Podcast
Questions and Answers
Most effusions are not noticed by the pet owner until ____________
Most effusions are not noticed by the pet owner until ____________
- They vomit blood
- The have melena
- They are dead
- They are severe (correct)
What is characteristic of synovial fluid?
What is characteristic of synovial fluid?
- It has high viscosity
- It has high turbidity
- It does not clot (correct)
- It clots when contaminated with blood
What is the primary cell type in exudates?
What is the primary cell type in exudates?
- Neutrophils (correct)
- Lymphocytes
- Eosinophils
- Mononuclear cells
Why is it important to examine cytology samples quickly?
Why is it important to examine cytology samples quickly?
What is the purpose of adding EDTA to a sample?
What is the purpose of adding EDTA to a sample?
What is the typical protein concentration in synovial fluid?
What is the typical protein concentration in synovial fluid?
What is the primary use of the mucin clot test?
What is the primary use of the mucin clot test?
What is the typical composition of cells in synovial fluid?
What is the typical composition of cells in synovial fluid?
What is the significance of using relatively clear samples for automated TNCC?
What is the significance of using relatively clear samples for automated TNCC?
Which cell type is typically present in variable numbers in effusions?
Which cell type is typically present in variable numbers in effusions?
What is the purpose of classifying effusions based on TNCC and TP?
What is the purpose of classifying effusions based on TNCC and TP?
What is the characteristic of transudates in terms of appearance and protein concentration?
What is the characteristic of transudates in terms of appearance and protein concentration?
What is the potential source of error in both manual and automated cell count methods?
What is the potential source of error in both manual and automated cell count methods?
Which of the following cells can be the predominant cell in effusions associated with inflammation?
Which of the following cells can be the predominant cell in effusions associated with inflammation?
What is the purpose of using the Unopette system in manual cell count?
What is the purpose of using the Unopette system in manual cell count?
What is the recommended method for determining total protein in opaque fluids?
What is the recommended method for determining total protein in opaque fluids?
What is the primary reason why pet owners may not notice effusions until they are severe?
What is the primary reason why pet owners may not notice effusions until they are severe?
What is the purpose of radiographs and ultrasound in the diagnosis of pleural effusions?
What is the purpose of radiographs and ultrasound in the diagnosis of pleural effusions?
What is the typical characteristic of pleural effusions?
What is the typical characteristic of pleural effusions?
What is the purpose of collecting a sample of effusion in an EDTA tube?
What is the purpose of collecting a sample of effusion in an EDTA tube?
What is the purpose of making sediment smears on non-turbid samples?
What is the purpose of making sediment smears on non-turbid samples?
What is the purpose of performing a fluid analysis with cytologic examination?
What is the purpose of performing a fluid analysis with cytologic examination?
Lines the plural, peritoneal and visceral surfaces
Lines the plural, peritoneal and visceral surfaces
When do problems arise
When do problems arise
Clinical signs of pleural effusion
Clinical signs of pleural effusion
List the 5 clinical signs of pleural effusion
List the 5 clinical signs of pleural effusion
Pleural effusions are typically
Pleural effusions are typically
Sample preparation depends on the ______ (clear or cloudy) and ________of the fluid
Sample preparation depends on the ______ (clear or cloudy) and ________of the fluid
• Whether it will be evaluated in the hospital lab or sent to a pathologist, what must you do
• Whether it will be evaluated in the hospital lab or sent to a pathologist, what must you do
Study Notes
Evaluation of Effusions
- Total Nucleated Cell Count (TNCC) can be done using automated or manual methods
- Automated method may count debris, so only relatively clear samples should be used
- Manual count utilizes the Unopette system for WBC count
- Cell clumping, cell fragmentation, and noncellular debris can cause errors with both methods
- Total Protein (TP) is used to classify effusions as transudates, modified transudates, or exudates
- TP can be estimated by refractometry or biochemically
Cells Seen in Effusions
- Neutrophils: present in most effusions, can be the predominate cell in effusions associated with inflammation
- Mesothelial cells: line the pleural, peritoneal, and visceral surfaces, present in variable numbers in effusions
- Macrophages
- Lymphocytes
- Eosinophils
- Mast cells
- Erythrocytes
- Neoplastic cells
- Microfilaria
- Basket cells: ruptured nucleated cells with eosinophilic chromatin spreads
Classification of Effusions
- Classification is based solely on TNCC and TP
- Classification helps determine the general mechanism of fluid accumulation
- Helps in differentiating infection from neoplasia
- All findings must be interpreted with historical, physical, and clinical findings to achieve a definitive diagnosis
Transudates
- Clear, colorless fluid
- Low protein concentrations (<7,000)
- Neutrophils are the predominant cell type
- Occasionally, an exudate develops due to abundant exfoliation of cells from a tumor or chylous effusion
Synovial Fluid
- Arthrocentesis
- Synovial fluid does not clot
- Blood contaminates will clot unless processed immediately or added to EDTA
- Limited tests due to small yield
Sample Handling and Test
- Color: straw yellow
- Turbidity: non-turbid
- Viscosity: sticky
- Cytology: normal morphology (90% mononuclear cells, <10% neutrophils)
- Mucin clot test (heparin)
- Cell count if enough fluid is available
- Useful in confirming the presence and type of primary CNS disease
Cerebrospinal Fluid (CSF)
- Color: colorless and transparent
- TNCC
- Protein concentration: normally very low
- 50mg/dl of albumin
- Cytologic examination: should be done as fast as possible (within 15 minutes) because cells begin to degenerate quickly
- Cell types: Mononuclear cells (Lymphocytes 95-100%)
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