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97 Cards in this Set
- Front
- Back
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Synovial fluid is a highly viscous fluid that is a ____ of plasma and contains ____.
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Transudate
hyaluronic acid |
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What is the function of synovial fluid?
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to lubricate the joint space and transport nutrients to the articular cartilage.
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clear
colorless or straw colored does not form a fibrin clot <200 WBC/uL produces a mucinous clot upon addition of acetic acid |
Normal synovial fluid
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Synovial fluid analysis is commonly performed to determine the cause of what?
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acute arthritis
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What are the common lab procedures for synovial fluid?
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gross appearance
viscosity cell count and WBC count diff microscopic exam for cyrstals protein and glucose grams stains cultures |
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Synovial fluids may be classified as:
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normal
non-inflammatory (group 1) inflammatory (group 2) septic (group 3) hemorrhagic |
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high viscosity
volume <3.5 clear colorless or straw <200 WBC gram stain neg |
normal knee
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>3.5 mL
high viscosity clear straw to yellow 200-2000 WBC gram stain neg |
non inflammatory group 1
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>3.5 mL
low viscosity cloudy or turbid yellow 2000-75,000 WBC gram stain neg |
inflammatory group 2
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>3.5 mL
variable viscosity opaque clarity variable color >100,000 WBC gram stain pos |
septic group 3
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>3.5 mL
high viscosity variable clarity red wbc=rbc gram stain neg |
hemorrhagic
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osteoarthritis
trauma neuropathic arthropathy sickle cell hemochromatosis acromegaly amyloidosis subsiding or early inflammation |
non inflammatory group 1
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rheumatoid arthritis
reiter's syndrome psoriatic arthritis ankylosing spondylitis arthritis of inflammatory bowel viral or fungal acute crystal synovitis |
inflammatory group 2
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pyogenic bacterial infections
bacterium most commonly responsible for septic arthritis is S. aureus |
septic group 3
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gonococcal septic arthritis
localized purulent effusion periarthritis, polyarthritis bacteria may or may not be cultured |
septic group 3
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trauma with or without fracture
tumors hemophilia or other coagulopathy scurvy ehlers-danlos syndrome neuropathic arthropathy |
hemorrhagic
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urate
thin, needle-shaped strong, bright negative yellow parallel, blue perpendicular |
crystal analysis
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needle shaped
frequently intracellular strongly neg birefringent |
monosodium urate (MSU) crystals: Gout
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rod or rhomboidal shaped
weakly pos birefringent |
calcium pyrophosphate dihydrate CPPD: Pseudogout
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Causes:
acute calcific periarthritis acute arthritis destructive arthorpathy (Milwaukee shoulder/knee) |
basic calcium phosphate
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Causes:
acute, subacute arthritis asymptomatic |
calcium oxalate
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Causes:
acute arthritis |
lipid crystals
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Which synovial crystal is asymptomatic?
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cholesterol crystal
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What is the accumulation of fluid caused by alteration of pressure differences between the cavity and plasma?
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transuduction
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Increased venous hydrostatic pressure in CHF
hypertension decreased plasma proteins |
transuduction
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What is characterized by low albumin as specific gravity, is clear, and is seen in cirrhosis and nephrotic syndrome?
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transuduction
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an accumulation of fluids caused by vascular permeability to protein most commonly due to inflammation
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exudation
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leaky cell membranes in malignant tumors
extended inflammation causes degeneration of cell membranes, releasing lipids causes a cloudy appearance, turbid effusion |
exudation
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What is leakage of the lymphatic fluid into the peritoneal space?
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chylous effusion
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chylomicrons, triglycerides present in fluid
cloudy, almost white, turbid fluid |
chylous effusion
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The peritoneal space usually contains ___ fluid.
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minimal
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What is the procedure in which a needle is inserted thru the abdominal wall to obtain a sample of any fluid that is present?
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abdominal tap
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An inflammation of the stomach and intestines caused by a viral infection. 2nd most common illness after URI
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viral gastroenteritis
(rotavirus and norwalk) |
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What is the leading cause of gastroenteritis in children and can also occur in adults exposed to children with virus?
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rotavirus
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What is the cause of group-related or institutional diarrhea with peak frequency during the winter?
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norwalk
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A life threatening complication of other intestinal conditions, characterized by symptoms of toxicity and a dilated colon
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toxic megacolon
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Causes:
ulcerative colitis crohn's amebiasis pseudomembranous colitis typhoid, and bacterial dysentery hischsprung's |
toxic megacolon
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color and clarity
red and WBC counts glucose and protein amylase ammonia ALP LD microbes tumors and other substances |
peritoneal fluid analysis
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An inflammation of the peritoneum, the membrane that lines the wall of the abdomen and covers the organs
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peritonitis
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most cases of bacterial peritonitis occur when fluid ascites accumulates in the peritoneal cavity because of chronic liver disease
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spontaneous peritonitis
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infection of the blood that spreads to the peritoneal fluid
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spontaneous peritonitis
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An acute or chronic inflammation of the peritoneum that occurs because of the entry of bacteria or enzymes into the peritoneum from the GI tract
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secondary peritonitis
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Albumin >50% of plasma protein
>3.0g/dL indicates: |
exudate
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Do exudates have a low or high protein content?
