Chapter 13 - Serous Fluid

Sterile

________ heparinized evacuated tubes are used for microbiology and cytology.

accidental puncture

Ruptured bladder or ________ of the bladder during the paracentesis.

carcinoembryonic antigen

Detection of the tumor markers ________ (CEA), CA 125 (metastatic uterine cancer), CA15.3 and CA 549 (breast cancer), and CYFRA 21- 1 (lung cancer) provide valuable diagnostic information in effusions of malignant origin.

RBC

________ counts greater than 100, 000 /μL are indicative of blunt trauma injuries.

serum proteins

Under normal conditions, colloidal pressure from ________ is the same in the capillaries on both sides of the membrane.

lymphocytes

In ascitic fluid, ________ are the predominant cell in tuberculosis.

Haemophilus

Infections are frequently caused by previous respiratory infections including ________, Streptococcus, Staphylococcus, Adenovirus and Coxsackievirus.

Acid

________- fast stains and chemical tests for ADA are done in cases of AIDS infection.

Effusions

________ that form because of conditions that directly involve the membranes of the particular cavity are called exudates.

systemic disorder

Effusions that form because of a(n) ________ that disrupts the balance in the regulation of fluid filtration and reabsorption are called transudates.

Hemathorax

________ (traumatic injury, appears streaked and uneven), hemorrhagic effusion, pulmonary embolis, tuberculosis, membrane damage.

Malignant cells

________ are frequently found in cases of metastatic lung or breast carcinoma, supported by positive detection of carcinoembryonic antigens.

Psammoma bodies

________ containing concentric striations of collagen- like material can be seen in benign conditions and are also associated with ovarian and thyroid malignancies.

Differentiation

________ is done by determining the fluid- to- blood ratios for protein and lactic dehydrogenase.

Normal saline

________ is sometimes introduced into the peritoneal cavity to act as a lavage for the detection of abdominal injuries that have not yet resulted in the accumulation of fluid.

ethylenediaminetetraacetic acid

A(n) ________ (EDTA) tube is used for cell counts and differential counts.

noninflammatory processes

Antinuclear antibody (ANA) and rheumatoid factor (RF) tests are usually performed to differentiate effusions of immunologic origin from ________.

Chemistry tests

________ can be run on clotted specimens in plain tubes or on heparinized tubes.

Ascites

________ refers to the accumulation of fluid between the peritoneal membranes.

Inoculation of fluid

________ into blood culture bottles at the bedside increases the recovery of anaerobic organisms.

chronic membrane disease effusion

A(n) ________ contains both blood and increased pleural fluid, resulting in a much lower hematocrit.

cells μL

An absolute neutrophil count greater than 250 ________ or greater than 50 % of the total WBC count is indicative of infection.

peritoneal cavities

The closed cavities of the body- the pleural, pericardial and ________- are each lined by two membranes referred to as the serous membranes.

Serous fluids

________ are formed as ultrafiltrates of plasma, with no additional material contributed by the mesothelial cells that line the membranes.

Peritoneal lavage

________ is a sensitive test for the detection of 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.

unequal pressure

A slightly ________ in the parietal and visceral capillaries creates a small excess of fluid that is reabsorbed by the lymphatic capillaries.

Blood specimens

________ should be obtained at the time of collection for comparison with chemical tests.

hydrostatic pressure

The ________ in the parietal and visceral capillaries causes fluid to enter between the membranes.

Bacterial cultures

________ and Gram staining for both aerobes and anaerobes are performed when bacterial peritonitis is suspected.

better recovery of microorganisms

For ________ and abnormal cells, concentration of large amounts of fluid is performed by centrifugation.

Differentiation

________ between ascitic fluid transudates and exudates is more difficult than for pleural and pericardial effusions.

The serum-ascites albumin gradient (SAAG) is recommended over the fluid

serum total protein and LD ratios for the detection of transudates of hepatic origin

EDTA tube

What collection tube is suitable for cell counts and differential counts?

sterile heparinized tubes

What collection tube is suitable for microbiology and cytology?

transudates

These effusions form because of a systemic disorder that disrupts the balance in the regulation of fluid filtration and reabsorption.

rupture of amoebic liver abscess

What is brown pleural fluid indicative of?

pseudochylous material

A pleural fluid specimen is milky with a green tinge and contains cholesterol crystals. What is it indicative of?

tuberculosis

There are decreased mesothelial cells and plasma cells in a pleural fluid specimen. What is this indicative of?

bacterial infection

What is increased pleural fluid lactate indicative of?

bacterial endocarditis

A pericardial fluid WBC count greater than 1000 WBCs/μL is indicative of what?

transudate

A blood specimen has 3.8 mg/dL of albumin while an ascitic fluid specimen has 1.2 mg/dL of albumin. Is it a transudate effusion or exudate effusion?

blunt trauma injury

An ascitic fluid RBC count greater than 100000 RBCs/μL is indicative of what?

intestinal perforation

What is increased ascitic fluid amylase and alkaline phosphatase indicative of?