10-11-12-13-14

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Answer

*Cavity surrounding lungs *Lined by two separate membranes in close proximity to each other *Contains a small amount of fluid that serves as a lubricant during respiration

Pleural cavity

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Cavity surrounding abdominal organs

peritoneal cavity

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What Consists of two areas: the Greater sac & Lesser sac?

Peritoneal Cavity

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*Sac surrounding the heart *Also lined by two separate membranes in close proximity to each other *Space allows heart to contract easier

Pericardial cavity

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What are the General Features of Body Cavities?

1)Two thin layers of tissue lined by a single layer of mesothelial cells *Parietal layer: outer layer near wall of cavities, site of fluid production *Visceral layer: inner layer near internal organs, site of fluid absorption

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What are the General Features of Body Cavities?

2)Form an enclosed space that forms a sac

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True or False: A small amount of serous fluid fills each cavity Called serous fluid since it resembles the composition of serum

True:A small amount of serous fluid fills each cavity Called serous fluid since it resembles the composition of serum

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True or False:The cavity is considered a potential space

True:The cavity is considered a potential space

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True or False:Normally, there is not enough fluid to aspirate Aspiration only takes place when an effusion is present

True:Normally, there is not enough fluid to aspirate Aspiration only takes place when an effusion is present

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True or False:Effusion – a build-up of fluid within a body cavity

True:Effusion – a build-up of fluid within a body cavity

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Describe the Serous Fluid Formation process.

*Filtration of plasma through capillary endothelial cells (in normal conditions) *Reabsorption by lymphatic vessels *Fluid in each cavity is constantly being turned over

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True or False: Serous Fluid Formation is Controlled by several pressures

True: Serous Fluid Formation is Controlled by several pressures

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Synovium

joint space contains synovial fluid

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*Color: Clarity - pale yellow and clear *Plasma is filtered through capillary endothelial cells *Synovial lining cells add hyaluronic acid to the filtrate

Synovial fluid

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1-3 cell layers in thickness Cellular criteria resemble mesothelial cells

Synovial lining cells

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What is the Composition of synovial fluid?

*Hyaluronic acid *Collagenases (degradative enzymes) *Small amount of plasma protein

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What are the Functions of synovial fluid

*Supplies nutrients to cartilage in joint *Acts as a lubricant to facilitate movement of the joint

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Arthrocentesis

Synovial Fluid Aspiration

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Normal total volume of fluid in a joint

up to 3.0 mL

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True or false: Normal joint fluid does not clot Clotting occurs in inflammatory conditions

True: Normal joint fluid does not clot Clotting occurs in inflammatory conditions

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True or False: Synovial Fluid has a high viscosity, forms strings up to 6cm in length & should not have consistency of water

True:Synovial Fluid has a high viscosity, forms strings up to 6cm in length & should not have consistency of water

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Hematology Specimen Requirements:

2-5 mL in EDTA

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Microbiology Specimen Requirements:

3-10 mL in a sterile sodium heparin container

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Chemistry Specimen Requirements:

1-3 mL, no anticoagulant needed

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Cytology Specimen Requirements:

5-50 mL in sodium heparin, larger volumes increases the chance of seeing cellular elements

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True or False: Fluid should NOT be submitted in powder anticoagulants, such as oxalate as it Can form crystals as an artifact

True : Fluid should NOT be submitted in powder anticoagulants, such as oxalate as it Can form crystals as an artifact

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True or False: Blood sample can be taken at the same time to compare plasma to fluid values

True:Blood sample can be taken at the same time to compare plasma to fluid values

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Diseases of the joint are separated into groups: Name them

Group 1 – Non-inflammatory Group 2 – Inflammatory Group 3 – Septic Group 4 – Hemorrhagic

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Name the Synovial Group to which the following values apply:*Osteoarthritis -Noninflammatory degenerative joint disease *Pigmented villonodular synovitis -Both joints involved, hemosiderin deposited in joint *Traumatic arthritis

Group 1 - Noninflammatory

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Name the Synovial Group to which the following values apply:*Yellow Clear *Good visocisty *WBC=<2000/mcL *Neutrophil - greater than 30% *Glucose= normal *Yellow Clear *Good visocisty *WBC=<2000/mcL *Neutrophil - greater than 30% *Glucose= nor

Group 1 - Noninflammatory

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Name the Synovial Group to which the following values apply:*Immunologic *Rheumatoid arthritis *Systemic lupus erythematosus (SLE) *Rheumatic fever -Inflammation of joints and damage to heart valve due to streptococcal infection *Other

Group 2 - Inflammatory

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Name the Synovial Group to which the following values apply:*Yellow cloudy *Poor viscosity *WBC= 2000-5000/mcL *Neutrophils -Greater than 50% *Glucose= decreased *Antibodies present

Group 2 - Inflammatory

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Name the Synovial Group to which the following values apply: *Crystal induced *Crystal synovitis *Gout -Uric acid crystals *Pseudogout -Calcium pyrophosphate

