Body Fluid Review Fall 2014

Serous Fluids Pleural, Pericardial, Ascites/Peritoneal Trans vs Exudate Table 13.2 page 223 Glucose similar to serum unlike CSF which should have a glucose 2/3 of serum

Pleural Fluid Trans Vs Exudate pH < 7.3 Tube Drainage pH < 6 Esophageal Rupture Amylase > serum Esophageal Rupture Chylous vs Pseudochylous Table13-4 Chylous >Trig, Pos Sudan III, Lymphs, Thoracic Duct Leakage Pseudochylous Cholesterol Crytals, mixed WBC Chronic Inflamation

Peritoneal/Ascitic Trans vs Exudate More difficult than other fluids SAAG Serum-Ascites Albumin Gradient Page 230 Serum Albumin – Fluid Albumin > 1.1 Transudate of hepatic origin <1.1 Exudate

Serum-Ascites Albumin Gradient (SAAG) TransudateExudate Serum Albumin3.9 Fluid Albumin Gradient > 1.1 = Transudate< 1.1= Exudate Hepatic origin

CSF Glucose 2/3 Serum Total Protein 15 – 45 mg/dL Tube Order & Label Color, Traumatic Tap, Xanthochromia

Amniotic Fluid Color and Appearance Page 238 Fetal Lung Maturity Testing L/S, PG, Foam Stability Testing, Lamellar Bodies pages Specimen Considerations Temp, Centrifugation speed, Exposure to light, Filtration page 237 Fetal Distress HDN, Bilirubin, Liley Graph page 240 Zone I, II, III

Fetal Lung Maturity L/S Ratio L/S ratio 2 or greater = mature lungs Falsely elevated in presence of meconium or blood and diabetic mothers sometimes have L/S ratios > 2 but infants have immature lungs Thin layer chromatography

Fetal Lung Maturity PG PG (Phosphatidly Glycerol) Immunologic Agglutination Test Quantitative Easier to perform than L/S ratio and not affected by meconium or blood. Diabetic mothers sometimes have L/S ratios >2 but infants with immature lungs so PG should also be performed to confirm maturity

Fetal Lung Maturity Foam Stability Index Aminiotic Fluid and 95% ethanol are mixed Shake for 15 seconds Set for 15 minutes Continuous line of bubbles around ege indicates maturity

Fetal Lung Maturity Lamellar Bodies Size is similar to platelets Automated instruments use plt channel Counts of > than 50,000ul considered mature

Synovial Fluid Crystals Viscosity Hyaluronic acid Fluid should be viscous Test WBC, Dif, Gram stain, culture, and crystal ID