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35 Cards in this Set
- Front
- Back
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Effusion |
Fluid accumulation in body cavity |
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Use of cytology for effusions |
Correct ID can help determine etiology of fluid Interpretation is done in light of other clinical parameters to establish diagnosis |
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What do you do with effusions |
Use of Serum tube Na or K EDTA Sterile tube Direct and sediment smears |
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Analysis of effusions: Appearance |
Color Turbidity Clot presence |
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Analysis of effusions: Total protein |
Done on supernatant of centrifuged sample Refractometer or biochemical |
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Analysis of effusions: Total nucleated cell count (TNCC) |
Use anticoagulated sample if clots are present Unipette system or Automated cell counter |
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Analysis of effusions |
Appearance Total protein Total nucleated cell count (TNCC) Cytologic examination |
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Microscopic assessment of effusions |
Low power- feathered edge Cell clumps or clusters Nucleated cell count High power- cell ID and differentiation Check for bacteria and fungi Unexpected cells or contents |
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What type of cells or contents are unexpected in effusion |
Ingesta Bile |
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What cells are normal in effusions |
Neutrophils Macrophages/monocytes Lymphocytes (usually small) Mesothelial RBCs |
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What are some uncommon cells you may see in an effusion |
Plasma Eosinophils Mast cells Neoplastic Microorganisms |
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Special studies in effusions |
Culture (anaerobic/aerobic) Triglycerides Creatinine Bilirubin Amylase/lipase WBC or PCV |
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Causes of effusion |
Trauma Neoplasia Cardiovascular Hepatic Renal Hypoproteinemia Infection |
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Mechanism based classification |
Transudate Exudate Disruption of vessel or viscus |
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Classical classification of effusion |
Pure transudate Modified transudate Exudate Chylous Pseudochylous |
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Transudate |
Normal fluids in abnormal amount |
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Characteristics of transudate |
From non inflammatory process Clear Low cellularity and total protein Arises from hypoalbuminemia or venous stasis May be pure or modified |
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Identification of pure transudate |
Clear or colorless Total protein <2.5 g/dl <1500 cells/ul |
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Identification of modified transudate |
Modified by addition of protein and +/- cells May be clear, straw colored, serosanguinous, or milky Translucent to opaque Total protein 2.5-7.5 <5000 cells/ul |
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Exudate |
Abnormal fluid in excessive amounts |
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What causes exudate |
Inflammatory conditions Increased capillary permeability Leakage of protein, fluid and cells |
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TP and cell count for exudate |
TP >3.0g/dl Cell count >20000 |
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Aseptic |
FIP/sterile FB/neoplasia |
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Septic |
Wide variety of organisms |
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ID of exudate |
Variable color Turbid to opaque Often clots |
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Cardiovascular disruption |
Hemorrhage Red May clot |
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Lymphatic disruption |
Chylous Pseudochylous Milky white |
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Gall bladder/Duct disruption |
Bile Yellow-green Murky |
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Bowel perforation |
Ingesta |
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Bladder perforation |
Urine |
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Causes of chylous effusion |
CHF-cat most common Ruptured thoracic duct |
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TP and cell count of chylous |
TP is unreadable <10000 cells |
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Predominant cell type of chylous |
Small lymphocyte |
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What can be present in chylous |
Chylomicrons |
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What can confirm chylous effusion |
Sudan III or IV stain |
