Diagnosis of Effusions Flashcards Preview

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Flashcards in Diagnosis of Effusions Deck (20):
1

What tubes should be used for collection of fluid samples?

EDTA tube for cell counts/cytology/protein

Serum tubes for biochemistry

2

What are the main things to count in a fluid sample?

Total nucleated cell count (TNCC)

Cell identification and morphology

Protein concentration

3

What are the factors affecting fluid movement in/out of body cavities?

Hydrostatic pressure
Oncotic pressure
Capillary wall permeability
Lymphatic drainage.

4

What are the types of effusions and their charecteristics?

Transudate (low cell count low protein)

Modified transudate - in between

Exudate - high protein, high cell count

5

What are the causes of modified transudates?

-Cardiac disease
-Chylous effusion
-Lymphatic drainage

6

What are the causes of exudates?

-Inflammation of plural/abdominal cavities or linings
-Long standing modified transudate
-Neoplasia

7

How can iatrogenic, ongoing, acute and chronic haemorrhage be distinguished?

I/ongoing - erythrocytes
platelet clumps

Acute - erythrophages

Chronic - siderophages, haemosiderin

8

What is chylous effusion?

effusion with chylomicrons in. It appears opaque and milky.

9

What is seen in a chylous effusion cytologically?

Small lymphocytes

10

What are mesothelial cells?

Normal lining cells of the thoracic and abdominal cavities.

11

How can reactive meothelial cells be distinguished from neoplastic cells?

Reactive: occur due to inflammation/effusions.

V. hard to distinguish reactive from neoplastic - need experience/ to biopsy a mass if seen.

12

What ectopic sources of fluid are there?

Urine - urabdomen
Bile
Pancreatitis

13

What might the following things indicate if they are increased in the fluid compared to plasma?

a)creatinine
b)lipase
c)bilirubin

a) uroabdomen
b) pancreatitis
c) bile duct/gall bladder rupture

14

What is the normal amount of fluid that can be collected from a horse abdomen?

3-5ml - more than this = effusion

15

What type of fluid is a normal equine peritoneal fluid?

Modified transudate

16

What is the normal protein, cell count and cell type for small animals?

TP 25 - 30g/L

TNCC - <3 x10e9/L

Mesothelial cells/macrophages

17

What is the transudate protein, cell count and cell type for small animals?

TP <0.5 x10e9/L

Mesothelial cells/macrophages/low nos. non-degenerate neutrophils

18

What is the modified transudate protein, cell count and cell type for small animals?

TP 25 - 50g/L

TNCC - 0.3 - 5.5 x10e9/L

Mesothelial cells/macrophages, non-degenerate neutrophils, small lymphocytes

19

What is the exudate protein, cell count and cell type for small animals?

TP >30g/L

TNCC - >3 x10e9/L

Neutrophils, macrophages (lymphocytes, eosinophils)

20

What is the normal protein, cell count and cell type for horses?

TP <15g/L

TNCC - 0.5 - 9 x10e9/L

50% macrophages & 50% non-degenerate neutrophils