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AUBF > SYNOVIAL FLUID > Flashcards

SYNOVIAL FLUID Flashcards

1
Q

Synovial fluid is also known as?

A

Joint fluid

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2
Q

It is a viscous liquid found in the cavities of the movable joints (diarthroses) or synovial joints

A

Synovial fluid

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3
Q

Functions of synovial fluid:

A
  1. Lubricate joints
  2. Reduce friction between bones
  3. Provides nutrients to the articular cartilage
  4. Lessen shock of joint compression occurring during activities such as walking and jogging
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4
Q

Masakit sa arthritis =

A

Watery synovial fluid

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5
Q

It is the polymerization of hyaluronic acid

A

viscosity

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6
Q

Decrease of synovial fluid viscosity =

A

arthritis

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7
Q

Method of collection for synovial fluid

A

arthrocentesis

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8
Q

Normal synovial fluid does not ________

A

Clot (diseased joint may clot)

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9
Q

Synovial fluid

Normal volume in adult knee cavity =
Inflammation =

A

<3.5 mL
>25 mL

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10
Q

SF:

Colorless - pale yellow (clear) =

A

normal

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11
Q

SF:

Deeper yellow =

A

inflammation

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12
Q

SF:

Greenish tinge

A

Bacterial infection

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13
Q

SF:

Red =

A

Traumatic tap, hemorrhagic arthritis

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14
Q

SF:

Turbid =

A

WBCs, synovial cell debris, fibrin

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15
Q

SF:

Milky =

A

Presence of crystals

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16
Q

SF:

Plain red top tube (no anticoagulant) =

A

Chemical and immunologic evaluation

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17
Q

SF microscopic examination:

Sodium Heparin/ liquid EDTA =

A

Hematology or cell count

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18
Q

SF microscopic examination:

Do not use ________ and _________
Do not _______ samples

A

Powdered anticoagulants
Lithium heparin
refrigerate

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19
Q

SF:

Sterile anticoagulant tube ( heparin or SPS) =

A

Microbiological studies (GS and culture)

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20
Q

Synovial fluid viscosity normal value =

A

Forms a string that is 4-6 cm long

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21
Q

Test for SF viscosity

A

Ropes or Mucin Clot test (Hyaluronate Polymerization test)

22
Q

Ropes or Mucin clot test:

Reagent =
Positive reaction (hyaluronic acid + acetic acid) =

A

2-5% acetic acid
Mucin clot

23
Q

Grading for SF viscosity:

Good =
Fair =
Low =
Poor =

A

Solid or compact clot, clear solution
Soft clot
Priable clot, cloudy solution
No clot

24
Q

Most frequently performed count in synovial fluid

A

WBC count

25
Q

SF WBC count diluting fluids:

A

NSS with methylene blue
Hypotonic saline (0.3%)
Saline with saponin

26
Q

Differential count of cells in SF:

Rbcs =
WBCs =
WBC differential =

A

<2,000/uL
< Or = 200/uL

65% = monocytes and macrophages
25% = neutrophils
15% = lymphocytes

27
Q

For every viscous liquid in SF:

  • add a pinch of hyaluronidase to ____________ or add 1 drop of _______________ in phosphate buffer per mL of fluid
  • incubate at ________________ for ___________
A

0.5 mL
0.05% hyaluronidase
37° C
5 min.

28
Q

Cells and inclusions seen in SF:

Polymorphonuclear leukocytes = bacterial sepsis, crystal- induced inflammation

A

Neutrophils (3 lobes)

29
Q

Mononuclear leukocyte = nonseptic inflammation

A

lymphocyte

30
Q

Large mononuclear monocyte, may be vacuolated = normal, viral infections

A

macrophages

31
Q

Neutrophils ingested “round body” = lupus erythematosus

A

LE cell

32
Q

Vacuolated macrophage with ingested neutrophils = reactive arthritis

A

Reiter cells

33
Q

Neutrophils with dark cytoplasmic granules containing precipitated rheumatoid factor = rheumatoid arthritis, immunologic inflammation

A

RA cell

34
Q

Morphologically resembles polished rice = tuberculosis, septic, and rheumatoid arthritis

A

Rice bodies

35
Q

Debris from metal and plastic joint prosthesis “ground pepper appearance” = ochronotic arthropathy, alkaptonuria, ochronosis

A

Ochronotic shards

36
Q

Large, multinucleated cells = osteoarthritis

A

Cartilage cells

37
Q

Similar w/ macrophage, but may be multinucleated, resembling a mesothelial cell = normal, disruption from arthrocentesis

A

Synovial lining cell

38
Q

Refractive intracellular and extracellular globules = traumatic injury, chronic inflammation

A

Fat droplets

39
Q

Inclusions w/in clusters of synovial cells = pigmented villonodular synovitis

A

hemosiderin

40
Q

Normal synovial fluid should _________ contain any crystal

A

not

41
Q

Cause of crystal formation in SF:

A
  1. Metabolic disorders
  2. Decreased renal excretion that produces increased blood levels of crystallizing chemicals
  3. Degeneration of cartilage and bones
  4. Injection of medications (corticosteroid)
42
Q

Most common
Needles
- birefringe
gout

A

Monosodium urate

43
Q

Rhombic square, rods
Most common
+ Birefringe
Pseudogout

A

Calcium pyrophosphate

44
Q

Notched, rhombic plates
- birefringe
extracellular

A

Cholesterol

45
Q

Flat, variable-shaped plates
+ And - birefringes
Injections

A

Corticosteroid

46
Q

Envelopes
- birefringe
Renal dialysis

A

Calcium oxalate

47
Q

Small particles, requires electron microscopy
- birefringe
Osteoarthritis

A

apatite

48
Q

Detects the presence or absence of birefringes

A

Polarizing microscope

49
Q

Confirm the type of birefringence (+ or -)
Red compensator is placed between crystal and analyzer

A

Compensated polarizing microscope

50
Q
  • birefringes
    Yellow color
    Parallel to long axis
A

Monosodium urate

51
Q

+ birefringes
Blue color
Perpendicular to long axis

A

Calcium pyrophosphate dihydrate (CPPD)

AUBF (5 decks)

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