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CLINICAL MICROSCOPY > Synovial Fluid > Flashcards

Synovial Fluid Flashcards

1
Q

indicate nonspetic inflammation (Inflammatory, non-inflammatory, hemorraghic)

A

Increased lymphocytes

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2
Q

rheumatic fever, parasitic infections, metastatic carcinoma, post radiation therapy or arthrography

A

Increased eosinophils

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3
Q

patients with lupus erythematosus

A

LE cells

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4
Q

macrophages with ingested neutrophils

A

Reiter cells

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5
Q

precipitated rheumatoid factor appearing as cytoplasmic granules in neutrophils

A

RA cells (ragocytes

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6
Q

due to hemorrhagic process or cases of pigmented villonodular synovitis

A

Hemosiderin granules

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7
Q

observed in cases of osteoarthritis

A

Cartilaginous cells

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8
Q

found in septic and rheumatoid arthritis and Tuberculosis

A

Rice bodies

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9
Q

– indicate traumatic injury

A

Fat droplets

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10
Q

Crystals aligned parallel to the compensator

appear__________?

A

yellow (negative birefringence)

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11
Q

In MSU Crystals aligned perpendicular to the

compensator appear ___________

A

Blue ( positive birefringence)

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12
Q

Indicate gouty arthritis due to

A

Monosodium Urate Crystals (MSU

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13
Q

§ Increased serum uric acid

§ Decreased renal excretion of uric acid

§ Impaired metabolism of nucleic acid

A

gouty arthritis

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14
Q

Acute stages

A

Intracellular

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15
Q

strongly birefringent in MSU

A

Polarized light

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16
Q

yellow when parallel blue when perpendicular

A

Compensated polarized lightin MSU

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17
Q

Needle shaped crystal

A

Monosodium Urate Crystals (MSU

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18
Q

Indicates pseudogout

A

Calcium pyrophosphate (CCPD

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19
Q

Degenerative arthritis
Endocrine disorders with increased serum calcium
Calcification of cartilage

A

Pseudogout

20
Q

Blunt rods or rhombic shapes

A

Calcium pyrophosphate (CCPD)

21
Q

weakly birefringent

A

Polarized light in CCPD

22
Q

– blue when parallel (yellow when perpendicular)

A

Compensated polarized light in CCPD

23
Q

Nonspecific indications
Associated with chronic inflammation

A

Cholesterol crystal

24
Q
  • Usually seen extracellularly
  • Polarized light – strongly birefringence
  • Rhombic plates
A

Cholesterol

25
Q
  • Associated with calcific deposition conditions
  • May produce an acute inflammatory reaction
A

Hydroxyapatite (HA) (Calcium phosphate)

26
Q
  • Can closely resemble MSU and CCPD
  • Flat, variable shaped plates
  • Associated with intra-articular injections, NO clinical significance
A

Corticosteroid

27
Q

Following renal dialysis

A

• Calcium Oxalate

28
Q

can be misidentified as crystals

A

Birefringent Artifacts

29
Q
  • Anticoagulant crystals (calcium oxalate, lithium heparin)
  • Starch granules
  • Prosthesis fragments
  • Collagen fibers
  • Fibrin
  • Dust particles
A

Birefringent Artifacts

30
Q

Done simultaneously with blood sample (prefer 8 hour fast)

31
Q

Draw in sodium fluoride – prevents ______

A

Glycolysis

32
Q

Not routinely performed in chemistry test in synovial fluid

A

Total protein

33
Q

§ Changes in membrane permeability
§ Increased joint synthesis
Caused of?

A
  • Increased protein
34
Q

Alone, not diagnostic

May determine gout in conjunction with plasma uric acid, esp. when crystals are undetectable

35
Q

If the lactate of synovial fluid is >250 mg/dL what condition?

A

Septic arthritis

36
Q

If the lactate of synovial fluid is normal to low levels

A

Gonococcal arthritis

37
Q

May differentiate between inflammatory and septic arthritis

38
Q

Performed on all specimens

A

Gram stain

39
Q

Most septic joint disorders are____________

A

microbial/bacterial in nature

40
Q

Autoantibody detection (same as found in serum

A

Serologic test

41
Q

Organism that
Causative agent of Lyme disease
Cause of arthritis

A

Borrelia burgdorferi

42
Q

Cloudy, yellow-green fluid Poor viscosity WBCs 10,000-200,000 µL Neutrophils > 90% Decreased glucose level Positive culture and Gram stain

A

Septic

Microbial infection

43
Q

Cloudy, red fluid
Poor viscosity
WBCs < 5000 µL
Neutrophils > 50%
Normal glucose level RBCs present

A

Hemorrhagic
Traumatic injury Coagulation deficiencies

44
Q

Cloudy or milky fluid
Poor viscosity
WBCs up to 50, 000 µL
Neutrophils < 90%
Decreased glucose level
Elevated uric acid level Crystals present

A

Crystal-induced gout and pseudogout

45
Q

Cloudy, yellow fluid
Poor viscosity
WBCs 2000-5000 µL
Neutrophils > 50%
Decreased glucose level Possible autoantibodies present

A

Immunologic problems, including rheumatoid arthritis and lupus erythematosus

46
Q

Clear, yellow fluid Good viscosity WBCs < 2000 µL Neutrophils < 30% Normal glucose (similar to blood glucose)

A

Degenerative joint disorders
Non inflammatory

CLINICAL MICROSCOPY (7 decks)

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