CM LEC - Pleural Fluid Flashcards Preview

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Flashcards in CM LEC - Pleural Fluid Deck (112):
1

Closed cavities

Pleural, pericardial, peritoneal cavities

2

Closed cavities

Pleural, pericardial, peritoneal cavities

3

type of serous membrane
lines the cavity wall

Parietal membrane

4

type of serous membrane
covers the organs within the cavity

Visceral membrane

5

– fluid between the membranes

serous fluid

6

why small amount of serous fluid is normally present

because production and reabsorption take place at a constant rate

7

function of serous fluid

provides lubrication

8

production and reabsorption of serous fluid subject to

hydrostatic pressure
colloidal pressure (oncotic pressure)

9

needle aspiration procedures for pleural fluid

Thoracentesis

10

needle aspiration procedures for pericardial fluid

Pericardiocentesis

11

needle aspiration procedures for peritoneal fluid

Paracentesis

12

volume of serous fluid to be collected

> 100 ml

13

type of tube for cell counts and diff count

EDTA

14

type of tube for microbiology and cytology

sterile heparinized or sodium polyanethol sulfonate (SPS)

15

done for better recovery of microorganisms and abnormal cells

Centrifugation

16

what type of tests are performed on clotted specimens in plain tubes or in heparin tubes

chemistry tests

17

results of chemistry tests compared with __ chemical concentrations

plasma

18

Specimens for pH must be ___

maintained anaerobically in ice

19

Cause of an effusion may be

transudate or exudate

20

cause of an effusion
formed because of a systemic disorder that disrupts the balance in the regulation of fluid filtration and reabsorption (ex of systemic disorder: changes in hydrostatic pressure created by congestive heart failure or the hypoproteinemia associated with the nephrotic syndrome)

transudates

21

cause of an effusion
produced by conditions that directly involve the membranes of the particular cavity, including infections and malignancies

exudates

22

- most reliable differentiation between transudate and exudate

Fluid: blood ratios for protein and lactic dehydrogenase

23

• Serous fluid cell counts can be performed manually by using a ____ counting chamber

Neubauer

24

fluid obtained from the pleural cavity

pleural fluid

25

additional procedures helpful when analyzing pleural fluid

--pleural fluid cholesterol and fluid:serum cholesterol ratio
--pleural fluid:serum total bilirubin ratio

26

when is a pleural fluid/effusion classified as an exudate

-- pleural fluid cholesterol >60 mg/dL
--pleural fluid:serum cholesterol ratio >0.3
--fluid:serum total bilirubin ratio of 0.6 or more

27

used to differentiate between hemothorax and hemorrhage exudate

Hematocrit

28

Hct > 50% = ?

hemothorax, effusion comes from the inpouring of blood from injury

29

Hct

chronic membrane disease effusion (has both blood and increased pleural fluid)

30

milky pleural fluid may be due to (2)

chylous
pseudochylous

31

most diagnostically significant hematology test performed on serous fluids

Differential count

32

what type of WBC increases in pulmonary infarction

neutrophils

33

what type of WBC increases in
-Presence of air or blood (pneumothorax and hemothorax)
-Allergic reactions
-Parasitic infections

eosinophil

34

– pleomorphic: resemble lymphocytes, plasma cells, and malignant cells, frequently making identification difficult

Mesothelial cells

35

what type of mesothelial cells: single small or large round cells with abundant blue cytoplasm and round nuclei with uniform dark purple cytoplasm

normal mesothelial cells

36

what type of mesothelial cells: in clusters; have varying amounts of cytoplasm, eccentric nuclei, and prominent nucleoli; and be multinucleated, thus more closely resembling malignant cells

reactive mesothelial cells

37

lack of mesothelial cells is due to

exudate covering pleural membranes

38

lack of mesothelial cells associated with

TB

39

What type of cells
nuclear and cytoplasmic irregularities

malignant cells

40

What type of cells
hyperchromatic nucleoli

malignant cells

41

What type of cells
cellular clumps with cytoplasmic molding (community borders)

malignant cells

42

What type of cells
abnormal nucleus:cytoplasm ratios

malignant cells

43

most common chemical tests for pleural fluid (4)

glucose
pH
Adenine deaminase (ADA)
Amylase

44

Decreased value for glucose in pleural fluid

45

Decreased value for glucose in pleural fluid (

TB
RA
Purulent infections

46

if pH reaches

chest-tube drainage

47

if pH reaches

antibiotics

48

what is considered significant pH in pleural fluid

at least 0.30 degrees lower than blood pH

49

pH of 6.0 associated with

esophageal rupture

50

ADA > 40 U/L associated with

TB or malignancy

51

elevated first in the pleural fluid

Amylase

52

Amylase elevated first in what type of serous fluid

pleural

53

increased amylase associated with (3)

pancreatitis, esophageal rupture, malignancy

54

used to confirm the presence of chylous effusion

triglyceride levels

55

- Staphylococcus aureus
- Enterobacteriaceae
- Anaerobes
- Mycobacterium tuberculosis

Microorganisms primarily associated with pleural effusions include:

56

most frequent serologic tests for pleural fluid

o antinuclear antibody (ANA)
o rheumatoid factor (RA)

57

tests for pleural effusions of malignant origin (5)

