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Flashcards in Serous Body fluids Deck (34)
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1
Q

What cavities are lined by two membranes?

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

A
  • Pleural
  • pericardial
  • peritonial
  • Parietal membrane
  • Visceral membrane
2
Q

Why is only a small amount of serous fluid present?

A

production and reabsorption take place at constant rate

3
Q

Production and reabsorbtion of serous fluid are maintained by?

A
  • Hydrostatic pressure
  • Colliodal (oncotic) pressure
4
Q

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

A
  • the same on both sides of capillaires membranes
  • fluid to enter between the membranes
5
Q

Disruption of serous fluid mechanisms causes?

A

increase in fluid between the membranes called Effusion

6
Q

Primary causes of effusion? (4)

A
  • congestive heart failure (CHF)
  • decreased oncotic pressure (hypoproteinemia)
  • increased capillary permeability (inflammagtion and infection)
  • Lymphatic obstruction (tumors)
7
Q

How is serous fluid collected?

How much fluid is collected?

A
  • Thoracentesis (pleural)
  • pericardiocentesis (pericardial)
  • paracentesis (peritoneal)
  • abundant >100 mL
8
Q

How are serous specimens maintained forpH tests?

A

Anaerobically on ice

9
Q

What are the two classifications of Effusions?

A

Trasudate and Exudate

10
Q

What is a transudate effusion?

A

Systemic disorder that disrupts balance of fluid filtration and reabsorbtion.

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

***** INDIRECT CAUSES

11
Q

What causes an exudate effusion?

A

conditions that DIRECTLY involve/affect membranes of particular cavity.

  • malignancies/infections
12
Q

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

A
  • Determine fluid-blood ratios of protein and lactic dehydrogenase
13
Q

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

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

A
  • provide little diagnostic info
  • Exudate
14
Q

Plueral fluids are of what effusion origins?

What differntiates them?

A
  • Transidative or Exudative
  • Plueral fluid cholesteral >60 mg/DL = exudate
  • Plural fluid: serum cholesterol ration >0.3 = exudate
  • fluid: serum bilirubin 6> = exudate
15
Q

blood in plural fluid can indicate?

A

hemothorax

16
Q

How to differentitate hemothorax from hemorrhage?

A
  • Hematocrit
  • Fluid Hct > 50% of whole blood Hct = hemothorax (because blood pouring in from injury)
17
Q

What can cause milky plural fluid?

A
  • Chylous material from thoracis duct leakage
  • pseudochylous material from chronic inflammatory conditions
18
Q

How to differentiate Chylous from Pseudochylous effusions?

A

Pseudochylous = higher [cholesterol]

Chylous = higher [triglyceride]

Sudan III strongly positive with chylous material

19
Q

Neutros increased in plural fluid indicate? (2)

A
  • bacterial infection (pneumonia)
  • Effusions from pancreatitis and pulmonary infarction
20
Q

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

A
  • tuberculosis
  • viral infections
  • malignancy
  • autoimmune disorders (artritis & systemic lupus)
21
Q

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

A
  • trauma from air or blood in cavity (pneumothorax / hemothorax)
  • allergic reaction
  • parasitic reaction
22
Q

Lack of mesothelial cells is associated with?

A

tuberculosis

23
Q

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?

A
  • Need for chest tube drainage
  • eosophigeal rupture
  • tubercolosis
  • Pancreatitis
24
Q

Pericardial fluid: How much is found between membrance?

A

10 - 50 mL

25
Q

Pericardial fluid: Effusions result from?

A

Changes in membrane permeability due to

  • infection
  • malignancy
  • trauma
26
Q

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

A
  • Metabolic disorders
    • uremia
    • hypothyroidism
  • Autoimmune disorders
27
Q

Peritoneal Fluid: Accumulation between membranse is called?

A

Ascites

28
Q

Peritoneal Fluid: Causes of ascitic transudases?

A
  • hepatic disorders
    • cirrhosis
29
Q

Peritoneal Fluid: Exudative effusions caused by? (2)

A
  • bacterial infections (peritonitis)
    • intestinal perforation
    • rutured apendix
  • malignancy
30
Q

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

What RBC count iindicates traum?

A
  • Peritoneal Lavage
  • >100,000/uL
31
Q

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

A
  • Serum-ascities albumin gradient (SAAG) is resommended over:
    • fluid: serum total protein
    • LD ratios
32
Q

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

A
  • Difference gradient 1.1> = transudate (hepatic)
  • <1.1 = exudate
33
Q

Peritoneal fluid:

What WBC count is normal?

A
  • <350 cells uL
34
Q

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

A

Absolute neutrophil count done