Serous Fluid

Question 1

What are the fluid inside the closed cavities of the body?

Answer 1

➔ Pleural (lungs)
➔ Pericardial (heart)
➔ Peritoneal (abdomen)

Question 2

What is the primary role of serous fluid?

Answer 2

provides lubrication between the organs and tissues within the cavity.

lung inflation & deflation
beating of heart
expansion of stomach

Question 3

Serous fluid is produced by?

Answer 3

Serous membrane or serosa

Question 4

Serous fluid is composed of what two layers?

Answer 4

a. Parietal membrane
b. Visceral membrane

Question 5

Lines the inner cavity wall

Answer 5

Parietal membrane

Question 6

lines the surface of the organs

Answer 6

Visceral membrane

Question 7

is an ultrafiltrate of plasma

Answer 7

Serous fluid

Question 8

Majority of composition of the serous fluid is from the?

Answer 8

plasma

Question 9

Mesothelial cells do not contribute to serous fluid (T/F)

Answer 9

T

Question 10

Two main forces that form serous fluid

Answer 10

Hydrostatic Pressure
Osmotic Pressure (Colloid Pressure)

Question 11

➔ Main force that drives the fluid into the cavities
➔ Hydrostatic pressure is higher than colloidal pressure = small amount of excess fluid will remain in the cavity

Answer 11

Hydrostatic Pressure

Question 12

➔ Reabsorbs the fluid back to the capillary
➔ During the reabsorption the serous fluid is also further filtered

Answer 12

Osmotic Pressure (Colloid Pressure)

Question 13

It maintains the continuous exchange of ions in serous fluid and maintains its volume

Answer 13

The pulling force of colloid pressure (cavities - capillaries) + the pushing force of hydrostatic pressure (capillaries— cavities)

Question 14

located in the membranes also contribute to the reabsorption of the fluid

Answer 14

Lymphatic capillaries

Question 15

disruption of the formation and reabsorption of serous fluid

Answer 15

Effusion

Question 16

Effusion can be caused by:

Answer 16

➔ Congestive heart failure (↑ hydrostatic pressure)
➔ Hypoalbuminemia such as in nephrotic syndrome (↓ oncotic pressure)
➔ Inflammation (↑ capillary permeability)
➔ Lymphatic obstruction or tumors (↓ lymphatic reabsorption)

Question 17

Serous fluid is Collected via

Answer 17

needle aspiration

Question 18

a. Pleural fluid = ?
b. Pericardial fluid = ?
c. Peritoneal fluid = ?

Answer 18

thoracentesis
pericardiocentesis
paracentesis

Question 19

Tubes for processing:

Answer 19

➔ EDTA tube = cell counting
➔ Sterile heparin or SPS evacuated tube = microbial & cytology studies
➔ Plain tubes (clotted) or heparin (unclotted) = Chemistry
➔ pH testing should be maintained anaerobically and on ice

Question 20

Since serous fluid is an ultrafiltrate of plasma…

Answer 20

chemistry tests must be compared with plasma levels

Question 21

must be classified into transudate or exudate

Answer 21

Effusion

Question 22

Effusions from a systemic disorder that disrupts the fluid regulation between membranes

Answer 22

Serous Transudates

Question 23

Example of transudates

Answer 23

congestive heart failure (t hydrostatic pressure) or in nephrotic syndrome (1 oncotic pressure due to hypoalbuminemia)

Question 24

Effusions produced from an abnormality or damage to the membrane

Answer 24

Serous Exudates

Question 25

Example of exudates

Answer 25

Infections and malignancies

Question 26

Why is classifying the effusion as transudate or exudate is important?

Answer 26

testing algorithm of the serous fluid in the laboratory

Question 27

no further tests done

Answer 27

Transudates

Question 28

must be sent to microbiology or cytology section to determine cause

Answer 28

Exudates

Question 29

Variety of lab tests are used to differentiate transudate and exudate:

Answer 29

➔ Appearance ➔ Total protein ➔ Lactic dehydrogenase ➔ Cell counts ➔ Spontaneous clotting

Question 30

Most reliable test to differentiate transudate and exudate

Answer 30

Fluid:Blood Ratio for protein and LDH

Question 31

Presence of large proteins in the fluid =

Answer 31

membrane damage (exudate)

Question 32

Presence of LDH =

Answer 32

cellular damage → leak of fluid (exudate)

Question 33

Appearance of transudate

Answer 33

Clear, pale yellow

Question 34

Appearance of exudate

Answer 34

Cloudy, color variable

Question 35

Transudate WBC counts

Answer 35

<1000/ul (pleural, pericardial) <500 (peritoneal)

Question 36

Exudate WBC count

Answer 36

>1000/uL

Question 37

Transudate spontaneous clotting

Answer 37

No

Question 38

Exudate spontaneous clotting

Answer 38

Possible

Question 39

Transudate total protein

Answer 39

30g/L or less

Question 40

Exudate fluid total protein

Answer 40

>30g/L

Question 41

Transudate fluid:serum protein ratio

Answer 41

<0.5

Question 42

Exudate fluid:serum protein ratio

Answer 42

>0.5

Question 43

Transudate fluid fluid:serum LD ratio

Answer 43

<0.6

Question 44

Exudate fluid:serum LD ratio

Answer 44

>0.06

Question 45

Trasudate Fluid LD

Answer 45

<0.67 X ULN serum

Question 46

Exudate Fluid LD

Answer 46

>0.67 x ULN serum

Question 47

Transudate Glucose

Answer 47

Equal to serum

Question 48

Exudate Glucose

Answer 48

Less than or equal to serum

Question 49

Transudate Specific Gravity

Answer 49

<1.015

Question 50

Exudate Specific Gravity

Answer 50

>1.015

Question 51

is performed in the same manner with all serous fluids

Answer 51

Effusion examination

Question 52

Significant results may need additional tests =

Answer 52

vary per fluid

Question 53

Serous fluids are initially evaluated by:

Answer 53

➔ Appearance ➔ Identify whether its transudate or exudate * Exudate: further evaluated in microbiology & cytology * Transudate: no further test required

Question 54

Provide little significance (not routinely performed)

Answer 54

Cell counting

Question 55

Exudates in cell counting

Answer 55

Exudates: WBC of > 1000/uL and RBC of >100,000/uL

Question 56

Most clinically significant hematologic procedure

Answer 56

Differential count

Question 57

Differential count is performed on?

Answer 57

cytocentrifuge + wright stained smear

Question 58

Identification of typical cells and malignant cells

Answer 58

Differential count

Question 59

In differential counting, suspected malignant cells →?

Answer 59

sent to cytology studies