1. Is it normal to have small amounts of fluid in the body cavities?
    yes - in chest and abdomen
  2. What is the small amounts of fluid in the body cavities for?
    lubricates organs so they can move easily
  3. Where does the small amount of fluid in body cavities originate from?
    capillaries found throughout tissue
  4. What are the two main types of pressure that affect the fluid in body cavities?
    • capillary hydrostatic pressure
    • colloid osmotic pressure
  5. What is capillary hydrostatic pressure?
    pushes fluid out of the vessels into the tissue
  6. What is the capillary hyrodstatic pressure driven by?
    • the blood pressure
    • the higher the blood pressure, the more fluid that is being pushed out
  7. What is colloid osmotic pressure?
    draws fluid back in
  8. What is colloid osmotic pressure due to?
  9. What is albumin?
    main plasma protein that maintains fluid balance in the vessels
  10. What would happen if we didn't have colloid osmotic pressure?
    the capillary hydrostatic pressure would cause the abdomen to fill up like a balloon
  11. What is effusion?
    increase fluid in a body cavity
  12. What is effusion usually due to?
    an underlying disorder
  13. Any process that impairs absorption, alters capillary pressure, or alters albumin causes what?
  14. What are two main diagnositc reasons for effusion?
    • inflammation
    • neoplasia
  15. What are the different classifications of effusion?
    • transudate
    • modified transudate
    • exudate
    • hemorrhagic effusion
    • chylous effusion
  16. What are the clinical conditions that cause effusion?
    • ascites
    • hydrothorax
    • hemothorax
    • chylothorax
    • pyothorax
  17. What is ascites?
    increase in fluid in the abdomen
  18. What is hydrothorax?
    water in the thorax
  19. What is hemothorax?
    blood in the thorax
  20. What is chylothorax?
    chyle in the thorax
  21. What is pyothorax?
    puss in the thorax
  22. What is centesis?
    collecting fluid sample
  23. Should we use aseptic technique when doing a centesis?
    • yes
    • shave and scrub
  24. If we want to culture a centesis what do we need to remember to do?
    collect that sample first as a separate sample
  25. What do we use to do a centesis?
    needle or catheter
  26. What type of catheter should we use to do a centesis?
    peritoneal dialysis catheter
  27. What is the main problem too much fluid causes for the animal?
    problems breathing
  28. What type of gross characteristics should we note when looking at a fluid sample?
    • color
    • clarity
    • odor
    • viscosity
  29. What is viscosity?
    the texture of the fluid (thin, thick, etc)
  30. Should we perform a total protein of a fluid sample?
  31. If the sample is bloody, what should we do?
    buffy coat smear
  32. What is flocculent fluid?
    stuff floating in the fluid
  33. How many smears should we make of the fluid?
    at least 2
  34. If the fluid is clear, what should we do?
    want to centrifuge it down and treat it like a urine sediment
  35. What kind of stain should we use?
    diff quik
  36. What does transudate fluid look like?
    looks like water - clear, colorless, thin
  37. Are pure transudates common?
    no, they are rare
  38. What are most transudates due to?
    low albumin
  39. What could cause low albumin levels?
    • starvation
    • not enough protein in the diet
  40. What is the total protein of transudate fluid?
    < 2.5 gm/dl
  41. How many cells do we see in transudate fluid?
    fewer than 1000 cells/ul
  42. What kind of cells will we see in transudate fluid?
    • mesothelial cells
    • macrophages
  43. Where do we find mesothelial cells?
    they are cells tha tline the body cavities
  44. What do mesothelial cells look like?
    • basophilic cytoplasm
    • oval nucleus (may or may not see nucleolus)
    • may see clusters of cells
    • may see mitosis 
    • may see vacuoles
  45. If we catch a mesothelial cell while it is changing into a macrophage, what might it be confused with?
  46. Which is more common transudate or modified transudate fluid?
    modified transudate
  47. What does modified transudate fluid look like?
    • can be clear and colorless
    • or cloudy and tinged with red
  48. What is modified transudate due to?
    • change in vasular pressure
    • usually due to an increase in osmotic pressure because of masses blocking capillary flow
