Exam 5 Flashcards
(132 cards)
1
Q
What are the names of the 3 main cavities in the body
A
lungs- pleural
heart- pericardial
abdominal-peritoneal
2
Q
What is serous fluid
A
fluid that are an ultrafiltrate of plasma, lubricates membranes and allows for movement of enclosed organs
3
Q
What are the 4 factors that control serous fluid formation
A
-permeability of capillaries in parietal membrane
-Hydrostatic pressure in capillaries
-oncotic pressure by presence of plasma proteins in capillaries
-absorption of fluid by lymph system
4
Q
What is effusion
A
accumulation of fluid in a body cavity, abnormal or pathologic
5
Q
What is paracentesis
A
percutaneous puncture of a body cavity to pull out the fluid
6
Q
What is thoracentesis
pericardiocentesis
peritonecentesis
A
thora- collection of plueral fluid
pericardio-collection of pericardial fluid
peritoneal- collection of peritoneal fluid
7
Q
What is ascites
A
an effusion/ accumulation of fluid in the peritoneal cavity
8
Q
What is abnormal to see in serous fluid
A
blood or fibrinogen
9
Q
What type of fluids are transudate and exudate ?
A
pleural and peritoneal
10
Q
Distinguish if transudate or exudate
increased hydrostatic pressure
decreased oncotic pressure
In pleural fluid
A
transduate
11
Q
Distinguish if transudate or exudate
increased capillary permeability
decreased lymphatic absorption
A
Exudate
12
Q
Transudate or exudate?
CHF
hepatic cirrhosis
nephrotic syndrome
A
transudate
13
Q
Transudate or exudate
infections
neoplasms
trauma
inflammatory conditions
A
exudate
14
Q
Transudate is ___ in protein and LDH
Exudate is ___ in protein and LDH
Both cause
A
trans- low
exu- high
fluid in pleural space
15
Q
Transudate or exudate
clear, yellow, no clots
A
transduate
16
Q
Transudate or exudate
cloudy, yellow to red, clotted
A
exudate
17
Q
A cloudy paracentesis fluid indicates
A
a large number of WBCs, chyle, lipids
18
Q
pleural or peritoneal fluid it a milky appearance indicates
A
chyle
19
Q
What is chyle
A
an emulsion of lymph and chylomicrons
20
Q
What is a chylous effusion
A
caused by an obstruction of or damage to the lymphatic system
21
Q
What are chylous effusions associated with in the pleural cavity? and the peritoneal?
A
pleural- tumors
peritoneal- thrombosis, obstruction to lymphs
22
Q
____ elevated triglyceride level with chylomicrons present
______ low triglyceride level with NO chylomicrons
chylous or pseudochylous
A
chylous
pseudochylous
23
Q
How to tell if blood in serous fluid is due to traumatic tap or hemorrhage
A
traumatic tap- blood decreases and clots
hemorrhage- distributed blood, no clotting
24
Q
What is the normal WBC count in transudate and exudate
A
trans- <1000
exudate > 1000
25
___ predominate in exudates and ____ predominate in effusions
neutrophils
lymphocytes
26
it is ___ to see macrophages and mesothelial cells in serous fluid
It is ___ to see plasma cells
normal
abnormal
27
What patients tend to have malignant cells in effusions
pts with neoplastic disease
28
What are the characteristics of malignant cells that help ID them
can be clumped
jagged nuclei
uneven chromatin
many nuclei
basophilic and has vacuoles
29
What are the TP and LD ratios
total protein and lactate dehydrogenase
help determine if transudate or exudate
30
What are the TP and LD formulas
TP= TP fluid/ TP serum
LD= LD fluid/ LD serum
31
What ratio of TP and LD mean transudate
TP<0.5 and LD < 0.6
32
What ratio of TP and LD mean exudate
TP >0.5 and LD > 0.6
33
What are glucose levels supposed to be in serous fluid
shouldnt be too low,
if less than 60 or difference between serum and fluid is more than 30 - means the fluid is an exudate
34
What does a fluid triglyceride of > 100 mean
chylous effusion
35
What does a triglyceride of < 50 mean
it is not a chylous fluid,
36
What does the presence of cholesterol crystals in serous fluid mean
pseudochylous effusion
37
What can cholesterol of pleural fluid help determine
differentiate between chylous and pseudochylous effusion
38
If a fluid to serum cholesterol ratio is > 1, this indicates
pseudochylous effusion
39
What does the pH of pleural fluid help determine
if patient hasa parapneumonic effusions
pH <7.30
40
If the pH of pleural fluid is >7.30
effusion will resolve with antibiotics
41
T or F pericardial and peritoneal fluid pH have a high clinical significance
