Body Fluids Flashcards
(76 cards)
1
Q
Where is cerebrospinal fluid located?
A
Brain and spinal cord
2
Q
Where is pleural fluid found?
A
Lungs
3
Q
Where is pericardial fluid found?
A
Heart
4
Q
Where is peritoneal fluid found?
A
Abdominal organs
5
Q
Where is synovial fluid found?
A
Joints
6
Q
Normal volume of CSF in an adult
A
90-150 mL in adults
7
Q
What is the name given to the change in color of a supernatant, caused by the breakdown of hemoglobin?
A
Xanthochromia
8
Q
CSF for neonates
- WBC count
- Lymphs vs. monos
A
- WBC count: 0-274 cells/cumm
- Monos > Lymphs
9
Q
CSF for adults
- WBC count
- Lymphs vs. monos
A
- WBC count: 0-5 cells/cumm
- 70% lymphs vs. 30% monos
10
Q
An increased cell count, particularly an increase in WBC count, in a bodily fluid, such as CSF
A
Pleocytosis
11
Q
Bacterial meningitis leads to an increase in ____
A
Neutrophils
12
Q
Viral meningitis leads to an increase in ____
A
Lymphocytes
13
Q
Acute leukemias lead to an increase in ____
A
Blasts
14
Q
Lymphomas lead to an increase in ____
A
Lymphoma cells
15
Q
Cerebral hemorrhage (including strokes) lead to an increase in ____
A
Segs, monos, and macrophages
16
Q
Correcting for a traumatic tap (formula 1)
A
True WBCCSF = subtract 1 WBC per 500 RBCs counted
17
Q
Correcting for a traumatic tap (formula 2)
A
WBCcsf count - [WBCblood x (RBCCSF/RBCblood)}
18
Q
Cytospin preps are made on all ____ specimens regardless of ____ ____
A
CSF; cell count
19
Q
How do you make a cytopsin slide?
A
Add one drop of 22% albumin and 5 drops of fluid to make the cytospin prep
20
Q
What type of serous body fluid accumulates due to a pathologic state such as infection or malignancy?
A
Exudate
21
Q
Abnormal collection of fluid in a cavity?
A
Effusion
22
Q
Accumulation due to a systemic disease state
A
Transudates
23
Q
Causes of transudates
A
Congestive heart failure, ↓ plasma COP, hypoproteinemia of the nephrotic syndrome, liver failure
24
Q
Accumulation due to a primary pathologic state
A
Exudate
25
Examples of exudates
Bacterial infections, viral infections, neoplasms, trauma, noninfectious inflammatory conductions (RA), collagen vascular disease (SLE)
26
Serous fluids are ultrafiltrates of what?
Plasma
27
Systemic causes of effusions and the underlying mechanism
- ↑ capillary HP - ↓ plasma COP
28
Local causes of effusions and the underlying mechanism
- ↑ capillary permeability - ↓ lymphatic resorption
29
Transudate
- Appearance
- Specific gravity
- Total protein
- LDH
- LDH activity ratio (BF: Serum)
- Cell count
- Spontaneous clotting
- Appearance: Clear
- Specific gravity: \< 1.015
- Total protein: \< 3.0 g/dL
- LDH: \< 200 IU
- LDH activity ratio (BF: Serum): \< 0.6
- Cell count: \< 1000/uL
- Spontaneous clotting: No
30
Exudate
- Appearance
- Specific gravity
- Total protein
- LDH
- LDH activity ratio (BF: Serum)
- Cell count
- Spontaneous clotting
- Appearance: Cloudy
- Specific gravity: \> 1.015
- Total protein: \> 3.0 g/dL
- LDH: \> 200 IU
- LDH activity ratio (BF: Serum): \> 0.6
- Cell count: \> 1000/uL
- Spontaneous clotting: Possible
31
Chylous effusion
Triglycerides \> 110 mg/dL
32
If chylomicrons are present that = ____ If cholesterol crystals are present = \_\_\_\_
Chylous effusion; pseudochylous effusion
33
Chylous effusions are obstructions of the ____ \_\_\_\_ from lymphoma, neoplasm, or surgery
Lymphatic system
34
Pseudochylous effusions are ____ conditions such as RA and often have higher concentration of ____ than serum
Inflammatory; cholesterol
35
Normal cells in serous fluids
- Lymphs
- Mono-histiocytes (macrophages)
- Siderophages
- Erythrophages
- Signet Ring cells/Lipophages
- Mesothelial cells
36
Serous fluid is straw colored to yellow to clear, what does that mean?
Normal
37
Serous fluid is cloudy to hazy, what does that mean?
Infectious process
38
Serous fluid is bloody, what does that mean?
Malignancy or trauma
39
Serous fluid is milky, what does that mean?