    • commonly seen with neoplasms
  49. Are masses always seen in neoplastic effusion?
    no due to fluid covering the mass
  50. Which tumors exfoliate more readily than others ?
    • lymphoma
    • mast cell tumor
  51. Are negative neoplasic findings significant?
    no, a negative finding may not always be negative
  52. How many of the neoplastic criteria do we need to see in order to safely say it is neoplastic?
    more than 3
  53. What are the two main causes of modified transudate?
    • heart disease
    • neoplasia
  54. What is exudate due to?
  55. What does exudate fluid look like?
    • cloudy
    • reddish
    • flocculent
  56. What are the two types of exudates?
    septic and nonseptic
  57. What is the total protein of exudate?
    > 2.5 gm/dl
  58. How many cells will we see with exudate?
    more than 5,000 cells/ul
  59. What kind of cells will we see with exudate fluid?
    • mostly segs
    • some macrophages and mesothelial cells
  60. What will we see with septic exudate?
  61. Where will we see bacteria in septic exudate?
    • most in segs
    • free floating in sample
    • occasionally in macrophages
  62. Should we culture septic exudate?
  63. What will the segs look like in septic exudate fluid?
    • degenerating
    • will see karyolysis, karyorrhexis, pyknosis
  64. What are the two types of septic exudate?
    • pyothorax
    • peritonitis
  65. What does a cytology of nonseptic exudate look like?
    • many segs (may become hypersegmented or pyknosis)
    • macrophages (may see segs being phagocitized in macrophages)
    • no bacteria
  66. What does it mean if we see eosinophils in exudate fluid?
    there is parasite migration
  67. What type of effusion is the wet form of FIP?
    nonseptic exudate
  68. What does the fluid of FIP look like?
    yellow-green and viscous
  69. What is elevated in FIP?
    • elevated total protein
    • elevated cell counts
  70. What does the background of an FIP cytology look like and why?  What do we often get this confused with?
    • bluish granular background
    • due to protein precipitate
    • may be confused with bacteria
  71. What are some causes for nonseptic exudate?
    • FIP
    • gall bladder rupture (not common)
    • urinary bladder rupture
  72. What is different in the cytology of a gall bladder rupture?
    green pigment in macrophages
  73. If we catch the urinary bladder rupture within 24 hours after the rupture then what test can we do?
    • compare the creatinine in the fluid and serum
    • the creatinine in the fluid will be higher than in the serum
  74. What will we see in the fluid if there is a urinary bladder rupture?
  75. What are the three main effusions?
    • transudate
    • modified transudate
    • exudate
  76. An abdomen full of blood that is not due to a trauma usually mean _____.
  77. What is hemmorhagic effusion usually due to?
    internal bleeding
  78. What typically causes internal bleeding?
    • spleen or liver rupture
    • vessel ruptures/coagulopathy
    • blood vessel tumor rupture
  79. What will we see in the cytology of hemmorhagic effusion?
    erythophagocytosis (macrophages phagocytizing RBCs)
  80. If there platelets seen in a hemmorhagic effusion sample what does that mean?
    it is fresh blood and it happened within 4 hours
  81. In order to look at a cytology of hemmorhagic effusion what do we need to do?
    spin it down because if not then all we will see if a bunch of RBCs
  82. How can we tell if the blood is old or new after we spin down a sample from a hemmorhagic effusion?
    • the supernant will be clear/straw colored if the blood is fresh
    • the supernant will be yellow if the blood is old
  83. What does the fluid from chylous effusion look like?
    white-pinkish and opaque
  84. What causes chylous effusion?
    leakage from lymphatics
  85. Which species do we usually see chylous effusion in and why?
    • cats
    • cats will sometimes have a spontaneous leakage in the thoracic duct
  86. What is the thoracic duct?
    largest lymph vessel that dumps lymph back into the systemic circulation
  87. What will be elevated with chylous effusion?
    triglycerides (fats)
  88. What will we see on a cytology of chylous effusion?
    many small lymphs
  89. What is the total protein of chylous effusion?
    2 - 6.5 gm/dl
  90. How many cells will we see with chylous effusion?
    900 - 16,650 cells/ul
  91. In addition to many small lymphs on a chylous effusion what other cells will we see?
  92. What are some other diseases that we will see with chylous effusion (these are not common!)?
    • cardiomyopathy
    • lymphosarcoma
  93. Image Upload 1
    What type of fluid is this?
    chylous effusion
  94. Image Upload 2
    What type of fluid is this?
    chylous effusion
  95. Image Upload 3
    • A:  reactive mesothelial cell
    • B:  RBC
    • C:  segs
    • D:  macrophages
  96. Image Upload 4
    What is this?
    eosinophils in an effusion - not normal - due to parasite migration
  97. Image Upload 5
    What is this?
  98. Image Upload 6
    What kind of patient is this from?
    FeLV cat
  99. Image Upload 7
    What is this due to?
  100. Image Upload 8
    What is this due to?
  101. Image Upload 9
    Describe this fluid.
  102. Image Upload 10
    What kind of effusion is this from?
    hemmorrhagic effusion
  103. Image Upload 11
    What is this?
    hyperplastic mesothelial cells
  104. Image Upload 12
    What is this?
  105. Image Upload 13
    What is this?
  106. Image Upload 14
    What type of cell is this?
    mesothelial cell
  107. Image Upload 15
    What is this?
    a cluster of mesothelial cells
  108. Image Upload 16
    What cell is this and what is happening to it?
    • mesothelial cell
    • mitosis
  109. Image Upload 17
    What is this?
  110. Image Upload 18
    Where did this sample come from?
    thoracic effusion
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