F
42
Why do serous fluid stains include a acid fast stain
looks for tb
43
Where is synovial fluid located
areas where skeleton friction can occur, joints, bursae and tendons
44
What is the function of synovial fluids what texture does it have
sole nutrient source for the metabolically active articular cartilage
viscous
45
What are the 4 categories of joint disorders
noninflammatory
inflammatory
septic
hemorrhagic
46
What is arthrocentesis
percutaneous aspiration fluid from a joint using aseptic technique
47
What is the normal volume of synovial fluid in a joint
0.1-3.5mL
48
What are the tubes used in synovial fluid analysis and what tests are they used for
#1 chemistry- lactate, lipids, protein, uric acid, glucose
#2 Microscopic exam, cytology- cell count, diff, crystal ID
#3 Micro- culture
49
What is the normal color of synovial fluid
pale yellow or colorless
50
What does it mean for synovial fluid to be red or brown
trauma
51
What does it mean for synovial fluid to be green
bacterial infection
52
What are rice bodies and what do they indicate
white- free floating particles made of collagen, associated with rheumatoid arthritis
53
What are ochronotic shards
dark pepper looking particles of cartilage that have broken off and are loose in the fluid
54
What gives synovial fluid its viscosity
hyaluronate
55
What does hyaluronidase do
depolymerizes hyaluronate, makes synovial fluid less viscous, Can be used prior to analysis
56
Is it normal to see fibrinogen in synovial fluid
No, synovial fluid should not be clotting, no fbg allowed
57
What is the normal RBC count in synovial fluid
<2000
58
What is the normal WBC count in synovial fluid
<200 WBC
59
What do increased RBCs in synovial fluid indicate
hemorrhage, traumatic procedure
60
What do increased WBCs in synovial fluid indicate
bacterial arthritis
and urate gout
61
What are the normal WBC % in synovial fluid diff
60% mono
30% lymphs
10% neutrophils
62
What do increased lymphs in synovial fluids mean
early RA
63
What do monosodium urate crystals mean in synovial fluid
gouty arthritis
64
needle like crystals
yellow parallel
blue perpendicular
MSU
gouty arthritis
65
What do calcium pryophosphate dihydrate crystals mean
CCPD crystals mean pseudogout
66
What do CPPD crystals look like
rhomboid, smaller and blunter than MSU
67
rhomboid crystals that are
blue parallel
yellow perpendicular
CPPD crystals
pseudogout
68
What do cholesterol crystals look like, what do they indicate
notched corners
chronic inflammation
69
irregular, jagged or serrated edged crystals that look broken in varied sizes, what crystals are these and what do they indicate
corticosteroid crystals
indicate previous drug injection into joint
70
What tube tops are used to do synovial fluid specimen
sodium heparin or liquid EDTA, these do not form crystals themselves
71
What are do these glucose levels in synovial fluid mean
<20
>20
>40
< 20 non inflammation or hemorrhagic
>20 inflammatory
>40 septic condition
72
What are the normal uric acid levels in synovial fluid
the same as the levels in blood plasma
73
What does an increased uric acid level in plasma vs synovial fluid mean
gout
74
What organism is the most frequent cause of septic arthritis
staph aureus
75
What organism is the second most common organism to cause septic arthritis
step species
76
What is the difference between vuvlovaginitis and vaginitis
vulvo- inflammation of vulva and vagina or vulvovaginal glads
vag- inflammation of vagina only
77
What are the 3 most common causes of
bacterial vaginosis
candidiasis
trichomoniasis
78
What tool do we use to collect vaginal secretions and what part of the vagina do we collect from
collected with sterile polyester Dacron swaps with a plastic shaft
taken from vaginal fornix and vaginal pool
79
What not to do when collecting vaginal secretion sample
dont refrigerate
no cotton or wood shaft swabs
80
What organisms are affected by cotton tipped swabs and wood shafts
Chlamydia and Neisseria
81
What is the normal pH of the vagina
3.8-4.5
82
What are the predominant bacteria in healthy vaginas
lactobacilli
83
What does a vaginal ph that is more than 4.5 mean
bacterial vaginosis, trichomoniasis, atrophic vaginitis
84
What is measured in wet mounts for vaginal secretions
