Synovial Fluid Textbook Questions

Question 1

Which of the following tasks is a function of synovial fluid?
1. Providing lubrication for a joint
2. Assisting in the structural support of a joint
3. Transporting nutrients to articular cartilage
4. Synthesizing hyaluronate and degradative
enzymes
A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct.

Answer 1

B. 1 and 3 are correct.

Question 2

Which of the following statements is a characteristic of normal synovial fluid?
A. Synovial fluid is viscous.
B. Synovial fluid is slightly turbid.
C. Synovial fluid is dark yellow.
D. Synovial fluid forms small clots on standing.

Answer 2

A. Synovial fluid is viscous.

Question 3

Which of the following components is not normally
present in synovial fluid? 
A. Fibrinogen
B. Neutrophils
C. Protein
D. Uric acid

Answer 3

A. Fibrinogen

Question 4

Which of the following substances will not increase
the turbidity of synovial fluid? 
A. Fat
B. Crystals
C. Hyaluronate
D. WBCs

Answer 4

C. Hyaluronate

Question 5

Abnormally decreased viscosity in synovial fluid results from
A. mucin degradation by leukocytic lysosomes.
B. overproduction of synovial fluid by synoviocytes.
C. autoimmune response of synoviocytes in joint
disease.
D. depolymerization of hyaluronate by neutrophilic enzymes.

Answer 5

D. depolymerization of hyaluronate by neutrophilic enzymes.

Question 6

A synovial fluid specimen is received in the labora-
tory 2 hours after collection. Which of the following changes to the fluid will most likely have taken place?
A. The specimen will have clotted.
B. The uric acid concentration will have decreased.
C. Crystals may have precipitated or dissolved.
D. The lactate concentration will have decreased because of anaerobic glycolysis.

Answer 6

C. Crystals may have precipitated or dissolved.

Question 7

Which of the following anticoagulants does not have the potential to precipitate out in crystalline form when used for synovial fluid specimens?
A. Sodium citrate
B. Sodium heparin 
C. Lithium heparin 
D. Potassium oxalate

Answer 7

B. Sodium heparin

Question 8

A synovial fluid specimen has a high cell count and requires dilution to be counted. Which of the following diluents should be used?
A. Normal saline
B. Dilute acetic acid (2%)
C. Dilute methanol (1%)
D. Phosphate buffer solution (0.050 mol/L)

Answer 8

A. Normal saline

Question 9

Which of the following results from synovial fluid analysis indicates a joint disease process?
A. A few synoviocytes present in the fluid
B. A WBC count lower than 200 cells/mL
C. An RBC count lower than 2000 cells/mL
D. A differential count showing greater than 25% neutrophils

Answer 9

D. A differential count showing greater than 25% neutrophils

Question 10

Differentiation of synovial fluid crystals, based on
their birefringence, is achieved using
A. transmission electron microscopy.
B. phase-contrast microscopy.
C. direct polarizing microscopy.
D. compensated polarizing microscopy.

Answer 10

D. compensated polarizing microscopy.

Question 11

The microscopic examination of synovial fluid for
crystals can be difficult because
1. numerous artifacts are also birefringent.
2. few crystals may be present.
3. free-floating crystals can become enmeshed
or hidden in fibrin.
4. different crystals can closely resemble each
other morphologically.
A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct.

Answer 11

D. All are correct.

Question 12

Which of the following crystals characteristically occurs in patients with gout?
A. Cholesterol crystals
B. Hydroxyapatite crystals
C. Monosodium urate crystals
D. Calcium pyrophosphate dihydrate crystals

Answer 12

C. Monosodium urate crystals

Question 13

In synovial fluid, which of the following crystals is
not birefringent?
A. Cholesterol crystals
B. Hydroxyapatite crystals
C. Monosodium urate crystals
D. Calcium pyrophosphate dihydrate crystals

Answer 13

B. Hydroxyapatite crystals

Question 14

Assuming that a patient is fasting, which of the following analytes is normally present in the synovial fluid in essentially the same concentration as in the blood plasma?

1. Glucose
2. Lactate
3. Uric acid
4. Protein

A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct.

Answer 14

B. 1 and 3 are correct.

Question 15

Which of the following findings provides a definitive diagnosis of a specific joint condition?
A. Staphylococcal bacteria identified by Gram stain B. Corticosteroid crystals identified during the microscopic examination
C. A plasma–synovial fluid glucose difference
exceeding 20 mg/dL
D. Greater than 25 WBCs/μL observed during the
microscopic examination

Answer 15

A. Staphylococcal bacteria identified by Gram stain B. Corticosteroid crystals identified during the microscopic examination

Question 16

Analysis of a synovial fluid specimen reveals the
following:
• Cloudy, yellow-green fluid of low viscosity
• Total leukocyte count of 98,000 cells/μL
• Plasma–synovial fluid glucose difference of
47 mg/dL

Based on the information provided and Table
14-2, this specimen most likely would be classified as
A. noninflammatory.
B. inflammatory.
C. septic.
D. hemorrhagic.

Answer 16

C. septic.

Question 17

An analysis of a synovial fluid specimen reveals the
following:
• Yellow fluid of high viscosity
• Total leukocyte count of 300 cells/μL
• Plasma–synovial fluid glucose difference of
17 mg/dL

Based on the information provided and Table
14-2, this specimen would most likely be classified as
A. noninflammatory.
B. inflammatory.
C. septic.
D. hemorrhagic.

Answer 17

A. noninflammatory.