SEROUS FLUID

Question 1

Normal

Answer 1

Clear, Pale Yellow

Question 2

Microbial Infection

Answer 2

turbid

Question 3

Hemothorax (traumatic injury)
Hemorrhagic effusion, pulmonary
embolism, tuberculosis, malignancy

Answer 3

bloody

Question 4

Chylous material from thoracic duct
leakage
Pseudochylous material from chronic
inflammation

Answer 4

milky

Question 5

Rupture of amoebic liver abscess

Answer 5

brown

Question 6

Aspergillus

Answer 6

black

Question 7

Malignant mesothelioma (increased
hyaluronic acid)

Answer 7

viscous

Question 8

Uneven Distribution of
Blood

Answer 8

hemothorax

Question 9

aspiration
procedures of pleural

Answer 9

THORACENTESIS

Question 10

aspiration
procedure of pericardial

Answer 10

PERICARDIOCENTESIS

Question 11

aspiration
procedure of peritoneal

Answer 11

PARACENTESIS

Question 12

Usually, abundant fluid _____ is collected; therefore,
suitable specimens are available for each section of the
laboratory.

Answer 12

> 100mL

Question 13

is used for
cell counts and the differential.

Answer 13

EDTA

Question 14

evacuated tubes are used for
microbiology and cytology.

Answer 14

Sterile heparinized or SPSS

Question 15

can be run on clotted specimens in plain tubes or in heparin
tubes.

Answer 15

CHEMISTRY TESTS x PLAIN TUBES OR HEPARIN

Question 16

Effusions that form because of a systemic disorder that
disrupts the balance in the regulation of fluid filtration and
reabsorption—such as the changes in hydrostatic pressure created
by congestive heart failure or the hypoproteinemia associated with
nephrotic syndrome

Answer 16

TRANSUDATES - systemic and nephrotic syndrome, CHF, hypoproteinemia

Question 18

produced by conditions that directly involve the
membranes of the particular cavity, including infections and
malignancies.

Answer 18

EXUDATES - infections and malignancies

Question 19

However, the most reliable
differentiation is obtained by determining the

Answer 19

Fluid blood ratios for protein and lactic dehydrogenase

Question 20

Cloudy Appearance

Answer 20

EXUDATE

Question 21

No Spontaneous
clotting

Answer 21

TRANSUDATE

Question 22

To differentiate between transudates and exudates, two more
procedures are helpful when analyzing pleural fluid:

Answer 22

pleural fluid cholesterol (>60) and fluid:serum
cholesterol (>0.3)

the ratio of pleural fluid:serum total bilirubin. (>0.6)

Question 23

is recommended only in
effusions suspected of being due to rheumatoid
arthritis.

Answer 23

GLUCOSE

Question 24

only a small amount (10 to 50 mL) of fluid is found
between the pericardial serous membranes

Answer 24

PERICARDIAL FLUID

Question 25

suspected when cardiac compression (tamponade) is noted during the physicianʼs examination.

Answer 25

EFFUSION

Question 26

Accumulation of fluid between the peritoneal membranes

Answer 26

ASCITES = PERITONEAL

Question 27

Hepatic disorders, such as cirrhosis, are frequent causes of

Answer 27

Ascitic transudates

Question 31

Bacterial infections (peritonitis)—often as a result of intestinal perforation or a ruptured appendix—and malignancy are the most frequent causes

Answer 31

Exudative fluids

Question 32

Sometimes normal saline is introduced into the peritoneal cavity as a lavage to detect abdominal injuries that have not yet resulted in fluid accumulation.

