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Questions and Answers
What is the normal amount of peritoneal fluid collected through paracentesis?
What is the normal amount of peritoneal fluid collected through paracentesis?
What is the characteristic of peritoneal fluid in cholecystitis?
What is the characteristic of peritoneal fluid in cholecystitis?
Which of the following is a therapeutic indication for paracentesis?
Which of the following is a therapeutic indication for paracentesis?
What is the likely cause of hemorrhagic ascites in a patient with a history of trauma?
What is the likely cause of hemorrhagic ascites in a patient with a history of trauma?
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In a patient with tuberculosis, what is the characteristic finding in the peritoneal fluid?
In a patient with tuberculosis, what is the characteristic finding in the peritoneal fluid?
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What is the pathogenesis of malignant ascites due to low serum albumin?
What is the pathogenesis of malignant ascites due to low serum albumin?
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Which of the following is a characteristic of chylous ascites?
Which of the following is a characteristic of chylous ascites?
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What is the diagnostic indication for paracentesis in a patient with internal perforation?
What is the diagnostic indication for paracentesis in a patient with internal perforation?
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What is the likely cause of serous ascites in a patient with chronic hypoproteinemia?
What is the likely cause of serous ascites in a patient with chronic hypoproteinemia?
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What is the diagnosis of portal hypertension marked by?
What is the diagnosis of portal hypertension marked by?
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Study Notes
CSF (Cerebrospinal Fluid)
- Protects the brain from sudden changes in pressure, maintains a stable chemical environment, and removes waste products of cerebral metabolism
- Normal adult volume: 100-200 ml
CSF Exam
- Indications:
- Urgent: subarachnoid hemorrhage, CNS malignancy
- Selective: meningial infection, demyelinating disease
- Sample: lumbar puncture or ventricular canula
- Macroscopic exam:
- Normal CSF: clear colorless, clot-free, viscosity of water
- Turbidity: RBCs > 400/ul, WBCs > 200/ul, increased protein level, microorganism
- Clot formation: traumatic tap, TB meningitis
CSF Microscopic Exam
- Normal WBCs: 0-5 cells/ul, mostly lymphocytes and RBCs 0-5 cells/ul
- Microbiological exam:
- Bacteriological
- Serological
CSF Chemical Exam
- Total protein: normal 20-40 mg/dl
- Increase: traumatic, toxic, tissue degeneration
- Decrease: leakage of CSF, increased intracranial pressure, hyperthyroidism
- Glucose: normal 40-80 mg/dl
- Increase: hyperglycemia
- Decrease: bacterial meningitis, TB, fungal, viral
- Lactate:
- Normally parallels blood concentrations
- Increased in intracranial hemorrhage, epilepsy, and bacterial meningitis
- Xanthochromia:
- Yellow or pink discoloration of CSF, indicating presence of hemoglobin degradation products
- Indicates blood has been in CSF for at least 2 hours (e.g. subarachnoid hemorrhage)
Serous Fluids
- Peritoneal fluid:
- Definition: fluid lining abdominal and pelvic cavity
- Types: transudate (congestive HF, liver cirrhosis, hypoproteinemia) and exudate (infection, trauma, tumor, chylous effusion)
- Sample: paracentesis, normal amount 50-100 ml
- Indications: diagnostic (ascites, internal perforation, abdominal hemorrhage) and therapeutic (treatment of malignancy)
Urine Analysis
- Overview:
- Indications: routine check-up, diagnosis, and follow-up
- Sampling: random (mid-stream urine), first morning sample, 24-hour collection
- Examination:
- Physical: color, volume, specific gravity
- Chemical: pH, protein, glucose, ketone
- Microscopic: RBCs, pus cells, casts
Urine Physical Exam
- Color: normal yellow
- Volume:
- Anuria: 24-hour output below 100 ml
- Oliguria: 24-hour output below 500 ml
- Polyuria: 24-hour output above 3000 ml
- Specific gravity: normal 1.005-1.030
- High: glucosuria, proteinuria, and disorders associated with oliguria
- Low: polyuria (except in diabetes mellitus), cases of oliguria with low specific gravity
- Fixed: chronic renal disease
Urine Chemical Exam
- pH: normal 4.5-8.0
- Protein: normal 100-150 mg/24h
- Glomerular proteinuria: nephrotic syndrome
- Tubular proteinuria: pyelonephritis
- Transient proteinuria: physical exertion, trauma, etc.
- Glucose: normal 20-200 mg/24h
- Causes of glucosuria: hyperglycemia, renal glucosuria
- Ketone: causes of ketonuria: prolonged fasting, severe vomiting or diarrhea, diabetic ketoacidosis
Urine Microscopic Exam
- RBCs: acute glomerulonephritis, stones, trauma of the urinary tract, malignancy of the urinary tract
- Pus cells: urinary tract infections
- Casts:
- Red cell casts: acute glomerulonephritis
- Pus cell casts: pyogenic kidney
- Granular casts: chronic glomerulonephritis, chronic renal failure
- Waxy casts: late nephrosis
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Description
This quiz covers the functions and characteristics of cerebrospinal fluid, including its normal volume, examination indications, and macroscopic examination. It also touches on the differences between normal and abnormal CSF samples.
