Diagnosis of Effusions Flashcards
What tubes should be used for collection of fluid samples?
EDTA tube for cell counts/cytology/protein
Serum tubes for biochemistry
What are the main things to count in a fluid sample?
Total nucleated cell count (TNCC)
Cell identification and morphology
Protein concentration
What are the factors affecting fluid movement in/out of body cavities?
Hydrostatic pressure
Oncotic pressure
Capillary wall permeability
Lymphatic drainage.
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
What are the causes of modified transudates?
- Cardiac disease
- Chylous effusion
- Lymphatic drainage
What are the causes of exudates?
- Inflammation of plural/abdominal cavities or linings
- Long standing modified transudate
- Neoplasia
How can iatrogenic, ongoing, acute and chronic haemorrhage be distinguished?
I/ongoing - erythrocytes
platelet clumps
Acute - erythrophages
Chronic - siderophages, haemosiderin
What is chylous effusion?
effusion with chylomicrons in. It appears opaque and milky.
What is seen in a chylous effusion cytologically?
Small lymphocytes
What are mesothelial cells?
Normal lining cells of the thoracic and abdominal cavities.
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.
What ectopic sources of fluid are there?
Urine - urabdomen
Bile
Pancreatitis
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
What is the normal amount of fluid that can be collected from a horse abdomen?
3-5ml - more than this = effusion
What type of fluid is a normal equine peritoneal fluid?
Modified transudate
