SYNOVIAL, SEROUS, GASTRIC FLUID Flashcards
1
Q
AKA joint fluid
A
Synovial fluid
2
Q
Viscosity is due to polymerization of
A
Hyaluronic acid
3
Q
Produced by Type 3 synoviocytes
A
Hyaluronic acid
4
Q
Type A synoviocytes promotes
A
Phagocytosis
5
Q
Method of collection for synovial fluid
A
Arthrocentesis
6
Q
Normal volume of synovial fluid
A
<3.5 mL.
7
Q
Volume of synovial fluid in inflammation
A
> 25 mL
8
Q
Tube for chemical and immunologic evaluation
A
Plain red top tube ( no anticoagulant)
9
Q
Tube for chemical and immunologic evaluation
A
Plain red top tube ( no anticoagulant)
10
Q
Anticoagulant for glucose analysis
A
Sodium fluoride
11
Q
Powdered anticoagulants and lithium heparin may interfere with ____
A
Crystal identification
12
Q
Tube for synovial fluid to be used for microscopic exam
A
Sodium heparin or liquid EDTA
13
Q
Liquid EDTA for synovial fluid exam is used in what section
A
Hematology/ cell count
14
Q
Normal color and clarity of synovial fluid
A
Colorless-pale yellow and clear
15
Q
color and clarity of synovial fluid when there is an inflammation
A
Deeper yellow
16
Q
color and clarity of synovial fluid in bacterial infection
A
Greenish tinge
17
Q
color and clarity of synovial fluid in the presence of WBCs, synovial cell debris or fibrin
A
Turbid
18
Q
color and clarity of synovial fluid with presence of crystals
A
Milky
19
Q
Synovial fluid normal viscosity:
A
Highly viscous
20
Q
Synovial fluid fluid forms string that is ______ cm long
A
4-6 cm
21
Q
Normal Hyaluronic acid level
A
0.3 to 0.4 g/dL
22
Q
Ropes of mucin clot test (Hyaluronic polymerization test) REAGENT
A
2-5% Acetic acid
23
Q
GRADING: solid or compact clot; clear solution
A
Good
24
Q
WBC count of synovial fluid: DILUTING FLUIDS
A
SALINE WITH SAPONIN
HYPOTONIC SALINE (0.3%)
NSS with METHYLENE BLUE
25
For every viscous fluid, add 1 drop of ___________ in phosphate buffer per mL of fluid
0.05% hyaluronidase
26
SYNOVIAL FLUID Differential count : RBC normal value
<2000/uL or ABSENT
27
SYNOVIAL FLUID Differential count : WBCs normal value
<200/uL
28
Neutrophil containing ingested “round body” seen in lupus erythymatosus
LE cell
29
Vacuolated macrophage with ingested neutrophil seen in REACTIVE ARTHRITIS
Reiter cell (neutrophage)
30
Neutrophil with dark cytoplasmic granules containing precipitated rheumatoid factor
RA cell (ragocyte)
31
Macroscopically resemble polished rice , it shows collagen and fibrin
Rice bodies
32
Debris from metal and plastic joint prosthetics
Ground pepper appearance
Orchonotic shards
33
Similar to macrophage but may be multinucleated resembling a mesothelial cell
Synovial cell lining
34
Refractile intracellular and extracellular globules stain with Sudan dyes
Fat droplets
35
Inclusions within clusters of synovial cells ; pigmented villonodular synovitis
Hemosiderin
36
CRYSTAL SHAPE: NEEDLES
MONOSODIUM URATES
37
CRYSTAL SHAPE: Rhombic, rods
Calcium pyrophosphate
38
CRYSTAL SHAPE: notched, rhombic plates
Cholesterol
39
CRYSTAL SHAPE: flat, variable-shaped plates
Corticosteroid
40
CRYSTAL SHAPE: envelopes
Calcium oxalate
41
CRYSTAL SHAPE: small particles ; requires electron microscopy
Apatite (calcium phosphate)
42
Synovial crystal with NO BIREFRINGENCE
APATITE (calcium phosphate)
43
Synovial crystal (+) BIREFRINGENCE
CALCIUM PYROPHOSPHATE
COSRTICOSTEROID
44
Detects the presence or absence of birefringence
Polarizing microscope
45
Confirms the type of birefringence (positive or negative BR)
COMPENSATED POLARIZING MICROSCOPE
46
Color of positive birefringence
Blue
47
Color of negative birefringence
Yellow
48
What color of compensator is placed between crystal and analyzer
Red
49
A control slide for MSU polarization can be prepared using __________
Betamethasone acetate corticosteroids
50
The molecules in the MSU crystals run _______ to the long axis of the crystal
Parallel
51
The molecules in the CPPD crystals run ________ to the long axis of the crystal
Perpendicular
52
When the crystals are aligned perpendicular to the slow vibration, the color is _______
Reversed
53
Most frequently tested chemistry test for synovial fluid ; done in conjunction with blood glucose
Glucose
54
Formula for total glucose
Blood glucose - synovial fluid fluid glucose
55
Formula for total glucose
Blood glucose - synovial fluid fluid glucose
56
Normal value of SF protein
<3 g/dL
57
Common bacteria infecting the synovial fluid
S. Aureus
Streptococcus
Haemophilus
N. Gonorrheae
58
Non inflammatory group of joint disorders
Group 1
59
Color and clarity of group 1 joint disorder
Clear, yellow
60
Viscosity of type 1 joint disorder
Good
