SYNOVIAL AND SEROUS FLUID Flashcards

1
Q

AKA joint fluid

A

Synovial fluid

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2
Q

Viscosity is due to polymerization of

A

Hyaluronic acid

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3
Q

Produced by Type 3 synoviocytes

A

Hyaluronic acid

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4
Q

Type A synoviocytes promotes

A

Phagocytosis

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5
Q

Method of collection for synovial fluid

A

Arthrocentesis

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6
Q

Normal volume of synovial fluid

A

<3.5 mL.

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7
Q

Volume of synovial fluid in inflammation

A

> 25 mL

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8
Q

Tube for chemical and immunologic evaluation

A

Plain red top tube ( no anticoagulant)

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9
Q

Tube for chemical and immunologic evaluation

A

Plain red top tube ( no anticoagulant)

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10
Q

Anticoagulant for glucose analysis

A

Sodium fluoride

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11
Q

Powdered anticoagulants and lithium heparin may interfere with ____

A

Crystal identification

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12
Q

Tube for synovial fluid to be used for microscopic exam

A

Sodium heparin or liquid EDTA

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13
Q

Liquid EDTA for synovial fluid exam is used in what section

A

Hematology/ cell count

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14
Q

Normal color and clarity of synovial fluid

A

Colorless-pale yellow and clear

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15
Q

color and clarity of synovial fluid when there is an inflammation

A

Deeper yellow

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16
Q

color and clarity of synovial fluid in bacterial infection

A

Greenish tinge

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17
Q

color and clarity of synovial fluid in the presence of WBCs, synovial cell debris or fibrin

A

Turbid

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18
Q

color and clarity of synovial fluid with presence of crystals

A

Milky

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19
Q

Synovial fluid normal viscosity:

A

Highly viscous

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20
Q

Synovial fluid fluid forms string that is ______ cm long

A

4-6 cm

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21
Q

Normal Hyaluronic acid level

A

0.3 to 0.4 g/dL

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22
Q

Ropes of mucin clot test (Hyaluronic polymerization test) REAGENT

A

2-5% Acetic acid

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23
Q

GRADING: solid or compact clot; clear solution

A

Good

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24
Q

WBC count of synovial fluid: DILUTING FLUIDS

A

SALINE WITH SAPONIN
HYPOTONIC SALINE (0.3%)
NSS with METHYLENE BLUE

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25
Q

For every viscous fluid, add 1 drop of ___________ in phosphate buffer per mL of fluid

A

0.05% hyaluronidase

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26
Q

SYNOVIAL FLUID Differential count : RBC normal value

A

<2000/uL or ABSENT

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27
Q

SYNOVIAL FLUID Differential count : WBCs normal value

A

<200/uL

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28
Q

Neutrophil containing ingested “round body” seen in lupus erythymatosus

A

LE cell

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29
Q

Vacuolated macrophage with ingested neutrophil seen in REACTIVE ARTHRITIS

A

Reiter cell (neutrophage)

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30
Q

Neutrophil with dark cytoplasmic granules containing precipitated rheumatoid factor

A

RA cell (ragocyte)

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31
Q

Macroscopically resemble polished rice , it shows collagen and fibrin

A

Rice bodies

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32
Q

Debris from metal and plastic joint prosthetics

Ground pepper appearance

A

Orchonotic shards

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33
Q

Similar to macrophage but may be multinucleated resembling a mesothelial cell

A

Synovial cell lining

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34
Q

Refractile intracellular and extracellular globules stain with Sudan dyes

A

Fat droplets

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35
Q

Inclusions within clusters of synovial cells ; pigmented villonodular synovitis

A

Hemosiderin

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36
Q

CRYSTAL SHAPE: NEEDLES

A

MONOSODIUM URATES

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37
Q

CRYSTAL SHAPE: Rhombic, rods

A

Calcium pyrophosphate

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38
Q

CRYSTAL SHAPE: notched, rhombic plates

A

Cholesterol

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39
Q

CRYSTAL SHAPE: flat, variable-shaped plates

A

Corticosteroid

40
Q

CRYSTAL SHAPE: envelopes

A

Calcium oxalate

41
Q

CRYSTAL SHAPE: small particles ; requires electron microscopy

A

Apatite (calcium phosphate)

42
Q

Synovial crystal with NO BIREFRINGENCE

A

APATITE (calcium phosphate)

