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CLINICAL MICROSCOPY > SYNOVIAL, SEROUS, GASTRIC FLUID > Flashcards

SYNOVIAL, SEROUS, GASTRIC FLUID Flashcards

1
Q

AKA joint fluid

A

Synovial fluid

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2
Q

Viscosity is due to polymerization of

A

Hyaluronic acid

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3
Q

Produced by Type 3 synoviocytes

A

Hyaluronic acid

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4
Q

Type A synoviocytes promotes

A

Phagocytosis

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5
Q

Method of collection for synovial fluid

A

Arthrocentesis

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6
Q

Normal volume of synovial fluid

A

<3.5 mL.

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7
Q

Volume of synovial fluid in inflammation

A

> 25 mL

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8
Q

Tube for chemical and immunologic evaluation

A

Plain red top tube ( no anticoagulant)

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9
Q

Tube for chemical and immunologic evaluation

A

Plain red top tube ( no anticoagulant)

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10
Q

Anticoagulant for glucose analysis

A

Sodium fluoride

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11
Q

Powdered anticoagulants and lithium heparin may interfere with ____

A

Crystal identification

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12
Q

Tube for synovial fluid to be used for microscopic exam

A

Sodium heparin or liquid EDTA

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13
Q

Liquid EDTA for synovial fluid exam is used in what section

A

Hematology/ cell count

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14
Q

Normal color and clarity of synovial fluid

A

Colorless-pale yellow and clear

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15
Q

color and clarity of synovial fluid when there is an inflammation

A

Deeper yellow

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16
Q

color and clarity of synovial fluid in bacterial infection

A

Greenish tinge

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17
Q

color and clarity of synovial fluid in the presence of WBCs, synovial cell debris or fibrin

A

Turbid

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18
Q

color and clarity of synovial fluid with presence of crystals

A

Milky

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19
Q

Synovial fluid normal viscosity:

A

Highly viscous

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20
Q

Synovial fluid fluid forms string that is ______ cm long

A

4-6 cm

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21
Q

Normal Hyaluronic acid level

A

0.3 to 0.4 g/dL

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22
Q

Ropes of mucin clot test (Hyaluronic polymerization test) REAGENT

A

2-5% Acetic acid

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23
Q

GRADING: solid or compact clot; clear solution

A

Good

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24
Q

WBC count of synovial fluid: DILUTING FLUIDS

A

SALINE WITH SAPONIN
HYPOTONIC SALINE (0.3%)
NSS with METHYLENE BLUE

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25
Q

For every viscous fluid, add 1 drop of ___________ in phosphate buffer per mL of fluid

A

0.05% hyaluronidase

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26
Q

SYNOVIAL FLUID Differential count : RBC normal value

A

<2000/uL or ABSENT

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27
Q

SYNOVIAL FLUID Differential count : WBCs normal value

A

<200/uL

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28
Q

Neutrophil containing ingested “round body” seen in lupus erythymatosus

A

LE cell

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29
Q

Vacuolated macrophage with ingested neutrophil seen in REACTIVE ARTHRITIS

A

Reiter cell (neutrophage)

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30
Q

Neutrophil with dark cytoplasmic granules containing precipitated rheumatoid factor

A

RA cell (ragocyte)

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31
Q

Macroscopically resemble polished rice , it shows collagen and fibrin

A

Rice bodies

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32
Q

Debris from metal and plastic joint prosthetics

Ground pepper appearance

A

Orchonotic shards

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33
Q

Similar to macrophage but may be multinucleated resembling a mesothelial cell

A

Synovial cell lining

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34
Q

Refractile intracellular and extracellular globules stain with Sudan dyes

A

Fat droplets

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35
Q

Inclusions within clusters of synovial cells ; pigmented villonodular synovitis

A

Hemosiderin

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36
Q

CRYSTAL SHAPE: NEEDLES

A

MONOSODIUM URATES

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37
Q

CRYSTAL SHAPE: Rhombic, rods

A

Calcium pyrophosphate

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38
Q

CRYSTAL SHAPE: notched, rhombic plates

A

Cholesterol

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39
Q

CRYSTAL SHAPE: flat, variable-shaped plates

A

Corticosteroid

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40
Q

CRYSTAL SHAPE: envelopes

A

Calcium oxalate

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41
Q

CRYSTAL SHAPE: small particles ; requires electron microscopy

A

Apatite (calcium phosphate)

