells (protein >25g/l)
*Colourless to amber pink
*More neutrophils + erythrocytes than transudate

17
Q

What causes modified transudate?

A

*Increased intravascular hydrostatic pressure in liver or lung
- Congestive heart failure
- Thrombi or neoplasia
- Liver disease - portal hypertension

18
Q

What are exudates?

A

*Turbid, yellow/brown/bloody
*high cell count + high protein
*mostly neutrophils - inflammation + increased vascular permeability

19
Q

What is the difference between septic + non-septic exudates?

A
  • Septic = intracellular organisms + degenerate neutrophils
  • Non-septic = non-degenerate neutrophils + lower number of hypersegmented neutrophils + pyknotic cells
20
Q

What causes septic exudates?

A
  • Penetrating wounds
  • Foreign bodies
  • GI perforations
  • Haematogenous route
  • LESS commonGall bladder rupture, pancreatitis + rupture of pyometra, abscess in liver/spleen/prostate
21
Q

What are causes of non-septic exudates?

A
  • Ruptured gall bladder
  • Ruptured urinary bladder
  • Necrotic tumour
  • Pancreatitis
  • FIP
22
Q

What is seen with albumin : globulin ratio in FIP?

A

*A:G low in FIP
*A:G <0.4 then FIP likely
*A:G >0.8 = NOT FIP

more globulin + less albumin = FIP

23
Q

What is seen on cytology of bile peritonitis?

A

*Neutrophils
*Background green pigment
*Macrophages with green pigment

24
Q

What is seen with ruptured bladder?

A
  • Fluid creatinine > serum creatinine
  • Urine = irritant = changes from transudate to exudate
25
Q

What are the most common neoplastic effusions?

A

*Lymphoma
*Adenocarcinoma
*Mesothelioma

26
Q

What are indications for arthrocentesis (joint fluid exam)?

A

*Joint disease of unknown aetiology
*Diseases in multiple joints
*Suspected infective arthritis
*Pyrexia of unknown origin
*Monitoring therapeutic response

27
Q

What is seen with synovial fluid colour?

A
  • Normal = clear, pale yellow
  • Inflammation = yellow / turbid
  • Uniformly bloody = haemarthrosis
  • Clear then bloody = contamination

MOD (103 decks)

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