Answer 32

TRUE

Question 33

Peritoneal lavage is a diagnostic procedure used to detect intra-abdominal bleeding in blunt trauma cases, and results of the RBC count can be used along with radiographic procedures to aid in determining the need for surgery

Answer 33

TRUE PERITONEAL RBC COUNT OF GREATER THAN 100,000 = blunt trauma injuries

Question 34

Bile, gallbladder, pancreatic disorders

Answer 34

GREEN PERITONEAL

Question 35

Malignancy of gastrointestinal origin

Answer 35

CEA

Question 36

Malignancy of ovarian origin

Answer 36

CA 125

Question 37

Decreased in tubercular peritonitis, malignancy

Answer 37

GLUCOSE DECREASED IN PERITONEAL

Question 38

Increased in pancreatitis, gastrointestinal perforation

Answer 38

AMYLASE INCREASED

Question 39

Increased in gastrointestinal perforation

Answer 39

ALKALINE PHOSPHATASE INCREASED

Question 40

Ruptured or punctured bladder

Answer 40

Blood urea nitrogen/ creatinine

Question 41

recommended over the fluid:serum total protein and LD ratios to detect transudates of hepatic origin.

Answer 41

SAAG - detect transudates OF HEPATIC (>1)

Question 42

are pleomorphic; they resemble lymphocytes, plasma cells, and malignant cells, frequently making identification difficult.

Answer 42

MESOTHELIAL

Question 43

● Pancreatitis ● Pulmonary Infarction

Answer 43

NEUTROPHILS

Question 44

● Tuberculosis ● Viral Infection ● Autoimmune Disorders ● Malignancy

Answer 44

LYMPHOCYTES

Question 45

Normal and reactive forms have no clinical significance

Answer 45

MESOTHELIAL

Question 46

Tuberculosis

Answer 46

PLASMA CELLS

Question 47

● Primary adenocarcinoma and small-cell carcinoma ● Metastatic Carcinoma

Answer 47

MALIGNANT CELLS

Question 48

Characteristics of malignant cells

Answer 48

Increased N:C ratio Irregularly distributed nuclear chromatin Increased number and size of nucleoli Hylerchromatic nucleoli Giant cells and multinucleation Nuclear molding Cytoplasmic molding Vacuolated cytoplasm mucin production Cellular crowding phagocytosis

Question 49

measured to confirm presence of chylous effusion

Answer 49

TRIGLYCERIDES CHOLESTEROL - PSEUDOCHYLOUS

Question 50

Decreased in rheumatoid inflammation. ● Decreased in purulent infection.

Answer 50

GLUCOSE

Question 51

Elevated in bacterial infection Elevated in chylous effusions

Answer 51

LACTATE - BACTERIAL TRIGLYCERIDES - CHYLOUS

Question 52

Decreased in pneumonia not responding to antibiotics ● Markedly decreased with esophageal rupture.

Answer 52

pH

Question 53

Elevated in tuberculosis and malignancy.

Answer 53

ADA

Question 54

Elevated in pancreatitis, esophageal rupture, and malignancy

Answer 54

AMYLASE

Question 55

may indicate the need for chest-tube drainage in addition to administration of antibiotics in cases of pneumonia

Answer 55

pH LOWER THAN 7.3

Question 56

indicates an esophageal rupture that is allowing the influx of gastric fluid.

Answer 56

pH LOWER THAN 6.0

Question 57

Collection of specimens for pH should be taken and analyzed in a manner identical to that for

Answer 57

arterial blood gas

Question 58

Should be collected anaerobically using a heparinized syringe ○ measured in a blood gas analyzer at 37°C

Answer 58

TRUE

Question 59

ADA levels higher than 40 U/L are highly indicative of

Answer 59

TUBERCULOSIS

Question 60

elevated amylase levels are associated with ______, and often amylase is elevated first in the pleural fluid.

Answer 60

PANCREATITIS

Question 61

that is seen frequently in pleural fluid and is associated with asbestos contact.

Answer 61

Metastatic giant mesothelioma cell

Question 62

Normal WBC counts are less than 500 cells/µL, and the count increases with bacterial peritonitis and cirrhosis. ● To distinguish between those two conditions, an ______

Answer 62

ABSOLUTE NEUTROPHIL

Question 63

predominant cell in tuberculosis and peritoneal carcinomatosis

Answer 63

LYMPHOCYTES