Glossary of Serous fluids
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- What are causes of ASCITIC TRANSUDATES?
- -Increased HP - Cong. heart failure
-Decreased COP - hepatic cirrhosis, nephrotic syndrome.
- What are causes of ASCITIC EXUDATES?
-Metabolic disease (uremia) -Decreased lymphatic resorption
- What's the procedure for getting ascitic fluid?
- What are most peritoneal effusions related to?
- Alcoholic liver cirrhosis.
- How is protein in ascitic fluid evaluated?
- what is SAAG?
- serum-ascities albumin gradient;
Serum alb - fluid alb = SAAG
--OR USE TOTAL PROTEIN---
- How is the SAAG evaluated?
- Elevated is higher than 1.1 g/dL
Decreasd is lower than 1.1
- What causes an elevated SAAG?
- Portal hypertension from alcoholic cirrhosis.
- What causes a decreased SAAG?
- Hi-protein effusions;
- NEPHROTIC SYNDROME
- When do cell counts become important when evaluating peritoneal fluid?
- When the SAAG is High. Alcoholic cirrhosis can be uncomplicated, or Complicated.
- What complication can result from alcoholic cirrhosis?
- Spontaneous Bactrial Peritonitis
- What distinguishes SBP
- A PMN count of >250/uL
- Name 5 other tests for peritoneal fluid:
- 1. Amylase/lipase
2. Peritoneal lavage
3. Alkaline phosphatase
5. CEA and CA-125
- M"oving onto pleural fluid
- What are causes of pleural TRANSUDATES?
- same as ascitic;
-High HP from CHF
-Low COP from NS, cirrhosis.
- What are causes of pleural EXUDATES?
-Systemic disease - SLE/RA
-Decrsd lymphatic resorption.
- What are SPECIAL APPEARANCES of various pleural effusions?
- What does cloudy pleural fluid mean?
- Probably WBCs and/or bacteria.
- What does bloody pleural fluid mean? (3 things)
- -Traumatic tap
- What does milky pleural fluid mean? (2 things)
- What causes:
- Chylous: from dmg to the thoracic duct of lymphatics.
Pseudochylous: assoc w/ Rh. Arth
- What are other tests that can/should be done on Pleural fluid?
-CEA and CA-125.
- What information does the pH give about pleural fluid?
- -Intubation -> if over 7.3, don't.
-Esophageal damage - acidic.
- What is the Amylase/lipase useful for?
- Evaluating/looking for esophageal damage. If salivary amylase is present in the pleural fluid, that's bad.
- What info does CEA and CA-125 give about pleural fluid?
- Whether it's malignant or not.
-45% of pleural fluids are!
- Moving on to PERICARDIAL
- What are 3 causes of pericardial exudates?
-Neoplasms of lung/breast
- What are indications for a pericardial tap?
- to rule out infection
to rule out neoplasm.
- What do hemosiderin crystals tell?
- that there's been RBC ingestion.
- What is an LE cell?
- a neutrophil with ingested material.
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