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42
Q

Synovial crystal with NO BIREFRINGENCE

A

APATITE (calcium phosphate)

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43
Q

Synovial crystal (+) BIREFRINGENCE

A

CALCIUM PYROPHOSPHATE
COSRTICOSTEROID

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44
Q

Detects the presence or absence of birefringence

A

Polarizing microscope

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45
Q

Confirms the type of birefringence (positive or negative BR)

A

COMPENSATED POLARIZING MICROSCOPE

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46
Q

Color of positive birefringence

A

Blue

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47
Q

Color of negative birefringence

A

Yellow

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48
Q

What color of compensator is placed between crystal and analyzer

A

Red

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49
Q

A control slide for MSU polarization can be prepared using __________

A

Betamethasone acetate corticosteroids

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50
Q

The molecules in the MSU crystals run _______ to the long axis of the crystal

A

Parallel

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51
Q

The molecules in the CPPD crystals run ________ to the long axis of the crystal

A

Perpendicular

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52
Q

When the crystals are aligned perpendicular to the slow vibration, the color is _______

A

Reversed

53
Q

Most frequently tested chemistry test for synovial fluid ; done in conjunction with blood glucose

A

Glucose

54
Q

Formula for total glucose

A

Blood glucose - synovial fluid fluid glucose

55
Q

Formula for total glucose

A

Blood glucose - synovial fluid fluid glucose

56
Q

Normal value of SF protein

A

<3 g/dL

57
Q

Common bacteria infecting the synovial fluid

A

S. Aureus
Streptococcus
Haemophilus
N. Gonorrheae

58
Q

Non inflammatory group of joint disorders

A

Group 1

59
Q

Color and clarity of group 1 joint disorder

A

Clear, yellow

60
Q

Viscosity of type 1 joint disorder

A

Good

61
Q

WBC count of type 1 joint disorder

A

<1,000/uL

62
Q

Inflammatory (immunologic) group of joint disorder

A

Group IIa

63
Q

Positive for autoantibodies

A

Group IIa (immunologic)

64
Q

Inflammatory (crystal-induced) group of joint disorder

A

Group IIb

65
Q

Color and clarity of group IIb joint disorder

A

Cloudy or milky

66
Q

Joint group positive for crystals

A

Group IIb

67
Q

Septic group of joint disorders

A

Group III

68
Q

Color and clarity of group III joint disorder

A

Cloudy, yellow-green

69
Q

Neutrophil count in septic group joint disorder (group III)

A

> 75%

70
Q

Group of joint disorder positive for culture and gram stain

A

Group III septic

71
Q

Hemorrhagic group of joint disorder

A

Group IV

72
Q

Accumulation of fluid between the membranes

A

Effusion

73
Q

Disruption of fluid production and regulation between membrane

A

Transudate

74
Q

Changes in hydrostatic and oncotic pressure

A

Transudate

75
Q

Congestive heart failure, hypoproteinemia, nephrotic syndrome are examples of what type of effusion

A

Transudate

76
Q

Direct damage to the membrane of a particular cavity

A

Exudate

77
Q

Infection, inflammation, malignancy are examples of what type of effusion

A

Exudate

78
Q

Seromucin clot test for exudate

A

Rivalta’s test

79
Q

Recommended to detect the Transudate of hepatitis origin

A

Serum-ascites albumin gradient (SAAG)