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high
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Do transudates have a low or high protein content?
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low
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>60% of plasma LD indicates?
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exudate
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cholesterol >60mg/dL indicates
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exudate
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limit movement between blood and brain extracellular space
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capillary endothelial cell tight junctions
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limits movement between blood and CSF
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choroid plexus epithelial cells
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What are impermeable substances in cellular neurochemistry?
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large molecules
polar, non-lipid soluble charged (ionized) molecules |
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what are permeable substances in cellular neurochemistry?
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gases
lipid soluble water nutrients transmitter precursors |
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Driven by conc gradient
accounts for movement of lipid soluble substances no energy |
simple diffusion
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movement down a conc gradient
saturable stereospecificity no energy |
carrier mediated diffusion
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movement agains conc gradient
required energy highly selective moves substances out of CNS |
active transport
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___ is a major energy substrate for brain as well as a major carbon source for many molecules.
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Glucose
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an enzyme in glycolytic pathway, exists in nerve cells in unique isoform.
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enolase
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thin, transparent membrane called the serous coat, or pleura, that covers each lung
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pleural space
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prevents the lung from making direct contact with the chest wall and the diaphragm
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pleural membranes
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In the pleural space are the membranes permeable or semiperiable?
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semi-permeable
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Fluid accumulates in the pleural space by three mechanisms?
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increased drainage of fluid into the space
increased production of fluid by cells in the space decreased drainage of fluid from the space |
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Hypertension in the venous system
Decrease protein in blood Ascites can drain thru small perforations in the diaphragm Large amount of fluid can drain directly into pleural space |
pleural fluid accumulation
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Abnormal ____ cells can produce large amount of fluid.
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mesothelial (as in asbestosis)
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These cells accumulate in inflammation and infection and can produce fluid that is difficult to drain or that are in such large quantities that normal drainage thru lymphatic system can't happen.
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WBCs
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______ can metastasize to the pleural cells and attach to either the visceral or parietal pleural surfaces or float freely and produce large amounts of fluid.
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malignant tumor cells
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cardiac failure
TB pulmonary embolism metastic disease lymphoma trauma liver and kidney disease viral and fungal mesotheilioma |
pleural fluid accumulation
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what is pleural effusion with blood accumulating in the fluid that is caused by trauma?
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hemothorax
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What is pleural effusion with chyle (lymph and fat) in the accumulating fluid that is caused by neoplastic disease and trauma that impairs the lymphatic drainage system?
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chylothorax
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What laboratory finding is commonly associated with malignancy, pneumonia, and TB?
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Exudates
protein >25g/L |
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What laboratory finding is commonly associated with congestive cardiac failure, cirrhosis, nephrotic syndrome, hypothyroidism and Meigs syndrom?
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Transudate
protein <25g/L |
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LD1 and LD2
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red cells
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LD2 and LD3
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malignancy
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LD5
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neutrophils (bacterial infection when increased)
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___ may be increased in TB or malignancy.
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Lymphocytes
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Glucose levels may be low in pleuritis or pericarditis due to ____.
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rheumatoid arthritis
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___ is raised in pleuritis associated with pancreatitis.
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amylase
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Causes of pericardial effusion:
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infection (viral, bacterial, fungal TB)
cardiovascular disease neoplasm hemorrhage autoimmune disease |
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Fluid around the heart may show on:
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chest xray
echocardiogram transesophageal echocardiogram (TEE) chest MRI chest CT ECG |
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Surgical pericardiectomy (cutting or removing part of the pericardium) may be recommended if ______ is chronic or recurrent.
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bacterial pericarditis
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removal of fluid from the pericardial sac is necessary to drain infected pericardial fluid and to prevent or treat cardiac tamponade.
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pericardiocentesis
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TP ratio/LD ratio
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TP fluid/TP serum
LD fluid/LD serum TP <0.5 and LD <0.6 = trasudate TP >0.5 and LD >0.6 = exudate |
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High viscosity of seminal fluid is associated with _____.
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prostate secretion problems
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volume of seminal fluid is:
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2-5 mL
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discrete droplets within 60 seconds SpG ranges from 0-4. Closeness to 0 is more normal.
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viscosity/liquefaction of seminal fluid
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spermatozoa/mL of ejaculate:
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20-250 million
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Leukocytes in sperm:
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<1 million/mL of ejaculate
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pH of sperm
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7.2-7.8
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Acid phosphatase of sperm
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>200 U per ejaculate at 37C
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citric acid in sperm
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>52 umol/ejaculate
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fructose of sperm
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>13 umol/ejaculate
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zinc of sperm
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>2.4 umol/ejaculate
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Low counts of sperm are associated with ____ and high counts are associated with ____.
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viral infections and stress: abstinence
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pH >7.8 in sperm suggests:
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infection
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pH <7.2 in sperm suggests:
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high sperm count and lactic acid
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Low levels of ____, secreted by seminal vesicles, indicate obstruction of the ejaculatory ducts.
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fructose
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lower levels of _____ assess function of the prostate.
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citric acid
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____ assess secretory function of prostate.
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acid phosphatase
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most common sources of error in specimen collection of semen:
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collection after a 3 day period of abstinence
decreased motility in plastic containers condoms should not be used for collection specimen should be delivered to the lab within one hour motility should be done at 37C |
