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Questions and Answers
What is the typical procedure used to collect pleural fluid?
What is the typical procedure used to collect pleural fluid?
Which anticoagulant is used for microbiology and cytology in fluid analysis?
Which anticoagulant is used for microbiology and cytology in fluid analysis?
What should be done with fecal samples before testing pH?
What should be done with fecal samples before testing pH?
Which type of fluid analysis is associated with the use of plain tubes?
Which type of fluid analysis is associated with the use of plain tubes?
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What volume of fluid is typically considered for serious fluid analysis?
What volume of fluid is typically considered for serious fluid analysis?
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What is the primary function of serous fluid between the membranes?
What is the primary function of serous fluid between the membranes?
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What characterizes transudates compared to exudates?
What characterizes transudates compared to exudates?
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Which of the following is NOT a primary cause of effusions?
Which of the following is NOT a primary cause of effusions?
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What is the typical appearance of transudates?
What is the typical appearance of transudates?
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Which condition is most likely to produce an exudate?
Which condition is most likely to produce an exudate?
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What is the fluid:serum protein ratio typically associated with transudates?
What is the fluid:serum protein ratio typically associated with transudates?
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Which of the following is a characteristic of exudates?
Which of the following is a characteristic of exudates?
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How do transudates differ from ultrafiltrates of plasma?
How do transudates differ from ultrafiltrates of plasma?
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What is indicated by a pleural fluid:serum cholesterol ratio greater than 0.3?
What is indicated by a pleural fluid:serum cholesterol ratio greater than 0.3?
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Which condition is NOT associated with elevated lymphocyte counts in pleural effusions?
Which condition is NOT associated with elevated lymphocyte counts in pleural effusions?
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What pleural fluid:serum bilirubin ratio indicates the presence of exudate?
What pleural fluid:serum bilirubin ratio indicates the presence of exudate?
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What does a pleural fluid cholesterol level of 45 to 60 mg/dL suggest?
What does a pleural fluid cholesterol level of 45 to 60 mg/dL suggest?
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In the presence of trauma, what percent of eosinophil levels might be associated with pneumothorax or hemothorax?
In the presence of trauma, what percent of eosinophil levels might be associated with pneumothorax or hemothorax?
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Which condition is likely to cause spontaneous clotting in pleural fluid analysis?
Which condition is likely to cause spontaneous clotting in pleural fluid analysis?
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What would a serum-ascites fluid ratio greater than 1.1 typically suggest?
What would a serum-ascites fluid ratio greater than 1.1 typically suggest?
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What condition can lead to pleural effusions with elevated eosinophils due to the presence of air or blood?
What condition can lead to pleural effusions with elevated eosinophils due to the presence of air or blood?
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What is indicated by an absolute neutrophil count greater than 250 cells/uL?
What is indicated by an absolute neutrophil count greater than 250 cells/uL?
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Which type of cell predominates in tuberculosis infections?
Which type of cell predominates in tuberculosis infections?
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Which microorganism is commonly associated with pleural effusions?
Which microorganism is commonly associated with pleural effusions?
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What is primarily determined in a chemical examination of ascitic fluid?
What is primarily determined in a chemical examination of ascitic fluid?
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In the context of pleural effusion, what is the significance of elevated amylase levels?
In the context of pleural effusion, what is the significance of elevated amylase levels?
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An elevated alkaline phosphatase level in ascitic fluid is indicative of what condition?
An elevated alkaline phosphatase level in ascitic fluid is indicative of what condition?
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Which test is frequently performed to differentiate effusions of immunologic origin?
Which test is frequently performed to differentiate effusions of immunologic origin?
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Which of the following conditions is indicated by a glucose level in ascitic fluid that is decreased below serum levels?
Which of the following conditions is indicated by a glucose level in ascitic fluid that is decreased below serum levels?
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What common condition is referred to as ascitic fluid?
What common condition is referred to as ascitic fluid?
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Which of the following tumor markers is associated with lung cancer?
Which of the following tumor markers is associated with lung cancer?
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What is the significance of examining ascitic exudates for malignant cells?
What is the significance of examining ascitic exudates for malignant cells?
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Which bacterial infection is most commonly associated with peritonitis?
Which bacterial infection is most commonly associated with peritonitis?
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Which malignancies are most frequently detected through examination of ascitic fluid?
Which malignancies are most frequently detected through examination of ascitic fluid?
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What WBC count and its characteristics suggest bacterial endocarditis in ascitic fluid?
What WBC count and its characteristics suggest bacterial endocarditis in ascitic fluid?
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What type of stains and cultures are performed for pleural fluid analysis?
What type of stains and cultures are performed for pleural fluid analysis?
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Hepatic disorders, such as cirrhosis, commonly cause which type of effusion?