Group 2 - Inflammatory

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Name the Synovial Group to which the following values apply:-Yellow cloudy or milky -Poor viscosity -WBC=up to 50000/mcL -Neutrophils Greater than 90% -Glucose= decreased -Uric acid =increased (gout) -Crystals present

Group 2 - Inflammatory

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Name the Synovial Group to which the following values apply:-Bacterial -Mycobacterial -Fungal -Viral -Spirochetal

Group 3 - Septic

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Name the Synovial Group to which the following values apply:-Yellow-green, Cloudy -Poor viscosity -WBC= 10,000 -200,000 /mcL -Neut= greater than 90% -Glucose decreased -Positive gram stain and culture

Group 3 - Septic

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Name the Synovial Group to which the following values apply:-Trauma -Anticoagulation induced bleeding -Thrombocytopenia -Pigmented villonodular synovitis -Synovial hemangioma -Tumor

Group 4 – Hemorrhagic

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Name the Synovial Group to which the following values apply:-Red cloudy -Poor viscosity -WBC= less than 5000/mcL -Neut less than 50% -Glucose normal -RBC present -Clot due to fibrinogen from blood

Group 4 – Hemorrhagic

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Amber synovial fluid:

possible breakdown of hemoglobin

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Red colored synovial fluid:

presence of blood.

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Turbib Synovial fluid:

Due to an increase number of inflammatory cells or crystals.

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Green synovial fluid:

infections

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Milky

Tuberculosis, SLE

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All of the following are secreted into the small intestine by the pancreas except: A. bile salts B. chymotrypsin C. lipase D. elastase 1

Bile Salts

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State whether each of the following scenarios relates to osmotic diarrhea, secretory diarrhea, or altered motility: Staphylococcal food poisoning

A. osmotic diarrhea B. secretory diarrhea C. altered motility Secretory Diarrhea

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In the Van de Kamer method for quantitative fecal fat determinations, fecal lipids are:

converted to fatty acids before titrating with sodium hydroxide

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Stools from persons with steatorrhea contain excess amounts of:

fat

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The Apt test should not be performed on a black, tarry stool.

True

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When performing microscopic examination of a stool for muscle fibers, the structures that are counted:

have vertical and horizontal striations

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Microscopic screening of a pale, frothy stool from a patient with prolonged diarrhea is performed for fecal neutrophils, fats, and meat fibers. The fecal neutrophil examination result is negative, increased large and small orange droplets are seen in the

Bile salts

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To prevent false-positive fecal occult blood tests, patients should avoid eating all of the following for 3 days before testing except:

chicken

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Crystals seen in a stool after it has been mixed with acetic acid and Sudan III and heated may be composed of:

cholesterol fatty acid soaps

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Large orange-red droplets seen on direct microscopic examination of stools mixed with Sudan III represent:

neutral fats

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The A450 of an amniotic fluid is plotted in zone 3 of a Liley graph. The physician should:

. request testing for fetal lung maturity

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Lamellar bodies contain:

phospholipids

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Analysis of amniotic fluid bilirubin levels is performed using:

spectrophotometry

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A dark yellow amniotic fluid is caused by:

bilirubin

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Alpha fetoprotein is produced by the fetal:

liver

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An amniotic fluid optical density at 650 nm of 0.180 correlates with:

a lamellar body count over 32,000/L

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A second amniocentesis is performed on a diabetic woman believed to be at approximately 35 weeks gestation. She is pregnant with her second child, and the bilirubin A450 on the first amniocentesis was in zone 2 of the Liley graph. If the bilirubin A450 is

Fluorescence polarization assay

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An amniocentesis is performed on a woman believed to be at approximately 15 weeks gestation. A possible abnormality has been observed on her sonogram, and her serum alpha fetoprotein is elevated. What additional test could be performed if the alpha fetopr

Acetylcholinesterase

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To differentiate between maternal and fetal blood in blood-streaked amniotic fluid, the fluid is tested for:

fetal hemoglobin

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A technical error that could produce a falsely low fetal lung maturity test is:

centrifuging the specimen at too high a speed

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Which of the following structures contain(s) one-way valves?

Arachnoid granulations

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The third tube of CSF collected from a lumbar puncture should be used for:

hematology tests

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Measurement of CSF lactate is useful in monitoring cases of:

bacterial meningitis

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An IgG index greater than 0.77 is indicates:

. synthesis of IgG within the

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Calculate the WBC count in the following from the information provided: Using a 1:10 dilution, 120 cells are counted in the four large corner squares on one side of the hemocytometer.

. 3000 cells/L

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The IgG index is a comparison between the:

CSF/serum albumin index and CSF/serum IgG index

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An unknown fluid can be identified as CSF by determining the:

presence of “tau” transferrin

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Oligoclonal bands are significant in the diagnosis of multiple sclerosis when:

they are seen in the CSF and not in the serum

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When choroid plexus cells are present in the CSF, they:

may resemble clusters of malignant cells

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The presence of macrophages containing hematoidin crystals indicates a recent hemorrhage.

