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Synovial Fluid Flashcards

1
Q

Synovium refers to the

A

tissue lining synovial tendon sheaths
bursae
diarthrodial joints

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2
Q

Synovium is composed of one to three cell layers that form a discontinuous surface overlying

A

fatty, fibrous, or periosteal joint tissue

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3
Q

An ultrafiltrate of plasma combined with hyaluronic acid produced by the synovial cells or synoviocytes

A

Synovial fluid

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4
Q

Synovial fluids findings by disease category:

Clarity: Transparent

A

Normal

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5
Q

Synovial fluids findings by disease category:

Clarity: Transparent

A

Group I: Noninflammatory

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6
Q

Synovial fluids findings by disease category:

Clarity: Transparent/opaque

A

Group II: Inflammatory

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7
Q

Synovial fluids findings by disease category:

Clarity: Opaque

A

Group III: Infectious and Group IV: Hemorrhagic

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8
Q

Synovial fluids findings by disease category:

Color: Clear to pale yellow

A

Normal

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9
Q

Synovial fluids findings by disease category:

Color: Xanthochromic

A

Group I: Noninflammatory

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10
Q

Synovial fluids findings by disease category:

Color: Xanthochromic to white/bloody

A

Group II: Inflammatory

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11
Q

Synovial fluids findings by disease category:

Color: White

A

Group III: Infectious

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12
Q

Synovial fluids findings by disease category:

Color: Red-brown or xanthrochromic

A

Group IV: Hemorrhagic

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13
Q

Synovial fluids findings by disease category:

WBCs/mL: 0-150

A

Normal

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14
Q

Synovial fluids findings by disease category:

WBCs/mL: <3000

A

Group I: Noninflammatory

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15
Q

Synovial fluids findings by disease category:

WBCs/mL: 3000-75,000

A

Group II: Inflammatory

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16
Q

Synovial fluids findings by disease category:

WBCs/mL: 50,000-200,000

A

Group III: Infectious

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17
Q

Synovial fluids findings by disease category:

WBCs/mL: 50-10,000

A

Group IV: Hemorrhagic

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18
Q

Synovial fluids findings by disease category:

PMNs, %: <25

A

Normal

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19
Q

Synovial fluids findings by disease category:

PMNs, %: <30

A

Group I: Noninflammatory

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20
Q

Synovial fluids findings by disease category:

PMNs, %: >50

A

Group II: Inflammatory

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21
Q

Synovial fluids findings by disease category:

PMNs, %: >90

A

Group III: Infectious

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22
Q

Synovial fluids findings by disease category:

PMNs, %: <50

A

Group IV: Hemorrhagic

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23
Q

Synovial fluids findings by disease category:

RBCs present:

A

Group III: Infectious
Group IV: Hemorrhagic

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24
Q

Synovial fluids findings by disease category:

RBCs absent:

A

Normal
Group I: Noninflammatory
Group II: Inflammatory

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25
Q

Synovial fluids findings by disease category:

Glucose (blood/SF difference, mg/dL): 0-10 (0-0.56 mmol/L)

A

Normal
Group I: Noninflammatory

26
Q

Synovial fluids findings by disease category:

Glucose (blood/SF difference, mg/dL): 0-40 (0-2.2 mmol/L)

A

Group II: Inflammatory

27
Q

Synovial fluids findings by disease category:

Glucose (blood/SF difference, mg/dL): 20-100 (1.11-5.5 mmol/L)

A

Group III: Infectious

28
Q

Synovial fluids findings by disease category:

Glucose (blood/SF difference, mg/dL): 0-20 (0-1.11 mmol/L)

A

Group IV: Hemorrhagic

29
Q

Little inflammatory response in Group I: Noninflammatory

A

Osteoarthritis
Traumatic arthritis
Neuropathic osteoarthropathy
Pigmented villonodular synovitis
Early rheumatoid arthritis

30
Q

Present in noninflammatory effusions

A

Early rheumatoid arthritis
Early bacterial infection
Viral arthritis

31
Q

Examples of reaction group in Group II: Inflammatory

A

Rheumatoid arthritis
Systemic lupus erythematosus (SLE)
Reiter syndrome
Rheumatic fever
Acute crystal-induced arthritis
Arthritis associated with inflammatory bowel disease
Psoriatic arthritis
Fat droplet synovitis

