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Aaaa > Synovial Fluid (Part III) > Flashcards

Synovial Fluid (Part III) Flashcards

1
Q

Appear as needle-shaped rods 5 to 20 um long

A

Monosodium urate (MSU)

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2
Q

may be only 1 to 2 um in length or, rarely, may appear as rounded spherolites

A

Monosodium urate (MSU)

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3
Q

Strongly birefringent

A

Monosodium urate (MSU)

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4
Q

Color of MSU when oriented parallel to compensator

A

Yellow

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5
Q

Color of MSU with perpendicular orientation

A

Blue

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6
Q

A steroid that appears as strongly negative birefringent rod, can be used to prepare a reference slide for the polarizing microscope

A

Betamethasone

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7
Q

Crystals found in a group conditions collectively known as CPPD crystal deposition disease or pseudogout

A

Calcium pyrophosphate dihydrate (CPPD)

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8
Q

Crystals that appear rhomboids, rods, or rectangles 1 to 20 um in length.

A

Calcium pyrophosphate dihydrate (CPPD)

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9
Q

Weakly birefringent with positive elongation

A

Calcium pyrophosphate dihydrate (CPPD)

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10
Q

Color od CPPD when aligned with the compensator axis

A

Blue

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11
Q

Many are too small to polarize the light, making them difficult to detect without phase-contrast microscopy

A

Calcium pyrophosphate dihydrate (CPPD)

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12
Q

CPPD crystals are associated with degenerative arthritis and are seen in arthritides associaed with

A

Hypomagnesemia
Hemochromatosis
Hyperparathyroidism
Hypothyroidism

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13
Q

Typically too small and nonbirefringent (isotropic) to see with light microscopy unless they are clumped into 1- to 50- um spherical microaggregates

A

Calcium hydroxyapatite and other BCP crystals

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14
Q

May be used to stain calcium hydroxyapatite and other BCP crystals, and other calcium-containing crystals

A

Alizarin red S dye

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15
Q

Bipyramidal octahedral “envelopes” with variable birefringence and positive elongation

A

Calcium oxalate dihydrate

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16
Q

Seen in arthropathy associated with chronic renal dialysis and primary oxalosis, a rare inborn error of metabolism

A

Calcium oxalate dihydrate

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17
Q

The monohydrate form of this is birefringent but nondescript in shape

A

Calcium oxalate dihydrate

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18
Q

1 to 20 um spheres with a Maltese cross appearance and positive birefringent under compensated polarized light, they have been implicated as a cause of acute arthritis

A

Lipid crystals or particels

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19
Q

It is from intraarticular injection that may have an appearance similar to MSU or CPPD crystals and persist up to 1 month following injection

A

Crystalline corticosteroids

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20
Q

They have blunt, jagged edges without clear crystal structure because they are prepared by grinding up larger crystalline forms

A

Crystalline corticosteroids

21
Q

A crystalline corticosteroids that is negatively birefringent

A

Triamcinolone hexacetonide

22
Q

Appear as irregular birefringent pates, often with notched corners

A

Cholesterol crystals

23
Q

in chronic effusions needle or rhomboid-shaped crystals similar to MSU or CPPD

A

Cholesterol crystals

24
Q

Introduced during joint surgery appears as round, strongly birefringent particles 5 to 30 um in diameter, with a central notch and a Maltese cross appearance when polarized

A

Glove powder (modified cornstarch)

25
Q

Serum-synovial differential is

A

> 10 mg/dL

26
Q

In septic arthritis, the serum-synovial differential ranges from

A

20 to 60 mg/dL

27
Q

Cutoff value of serum-synovial difference

A

75 mg/dL

28
Q

When the cutoff value of 75 mg/dL is used, the sensitivity of low glucose for detecting an inflammatory joint disease is only ____ and the specificity is _____

A

sensitivity: 20%
specificity: 84%

29
Q

Reference intervals for Synovial Fluid and Plasma:

Total protein

A

SF: 1-3 g/dL
Plasma: 6-8 g/dL

30
Q

Reference intervals for Synovial Fluid and Plasma:

Albumin

A

SF: 55%-70%
Plasma: 50%-65%

31
Q

Reference intervals for Synovial Fluid and Plasma:

a1-Globulin

A

SF: 6%-8%
Plasma: 3%-5%

32
Q

Reference intervals for Synovial Fluid and Plasma:

a2-Globulin

A

SF: 5%-7%
Plasma: 7%-13%

33
Q

Reference intervals for Synovial Fluid and Plasma:

B-Globulin

A

SF: 8%-10%
Plasma: 8%-14%

34
Q

Reference intervals for Synovial Fluid and Plasma:

y-Globulin

A

SF: 10-14%
Plasma: 12%-22%

35
Q

Reference intervals for Synovial Fluid and Plasma:

Hyaluronic acid

A

SF: 0.3-0.4 mg/dL

36
Q

Reference intervals for Synovial Fluid and Plasma:

Glucose

A

SF: 70-110 mg/dL
Plasma: 70-110 mg/dL

37
Q

Reference intervals for Synovial Fluid and Plasma:

Uric acid

A

SF: 2-8 mg/dL
Plasma: 2-8 mg/dL

38
Q

Reference intervals for Synovial Fluid and Plasma:

Lactate

A

SF: 9-29 mg/dL
Plasma: 9-29 mg/dL

39
Q

Numerous enzymes that has been studies in SF

A

lactate dehydrogenase
aspartate aminotransferase
adenosine deaminase
acid and alkaline phosphate
lysozyme

40
Q

Lactate dehydrogenase is elevated in

A

RA
gout
failed arthroplasties
infectious arthritis

41
Q

When compared with nonseptic monoarticular arthritis, SF _____ levels are usually increased in patients with septic arthritis

A

Lactic acid

42
Q

Measurement of this in SF appears to be a useful method for rapid diagnosis of bacterial synovitis

A

D-lactate levels

43
Q

Increased SF uric acid levels support a diagnosis of

A

gout

44
Q

Synovial fluid lipid abnormalities include

A

(1) rare cholesterol-rich pseudochylous effusions typically associated with chronic RA
(2) lipid droplets, usually the result of trauma
(3) extreme rare chylous effusions seen in association with RA, SLE, filariasis, pancreatitis, and trauma

45
Q

3 Immunologic studies

A

Rheumatoid factor (RF)
Antinuclear antibodies (ANAs)
Complement

46
Q

Immunologic study where found in the SF of about 60% of RA patients, usually a titer equal to or slightly lower than the serum titer

A

Rheumatoid factor (RF)

47
Q

Immunologic study found in the SF of about 70% of patients with SLE and 20% of patients with RA

A

Antinuclear antibodies (ANAs)

48
Q

Immunologic study normally about 10% of serum levels, increase to 40% to 70% of serum activity with inflammation, proportional to the increase in protein exudation

A

Complement

49
Q

Complement consumption in SLE, and RA in particular, results in levels _____ of serum complement

A

<30%

Aaaa (21 decks)

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