- CEA
- CA 125 (metastatic uterine cancer)
- CA 15.3
- CA 549 (breast cancer)
- CYFRA 21-1 (lung cancer)

58

type of serous membrane
lines the cavity wall

Parietal membrane

59

type of serous membrane
covers the organs within the cavity

Visceral membrane

60

– fluid between the membranes

serous fluid

61

why small amount of serous fluid is normally present

because production and reabsorption take place at a constant rate

62

function of serous fluid

provides lubrication

63

production and reabsorption of serous fluid subject to

hydrostatic pressure
colloidal pressure (oncotic pressure)

64

needle aspiration procedures for pleural fluid

Thoracentesis

65

needle aspiration procedures for pericardial fluid

Pericardiocentesis

66

needle aspiration procedures for peritoneal fluid

Paracentesis

67

volume of serous fluid to be collected

> 100 ml

68

type of tube for cell counts and diff count

EDTA

69

type of tube for microbiology and cytology

sterile heparinized or sodium polyanethol sulfonate (SPS)

70

done for better recovery of microorganisms and abnormal cells

Centrifugation

71

what type of tests are performed on clotted specimens in plain tubes or in heparin tubes

chemistry tests

72

results of chemistry tests compared with __ chemical concentrations

plasma

73

Specimens for pH must be ___

maintained anaerobically in ice

74

Cause of an effusion may be

transudate or exudate

75

cause of an effusion
formed because of a systemic disorder that disrupts the balance in the regulation of fluid filtration and reabsorption (ex of systemic disorder: changes in hydrostatic pressure created by congestive heart failure or the hypoproteinemia associated with the nephrotic syndrome)

transudates

76

cause of an effusion
produced by conditions that directly involve the membranes of the particular cavity, including infections and malignancies

exudates

77

- most reliable differentiation between transudate and exudate

Fluid: blood ratios for protein and lactic dehydrogenase

78

• Serous fluid cell counts can be performed manually by using a ____ counting chamber

Neubauer

79

fluid obtained from the pleural cavity

pleural fluid

80

additional procedures helpful when analyzing pleural fluid

--pleural fluid cholesterol and fluid:serum cholesterol ratio
--pleural fluid:serum total bilirubin ratio

81

when is a pleural fluid/effusion classified as an exudate

-- pleural fluid cholesterol >60 mg/dL
--pleural fluid:serum cholesterol ratio >0.3
--fluid:serum total bilirubin ratio of 0.6 or more

82

used to differentiate between hemothorax and hemorrhage exudate

Hematocrit

83

Hct > 50% = ?

hemothorax, effusion comes from the inpouring of blood from injury

84

Hct

chronic membrane disease effusion (has both blood and increased pleural fluid)

85

milky pleural fluid may be due to (2)

chylous
pseudochylous

86

most diagnostically significant hematology test performed on serous fluids

Differential count

87

what type of WBC increases in pulmonary infarction

neutrophils

88

what type of WBC increases in
-Presence of air or blood (pneumothorax and hemothorax)
-Allergic reactions
-Parasitic infections

eosinophil

89

– pleomorphic: resemble lymphocytes, plasma cells, and malignant cells, frequently making identification difficult

Mesothelial cells

90

what type of mesothelial cells: single small or large round cells with abundant blue cytoplasm and round nuclei with uniform dark purple cytoplasm

normal mesothelial cells

91

what type of mesothelial cells: in clusters; have varying amounts of cytoplasm, eccentric nuclei, and prominent nucleoli; and be multinucleated, thus more closely resembling malignant cells

reactive mesothelial cells

92

lack of mesothelial cells is due to

exudate covering pleural membranes

93

lack of mesothelial cells associated with

TB

94

What type of cells
nuclear and cytoplasmic irregularities

malignant cells

95

What type of cells
hyperchromatic nucleoli

malignant cells

96

What type of cells
cellular clumps with cytoplasmic molding (community borders)

malignant cells

97

What type of cells
abnormal nucleus:cytoplasm ratios

malignant cells

98

most common chemical tests for pleural fluid (4)

glucose
pH
Adenine deaminase (ADA)
Amylase

99

Decreased value for glucose in pleural fluid

100

Decreased value for glucose in pleural fluid (

TB
RA
Purulent infections

101

if pH reaches

chest-tube drainage

102

if pH reaches

antibiotics

103

what is considered significant pH in pleural fluid

at least 0.30 degrees lower than blood pH

104

pH of 6.0 associated with

esophageal rupture

105

ADA > 40 U/L associated with

TB or malignancy

106

elevated first in the pleural fluid

Amylase

107

Amylase elevated first in what type of serous fluid

pleural

108

increased amylase associated with (3)

pancreatitis, esophageal rupture, malignancy

109

used to confirm the presence of chylous effusion

triglyceride levels

110

- Staphylococcus aureus
- Enterobacteriaceae
- Anaerobes
- Mycobacterium tuberculosis

Microorganisms primarily associated with pleural effusions include:

111

most frequent serologic tests for pleural fluid

o antinuclear antibody (ANA)
o rheumatoid factor (RA)

112

tests for pleural effusions of malignant origin (5)

- CEA
- CA 125 (metastatic uterine cancer)
- CA 15.3
- CA 549 (breast cancer)
- CYFRA 21-1 (lung cancer)

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