Other Body Fluids Flashcards
(112 cards)
1
Q
Normal viscosity fluid resembles….
A
egg whites
2
Q
What could deeper yellow synovial fluid be due to ?
A
non-inflammatory or inflammatory effusions
3
Q
What could greenish synovial fluid be due to ?
A
bacterial infection
4
Q
How can you distinguish from a hemorrhagic arthritis vs. traumatic aspiration?
A
in a traumatic aspiration, the blood is distributed unevenly
5
Q
What makes synovial fluid viscous?
A
the polymerization of hyaluronic acid
6
Q
What are the methods to test for synovial viscosity?
A
string test (4-6 cm) ropes of mucin clot test
7
Q
Why could synovial fluid be milky?
A
due to the presence of crystals
8
Q
Calcium phosphate is seen in?
A
pseudogout
9
Q
What are the most frequently performed lab tests for synovial fluid?
A
WBC count differential gram stain crystal examination culture
10
Q
What are the group disorders for synovial fluid?
A
non inflammatory
inflammatory
septic
hemorrhage
11
Q
Non inflammatory diseases…
A
degenerative joint disease
osterorhi
12
Q
Inflammatory diseases….
A
pseudogout
lyme arthritis
gout
immunologic
13
Q
What is the name of the collection for synovial fluid?
A
arthrocentesis
14
Q
How to get rid of fibrinogen in synovial fluid?
A
collect the fluid with syringe moistened with heparin
15
Q
What can you use to identity an unknown fluid as synovial fluid?
A
acetic acid
16
Q
What do you use to dilute synovial fluid for a count? What stain can you use?
A
saline
methylene blue
17
Q
What lowers viscosity of synovial fluid?
A
hyaluronidase
18
Q
What is associated with pseudogout
A
degenerative
endocrine disorders
elevates serum
19
Q
What causes gout?
A
alcohol in fructose
hepatits
20
Q
How do calcium phosphate crystals appear?
A
rhombus
21
Q
What is the brain and spinal cord lined by?
A
meninges
22
Q
What are the three layers of the meninges?
A
dura mater (outer) arachnoid (filamentous inner) pia meter (thin lining)
23
Q
Where is CSF produced? How much is produced every hour?
A
the choroid plexuses, 20mL
24
Q
What is the volume of CSF in adults? Neonates?
A
90-150mL in adults
10-60mL in neonates
25
How does the chemical composition differ from the ultrafiltrate of plasma?
It has selective filtration under hydrostatic pressure and active transport secretion
26
What is the blood-brain barrier made of?
tight fitting endothelial cells
27
How is CSF routinely collected?
lumbar puncture between 3rd and fourth/fifth lumbar vertebrae
28
What is CSF collected in? What is each used for?
3 sterile tubes
1 is for chemical and serological tests bc least affected by blood or bacteria (frozen)
2 is for microbiology lab (room temp)
3 is for cell count, hematology (refrigerate)
4 may be used for microbio or additional serological tests
29
Xanthochromia...
CSF that is pink orange or yellow, may be caused by RBC degradation, oxyhgb, heavy hemolysis, bilirubin
30
Differentiate specimen tubes from a traumatic tap patient vs. cerebral hemorrhage patient...
a patient with traumatic tap will have heaviest blood concentration in tube 1 while a patient with cerebral hemorrhage will have even distribution of blood
31
What are diseases that allows inc filtration of protein and coagulation factors also causing clot formation but not a bloody fluid?
meningitis
froin syndrome
blockage of csf circulation
32
How many WBCs are found in adult CSF?
0-5 WBCs/uL
33
What is the standard Neubauer formula?
```
# cells counted x dilution factor
---------------------------------------------- = cells/uL
# squares counted x vol of 1 square
```
34
How are specimens concentrated?
centrifugation for 5-10min
35
What are the cells found in normal CSF?
lymphocytes and monocytes
36
What can cause infection of the meninges? What is the biggest symptom?
```
bacterial
viral
fungal
parasitic
biggest symptom is petechiae
```
37
A high CSF WBC count of neutrophils is indicative of...
bacterial meningitis
38
A high CSF WBC count of lymphocytes and monocytes is indicative of...
meningitis of viral, tubercular, fungal or parasitic origin
39
Inc eosinophils in CSF is seen with...
parasitic infections, fungal infections
40
What is the sac that surrounds the fetus?
amnion
41
How is amniotic fluid collected?
amniocentesis
42
What is a major contributor to the amniotic fluid volume?
fetal urine
43
What can cause fetal distress associated with neural tube disorders?
failure of the fetus to swallow
44
Increased fetal swallowing causes...
urinary tract deformities, membrane leakage, dec amniotic fluid
45
How do you determine the age of the fetus?
determining the level of creatinine
46
How can you differentiate amniotic fluid from urine?
levels of urea & creatinine
| fern test
47
When is amniocentesis recommended?
when screening blood tests are abnormal (maternal serum alpha fetal protein, triple screening or quadruple screening)
48
How do you determine maternal vs fetal blood in amniotic fluid?
kleihauer-betke test
49
The presence of bilirubin causes yellow color in amniotic fluid is result of...
RBC destruction from HDN
50
Very dark brown amniotic fluid is associated with...
fetal death
51
What is the oldest routinely performed lab test on amniotic fluid?
HDN (Hemolytic Disease of the newborn)
52
If HDN is occurring what will be present in the amniotic fluid?
bilirubin
53
What is the OD amniotic fluid range? What is the value when bilirubin is present?