61
WBC count of type 1 joint disorder
<1,000/uL
62
Inflammatory (immunologic) group of joint disorder
Group IIa
63
Positive for autoantibodies
Group IIa (immunologic)
64
Inflammatory (crystal-induced) group of joint disorder
Group IIb
65
Color and clarity of group IIb joint disorder
Cloudy or milky
66
Joint group positive for crystals
Group IIb
67
Septic group of joint disorders
Group III
68
Color and clarity of group III joint disorder
Cloudy, yellow-green
69
Neutrophil count in septic group joint disorder (group III)
>75%
70
Group of joint disorder positive for culture and gram stain
Group III septic
71
Hemorrhagic group of joint disorder
Group IV
72
Accumulation of fluid between the membranes
Effusion
73
Disruption of fluid production and regulation between membrane
Transudate
74
Changes in hydrostatic and oncotic pressure
Transudate
75
Congestive heart failure, hypoproteinemia, nephrotic syndrome are examples of what type of effusion
Transudate
76
Direct damage to the membrane of a particular cavity
Exudate
77
Infection, inflammation, malignancy are examples of what type of effusion
Exudate
78
Seromucin clot test for exudate
Rivalta’s test
79
Recommended to detect the Transudate of hepatitis origin
Serum-ascites albumin gradient (SAAG)
80
SAAG of 1.1 or greater
Transudate
81
SAAG of <1.1
Exudate
82
Color of pleural fluid with aspergillus infeciton
Black
83
T or E: Fluid total protein of 3.0 g/dL or less
Transudate
84
T or E: >3.0 g/dL
Exudate
85
Most reliable method for differentiating Transudate and exudate
Fluid:serum protein ratio
Fluid:serum LD ratio
86
T or E: >45-60 mg/dL
Pleural fluid cholesterol
87
Triglyceride value of a chylous effusion
>110 mg/dL
88
Triglyceride value of a pseudochylous effusion
<50 mg/dL
89
SUDAN III STAINING: +++
CHYLOUS EFFUSION
90
SUDAN III STAINING: (-) / weakly (+)
Pseudochylous effusion
91
Cell that is decreased in TB
Mesothelial cell
92
Pericardial Fluid: Adenosine deaminase significance
Tubercular effusion
93
Tumor marker for lung cancer, breast cancer
CYFRA 21-1
94
SPECIMEN : >100,000 RBCs / uL indicates blunt trauma injury (intra-abdominal bleeding)
PERITONEAL LAVAGE
95
Test performed when there is Decreased tubercular peritonitis
Glucose
96
Pleural Fluid: Adenosine deaminase positive
Tuberculosis, malignancy
97
Non beta islet cell adenoma of the pancreas
Zollinger-Elisson Syndrome (ZES)
98
Anti-parietal cells antibody
Pernicious anemia
99
Anti intrinsic factor antibody
Pernicious anemia
100
Hormone that stimulates protein production by parietal cells
Gastrin
101
Absence of hydrochloric acid
Achlorhydria
102
Produced by chief cells
Parietal cells
103
Produce HCl and intrinsic factor
Parietal cells
104
Produce gastrin
Specialized G cells
105
Produce mucus that protects the stomach wall from acid
Foveolar cells
106
Method of collection of gastric fluid
Gastric aspiration
107
Gastric tube that passed through the nose
Levin
108
Gastric tube that is passed through the mouth
Refuses
109
Other gastric tubes that are passed through the mouth
Lavacuator tube, Edwald’s tube, Edlich tube,
110
Total gastric secretion during unstimulated fasting state
Basal acid output
111
Duration of collection that Consists of four 15-minute specimen but single 1-hour can be used
1hour collection
112
Duration of collection consists of _______ specimen but single 1-hour can be used
four 15-minute
113
Duration of collection for insulin hypoglycemia test
2 hour collection
114
Total gastric secretion after gastric stimulation
Maximum acid output
115
Duration of collection for MAO when pentagastrin and histamine are used
1 hour (at 15-minute intervals)
116
Duration of MAO collection for insulin hypoglycemia test and when histology is used
2 hour collection
117
TEST MEAL : bread, weak tea or water
Edwald’s
118
TEST MEAL: oatmeal
Boa’s
119
Test meal: beef steak and mashed potatoes
Riegel’s
120
Most preferred chemical stimulant
Pentagastrin
121
Chemical stimulant to assess vagotomy procedure
Insulin
122
Gastric Chemical stimulants
Pentagastrin
Insulin
Histamine
Histology (betazole)
123
Normal color of gastric fluid
Pale gray slightly mucoid
124
Normal (fasting specimen) volume of gastric fluid
20-50 mL
125
Failure to produce a pH <6.0 following gastric stimulation
Anacidity
126
Clinical significance anacidity
Pernicious anemi
127
Developed by Squibb
Diagnose Tubeless Test (Diagnex Blue Test)
128
Specimen for diagnex tubeless test
Urine
129
A ______ is complexed with an ion exchange resin
Blue colored dye azure-A
130
Peritoneal Fluid: ADA and acid fast stain positive
Tubercular peritonitis
