Synovial Fluid/Serous Fluid

Question 1

ULTRAFILTRATE of plasma in synovial membrane

Answer 1

Synovial Fluid

Question 2

Substance secreted by synoviocytes to lubricate joints and increased viscosity

Answer 2

Hyaluronic Acid

Question 3

Method of Collection:

Volume of Collection:

Answer 3

Arthrocentesis

25 mL

Question 4

Collection Tubes & Handling
Tube > Section/Test > Anticoagulant

Tube 1: _____________, ___________
Tube 2: _____________, ___________
Tube 3: _____________, ___________
Tube 4: _____________, ___________

Answer 4

Collection Tubes & Handling
Tube > Section/Test > Anticoagulant

Tube 1: Microbio(GS/C) - Heparinized Tube
Tube 2: Cell Count - EDTA/Heparinized Tube
Tube 3: Chem/Sero/Other Test - Plain Tube
Tube 4: Glucose - Na Flouride

Question 5

____________ should not be used as they cause interference in crystal ID

Answer 5

Powdered Anticoagulant

Question 6

Color and Clarity

Normal:
Inflammation:
Bacterial infection:
Traumatic tap:
hemorrhagic arthritis
WBCs, fibrin:
Presence of crystals:

Answer 6

Color and Clarity

Normal: Colorless - Pale Yellow
Inflammation: Deep Yellow
Bacterial infection: Greenish tinge
Traumatic tap: Red
Hemorrhagic arthritis: Red
WBCs, fibrin: Turbid
Presence of crystals: Milky

Question 7

Color - Pale Yellow

Answer 7

Normal

Question 8

Color - Deep Yellow

Answer 8

Inflammation

Question 9

Color - Presence of crystals

Answer 9

Milky

Question 10

Color - Bacterial infection

Answer 10

Greenish Tinge

Question 11

Normal Values of Synovial Fluid

Volume 
Color
Clarity
Viscosity via String test
WBC Count (Neutrophils)
Crystals
Glucose (vs plasma)
Total Protein

Answer 11

Normal Values of Synovial Fluid

Volume: <3.5 ml
Color: Colorless - Pale Yellow
Clarity: Clear
Viscosity via String test: 4-6
WBC Count (Neutrophils): < 25%
Crystals: Neg (-)
Glucose (vs plasma): <10 mg/dL
Total Protein: < 3g/dL

Question 12

6 strings is considered ___________

Answer 12

Normal

Question 13

WBC Count of PMNs

Answer 13

<25%

Question 14

Normal fluid ______________

Answer 14

DO NOT CLOT

Question 15

Volume of >25 mL indicates for __________

Answer 15

INFLAMMATION

Question 16

Best Anticoagulant

Answer 16

Na Heparin

Liquid EDTA

Question 17

Used to Confirm if spx is Synovial Fluid

Answer 17

Ropes/Mucin Clot Test/Hyaluronate Polymerization Test

Question 18

Mucin Clot Test

aka - _______________
Rgt - _______________
(+) - _______________

Answer 18

Mucin Clot Test

aka - Hyaluronate Polymerization Test
Rgt - 2-5% Acetic Acid
(+) - Solid Clot

Question 19

Crystals are _______ in NORMAL fluid

Answer 19

ABSENT

Question 20

Cells in Rheumatoid Arthritis

Answer 20

RA Cells/Ragocyte

Question 21

Neutrophil with dark cytoplasmic granules containing

IMMUNE COMPLEXES - RHEUMATOID FACTOR

Answer 21

RA Cells/Ragocyte

Question 22

Neutrophil containing characteristic ingested ROUND BODY

Answer 22

LE Cells

Question 23

Macroscopically resemble POLISHED RICE

Answer 23

Rice bodies

Question 24

VACUOLATED macrophages with INGESTED NEUTROPHILS

Answer 24

Reiter cell

Question 25

Crystal associated to GOUT

Answer 25

Monosodium Urate

Question 26

Crystal associated to PSEDOGOUT

Answer 26

Calcium Pyrophosphate

Question 27

Associated in ASTEOARTHRITIS

Answer 27

Calcium Phosphate

Question 28

Birefringent Crystal

Answer 28

Calcium Pyrophosphate

Question 29

Monosodium Urate

Shape: ____________
Significance: ________
Birefringence: _____

Answer 29

Monosodium Urate

Shape: Needle-like
Significance: GOUT
Birefringence: Neg

Question 30

Calcium Pyrophosphate

Shape: ____________
Significance: ________
Birefringence: _____

Answer 30

Calcium Pyrophosphate

Shape: Rhombic square rods
Significance: PSEUDOGOUT
Birefringence: Pos (+)

Question 31

Calcium Phosphate

Shape: ____________
Significance: ________
Birefringence: _____

Answer 31

Calcium Phosphate

Shape: Small particle flat rectangular plates
Significance: OSTEOARTHRITIS
Birefringence: Neg

Question 32

Detects the presence or absence of birefringence

Answer 32

Polarizing Microscope

Question 33

Confirms type of birefringence if Positive or Negative

Answer 33

Compensated Polarizing Microscope

Question 34

Compensated Polarizing Microscope

Positive:
Negative:

Answer 34

Compensated Polarizing Microscope

Positive: Blue
Negative: Yellow

Question 35

Joint Disorders

Type 1;
Type 2a:
Type 2b:
Type 3:
Type 4:

Answer 35

Joint Disorders

Type 1; Non-inflammatory
Type 2a: Inflammatory - IMMUNOLOGIC
Type 2b: Inflammatory - CRYSTAL INDUCED
Type 3: Septic 
Type 4: Hemorrhagic

Question 36

Joint Disorder with the HIGHEST WBC COUNT (50, 000 - 100, 000)

Answer 36

Type 3 - Hemorrhagic

Question 37

Type 2a - Inflammatory - IMMUNOLOGIC

Color/Clarity:
Viscosity:
WBC count:
Glucose:
PMNS:
Others:

Answer 37

Type 2a - Inflammatory - IMMUNOLOGIC

Color/Clarity: Cloudy, Yellow Fluid
Viscosity: POOR
WBC count: 2,000 - 75,000/uL
Glucose: Decreased
PMNS: >50%
Others: (+) Autoantibodies

Question 38

Type 2b - Inflammatory -CRYSTAL INDUCED

Color/Clarity:
Viscosity:
WBC count:
Glucose:
PMNS:
Others:

Answer 38

Type 2b - Inflammatory -CRYSTAL INDUCED

Color/Clarity: Cloudy, MILKY
Viscosity: Low Viscosity
WBC count: up to 100,000/uL
Glucose: Decreased
PMNS: >70%
Others: (+) Crystal - Monosodium Urate/Calcium Pyrophosphate

Question 39

Type 2b - SEPTIC

Color/Clarity: 
Viscosity:
WBC count:
Glucose:
PMNS:
Others:

Answer 39

Type 2b - SEPTIC

Color/Clarity: Cloudy, YELLO GREEN
Viscosity: Variable
WBC count: HIGHEST
Glucose: Decreased
PMNS: >75%
Others: (+) C/S, G/S