Body Fluids (Part 2)
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high fluid volume in maternal diabetes mellitus, multifetal pregnancy, anencephaly, or spina bifida
Polyhydramnios
Low fluid volume in intrauterine growth retardation and anomalies of the fetal urinary tract
Oligohydramnios
3 Amniotic fluid tests used to assess fetal distress
1 Bilirubin spectral scan (Liley Plot) 2 Alpha Fetoprotein 3 DNA analysis for chromosomal abnormalities
What is the significance of an abnormal Liley Plot and what does it look like?
There is a sharp peak at 450nm which indicates Bilirubin in amniotic fluid. This will tell us how bad HDN is.
assesses neural tube disorders; ex: spina bifida, anencephaly
Alpha Feto protein
Four tests used to assess fetal lung maturity
1 Lecithin/Sphingomyelin (L/S) ratio 2 Phosphatidylglycerol (PG) and Phosphatidylinositol (PI) 3 Foam Stability Index 4 Lamellar Body Counts
An L/S ratio of >______ together with the presence of PG may suggest mature fetal lung development
2.0
performed by mixing equal volumes of amniotic fluid with ethanol, followed by vigorous shaking. If foam is produced adequate surfactants are present.
The shake test, foam stability test
An FSI greater than or equal to ______ correlates with fetal pulmonary maturity and is analogous to an L/S ratio of 2.0
0.48
Where surfactant is stored in cytoplasmic granules; counted on a hematology analyzer like platelets
Lamellar Body Counts
A value of _______ of lamellar body counts is considered “mature”
60,000
Performed to diagnose cystic fibrosis, a value >60 mEq/L is bad
Sweat Chloride Analysis
Purpose is to induce sweat on electrodes in order to analyze chloride
Pilocarpine
Used to detect organisms at the alveolar level; usually Pneumocystis jirovecii (carinii) in HIV pateints
Bronchoalveolar Lavage (BAL)
Color of stool -upper gastrointestinal bleeding, iron therapy, charcoal, bismuth
Black
Color of stool -Lower gastrointestinal bleeding, pyridium compounds, beets and food coloring, rifampin
Red
Color of stool -Bile duct obstruction, barium
Pale yellow, white , gray
Color of stool -Bulky/Frothy
Steatorrhea; in pancreatic dysfunction or fat malabsorption
Stool -Ribbonlike
Intestinal constriction
Stool -Mucous
Malignancy, colitis
Conditions which can cause neutrophils (polys) to be present in stool
Ulcerative colitis, bacillary dysentery, ulcerative diverticulitis, intestinal tuberculosis, abscesses or fistulae
Conditions which can cause the presence of muscle fibers in stool specimens
noted during fecal fat exam; correlates with impaired digestion and rapid intestinal transit time
Diagnostic use and and principle for fecal occult blood analysis
Detects hidden blood; screening for colorectal screeing and for GI bleed
Reagents used in fecal occult blood
peroxidase and pseudoperoxidase; Guaiac used as the most common indicator