Body Fluids

If the average cell count < 10, what percentage should the two sides agree?

Within 50%

If the average cell count < 100, what percentage should they agree?

20%

If the average cell count < 1000, what percentage should they agree?

10%

If the average cell count > 1000, what percentage should they agree?

Within 5%

What is the formula for calculating the # cells / uL?

[(Average cells counted)(dilution factor)] / [(# squares counted)(volume/square)]

What is the volume of 1 A square?

0.1 uL

What is the volume of 1 B square?

0.004 uL

How much should you dilute a slightly cloudy sample? List volumes.

1. 1:10 dilution

2. 20 uL sample, 180 uL diluent

How much should you dilute a moderately cloudy sample? List volumes.

1. 1:20

2. 20 uL sample, 380 uL diluent

How much should you dilute an opaque sample? List volumes.

1. 1:100

2. 20 uL sample, 1,980 uL diluent

Acetic acid can’t be used for which body fluid?

Synovial

Why is a lower dilution considered better?

It increases accuracy

What tube type should be used to collect synovial fluid for chem/imm tests?

No anticoagulant

What tube type should be used to collect synovial fluid for Heme tests?

Sodium Heparin

What does powered EDTA do to synovial fluid?

Increases artifacts during crystal analysis

What kind of tube is used for synovial fluid microbiology tests?

Sterile

What is the normal color of synovial fluid?

Clear or pale yellow

What does a deep yellow color signify in synovial fluid?

Inflammation

What does a greenish color signify in synovial fluid?

Infection

What does a red/brown color signify in synovial fluid?

Blood

What does turbidity signify in synovial fluid?

WBCs, crystals

What are Reiter’s Cells?

1. Macrophages that have phagocytized PMNs

2. PMN’s are removed after infection

3. See vacuoles, ingested PMNs

What are LE cells?

1. PMN with large inclusions

2. Nucleus of a cell that have been damaged

3. Lupus

What is the normal level of fibrinogen?

None

What are three causes of fibrinogen in synovial fluid?

1. Damage to synovial membrane

2. Contamination from PB

3. Traumatic tap

What are three signs of a traumatic tap in synovial fluid?

1. Decreasing amount of blood in tubes

2. Streaks of blood

3. Clots

What is the normal nucleated cell count in synovial fluid?

< 2000 cells / uL

What is the normal RBC count in synovial fluid?

< 2,000 cells/uL

What does Hyalurinodase do?

Decreases viscosity

What is the normal number of PMN’s in Synovial fluid?

< 25%

What are Ragocytes?

1. RA cells

2. PMNs with cytoplasmic granules of RF factor

What color are Monosodium Urate crystals when aligned with the axis under slow vibrations?

Yellow

What color are CPPD crystals when aligned with the axis?

Blue

If analyzing bilirubin in Amniotic fluid, what should be done to the sample?

Protect it from light

If giving an Amniotic fluid sample to cytogenetics, what temperature should it be kept at?

Body temp

If analyzing phospholipids in amniotic fluid, what temperature should it be kept at?

Delivered on ice

What is the normal color for Amniotic fluid?

Colorless or pale yellow

What does green amniotic fluid signify?

Meconium (Baby poop)

What does Yellow amniotic fluid symbolize?

Bilirubin (HDFN)

What does pink amniotic fluid signify?

Blood (traumatic tap)

Is Turbidity normal? If so, when does it increase, and what does it reflect?

1. Yes

2. Increases with weeks of gestation

3. Reflects cellular debris

Which phospholipid serves as an indicator for FLM? Which one serves as the baseline?

1. Indicator: Lecithin

2. Baseline: Sphingomyelin

What Lecithin-Sphingomyelin Ratio is associated with FLM?

> 2.0

What are Lamellar Bodies? What are they often confused with? What are they used to measure?

1. Cytoplasmic granules in which surfactants are stored

2. Platelets

3. FLM

What Lamellar concentration is associated with FLM?

>/= 50,000 / uL

What is the alpha-fetoprotein used to detect?

Neural Tube defects

Where is Alpha-Fetoprotein produced?

First in yolk sac, then by fetal liver

What level of Alpha-Fetoprotein indicates Neural Tube Defects?

Increased

If the Serum Alpha-Fetoprotein test is positive, what test is performed next?

Acetylcholinesterase

If both the Acetylcholinesterase and Alpha-Fetoprotein are positive, what is the likelihood of having a Neural Tube Defect?

96%

What is Acetylcholinesterase?

Enzyme in neural tube

What can cause a false positive Acetylcholinesterase test?

Blood

What was the gold standard for detecting Fetal Lung Maturity?

Thin Layer Chromatography

What is the Foam Stability or Shake test?

A test used to determine FLM by shaking amniotic fluid. If bubbles formed, surfactant was present and confirmed FLM. If no bubbles formed, FLM not confirmed.

How are Alpha-Fetoprotein results reported?

As a multiple of the media for that patient’s demographic

What method is used to detect Alpha-Fetoprotein?

Immunoassay

What MSAFP MoM value indicates a positive result?

> 2.5

What accounts for the majority of seminal fluid secretion?

Seminal vesicles

How do you store semen samples?

Store at body temp to protect sperm motility

How is sperm concentration reported?

sperm / mL

Normal Sperm concentration

> 20 million / mL

What is the diluting fluid for sperm?

Sodium bicarbonate and formalin

What dye is used to determine vitality? How does it work?

1. Eosin-nigrosin dye

2. Live sperm are white, dead sperm are red

Normal sperm vitality

> 75%

Normal sperm motility

> 50%

Normal semen pH

7.2-8.0

Normal morphology

> 14% normal

Two causes of cloudy white peritoneal fluid

1. Chylous (milky) - from lymphatic system

2. Pseudochylous - cholesterol from inflammation

Cause of green peritoneal fluid

Bile, gallbladder

What are transudates?

Fluid build up due to a mechanical process

Two causes of transudates

1. Congestive Heart Failure

2. Hypoproteinemia

What are exudates?

Build up involves membrane

Three causes of exudates

1. Infection

2. Malignancy

3. Trauma

Elevated cell counts are found in what kind of fluid?

Exudates

Strange colors are found in what kind of fluid?

Exudates

Low glucose in pleural fluid indicates what?

RA

High Adenosine Deaminase in pleural fluid indicates what?

TB

Two tests for malignancy in Peritoneal fluid

1. CEA

2. CA 125

An exudate has a SAAG gradient of what?

< 1.1

How do you calculate SAAG?

Serum albumin - Ascitic fluid albumin

How many leukocytes may be lost in 2 hours in CSF?

40%

What stain is used in CSF?

Wrights stain

What is the normal lymph and monos in Adults?

70% lymphs, 30% monos

What is the normal lymphs and monos in newbors?

30% lymphs, 70% monos

What do increased eosinophils in CSF indicate?

1. Parasitic infection

2. Shunt malfunction

What does an increase in plasma cells in CSF indicate?

MS

What are two methods for detecting total protein in CSF?

1. Turbimetric

2. Dye binding

What are three methods for detecting protein fractions?

1. Electrophoresis

2. RID

3. Nephelometry

Increased LD in CSF indicates what?

1. Oxygen deprivation in CNS

2. Anaerobic metabolism