80
Q

SAAG of 1.1 or greater

A

Transudate

81
Q

SAAG of <1.1

A

Exudate

82
Q

Color of pleural fluid with aspergillus infeciton

A

Black

83
Q

T or E: Fluid total protein of 3.0 g/dL or less

A

Transudate

84
Q

T or E: >3.0 g/dL

A

Exudate

85
Q

Most reliable method for differentiating Transudate and exudate

A

Fluid:serum protein ratio

Fluid:serum LD ratio

86
Q

T or E: >45-60 mg/dL

A

Pleural fluid cholesterol

87
Q

Triglyceride value of a chylous effusion

A

> 110 mg/dL

88
Q

Triglyceride value of a pseudochylous effusion

A

<50 mg/dL

89
Q

SUDAN III STAINING: +++

A

CHYLOUS EFFUSION

90
Q

SUDAN III STAINING: (-) / weakly (+)

A

Pseudochylous effusion

91
Q

Cell that is decreased in TB

A

Mesothelial cell

92
Q

Adenosine deaminase significance

A

Tuberculosis , malignancy

93
Q

Tumor marker for lung cancer, breast cancer

A

CYFRA 21-1

94
Q

SPECIMEN : >100,000 RBCs / uL indicates blunt trauma injury (intra-abdominal bleeding)

A

PERITONEAL LAVAGE

95
Q

Test performed when there is Decreased tubercular peritonitis

A

Glucose

96
Q

Adenosine deaminase positive

A

Tuberculosis, malignancy
Tubercular effusion
Tubercular peritonitis

97
Q

Non beta islet cell adenoma of the pancreas

A

Zollinger-Elisson Syndrome (ZES)

98
Q

Anti-parietal cells antibody

A

Pernicious anemia

99
Q

Anti intrinsic factor antibody

A

Pernicious anemia

100
Q

Hormone that stimulates protein production by parietal cells

A

Gastrin

101
Q

Absence of hydrochloric acid

A

Achlorhydria

102
Q

Produced by chief cells

A

Parietal cells

103
Q

Produce HCl and intrinsic factor

A

Parietal cells

104
Q

Produce gastrin

A

Specialized G cells

105
Q

Produce mucus that protects the stomach wall from acid

A

Foveolar cells

106
Q

Method of collection of gastric fluid

A

Gastric aspiration

107
Q

Gastric tube that passed through the nose

A

Levin

108
Q

Gastric tube that is passed through the mouth

A

Refuses

109
Q

Other gastric tubes that are passed through the mouth

A

Lavacuator tube, Edwald’s tube, Edlich tube,

110
Q

Total gastric secretion during unstimulated fasting state

A

Basal acid output

111
Q

Duration of collection that Consists of four 15-minute specimen but single 1-hour can be used

A

1hour collection

112
Q

Duration of collection consists of _______ specimen but single 1-hour can be used

A

four 15-minute

113
Q

Duration of collection for insulin hypoglycemia test

A

2 hour collection

114
Q

Total gastric secretion after gastric stimulation

A

Maximum acid output

115
Q

Duration of collection for MAO when pentagastrin and histamine are used

A

1 hour (at 15-minute intervals)

116
Q

Duration of MAO collection for insulin hypoglycemia test and when histology is used

A

2 hour collection

117
Q

TEST MEAL : bread, weak tea or water

A

Edwald’s

118
Q

TEST MEAL: oatmeal

A

Boa’s

119
Q

Test meal: beef steak and mashed potatoes

A

Riegel’s

120
Q

Most preferred chemical stimulant

A

Pentagastrin

121
Q

Chemical stimulant to assess vagotomy procedure

A

Insulin

122
Q

Gastric Chemical stimulants

A

Pentagastrin
Insulin
Histamine
Histology (betazole)

123
Q

Normal color of gastric fluid

A

Pale gray slightly mucoid

124
Q

Normal (fasting specimen) volume of gastric fluid

A

20-50 mL

125
Q

Failure to produce a pH <6.0 following gastric stimulation

A

Anacidity

126
Q

Clinical significance anacidity

A

Pernicious anemi

127
Q

Developed by Squibb

A

Diagnose Tubeless Test (Diagnex Blue Test)

128
Q

Specimen for diagnex tubeless test

A

Urine

129
Q

A ______ is complexed with an ion exchange resin

A

Blue colored dye azure-A

CLINICAL MICROSCOPY (9 decks)

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