M4: Serous Fluids (Part 4: Peritoneal Fluid)

Question 1

Peritoneal Fluid

clear and pale yellow

Identify what significance/condition based on appearance

Answer 1

Normal

Question 2

turbid with bacterial or fungal infections

Identify what significance/condition based on appearance

Answer 2

Exudates

Question 3

Green or dark-brown bile

Identify what significance/condition based on appearance

Answer 3

bilirubin

Check for chemical test for bilirubin

Question 4

Peritoneal Fluid

Blood-streaked fluid

Identify what significance/condition based on appearance

Answer 4

after trauma, tuberculosis, intestinal disorders, and malignancy

Question 5

Peritoneal Fluid

Chylous or pseudochylous material

Identify what significance/condition based on appearance

Answer 5

trauma or blockage of lymphatic vessels

Question 6

Peritoneal Fluid

Trauma

a. blood streaked fluid
b. chylous/psuedochylous material
c. both
d. NOTA

Answer 6

c. both

Question 7

Peritoneal Fluid: Laboratory Tests

accumulation of fluid between the peritoneal membranes

Answer 7

Ascites

Question 8

Peritoneal Fluid: Laboratory Tests

This is accumulation of fluid and is of hepatic origin

Answer 8

Ascitic fluid

Question 9

Peritoneal Fluid: Laboratory Tests

Indicate Hepatic Disorders

accumulation of fluid

Answer 9

Ascitic transudate

Question 10

Peritoneal Fluid: Laboratory Tests

• Intestinal Perforation
• Ruptured Appendix
• Malignancy

conditions listed are associated with what infection?

Answer 10

Peritonitis (bacterial infection)

Question 11

Peritoneal Fluid: Laboratory Tests

• Specimen used for diagnostic
  procedure used to detect intra-abdominal bleeding in blunt trauma cases
• Indicates patient needs surgery

Answer 11

Peritoneal lavage

Question 12

Peritoneal Fluid: Laboratory Tests

Volume of peritoneal lavage needed which indicates blunt trauma injuries causes internal bleeding (also indicates patient needs surgery)

Answer 12

> 100,000/μL RBC count

Question 13

Peritoneal Fluid: Laboratory Tests

Peritoneal lavage

a. Intra-abdominal bleeding
b. >100,000/mL RBC count
c. both
d. NOTA

Answer 13

a. Intra-abdominal bleeding

Question 14

Peritoneal Fluid: Laboratory Tests

tests used in detection of peritoneal fluid laternative to using peritoneal lavage

Answer 14

• FAST
• CT
• Cell counts and differential

FAST - Focused Assessment with Sonography for Trauma

CT - Computed Tomography

Question 15

Peritoneal Fluid: Laboratory Tests

WBC count of < 500
cells/μL indicate what condition?

Cell counts and differential

Answer 15

None, normal

>500 cells/ul ang abnormal

Question 16

Peritoneal Fluid: Laboratory Tests

Increased WBC Count involves what (2) conditions

Cell counts and differential

Answer 16

• Bacterial peritonitis
• Cirrhosis

Question 17

Peritoneal Fluid: Laboratory Tests

T or F

Absolute neutrophil count of < 250 cells/uL or WBC count of < 50% of indicates infection

Cell counts and differential

Answer 17

F (Absolute neutrophil count of >250 cells/uL or WBC count of >50% of indicates infection)

Question 18

Peritoneal Fluid: Laboratory Tests

Tuberculosis and Peritoneal Carcinomatosis indicates presence of?

a. Neutrophil
b. Eosinophil
c. Lymphocyte
d. ALL
e. NOTA

Cell counts and differential

Answer 18

c. Lymphocyte

Question 19

Peritoneal Fluid: Transudates Versus Exudates

• Is recommended than the fluid: serum total protein and LD ratios
• Detect Transudates of Hepatic Origin

Answer 19

SAAG

Serum–ascites albumin gradient

Question 20

T or F

In SAAG, you also get the blood serum of patient

Answer 20

T

Question 21

After peritoneal fluid and serum albumin are measured. What should be done?

Answer 21

Subtract fluid albumin level from serum albumin

Question 22

A difference (gradient) of 1.1 or greater = ?

A difference (gradient) less than 1.1 = ?

Levels of fluid and serum albumin

Answer 22

A difference (gradient) of 1.1 or greater = Transudate effusion of hepatic origin

A difference (gradient) less than 1.1 = Exudative Effusions

Question 23

Peritoneal Fluid: Cellular Examination

These are examined to:
* detects tumors of primary and metastatic origin
* Gastrointestinal, prostate, or ovarian origin
* Doctor expecting maglignancy
* Leukocytes, abundant, mesothelial cells, and macrophages, lipophages

Answer 23

Ascitic Exudates Malignant Cells

Question 24

Peritoneal Fluid: Cellular Examination

seen in Acscitic fluid except

a. Bacteria
b. RTE
c. Yeast
d. Toxoplasma gondii

Answer 24

b. RTE

Question 25

# Peritoneal Fluid: Cellular Examination Malignant cells of ovarian, prostatic, and colonic origin, often containing?

Answer 25

mucin-filled vacuoles

Question 26

# Peritoneal Fluid: Cellular Examination * containing concentric striations of collagen like material * benign conditions and associated with ovarian and thyroid malignancies

Answer 26

Psammoma bodies

Question 27

# Peritoneal Fluid: Chemical Testing Parameters observed in chemical testing of peritoneal fluid

Answer 27

* Glucose * Amylase * Alkaline phosphatase * BUN and creatinine * Bilirubin

Question 28

# Peritoneal Fluid: Chemical Testing This analyte is decreased below serum levels in bacterial and tuberculous peritonitis and malignancy

Answer 28

Glucose

Question 29

# Peritoneal Fluid: Chemical Testing This presence of analyte indicates pancreatitis, gastrointestinal perforations

Answer 29

Amylase

Question 30

# Peritoneal Fluid: Chemical Testing This presence of analyte indicates increased in intestinal perforations

Answer 30

Alkaline phosphatase

Question 31

# Peritoneal Fluid: Chemical Testing This presence of analyte indicates ruptured bladder or accidental puncture of the bladder

Answer 31

BUN and creatinine

Question 32

# Peritoneal Fluid: Chemical Testing This presence of analyte indicates leakage of bile into the peritoneum | due to trauma or accidents duirng surgery

Answer 32

Bilirubin

Question 33

# Peritoneal Fluid: Microbiology Tests are performed when bacterial peritonitis is suspected

Answer 33

Gram stains and bacterial cultures

Question 34

# Peritoneal Fluid: Microbiology Tests What other microbiology tests may be requested aside from gram stain and culture for detecting TB

Answer 34

AFS, Adenosine Deaminase, Cultures for TB

Question 35

# Peritoneal Fluid: Microbiology Tests * more sensitive and specific * done when doctor suspects TB

Answer 35

PCR

Question 36

# Peritoneal Fluid: Serological Tests is a valuable- ID of primary source of tumors producing ascitic exudates | tumor markers 'to beh ## Footnote 2

Answer 36

CEA and CA 125

Question 37

# Peritoneal Fluid: Serological Tests Presence of this tumor markers means the source are **ovaries, fallopian tubes, or endometrium**

Answer 37

CA 125 (**NEGATIVE CEA**)