SYNOVIAL FLUID

Question 1

Is a viscous liquid found in cavities of movable joint (diarthroses) or synovial joints

Answer 1

SYNOVIAL FLUID (JOINT FLUID)

Question 2

formed as an ultrafiltrate of plasma across the synovial membrane.

Answer 2

SYNOVIAL FLUID (JOINT FLUID)

Question 3

cells lining the synovial membrane, secrete a
mucopolysaccharide containing hyaluronic acid & a small amount of CHON into the fluid.

Answer 3

Synoviocytes

Question 4

Synovial fluid functions

Answer 4

• Provide lubrication in the joints
• Provides nutrient to the articular cartilage
• Lessens the shock of joint compression occurring during activities such as walking & jogging

Question 5

Damage to the articular membranes produces pain & stiffness in the joints.

Answer 5

Arthritis

Question 6

A variety of conditions including _____, ______, ______, _______, ______, and _______ are associated with arthritis.

Answer 6

infection, inflammation, metabolic disorders, trauma, physical stress and advanced age

Question 7

pathologic significance:
 Degenerative joint disorders,
 osteoarthritis

Answer 7

non inflammatory

Question 8

pathologic significance:
o Immunologic disorders o Rheumatoid arthritis
o Lupus erythematosus o Scleroderma
o Polymyositis
o Ankyolosing spondylitis
o Rheumatic fever
o Lyme arthritis crystal-induced gout and
pseudogout

Answer 8

Inflammatory

Question 9

pathologic significance:
- Microbial infection

Answer 9

Septic

Question 10

pathologic significance:
o Traumatic injury
o Tumors
o Hemophilia
o Other coagulation disorders Anticoagulant
overdose

Answer 10

Hemorrhagic

Question 11

FREQUENTLY PERFORMED TESTS IN SYNOVIAL FLUID

Answer 11

1. WBC count
2. Diff. count
3. Gram stain
4. Culture
5. Polarized microscopy exam for crystals

Question 12

NORMAL VOLUME IN SYN.F

Answer 12

<3.5 ML

Question 13

NORMAL COLOR IN SYN.F

Answer 13

COLORLESS TO PALE YELLOW

Question 14

NORMAL CLARITY IN SYN.F

Answer 14

CLEAR

Question 15

NORMAL VISCOSITY IN SYN.F

Answer 15

Able to form a string 4–6 cm long

Question 16

TOTAL PROTEIN IN SYN.F

Answer 16

<3 g/dL

Question 17

ERYTHROCYTE COUNT IN SYN.F

Answer 17

<2000 CELLS/ML

Question 18

LEUKOCYTE COUNT IN SYN.F

Answer 18

<200 CELLS/ML

Question 19

NEUTROPHIL IN SYN.F

Answer 19

<20% OF THE DIFFERENTIAL

Question 20

LYMPOCHYTE IN SYN.F

Answer 20

<15% OF THE DIFFERENTIAL

Question 21

MONOCYTE AND MACROPHAGE IN SYN.F

Answer 21

65% OF THE DIFFERENTIAL

Question 22

GLUCOSE IN SYN.F

Answer 22

<10 MG/DL LOWER THAN BLOOD GLUCOSE

Question 23

URIC ACID IN SYN.F

Answer 23

EQUAL TO BLOOD

Question 24

TUBE FOR CHEMICAL AND IMMUNOLOGIC

Answer 24

Plain Red Top Tube

Question 25

Tube for microscopic exams

Answer 25

With anticoagulant

Question 26

tube for microbiological studies

Answer 26

Sterile Anticoagulant Tube

Question 27

what tube is a Sterile Anticoagulant Tube

Answer 27

sodium polyanetholsulfonate

Question 28

best anticoagulant for synovial fluid oxalate.

Answer 28

Sodium heparin

Question 29

must be avoided because they can produce crystalline structure resembling monosodium urate crystals

Answer 29

Powdered EDTA

Question 30

Powdered EDTA must be avoided because they can produce ______ structure resembling _________

Answer 30

crystalline ; monosodium urate crystals

Question 31

collection of synovial fluid by needle aspiration

Answer 31

Arthrocentesis

Question 32

________ is used for collection (syn.f) is moistened with ____.

Answer 32

syringe ; heparin

Question 33

3 tubes used in syn.f

Answer 33

 1 – micro – heparinized tube  1 – hema – EDTA tube (liquid)  1 – other tests – non anticoagulated tube

Question 34

______ should not be used because they may produce artifacts that will interfere with crystal analysis.

Answer 34

Powdered anticoagulants

Question 35

responsible for the viscosity of S.F. & is essential for proper lubrication of the joints.

Answer 35

Polymerization of the hyaluronic acid

Question 36

In arthritis, production of _______ & its ability to polymerize is affected thus _______ the viscosity.

Answer 36

hyaluronate ; decreasing

Question 37

Measures the degree of hyaluronate polymerization.

Answer 37

Ropes or Mucin clot test

Question 38

2-5% HAC + normal S.F. =

Answer 38

form solid clot

Question 39

Neutrophil with dark cytoplasmic granules containing immune complexes

Answer 39

RA - rheumatoid arthritis cell (ragocyte)

Question 40

neutrophil containing characteristic ingested “round body”

Answer 40

LE - lupus erythematosus cell

Question 41

Vacuolated macrophage with ingested neutrophils

Answer 41

Reiter cell

Question 42

found in cases of gout

Answer 42

Monosodium urate (UA)

Question 43

found in Pseudogout

Answer 43

Calcium phosphate (CPPD)

Question 44

Calcium phosphate (CPPD) produces ____ color

Answer 44

blue

Question 45

Fluid is examined unstained under polarized & compensated polarized light for detection of ______ and _____

Answer 45

monosodium urate crystals (MSU) and Calcium pyrophosphate crystal deposition (CPPD)

Question 46

microbiological tests in syn.f

Answer 46

gram stain and culture

Question 47

culture should include an enrichment medium such as ______

Answer 47

Chocolate agar

Question 48

Most common organisms that infect S.F. are:

Answer 48

 Hemophilus spp  Neisseria gonorrhea  Staphylococcus  Streptococcus

Question 49

Demonstration of antibodies to the causative agent ________ in the patient’s serum can confirm the causes of the _________.

Answer 49

Borrelia burgdorferi ; ARTHRITIS

Question 50

Anticoagulant which prevent clotting if fibrinogen is present but do not form crystals

Answer 50

EDTA

Question 51

RBC TOTAL COUNT

Answer 51

fewer than 2000 RBCs/uL

Question 52

WBC TOTAL COUNT

Answer 52

lower than 200 WBC/uL

Question 53

WBC TOTAL COUNT

Answer 53

lower than 200 WBC/uL

Question 54

Greater than >2000 cells/uL are typically associated with ______

Answer 54

bacterial arthritis.