32
Q

Infections that constitutes Purulent (Infectious) Effusions (Group III)

A

Bacterial, fungal, and tuberculosis joint infections

33
Q

Diseases associated with Hemorrhagic effusions (Group IV)

A

Traumatic arthritis
Pigmented villonodular synovitis
Synovial hemangioma
Neuropathic osteoarthropathy
Joint prostheses
Hematologic disorders)

34
Q

Joint fluid aspiration

A

Arthrocentesis

35
Q

Caution is necessary to avoid aspirating a sterile joint in someone with ______ into a sterile joint

A

bacteremia
through a cutaneous or periarticular soft tissue infection

36
Q

Large joints such as the knee normally contain no more than

A

4.0 mL of SF

37
Q

Synovial fluid must be collected with a ____, ____, and ____ to avoid contamination by birefringent particulates

A

sterile, disposable needs, and plastic syringes

38
Q

In routine arthrocentesis, the syringe may be heparinized with

A

25 U of sodium heparin/mL of SF

39
Q

These should be avoided because they form crystal artifacts that may be misleading during the microscopic examination

A

Oxalate
Lithium heparin
Powdered ethylene-diaminetetraacetic acid (EDTA) anticoagulants

40
Q

The SF specimen should be separated into three groups:

A

1) 3 to 10 mL into a sterile heparinized tube or syringe for MICROBIOLOGICAL STUDIES
2) 2 to 5 mL in an anticoagulant tube (sodium heparin or liquid EDTA) for MICROSCOPIC EXAMINATIONS
3) 5 mL into a plain (no anticoagulant) tube for CHEMICAL ANALYSIS

41
Q

It has an inhibitory effect on some pathogenic bacteria

A

Heparin concentrations greater than 125 U/mL

42
Q

Specimens for culture should be at least:

A

1 to 2 mL in volume submitted in green-top sodium heparin tubes containing 143 U/tube of heparin
Submitted in recapped syringes after removal of the needle and excess air

43
Q

Sufficient for the most critical test

44
Q

Effective in collecting SF following a dry tap

A

Saline injection
Reaspiration

45
Q

Infectious organism

A

Staphylococcus aureus

46
Q

Under gross examination:

A

Total volume
Color
Clarity

47
Q

Part of gross examination where it should be recorded at the bedside, especially if the sample is to be divided for submission to different laboratory sections

A

Total volume

48
Q

Color should be evaluated in a

A

clear glass tube against a white background

49
Q

Normal SF color

50
Q

Disorders that impart a straw to yellow color (xanthocrhromia) specimen

A

Noninflammatory and inflammatory disorders

51
Q

Color of Septic fluid depending on the chromogens produced by the offending organisms and the host response, including the presence of WBCs and RBCs

A

Yellow, brown, or green

52
Q

Produces an uneven distribution of blood during arthrocentesis or streaking in the syringe

A

Traumatic tap

53
Q

A red-brown color following centrifugation is good evidence of

A

pathologic hemarthrosis

54
Q

Relates to the number and type of particles within the SF

55
Q

Clarity of normal SF

A

Transparent

56
Q

Clarity of the fluid that completely obscures the background

57
Q

Most commonly responsible for the changes in clarity

A

Leukocytes

58
Q

Produces an opaque, milky, opalescent fluid without leukocytes

A

very large number of crystals

59
Q

A shimmering, oily-appearing specimen suggests ____, which may grossly resemble pus

A

cholesterol crystals

60
Q

Increased turbidity is less often due to:

A

concentrations of fibrins
free-floating rice bodies
metal and plastic particles from patients with joint prostheses
Cartilage fragments in osteoarthritis

61
Q

It is fragments of degenerating proliferative synovial cells or microinfarcted synovium

A

Free-floating rice bodies

62
Q

Appearance from pigmented cartilage fragments that may be a result of metabolic disorders (i.e., ochronosis)

A

Ground pepper appearance

Aaaa (21 decks)

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