Serous Body fluids

Question 1

What cavities are lined by two membranes?

Which membrane lines the cavity wall and which covers the organs?

Answer 1

• Pleural
• pericardial
• peritonial
• Parietal membrane
• Visceral membrane

Question 2

Why is only a small amount of serous fluid present?

Answer 2

production and reabsorption take place at constant rate

Question 3

Production and reabsorbtion of serous fluid are maintained by?

Answer 3

• Hydrostatic pressure
• Colliodal (oncotic) pressure

Question 4

Under normal conditions colliodal pressure is ____________. Therfore, hydrostatic pressure in the parietal and visceral capillaries causes___________________.

Answer 4

• the same on both sides of capillaires membranes
• fluid to enter between the membranes

Question 5

Disruption of serous fluid mechanisms causes?

Answer 5

increase in fluid between the membranes called Effusion

Question 6

Primary causes of effusion? (4)

Answer 6

• congestive heart failure (CHF)
• decreased oncotic pressure (hypoproteinemia)
• increased capillary permeability (inflammagtion and infection)
• Lymphatic obstruction (tumors)

Question 7

How is serous fluid collected?

How much fluid is collected?

Answer 7

• Thoracentesis (pleural)
• pericardiocentesis (pericardial)
• paracentesis (peritoneal)
• abundant >100 mL

Question 8

How are serous specimens maintained forpH tests?

Answer 8

Anaerobically on ice

Question 9

What are the two classifications of Effusions?

Answer 9

Trasudate and Exudate

Question 10

What is a transudate effusion?

Answer 10

Systemic disorder that disrupts balance of fluid filtration and reabsorbtion.

• changes in hydrostaic pressure
• CHF
• hypoprotienemia ass. w/ nephrotic sydrome

***** INDIRECT CAUSES

Question 11

What causes an exudate effusion?

Answer 11

conditions that DIRECTLY involve/affect membranes of particular cavity.

• malignancies/infections

Question 12

What is the most reliable method for differentiating transudates from exudates?

Answer 12

• Determine fluid-blood ratios of protein and lactic dehydrogenase

Question 13

RBC and WBC counts not freq. done on serous fluid because?

WBC >1000 /uL and RBC >100,000/uL are indicative of?

Answer 13

• provide little diagnostic info
• Exudate

Question 14

Plueral fluids are of what effusion origins?

What differntiates them?

Answer 14

• Transidative or Exudative
• Plueral fluid cholesteral >60 mg/DL = exudate
• Plural fluid: serum cholesterol ration >0.3 = exudate
• fluid: serum bilirubin 6> = exudate

Question 15

blood in plural fluid can indicate?

Answer 15

hemothorax

Question 16

How to differentitate hemothorax from hemorrhage?

Answer 16

• Hematocrit
• Fluid Hct > 50% of whole blood Hct = hemothorax (because blood pouring in from injury)

Question 17

What can cause milky plural fluid?

Answer 17

• Chylous material from thoracis duct leakage
• pseudochylous material from chronic inflammatory conditions

Question 18

How to differentiate Chylous from Pseudochylous effusions?

Answer 18

Pseudochylous = higher [cholesterol]

Chylous = higher [triglyceride]

Sudan III strongly positive with chylous material

Question 19

Neutros increased in plural fluid indicate? (2)

Answer 19

• bacterial infection (pneumonia)
• Effusions from pancreatitis and pulmonary infarction

Question 20

Plueral fluid: increased lymp. seen in? (4)

Answer 20

• tuberculosis
• viral infections
• malignancy
• autoimmune disorders (artritis & systemic lupus)

Question 21

Plueral fluid: increased EOS >10% seen in? (3)

Answer 21

• trauma from air or blood in cavity (pneumothorax / hemothorax)
• allergic reaction
• parasitic reaction

Question 22

Lack of mesothelial cells is associated with?

Answer 22

tuberculosis

Question 23

Plueral fluid pH <7.0 may indicate?

pH as low as 6.0 indicates?

ADA (adenosine deaminase) >40 UIL indicate?

Elevated amalyse is associated with?

Answer 23

• Need for chest tube drainage
• eosophigeal rupture
• tubercolosis
• Pancreatitis

Question 24

Pericardial fluid: How much is found between membrance?

Answer 24

10 - 50 mL

Question 25

Pericardial fluid: Effusions result from?

Answer 25

Changes in membrane permeability due to * infection * malignancy * trauma

Question 26

Pericardial fluid: transudate effusions are primarily caused by? (2)

Answer 26

* Metabolic disorders * uremia * hypothyroidism * Autoimmune disorders

Question 27

Peritoneal Fluid: Accumulation between membranse is called?

Answer 27

Ascites

Question 28

Peritoneal Fluid: Causes of ascitic transudases?

Answer 28

* hepatic disorders * cirrhosis

Question 29

Peritoneal Fluid: Exudative effusions caused by? (2)

Answer 29

* bacterial infections (peritonitis) * intestinal perforation * rutured apendix * malignancy

Question 30

Peritoneal Fluid: What is a sensitive test for intr-abdominal bleeding in blunt trauma cases? What RBC count iindicates traum?

Answer 30

* Peritoneal Lavage * \>100,000/uL

Question 31

Peritoneal Fluid: what tests are recommened for the detection of hepatic origin transudates?

Answer 31

* Serum-ascities albumin gradient (SAAG) is resommended over: * fluid: serum total protein * LD ratios

Question 32

Peritoneal fluid: using the Serum-ascities albumin gradient (SAAG) what indicates hepatic transudate and exudate effusion?

Answer 32

* Difference gradient 1.1\> = transudate (hepatic) * \<1.1 = exudate

Question 33

Peritoneal fluid: What WBC count is normal?

Answer 33

* \<350 cells uL

Question 34

Peritoneal fluid: WBCs increase in bacterial peritonis and cirrhosis. How are the two distinguished?

Answer 34

Absolute neutrophil count done