Hepatic disorders, such as cirrhosis, commonly cause which type of effusion?
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What changes occur in the concentrations of creatinine, urea, and uric acid when bacterial peritonitis is suspected?
What changes occur in the concentrations of creatinine, urea, and uric acid when bacterial peritonitis is suspected?
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What is the range of amniotic fluid creatinine levels prior to 36 weeks of gestation?
What is the range of amniotic fluid creatinine levels prior to 36 weeks of gestation?
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Which statement about the comparison between maternal urine and amniotic fluid is correct?
Which statement about the comparison between maternal urine and amniotic fluid is correct?
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What is one of the primary functions of amniotic fluid?
What is one of the primary functions of amniotic fluid?
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What is indicated by an increase in amniotic fluid creatinine levels above 2.0 mg/dL?
What is indicated by an increase in amniotic fluid creatinine levels above 2.0 mg/dL?
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What is a common finding in the fern test of amniotic fluid?
What is a common finding in the fern test of amniotic fluid?
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Which constituent concentration does not exceed 30 mg/dL in amniotic fluid?
Which constituent concentration does not exceed 30 mg/dL in amniotic fluid?
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Which of the following is a metabolic product found in amniotic fluid?
Which of the following is a metabolic product found in amniotic fluid?
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Study Notes
Serous Fluid Analysis
- Serous fluid is collected from body cavities (pleural, pericardial, peritoneal) by aspiration techniques (thoracentesis, pericardiocentesis, paracentesis)
- Specimens >100mL usually collected
- EDTA for cell counts and differentials
- Heparin for microbiology and cytology
- Plain tubes/heparin tubes for chemistry tests
- Samples maintained anaerobically in ice for pH testing
Transudates vs Exudates
- Transudates result from a systemic disturbance disrupting fluid balance in the regulation of filtration and reabsorption (e.g., CHF)
- Exudates result from conditions affecting the membranes of the cavity (e.g., infections, malignancy)
Serous Fluid Formation
- Fluid is an ultrafiltrate of plasma with no additional material from mesothelial cells lining the membranes
- Subject to hydrostatic and colloidal pressures.
- Increased hydrostatic pressure or decreased oncotic pressure or increased capillary permeability or lymphatic blockage can disrupt normal formation and cause fluid build-up
Fluid Appearance
- Clear/pale yellow is considered normal or a transudate
- Cloudy indicates an exudate.
- Fluid:Serum protein ratio (<0.5) characteristic of Transudate.
- Fluid:Serum protein ratio (>0.5) characteristic of Exudate.
- WBC count (<1000/uL) characteristic of Transudate.
- WBC count (>1000/uL) characteristic of Exudate.
Amniotic Fluid Analysis
- Amniotic fluid is found between the fetal membranes and surrounds the fetus
- Important functions: Cushioning, fetal movement, stabilization of temperature, lung development.
- Fluid volume varies throughout pregnancy
- Tests measure fetal lung maturity or assess fetal distress.
- Volume abnormalities such as polyhydramnios (more than 1200 mL) or oligohydramnios (less than 800 mL) are abnormal findings noted as a potential signpost for a developing problem.
Fecal Analysis
- Macroscopic examination involves observing the stool's color, consistency, and presence of blood or mucus.
- Microscopic examination assesses fecal leukocytes, muscle fibers, and fat content.
- Chemical analysis measures fecal fat, electrolytes, and pH.
- Diagnoses include pancreatic insufficiency, malabsorption, and infections.
- Testing protocols vary depending on the patient's symptoms.
Pleural Fluid Analysis
- Pleural fluid is collected from the space between the lung and chest wall.
- A pleural fluid cholesterol >60 mg/dL or a pleural fluid:serum cholesterol ratio >0.3 indicates an exudate.
- High pleural fluid:serum total bilirubin ratio (>0.6) indicates an exudate.
Pericardial Fluid Analysis
- Pericardial fluid is the fluid found between the outer layer (parietal pericardium) and the inner layer (visceral pericardium) of the heart.
- Fluid usually is pale yellow in color.
- Disorders such as infections, malignancy, or trauma can affect fluid composition and appearance, and these conditions can be detected using laboratory tests.
Peritoneal Fluid Analysis
- Peritoneal fluid is the fluid found within the abdominal cavity.
- Usually, clear and pale yellow in appearance.
- Transudates or exudates can lead to accumulation of fluid, which can be identified by various diagnostic tests.
- A serum-ascites albumin gradient (SAAG) >1.1 suggests a transudate of hepatic origin, while gradients <1.1 often indicate exudative effusions.
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Description
Explore the crucial concepts in serous fluid analysis, including techniques for fluid collection and the distinctions between transudates and exudates. This quiz covers important factors such as fluid formation and its physiological implications. Test your knowledge on this essential topic in clinical medicine.