Chyle (lipids)
40
Macrophages containing siderotic (iron) granules
Siderophages
41
Macrophages that have phagocytized RBCs
Erythrophage
42
Macrophages that have phagocytized large amounts of lipids
Signet ring cells
43
These cells are neutrophils that have phagocytized a naked nucleus showing a homogenous, smooth chromatin pattern
LE cells
44
Five clues to identifying malignant cells
- Form clusters
- Nuclear membrane is irregular or jagged
- Contain prominent, frequently multiple nucleoli w/ irregular membranes
- Chromatin is unevenly distributed
- N/C ratio is higher than normal
45
Normal cells found in synovial fluid
- Monos/macrophages (60%)
- Lymphs (30%)
- Neutrophils (10%)
- LE cells
- Cartilaginous cells
- Malignant cells
- Synoviocytes
46
\*\*Purpose of hyaluronidase when analyzing synovial fluid
Synovial fluid is viscous, containing hyaluronic acid, adding hyaluronidase fixes that\*\*
47
What are the groups of the synovial fluid classification?
- Normal
- Group 1 (Noninflammatory)
- Group 2 (Inflammatory)
- Group 3 (Septic)
- Group 4 (Hemorrhagic)
48
How do you perform a bronchoalveolar lavage?
Warm saline is introduced into the lungs and then withdrawn
49
What is the purpose of a BAL?
To determine the types of organisms and cells in areas of lung inaccessible by other means
50
BAL cell findings
- Histiocytes
May have carbonaceous material from smokers (black, brown, ro blue-black)
51
BAL cell findings
- Pneumocystic jiroveci
Common in specimens from HIV patients (may look like amorphous material)
52
Normal cells found in BAL
- Neutrophils
- Macrophages
- Pneumocytes (alveolar)
- Ciliated epithelial cells
- Histocytes
- Pneumocystis jiroveci
53
What do ciliated epithelial cells in a BAL indicate?
Indicates that sample was collected from upper respiratory tract instead of the lung
54
Normal cells found in CSF
Lymphs
- Neutrophils should be absent or rare regardless of age
55
Lymphs are found in _all_ body fluids except for \_\_\_\_
BAL
56
Neutrophils are _abnormal_ in all body fluids except for \_\_\_\_
BAL
57
Monocytes are normal in _all_ body fluids except for \_\_\_\_
NONE!! Normal in ALL!!
58
Leukemia/Lymphoma cells are most common in what?
ALL and some AML
59
Rice bodies are found where and are made of what?
In synovial fluids; composed of collagen covered by fibrinous tissue
60
Monosodium Urate is seen in \_\_\_\_
Gout
61
Calcium pyrophosphate crystals are seen in \_\_\_\_
Pseudo-gout
62
How do MSU crystals look on a polarizer?
Bright needles strongly birefringent
63
How do CPP crystlas look on a polarizer?
Rhomboidal and weakly birefringent
64
How do MSU crystals look using a red compensator?
MSU crystals appear yellow when parallel to the axis and blue when perpendicular
65
How do CPP crystlas look using a red compensator?
CPP crystals appear blue when parallel to the axis and yellow when perpendicular
66
If the opening pressure is low in collection of spinal fluid, it leads to...
- Reduced volume
- Blocks the above puncture site
67
If the opening pressure is high in collection of spinal fluid, it leads to...
- High volume
- CNS hemorrhage
- Malignancy
- Hydrocephalus
- Meningitis
68
Describe how to differentiate a traumatic tap from a hemorrhage
- Amount of blood decreases b/w each successive tube
- Clotting
- Clear supernatant
69
Describe how to differentiate a hemorrhage from a traumatic tap
- Tubes are equally bloody
- Clotting is rare
- Pink, orange, or yellow supernatant
70
Significance of increased lymphs in body fluids
- Viral infections
- Mycobacterial, syphilitc, and leptospiral meningitis
- MS
- Guillian-Barre (autoimmune)
- Polyarteritis (autoimmune)
71
Found in tissues from hemoglobin and is chemically similar to bilirubin
Hematoidin
72
Rare finding the CSF; drug used for prophylaxis and treatment of meningeal leukemias; crystallized in a liposome which is destroyed by staining
Cytarabine crystals
73
Benign cells
- Size
- Staining
- Mitotic figures
- Nuclei shape
- Nucleoli
- Clumping
- Size: occasionally large; low N/C ratio
- Staining: light to dark
- Mitotic figures: Rare
- Nuclei shape: round to oval; nuclei uniform size w/ various amts of cytoplasm
- Nucleoli: Small if present
- Clumping: may have "windows"
74
Malignant cells
- Size
- Staining
- Mitotic figures
- Nuclei shape
- Nucleoli
- Clumping
- Size: Very large; high N/C ratio
- Staining: very basophilic
- Mitotic figures: Several
- Nuclei shape: irregular or even bizarre nuclear shape; disintegrated at edges; various sizes and shapes of nuclei
- Nucleoli: Large and prominent
- Clumping: no "windows"
75
Advantages of cytocentrifuge preparations for body fluids
- Concentrates cells when only a few WBC present
- Provides small area to search for tumor cells or indication of infection
- Provides permanent slide for file
76
Disadvantages of cytocentrifuge preparations for body fluids
- Requires special equipment - Cell integrity often compromised
