Serous fluid

Question 1

Three cavities that contain serous fluid

Answer 1

Pleural, pericardial, peritoneal

Question 2

what are the two serous membranes

Answer 2

parietal (cavity) and visceral (organ in cavity)

Question 3

Collection names for each of the cavities

Answer 3

Thoracentesis=pleural fluid
Pericardiocentesis=pericardial fluid
Paracentesis=peritoneal fluid

Question 4

What are serous fluids ultrafiltrates of?

Answer 4

Plasma

Question 5

4 forces that effect production and reabsorption rate

Answer 5

hydrostatic, oncotic, intrapleural, lymphatic

Question 6

Effusion

Answer 6

increase in serous fluid due to disruption in formation or reabsorption of fluid

Question 7

effusion causes

Answer 7

• increased capillary hydrostatic pressure (chronic heart failure)
• Decreased oncotic pressure (nephrotic syndromes)
• increased capillary permeability (infection/inflammation)
• lymphatic obstruction (tumor/lymphoma)

Question 8

Type 1: Transudate

Answer 8

secondary to a systemic disease process. No further testing, resolved when disorder is resolved

Question 9

Type 2: Exudate

Answer 9

Primary or local inflammation in the closed cavity. Infection or malignancies, further testing is necessary

Question 10

Pleural fluid colors

Answer 10

Normal=clear or pale yellow
Turbid/white=microbial infection
Bloody=hemothorax, hemorrhagic effusion, embolism, TB
Milky=chylous/pseudochylous material
Brown=rupture of liver abscess
Black=aspergillus
Viscous=malignant mesothelioma (increased hyaluronic acid)

Question 11

Chylous

Answer 11

thoracic duct leakage. High [triglycerides]. Lots of lymphocytes, sudan III stain=+

Question 12

Pseudo

Answer 12

chronic inflammatory conditions. High [cholesterol]. Mix of cells, sudan III stain=-

Question 13

Normal pleural cells

Answer 13

macrophages=64-80%
lymphocytes=18-30%
neutrophils=1-2%
mesothelial cells are decreased when TB

Question 14

Reactive mesothelial cells

Answer 14

very bad

Question 15

Glucose

Answer 15

decreased in infection and rheumatoid inflammation. Lactate may also be measured

Question 16

pH

Answer 16

decreased in pneumonia <7.2. esophageal rupture <6, lung abcess is <7.2

Question 17

Adenosine deaminase (ADA)

Answer 17

Increased=TB/malignancy

Question 18

Amylase

Answer 18

Increased=pancreatitis, esophageal rupture, malignancy

Question 19

Triglycerides

Answer 19

increased=chylous effusion

Question 20

Microbiology testing

Answer 20

gram stain and culture (aerobic and anaerobic) or acid fast stain. Autoimmune markers
- SLE = antinuclear antibodies
- RA = rheumatoid factor
Malignancy= uterine/ovarian cancer=CEA and CA125

Question 21

Pericardial fluid

Answer 21

10-15mL. Increased volume due to infection, malignancy, trauma, metabolic disorder, autoimmune disorder.

Question 22

pericardial fluid colors

Answer 22

normal=clear or pale yellow
turbid=infection and malignancy
bloody=malignancy/cardiac puncture, anticoag
milky=chylous, pseudochylous

Question 23

Testing of pericardial fluid

Answer 23

serum protein/LDH ratio

Question 24

Peritoneal fluid

Answer 24

ascites=accumulation of fluid btwn peritoneal membranes. could be from cirrhosis, peritonitis, malignancy

Question 25

Appearance of peritoneal fluid

Answer 25

normal=clear/pale yellow Turbid=micro infection Green=bile duct or gall bladder or pancreatic disorder bloody=trauma, infection, malignancy milky=lymph block/trauma

Question 26

Serum ascites albumin gradient (SAAG)

Answer 26

>1.1 = transudate effusion of hepatic origin <1.1 = exudative effusion