Term
| What physiologic state may be associated with increased TNCC of peritoneal fluid in cattle? |
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Definition
| TNCC may be increased in the first 2 weeks postpartum in cattle |
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Term
| What is the equation that defines starling's law? |
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Definition
Net filtration of fluid =
porosity of the capillary x surface area [(capillary hydrostatic pressure - interstitial hydrostatic pressure) - (capillary oncotic pressure - interstitial oncotic pressure) |
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Term
| In what anatomic location is the interstitial oncotic pressure nearly equal to the capillary oncotic pressure? |
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Definition
| hepatic interstitum - this is because hepatic sinusoids are permeable to most plasma proteins |
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Term
| List in order of most to least permeable (to plasma proteins) capillary beds: skeletal muscle, liver, lung |
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Definition
skeletal muscle (30% plasma oncotic pressure) < lung (70% plasma oncotic pressure) < liver (nearly 100% plasma oncotic pressure)
**this reflects the permeability of these capillary beds |
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Term
| When permeability is expressed as a reflection coefficient on the basis of starling's law, which is most permeable to proteins 0 or 1? |
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Definition
0 is completely permeable to proteins
1 is inmpermiable to proteins
* the reflection coefficient is nearly 1 in most capillary beds, but is smaller in the pulmonary and hepatic capillary beds |
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Term
| What are some compensatory mechanisms to reduce the development of a transudative effusion in individuals with hypoalbuminemia? |
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Definition
| increased synthesis of globulins, decreased intravascular hydrostatic pressure (e.g. vasodilation), increased lymphatic drainage (e.g. can increased by a factor of 10 in people with increased rate of fluid leaving the capillary) |
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Term
| Describe the pathogenesis of protein poor transudate formation in dogs with hepatic cirrhosis and/or PLN |
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Definition
1. decreased plasma oncotic pressure (initially interstitial proteins will redistribute into the vascular space but if protein is depleted enough decreased plasma oncotic pressure allows fluid to move into interstitum)
2. increased hydrostatic pressure (retention of sodium and water and in the case of cirrhosis portal hypertension) |
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Term
| Why does FIP tend to have a lower TNCC that other exudates? |
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Definition
Because the inflammation is localized to the blood vessel not the body cavity
**remember, only protein exude out of vessels with increased permeability, leukocytes migrate into cavitary effusions following chemotactic gradients |
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Term
| What percentage of RBC can be reabsorbed (i.e. auto transfusion) from a hemorrhagic effusion after 2 days? |
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Definition
65% of RBC in the effusion reabsorbed after 2 days
80% after 1-2 weeks |
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Term
| What is the minimum HCT of an effusion to confirm that hemorrhage is at least contributing to that effusion? |
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Definition
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Term
| What is a non-chylous lymphatic effusion? |
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Definition
| produced when lymph without chylomicrons leaks out of lymphatic vessels (i.e. lymphatic vessels that are not in the drainage path from intestine to thoracic duct), can also be seen in anorexic animals or animals with low dietary intake of lipid (i.e. minimal chylomicron production) |
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Term
| What pigmented solutes are associated with effusion supernates of yellow/orange, pink to red to brown, brown, or green? |
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Definition
yellow/orange = bilirubin
red/pink/brown = hemoglobin
brown = stercobilinogen (a metabolite of urobilinogen, created by bacterial degradation of bilirubin in the intestine)
green = chlorophyl |
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Term
| What nonprotein solutes can artifactual increased the refractive index of an effusion, and hence artifactual increase total protein estimation? |
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Definition
lipids (e.g. chylous effusions)
urea (e.g. uroabdomen) |
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Term
| What nonprotein solutes can artifactual increased the refractive index of an effusion, and hence artifactual increase total protein estimation? |
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Definition
lipids (e.g. chylous effusions)
urea (e.g. uroabdomen) |
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Term
| How does the converted urine SG and plasma SG change as the refractive index of a fluid increases? |
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Definition
| They also increase, but the urine SG is proportionally greater at higher refractive indices than plasma SG |
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Term
| What urine specific gravity corresponds to a total protein of 2.0-2.5 estimated via refractometry? |
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Definition
USG of 1.017-1.019 corresponds to TP of 2-2.5
**corresponding plasma SG is 1.012 |
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Term
| How long does it take before macrophages may phagocytize cells, material or organisms in vitro? |
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Definition
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Term
| What morphologic feature can be used to distinguish actinomyces and nocardia from fusobacterium? |
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Definition
| actinomyces and nocardia are filamentous BRANCHING bacteria while fusobacterium is filamentous but doesn't branch |
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Term
| What are the protozoa that can be seen in equine abdominal effusion if there is inadvertent sampling from the gut or acute gut rupture? |
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Definition
balantidium sp.
