Serous Fluid

Question 1

What is serous fluid?

Answer 1

Fluid that is an ultrafiltrate of plasma and therefore has a similar composition to serum.

Question 2

Where can serous fluid be found?

Answer 2

Primarily the lungs, heart, and abdominal organs.

Question 3

Where can pleural fluid be found?

Answer 3

Surrounds the lungs.

Question 4

Where can pericardial fluid be found?

Answer 4

Surrounds the heart.

Question 5

Where can peritoneal fluid be found?

Answer 5

Surrounds the abdominal organs.

Question 6

What is another name for peritoneal fluid?

Answer 6

Ascites fluid

Question 7

What is the name of the serous membrane covering the organs?

Answer 7

The visceral membrane

Question 8

What is the name of the serous membrane covering the body wall?

Answer 8

Parietal membrane

Question 9

What is the net pressure favoring fluid formation in the pleural cavity?

Answer 9

+9 mmHg

Question 10

What is the net pressure favoring fluid absorption out of the pleural cavity?

Answer 10

+10 mmHg

Question 11

What are characteristics of transudate serous fluid?

Answer 11

• Increased hydrostatic pressure
• Decreased plasma oncotic pressure
• Non-inflammatory changes

Question 12

What are characteristics of exudate serous fluid?

Answer 12

• Increase in capillary permeability
• Decrease in lymphatic absorption
• Inflammatory changes

Question 13

What is the clinical significance of transudate serous fluid?

Answer 13

Potential heart or liver failure

Question 14

What is the clinical significance of exudate serous fluid?

Answer 14

Caused by a primary pathologic state (i.e., bacterial or viral infection)

Question 15

Generally, what color is serous fluid?

Answer 15

Colorless to a light yellow.

Question 16

Generally, how much serous fluid can be obtained?

Answer 16

Between 1 and 10 mL

Question 17

Define Effusion

Answer 17

Accumulation of fluid in a body cavity as a result of a pathologic process

Question 18

Where on the body does a thoracentesis take place?

Answer 18

Lungs

Question 19

Where on the body does a pericardiocentesis take place?

Answer 19

Heart

Question 20

Where on the body does a peritoneocentesis take place?

Answer 20

Abdominal cavity

Question 21

What occurs when serous fluid is refrigerated after collection?

Answer 21

Decrease the viability of microorganisms

Question 22

For pH testing on serous fluid, what is the proper collection technique?

Answer 22

Anaerobic sampling, heparinized syringe, on ice.

Question 23

Why should serous fluid be transported to the lab ASAP?

Answer 23

To decrease viability of microorganisms

Question 24

What are some physical characteristics of transudate serous fluid?

Answer 24

(1) Color: Pale yellow
(2) Clarity: Clear
(3) Does not spontaneously clot

Question 25

What are some physical characteristics of exudate serous fluid?

Answer 25

(1) Color: Variable (yellow, green, etc) (2) Clarity: Cloudy (3) Clots spontaneously

Question 26

What are the two types of "milky" effusions that can occur with serous fluid?

Answer 26

Chylous and Pseudochylous

Question 27

What is indicative of chylous "milky" effusion?

Answer 27

(1) Predominance of lymphocytes | (2) Triglyceride level >110 mg/dL - chylomicrons present

Question 28

What is indicative of pseudochylous "milky" effusion?

Answer 28

(1) Cholesterol crystals present | (2) Triglyceride levels <50 mg/dL, no chylomicrons present

Question 29

Using TP and LD ratios, how would you determine transudate serous fluid?

Answer 29

TP ratio <= 0.5; LD ratio <= 0.6

Question 30

Using TP and LD ratios, how would you determine exudate serous fluid?

Answer 30

TP ratio >0.5; LD ratio >0.6

Question 31

For serous glucose, what would indicate exudate serous fluid?

Answer 31

<60 mg/dL OR serum-fluid difference greater than 30 mg/dL

Question 32

What is indicative of low fluid glucose?

Answer 32

Rheumatoid arthritis, bacterial infection, tuberculosis, maglignant neoplasm

Question 33

For amylase, what increments must it be compared to the serum value to be considered abnormal?

Answer 33

1.5 to 2x higher than the serum value

Question 34

If serous fluid has a triglyceride level of >110 mg/dL, what is that indicative of?

Answer 34

Chylous effusion

Question 35

If serous fluid has a triglyceride level of 50-110 mg/dL, what is that indicative of?

Answer 35

Chylomicrons

Question 36

If serous fluid has a triglyceride level of <50 mg/dL, what is that indicative of?

Answer 36

Pseudochylous effusion

Question 37

If serous fluid has a cholesterol fluid-to-serum ratio of >1.0, what is that indicative of?

Answer 37

Pseudochylous effusion

Question 38

If a serous fluid has a cholesterol fluid-to-serum ratio of >0.3, what is that indicative of?

Answer 38

Exudates

Question 39

If pleural fluid has a pH <7.3, what is that indicative of?

Answer 39

Complicated paraneumonic effusion

Question 40

If pleural fluid has a pH >7.3, what is that indicative of?

Answer 40

Uncomplicated paraneumonic effusion

Question 41

What is an important pre-analytical consideration when collecting for pH testing?

Answer 41

Place on ice after collection

Question 42

An increased carcinoembryonic antigen (CEA) value can indicate what?

Answer 42

Cancer treatment not working/cancer has spread

Question 43

A decreased or stagnant carcinoembryonic antigen (CEA) value can indicate what?

Answer 43

Cancer treatment working/cancer is not spreading

Question 44

A WBC count of >1000 cells/uL, may indicate what?

Answer 44

Pericarditis (transudate)

Question 45

A WBC count of >500 cells/uL may indicate what?

Answer 45

Bacterial peritonitis (exudates)

Question 46

What are types of cells are these, and what are some characteristics of them?

Answer 46

Mesothelial cells, they exist in the lining of the serous membrane. (1) Window between cells - indicate noncancerous (2) Low N/C ratio

Question 47

Identify these cells

Answer 47

Mesothelial cells

Question 48

Identify these cells

Answer 48

Signet ring macrophages

Question 49

What type of stain is needed for microbiological exam?

Answer 49

Gram stain - pleural fluid should also have acid-fast stain

Question 50

What different types of cultures are ran on serous fluid?

Answer 50

Aerobic, anaerobic, fungal