3S [LEC]: Serous Fluid Flashcards by 3sha Ann

Q

Provides lubrication between the parietal and visceral membranes

A

Serous fluid

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Q

Volume of serous fluid that is usually collected for examination

A

> 100 mL

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Q

Method of collection of pleural fluid

A

Thoracentesis

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Q

Method of collection of pericardial fluid

A

Pericardiocentesis

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Q

Method of collection of peritoneal fluid

A

Paracentesis

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Q

Pleura that is attached to the lungs

A

Visceral pleura

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Q

Pleura that is not attached to the lungs

A

Parietal pleura

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Q

Identify whether transudate or exudate based on pathologic cause:

Increased capillary hydrostatic pressure

A

Transudate

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Q

Identify whether transudate or exudate based on pathologic cause:

Decreased oncotic pressure

A

Transudate

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Q

Identify whether transudate or exudate based on pathologic cause:

Increased capillary permeability

A

Exudate

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Q

Identify whether transudate or exudate based on pathologic cause:

Lymphatic obstruction

A

Exudate

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Q

Identify whether transudate or exudate based on pathologic cause:

Infection, inflammation, malignancy

A

Exudate

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Q

Increase in fluid between the membranes

A

Effusion

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Q

Formed because of a systemic disorder that disrupts the balance in the regulation of fluid filtration and reabsorption

A

Transudate

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Q

Produced by conditions that directly involve the membranes of the particular cavity

A

Exudate

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Q

Contains high protein and may contain some white and red cells

A

Exudate

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Q

Contains low protein and few cells

A

Transudate

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Q

Transudate is caused by ___ hydrostatic pressure and ___ colloid osmotic pressure

A

increased
decreased

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Q

Exudate is caused by ___ interendothelial spaces

A

increased

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Q

Appearance of transudate

A

Clear

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Q

Appearance of exudate

A

Cloudy

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Q

Level of fluid : serum protein ratio of transudate

A

<0.5

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Q

Level of fluid : serum protein ratio of exudate

A

> 0.5

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Q

Level of fluid : serum LD ratio of transudate

A

<0.6

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Level of fluid : serum LD ratio of exudate

>0.6

WBC count of transudate

<1000/uL

WBC count of exudate

>1000/uL

T/F: Spontaneous clotting is possible in exudate

True

T/F: Spontaneous clotting is possible in transudate

False

Level of pleural fluid cholesterol of exudate

>45 to 60 mg/dL

Level of pleural fluid cholesterol of transudate

<45 to 60 mg/dL

Level of pleural fluid : serum cholesterol ratio of transudate

<0.6

Level of pleural fluid : serum cholesterol ratio of exudate

>0.6

Level of serum ascites albumin gradient of transudate

>1.1

Level of serum ascites albumin gradient of exudate

<1.1

Give the expected appearance of the serous fluid: Microbial infection

Turbid, white

Give the expected appearance of the serous fluid: Hemothorax

Bloody

Give the expected appearance of the serous fluid: Hemorrhagic effusion

Bloody

Give the expected appearance of the serous fluid: Pulmonary embolus

Bloody

Give the expected appearance of the serous fluid: Tuberculosis

Bloody

Give the expected appearance of the serous fluid: Malignancy

Bloody

Give the expected appearance of the serous fluid: Chylous material from thoracic duct leakage

Milky

Give the expected appearance of the serous fluid: Pseudochylous material from chronic inflammation

Milky

Give the expected appearance of the serous fluid: Rupture of amoebic liver abscess

Brown

Give the expected appearance of the serous fluid: Aspergillus

Black

Give the expected appearance of the serous fluid: Malignant mesothelioma

Viscous

T/F: Chylous material has a high concentration of cholesterol that's why it's milky

False (triglycerides)

Pseudochylous material has a high concentration of ___, contributing to its milky appearance

Cholesterol

Chylous material has a high concentration of ___, contributing to its milky appearance

Triglycerides

Identify whether hemothorax or hemorrhagic: Caused by traumatic injury

Hemothorax

Identify whether hemothorax or hemorrhagic: Caused by chronic membrane damage

Hemorrhagic

Identify whether hemothorax or hemorrhagic: Uneven blood distribution

Hemothorax

Identify whether hemothorax or hemorrhagic: Even blood distribution

Hemorrhagic

Identify whether hemothorax or hemorrhagic: Hematocrit is >50% of the whole blood hematocrit

Hemothorax

Identify whether chylous or pseudochylous effusion: Caused by thoracic duct damage

Chylous

Identify whether chylous or pseudochylous effusion: Caused by chronic inflammation

Pseudochylous

Identify whether chylous or pseudochylous effusion: Milky/ white appearance

Chylous

Identify whether chylous or pseudochylous effusion: Milky/ green tinge

Pseudochylous

Identify whether chylous or pseudochylous effusion: Predominantly lymphocytes

Chylous

Identify whether chylous or pseudochylous effusion: Mixed cells

Pseudochylous

Identify whether chylous or pseudochylous effusion: Absent cholesterol crystals

Chylous

Identify whether chylous or pseudochylous effusion: Present cholesterol crystals

Pseudochylous

Identify whether chylous or pseudochylous effusion: >110 mg/dL triglycerides

Chylous

Identify whether chylous or pseudochylous effusion: <50 mg/dL triglycerides

Pseudochylous

Identify whether chylous or pseudochylous effusion: Strongly positive sudan III staining

Chylous

Identify whether chylous or pseudochylous effusion: Negative/ weakly positive sudan III staining

Pseudochylous

Carries 60-70% of ingested fat from the intestine to the circulatory system

Thoracic duct

Tube used for cell counts and differential

EDTA

Tube used for microbiology and cytology

Sterile heparinized/ Sodium Polyanethol Sulfonate (SPS)

Tube used for chemistry tests

Plain tubes/ Heparinized tubes

The original criteria to diagnose a biochemically exudative effusion

Light's criteria

In pleural fluid, macrophages normally account for ___ of a nucleated cell count

64-80%

In pleural fluid, lymphocytes normally account for ___ of a nucleated cell count

18-30%

In pleural fluid, neutrophils normally account for ___ of a nucleated cell count

1-2%

The higher the ___, the more poorly differentiated are the cells

N:C ratio

Identify the chemical test affected: Rheumatoid inflammation

Glucose (decreased)

Identify the chemical test affected: Purulent infection

Glucose (decreased)

Identify the chemical test affected: Bacterial infection

Lactate (elevated)

Identify the chemical test affected: Chylous effusion

Triglyceride (elevated)

Identify the chemical test affected: Pneumonia not responding to antibiotics

pH (decreased)

Identify the chemical test affected: Esophageal rupture

pH (markedly decreased)

Identify the chemical test affected: Tuberculosis

ADA (elevated) Amylase (elevated)

Identify the chemical test affected: Malignancy

ADA (elevated) Amylase (elevated)

Identify the chemical test affected: Pancreatitis

Amylase (elevated)

In peritoneal fluid, these contain concentric striations of collagen-like material and can be seen in benign conditions and are also associated with ovarian and thyroid malignancies

Psammoma bodies

In peritoneal fluid, (__) CA125 with (__) CEA suggests the source is from the ovaries, fallopian tubes, or endometrium

(+) positive (-) negative

Increased chemistry test in peritoneal fluid in the case of GI perforations

Alkaline phosphatase Amylase