polymorphella sp.
cycloposthium sp. |
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Term
| What is the expected Cholesterol:TG ratio in a chylous effusion? |
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Definition
Very low (<1)
*chylous effusions are high in triglycerides |
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Term
| What absolute [triglyceride] is compatible with chylous effusion? |
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Definition
| [triglyceride] > 100 mg/dl |
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Term
| What conditions are associated with increased [lactate] in peritoneal fluid? |
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Definition
| intestinal obstructions (strangulating and non strangulating- but [lactate] in an effusion may be greater if there is a strangulating lesion), abdominal neoplasms and bacterial exudates |
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Term
| What criteria with regards to comparison of serum to effusion [lactate] can be used to try to classify dogs with septic ecudates? |
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Definition
difference of 2 mmol/L (higher lactate in effusion)
**Specificity is not as good as sensitivity with this cut off (false positives) |
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Term
| What are two proposed mechanisms for increased [lactate] secondary to septic exudates in dogs and cats? |
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Definition
bacteria can produce L- and D-lactate
L-lactate can be produced by WBC and RBC in the exudate, as TCC tend to be higher in septic exudates there is proportionally higher [lactate]*
** RBC and WBC can continue to produce lactate in vitro, so the sample must be quickly analyzed, placed in sodium fluoride tubes, or spun with the supernate stored separately from the precipitate (e.g. cells) |
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Term
| What difference in serum to effusion [glucose] has been proposed to identifiy septic exudates in dogs and cats? |
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Definition
difference > 20 mg/dl*
*differences in [glucose] in septic vs. nonseptic effusions may also be related to differences in TWCC. Glucose can be consumed in vitro by WBC/RBC so the sample must be quickly analyzed, stored in sodium fluoride tubes, or spun with the supernate stored separately from the cells |
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Term
| How can effusion [ammonium] be used to identify the etiology of an effusion? |
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Definition
| effusion [ammonium] was increased 24h after experimental intestinal strangulation in dogs (possibly due to ammonium passing through devitalized intestinal tissues) while plasma [ammonium] was relatively constant |
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Term
| What enzyme may be increased in an dog's peritoneal fluid (compared with serum) in acute pancreatitis? |
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Definition
| effusion [lipase] may be at least double plasma [lipase] in dogs with acute pancreatitis |
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Term
| What enzyme may be increased in a horse's peritoneal fluid (compared with serum) with colic or intestinal lesions? |
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Definition
effusion [ALP] > plasma [ALP], magnitude of increased was highest in horses with GI rupture compared to those with strangulating or non-strangulating lesions.
**increased [ALP] may originate from intestine ALP or granulocytic ALP |
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Term
| What color are gram negative vs. gram positive bacteria? |
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Definition
Gram negative are pink
Gram positive are purple/blue
*gram stains may be inconsistent when applied to effusions (they were designed for use with cultured bacteria) and WG stain is excellent for identifying the presence of bacteria |
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Term
| What are features of normal amniotic fluid? |
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Definition
grossly: clear and watery
Microscopically: numerous nucleated to anucleated variably keratinized squamous cells |
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