count RBCs, WBCs, any bacteria, yeast, trichs, clue cells, parabasal, baa, squamous
85
What is normal in a vaginal wet mount
WBCs- few
RBCs- none
yeast- occasional
bacteria- lactobacilli only
86
Decribe what lactobacilli look like
large, nonmotile GPR
87
How do lactobacilli benefit bagina
H2O2 for pH balance protect against proliferation of bacteria
88
What are clue cells
epithelial cells that are covered in bacteria, bearded appearance
89
How much of a cell should be covered to be considered a clue cell
75%
90
What do clue cells diagnose
bacterial vaginosis
91
What are parabasal cells
are just bellow the surface of mucosa in vagina, if too many could mean inflammation
92
What are basal cells
from the basal layer of the vagina, never normal to see, usually also high WBCs, definitely inflammation
93
pear shaped, unicellular bodies, with an undulating membrane
trichomonads
94
Where do trichomonads like to live
anaerobic pH of 6
95
T or F- you can diagnose trichomonads on a stained slide
F- you can only see them on a non stained wet mount
96
What does a fishy odor after an amine test mean
trimethylamine is present changes pH, positive for bacterial vaginosis
97
What is the most common cause of vaginal infections
bacterial vaginosis
98
What organisms are most often the cause of BV
G. vaginalis and Mobiluncus
99
What is a KOH test for
to ID fungal infections
100
What is the most important indicator of BV
clue cells
101
What is the second most common cause of vaginitis
candidiasis
102
– vulvovaginal itching and soreness, external dysuria, white curdlike discharge
candidiasis
103
What does a strawberry looking exocervix mean
trichamoniasis
104
in severe cases, patients complain of vaginal dryness, vaginal soreness, dyspareunia, and spotting
atrophic vaginitis
105
thin, diffusely red vaginal mucosa with little to no vaginal folding on pelvic exam
atrophic vaginitis
106
What is a fetal fibronectic test for
to ID women who are at risk of preterm labor
107
What is a PAMG1 test for
to find premature rupture of membrane, water breaking
108
What are the 3 reasons we test amniotic fluid
find genetic disorders
test pulmonary maturity
monitor fetal anemia caused by infection or isoimmunization
109
The liquid medium that bathes a fetus throughout gestation
amniotic fluid
110
membrane composed of a single layer of epithelial cells that surround the fetus
amnion
111
what is polyhydramnios
abnormally increased amounts of amniotic fluid >1200
112
What is oligohydramnios
abnormally decreased amniotic fluid
<800
113
What is the normal amount of amniotic fluid at 37 weeks of gestation
800-1200
114
what is amniocentesis
procedure for collection of amniotic fluid
115
When do we need to do amniocentesis
if a mother is older than 35
if there is a suspected issue with a metabolic disorder, deformity or lung immaturity
116
How should amniotic fluid be transported
must be in billirubin light protected container
ASAP
refrigerated
117
What is the normal color of amniotic fluid
colorless or pale yellow
118
What does amber yellow colored amniotic fluid indicate
HDFN
119
What does green amniotic fluid mean
meconium
120
What is RDS
respiratory distress syndrome
121
What are lamellar bodies
aveolar epithelial cells secrete them
122
What are surfactants
lamalar bodies secrete them into aveolar space
prevent aveoli from collapsing, reduce pressure
123
What does an LS ratio tell us
<2 immaturity of lungs
>2 maturity of lungs
124
What do PG levels tell us
negative- immature
positive low or high- mature
125
What does a lamellar body count tell us
> 50,000 mature lungs
< 15,000 immature lungs
126
What does an FSI test tell us
shake test
if foam is present when ethanol is added, then adequate surfactants are present, must be stable for 15 min
>0.47 mature
127
What does delta A450 tell us
365-550 normal
>450 increased billirubin
128
What are the 3 zones of the liley chart
1- normal
2- moderate hemolysis
3- severe hemolysis
129
What are the 4 zones of the Queenan chart
lowest- unaffected or mild
intermediate- increased severe anemia
Rh positive- affected
intrauterine death risk- severe hemolytic disease
130
Do we want delta A450 to increase or decrease
decreasing is good
131
What 2 things interefere with delta A450 test results
meconium
light exposure-billirubin
132
Practice slides
Bodyfluids exam PP