43
Q

Synovial crystal (+) BIREFRINGENCE

A

CALCIUM PYROPHOSPHATE
COSRTICOSTEROID

44
Q

Detects the presence or absence of birefringence

A

Polarizing microscope

45
Q

Confirms the type of birefringence (positive or negative BR)

A

COMPENSATED POLARIZING MICROSCOPE

46
Q

Color of positive birefringence

A

Blue

47
Q

Color of negative birefringence

A

Yellow

48
Q

What color of compensator is placed between crystal and analyzer

A

Red

49
Q

A control slide for MSU polarization can be prepared using __________

A

Betamethasone acetate corticosteroids

50
Q

The molecules in the MSU crystals run _______ to the long axis of the crystal

A

Parallel

51
Q

The molecules in the CPPD crystals run ________ to the long axis of the crystal

A

Perpendicular

52
Q

When the crystals are aligned perpendicular to the slow vibration, the color is _______

A

Reversed

53
Q

Most frequently tested chemistry test for synovial fluid ; done in conjunction with blood glucose

A

Glucose

54
Q

Formula for total glucose

A

Blood glucose - synovial fluid fluid glucose

55
Q

Formula for total glucose

A

Blood glucose - synovial fluid fluid glucose

56
Q

Normal value of SF protein

A

<3 g/dL

57
Q

Common bacteria infecting the synovial fluid

A

S. Aureus
Streptococcus
Haemophilus
N. Gonorrheae

58
Q

Non inflammatory group of joint disorders

A

Group 1

59
Q

Color and clarity of group 1 joint disorder

A

Clear, yellow

60
Q

Viscosity of type 1 joint disorder

A

Good

61
Q

WBC count of type 1 joint disorder

A

<1,000/uL

62
Q

Inflammatory (immunologic) group of joint disorder

A

Group IIa

63
Q

Positive for autoantibodies

A

Group IIa (immunologic)

64
Q

Inflammatory (crystal-induced) group of joint disorder

A

Group IIb

65
Q

Color and clarity of group IIb joint disorder

A

Cloudy or milky

66
Q

Joint group positive for crystals

A

Group IIb

67
Q

Septic group of joint disorders

A

Group III

68
Q

Color and clarity of group III joint disorder

A

Cloudy, yellow-green

69
Q

Neutrophil count in septic group joint disorder (group III)

A

> 75%

70
Q

Group of joint disorder positive for culture and gram stain

A

Group III septic

71
Q

Hemorrhagic group of joint disorder

A

Group IV

72
Q

Accumulation of fluid between the membranes

A

Effusion

73
Q

Disruption of fluid production and regulation between membrane

A

Transudate

74
Q

Changes in hydrostatic and oncotic pressure

A

Transudate

75
Q

Congestive heart failure, hypoproteinemia, nephrotic syndrome are examples of what type of effusion

A

Transudate

76
Q

Direct damage to the membrane of a particular cavity

A

Exudate

77
Q

Infection, inflammation, malignancy are examples of what type of effusion

A

Exudate

78
Q

Seromucin clot test for exudate

A

Rivalta’s test

79
Q

Recommended to detect the Transudate of hepatitis origin

A

Serum-ascites albumin gradient (SAAG)

80
Q

SAAG of 1.1 or greater

A

Transudate

81
Q

SAAG of <1.1

A

Exudate

82
Q

Color of pleural fluid with aspergillus infeciton

A

Black

83
Q

T or E: Fluid total protein of 3.0 g/dL or less

A

Transudate

84
Q

T or E: >3.0 g/dL

A

Exudate

85
Q

Most reliable method for differentiating Transudate and exudate

A

Fluid:serum protein ratio

Fluid:serum LD ratio

86
Q

T or E: >45-60 mg/dL

A

Pleural fluid cholesterol

87
Q

Triglyceride value of a chylous effusion

A

> 110 mg/dL

88
Q

Triglyceride value of a pseudochylous effusion

A

<50 mg/dL

89
Q

SUDAN III STAINING: +++

A

CHYLOUS EFFUSION

90
Q

SUDAN III STAINING: (-) / weakly (+)

A

Pseudochylous effusion

91
Q

Cell that is decreased in TB

A

Mesothelial cell

92
Q

Adenosine deaminase significance

A

Tuberculosis , malignancy

93
Q

Tumor marker for lung cancer, breast cancer

A

CYFRA 21-1

94
Q

SPECIMEN : >100,000 RBCs / uL indicates blunt trauma injury (intra-abdominal bleeding)

A

PERITONEAL LAVAGE

95
Q

Decreased tubercular peritonitis

A

Glucose