False

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CSF is formed in the _______________ and reabsorbed by the _______________.

choroid plexus, arachnoid granulations

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Normal CSF protein differs from serum protein by the:

absence of fibrinogen

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A patient previously diagnosed with acquired immunodeficiency arrives in the emergency room with symptoms of meningitis. A lumbar puncture is performed. What type of meningitis would most probably be suspected in this patient?

Fungal

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A CSF glutamine level is an indirect measure of CSF:

ammonia

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Xanthochromic CSF may appear pink, orange, or yellow.

True

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Cells seen in the CSF following pneumoencephalography are:

choroid plexus

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The CSF/serum albumin index is performed to determine:

the integrity of the blood-brain barrier

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A CSF lactate level should not be performed on a xanthochromic specimen.

True

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A lumbar puncture is performed on a 40-year-old man experiencing symptoms of blurred vision and numbness in his extremities. Results are: Appearance: Colorless, clear Albumin: 40 mg/dL (Serum: 5 g/dL) WBC count: 32 cells/L IgG globulin: 15 mg/dL (Serum: 2

Decreased blood-brain barrier integrity & Neural IgG synthesis

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Using the following laboratory results, determine whether they represent bacterial, viral, tubercular, or fungal meningitis: WBC count: 400/L WBC count: 400/L Lymphocytes: 90% Glucose: 70 mg/dL Monocytes: 8% Blood glucose: 100 mg/dL Neutrophils: 2% Lactat

Viral

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Abnormal sperm morphology is determined by:

head and tail morphology and size

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An increased amount of prostatic fluid in a semen specimen will:

lower the pH

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The following results were obtained on a semen analysis: Volume: 1.5 mL Sperm concentration: 5 million/mL Viscosity: 2.0 Sperm motility: >50%—Grade 3 pH: 7.6 Sperm morphology: <50% abnormal What is the sperm count for this specimen? A. 7.5 million/mL

7.5 million/mL

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Semen viscosity is most closely related to:

specimen liquefaction

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Before analysis semen specimens should be:

allowed to liquefy

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When using routine morphology criteria, the normal value is greater than:

30% normal forms

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Prior to reporting a postvasectomy specimen as negative for the presence of sperm, the specimen must be:

centrifuged

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Development of male antisperm antibodies can be caused by all of the following except:

prolonged abstinence

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A semen pH of 6.0 is associated with a decrease in prostatic fluid.

False

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Evaluation of sperm motility includes:

determining slow and fast movement differentiation between forward and lateral movement

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Which of the following crystals would most likely be present in conjunction with calcium pyrophosphate crystals in synovial fluid?

Hydroxyapatite

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Examination of synovial fluid under direct polarized light reveals intracellular needle-shaped crystals that appear white against the black background. When a red compensator is added and the crystals are aligned with the slow vibration, they appear yello

. monosodium urate showing negative birefringence

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A turbid synovial fluid with yellow-green color is indicates:

infection

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Fluid obtained from the knee of a 60-year-old man who has been experiencing episodes of severe pain for several years has the following results: Appearance: Yellow, slightly milky Glucose: 60 mg/dL (blood glucose: 90 mg/dL) WBC count: 60,000/L Gram's stai

Degenerative

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Blue

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Fat droplets seen in synovial fluid are associated with: A. crush injuries B. chronic inflammation C. sepsis D. both A and B

crush injuries and chronic inflammation

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In the Ropes' or mucin clot test, normal synovial fluid:

forms a solid clot when added to glacial acetic acid

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All of the following diseases are frequently associated with joint disorders except: A. Lyme disease B. tuberculosis C. lupus erythematosus D. rheumatoid arthritis

tuberculosis

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Neutrophils that contain precipitated rheumatoid factor in their cytoplasm are called:

macrophages

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Before performing a cell count on highly viscous synovial fluid, it may be necessary to incubate the fluid with:

hyaluronidase

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Increased serous fluid can be caused by all of the following except:

increased plasma sodium

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A blood-streaked pleural fluid has a fluid-to-serum cholesterol ratio of 0.45, a WBC count of 20,000/L, increased neutrophils, glucose: 40 mg/dL (serum 100 mg/dL), and a pH of 6.8. Is this fluid a transudate or exudate?

Exudate

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Elevated pleural fluid amylase can be indicative of all of the following except: A. pancreatitis

tuberculosis

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Additional testing is most frequently performed on transudates rather than exudates.

. False

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A peritoneal fluid with a positive CEA and a negative CA 125 indicates:

gastrointestinal malignancy

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A fluid obtained by thoracentesis has a cholesterol of 100 mg/dL. This would be classified as a/an:

pleural exudate

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Ascitic fluid from a patient with symptoms of severe abdominal pain has an elevated amylase and alkaline phosphatase, a WBC count of 30,000/L, an absolute neutrophil count of 80%, and albumin of 3.5 mg/dL (serum albumin: 4.0 mg/dL). What disorder is sugg

Peritonitis

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A pleural fluid delivered to the laboratory in ice would be accompanied by a requisition to test for:

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The cells lining the pleural cavities are primarily:

neutrophils

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Which of the following tests is valuable in the diagnosis of esophageal rupture?

Pleural fluid pH

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