365-550, 450
54
How do we measure neural tube defects? What are some defects?
alpha fetal protein
| anencephaly, spinal bifida
55
If AFP is detected, what is it followed by?
AChE (amniotic acetylcholinesterase)
56
What is diarrhea defined as?
>200g of stool weight
inc liquidity
poop more than 3x/day
57
What are the major cations tested in feces?
sodium and potassium
58
What is the osmotic gap in osmotic vs. secretory diarrhea?
osmotic greater than 50
| secretory less than 50
59
What is osmotic diarrhea?
incomplete breakdown or reabsorption of food leading to diarrhea
60
What is the test for malabsorption?
D-xylose
61
What can be useful in diagnosing pancreatic insufficiency and small bowel disorders that cause malabsorption?
steatorrhea
62
Pale stools can signify what?
a blockage of the bile duct or procedures using barium sulfate
63
What can cause muscle fibers to be present in feces?
undigested striated muscle (food)
pancreatic insufficiency
biliary obstruction
gastrocolic fistulas
64
How are partially digested fibers seen under microscope?
the striations go only in one direction
65
What is the most frequent fecal analysis?
Fecal Occult Blood Test
66
What is the most frequent screening test for occult blood?
the detection of pseudoperoxidase activity of Hgb
67
What reagent is tested in Occult Blood testing?
guaiac reagent
68
What is the confirmatory test for steatorrhea?
quantitative fecal fat analysis
69
What is lactoferrin testing for?
granules and neutrophils
70
What do you add to stain muscle fibers?
10% alcoholic eosin
71
What is a more sensitive test for the detection of occult blood? What does it test for?
hemoquant
| porphyrin
72
an intact blood brain barrier has an index value...
less than 9
73
What is the primary purpose for performing CSF protein electrophoresis?
for the detection of oligoclonal bands representing inflammation within the CNS
74
What is the presence of myelin basic protein in the CSF indicative of?
recent destruction of the myelin sheath
75
Measurement of what can be used to monitor multiple sclerosis?
MBP and CSF
76
How does glucose enter the CSF?
selective transport across the blood brain barrier
77
If plasma glucose is 100mg/dL what would a normal CSF glucose be?
65mg/dL
78
What contributes to the four fractions of semen?
```
testes
epididymis
seminal vessels
prostate
bulbourethral glands
```
79
What contains the seminiferous tubules? What type of cells are found inside?
the testes
| germ cells that produce spermatozoa located in the epithelial cells of the tubules
80
Where do the immature sperm cells go to mature? What signifies their maturation?
the epididymis
| the development of flagella
81
During ejaculation, where are the sperm propelled?
vas deferens -> ejaculatory ducts -> urethra?
82
What produces the majority of the fluid present in semen? It has a high concentration of...
the seminal vesicles
| fructose
83
What produces the acid found in semen?
prostate gland
84
What produces the alkaline fluid to help neutralize some acidity?
the bulbourethral glands
85
Analysis of semen can't begin until the sample...
liquefies after 30-60 min of collection
86
What is the most commonly used dilution for sperm count?
1:20
87
The percentage of sperm showing forward movement can be estimated after examining ____ high power fields
20
88
What stain is used for sperm?
Wright's
Giemsa or
Papanicolaou
89
Inclusion of extra sperm measurement parameters is known as...
Kruger's strict criteria
90
What are the additional testing methods for semen analysis?
sperm viability
seminal fluid fructose
anti-sperm antibodies
91
What fluid is known as "joint fluid"?
synovial fluid
92
What are the specialized cells in the synovial membrane?
synoviocytes
93
What can cause synovial fluid to clot?
the presence of fibrinogen
94
When should differential counts be performed on synovial fluid samples?
on cytocentrifuged preparations or thinly smeared slides
95
Normal synovial fluid glucose should not be more than _____ lower than the blood value
10 mg/dL
96
What type of testing plays an important role in the diagnosis of joint disorders?
serologic tests
97
What is the disruption of mechanisms of serous fluid formation and re-absorption?
effusion
98
A dec sperm count may be further evaluated by...
fructose test
99
Plasma cells when seen in pleural fluid are indicative of what disease?
tuberculosis
100
What are the primary causes of effusions?
inc hydrostatic pressure
dec oncotic pressure
inc capillary permeability
lymphatic obstruction
101
What are the methods of collection for serous fluid?
thoracentesis
pericardiocentesis
paracentesis
102
Serous fluid specimens for pH must be...
maintained anaerobically on ice
103
What are transudates?
effusions that form bc of systemic disorder
104
What are exudates?
effusions that form bc of conditions that directly involve the membranes ex. infections/malignancies
105
What is the most reliable lab tests that differentiate between transudates and exudates?
LDH (lactic dehydrogenase) and protein fluid-to-blood ratios
106
What two substances are have significance in fluid:serum ratios for pleural fluids?
cholesterol
| bilirubin
107
A fluid:serum bilirubin ratio of ___ or more indicates exudate
6
108
What is the most diagnostically significant hematology test performed on serous fluid?
differential cell count
109
What are the primary cells found in pleural, pericardial and peritoneal fluids?
```
neutrophils
lymphs
eosinos
mesothelials
plasma
malignant
```
110
What is a lack of mesothelial cells significant of?
tuberculosis
111
What are the most common chemistry tests performed on pleural fluid?
glucose
pH
ADA
amylase
112
What is the accumulation of fluid between the peritoneal membranes?
ascites
