20. Differential diagnosis of abdominal fluid accumulation

Question 1

pathophys of fluid accumulation

Answer 1

caused by a deficit to the continuous filtration from anterior capillaries absorbed by venous and lymphatic circulation

Question 2

Cause of fluid accumulation

Answer 2

Increased ; hydrostatic pressure of capillaries, hydrostatic pressure of interstitium, capillary permeability
decreased oncotic pressure
problems with lymphatic circulation

Question 3

Types of fluid accumulation

Answer 3

Transudate
Exudate

Question 4

Transudate

Answer 4

Stagnation
low protein content
clear appearance
fluid is pushed through capillaries due to high pressure

Question 5

Exudate

Answer 5

Inflammation
high protein - opaque colour
fluid leaks around capillary cells

Question 6

Specific gravity

Answer 6

Transudate = <1.016
Exsudate = >1.016

Question 7

Protein

Answer 7

Transudate = <3.0 G
Exsudate = >3.0 G

Question 8

WBCs

Answer 8

Transudate = Few lymphocytes
Exsudate = Many WBCs

Question 9

RBCs

Answer 9

Transudate = Few RBCS
Exsudate = variable RBCs

Question 10

causes of transudate (protein poor)

Answer 10

Hypoalbuminaemia
Portal hypertension
Liver cirrhosis
abnormal lymphatic circulation

Question 11

causes of transudate (protein rich)

Answer 11

CHF
prehepatic portal hypertension

Question 12

causes of exudate (septic)

Answer 12

infectious agents

Question 13

causes of exudate (sterile)

Answer 13

pancreatitis
FIB
uroperitoneum
bile peritonitis

Question 14

causes of uroperitoneum

Answer 14

urinary leakage
bladder rupture - check creatinine from fluid

Question 15

causes of bile peritonitis

Answer 15

gall bladder rupture
bile pigments in cytology

Question 16

causes of haemorrhagic

Answer 16

neoplasia
trauma
coagilopathy

Question 17

when is PLE suspected

Answer 17

no proteinuria
no portal hypertension
hypoalbuminaemia

Question 18

chyloperitoneum

Answer 18

cisterna chyli

Question 19

Ascites definition

Answer 19

abdominal fluid accumulation

Question 20

cause of ascites

Answer 20

cats - if there is ascites and no pleural effusion there is no likelihood of cardiac origin
dogs - could be of cardiac origin

Question 21

causes of different fluid types

Answer 21

HF - mod. transudate
Tumour - mod. transudate, haemorrhagic fluid, exudate
Infection - exudate
Thrombosis - mod trans
Hypoproteinaemia - trans

Question 22

Diagnosis of Fluid accumulation

Answer 22

Lab D - rivalta test ( differentiates trans and exudate)
Undulation test
US
Xray