Flashcards in CM LEC - Synovial fluid Part 2 Deck (94):
1
most frequently performed cell
count on synovial fluid
Total leukocyte count
2
When is RBC count requested
when there is traumatic tap
3
what to do if there is a delay in processing/testing of sx
refrigerate
4
Very viscous fluid may be pretreated by adding
(2)
a pinch amount of hyaluronidase to 0.5mL of fluid OR
one drop of 0.05% hyaluronidase in PO4 buffer per mL of fluid
& incubate at 37°C for 5mins
5
dilution of clear fluids
none
6
dilution is needed in what kind of fluids (2)
bloody or turbid fluids
7
diluting fluid not suitable for synovial fluid cell count
traditional WBC dil. fluid or acetic acid
8
Traditional WBC diluting fluid cannot be used – acetic
acid will cause formation of ___
mucin clot
9
recommended diluent for synovial fluid cell counts
normal saline
10
To lyse RBCs use: (2)
hypotonic saline (0.3%) or saline that
contains saponin as diluent
11
stain WBC nuclei permitting separation of RBCs & WBCs on mixed specimens
Methylene blue + normal saline
12
disadv of automated cell counters (2)
Highly viscous fluid may block the apertures
Presence of debris & tissue cells may falsely elevate
counts
13
differential counts must be performed on __
OR
specimen preparation used for diff count
Cytocentrifuged preparations or thinly smeared slides
14
in diff count, fluid should be incubated with ______ prior to
slide preparation
hyaluronidase
15
Primary cells seen in normal synovial fluid:
Monocytes
Macrophages
Synovial tissue cells
16
diff count
neutrophil %
17
diff count
lymphocyte %
18
Increased neutrophils means there is
septic condition
19
Increases lymphocytes = means
nonseptic inflammation
20
in diff count, in normal and abnormal specimen, cells may appear
more vacuolated than on a blood smear
21
lipid droplets may be present following ____
crash injuries
22
found in cases of pigmented villonodular synovitis
hemosiderin granules
23
Hemosiderin granules found in cases of ___
pigmented villonodular synovitis
24
other cell abnormalities (4)
- eosinophils
- LE cells
- Reiter cells
- RA cells or ragocytes
25
(vacuolated macrophages with ingested
neutrophils)
Reiter cells
26
(neutrophils with small, dark, cytoplasmic granules that consist of precipitated rheumatoid factor)
RA cells or ragocytes
27
Additional crystals present:
-basic calcium phosphate
-calcified cartilage degeneration
hydroxyapatite
28
Additional crystals present
following injections
corticosteroids
29
Additional crystals present
renal dialysis patients
calcium oxalate crystals
30
Crystal examination should be performed soon after fluid collection to ensure crystals are not affected by changes in (2)
temperature & pH
31
fluid must be examined before or after WBC disintegration
before because there is a need to report MSU & CPPD crystals as being located extracellularly & intracellularly (within neutrophils)
32
crystal type
needle-shaped, appears extracellularly
& within the cytoplasm of neutrophils
MSU crystals
33
crystal type
more highly birefringent & brighter against a dark
background
MSU crystals
34
crystal type
rhombic-shaped, intracellular
inclusions
CPPD crystals
35
most frequently requested chemical test
glucose determination
36
- blood & synovial fluid samples should be obtained after ??? hours of fasting to allow equilibration between the two
8
37
blood & synovial fluid samples should be obtained after 8hours of fasting to ???
allow equilibration between the two
38
specimens for glucose det. should be analyzed within ??hr or
preserved with sodium fluoride
1
39
what to do if specimens for glucose det. not analyzed within 1 hr
preserve with sodium fluoride
40
chemistry test
provide rapid differentiation between
inflammatory & septic arthritis
Synovial fluid lactate
41
most important tests performed on synovial fluid
Gram stain & culture
42
microbio test performed on all specimens
Gram stain
43
most frequent infection of synovial fluid
bacterial
44
Most common organisms infecting synovial fluid:
Hemophilus species
Neisseria gonorrhoeae
45
are diagnosed by demonstrating the presence of their particular antibodies in the patient’s serum
Rheumatoid arthritis & lupus erythromatosus
46
When is RBC count requested
when there is traumatic tap
47
what to do if there is a delay in processing/testing of sx
refrigerate
48
crystal seen in cases of pseudogout
CPPD
49
dilution of clear fluids
none
50
dilution is needed in what kind of fluids (2)
bloody or turbid fluids
51
diluting fluid not suitable for synovial fluid cell count
traditional WBC dil. fluid or acetic acid
52
Traditional WBC diluting fluid cannot be used – acetic
acid will cause formation of ___
mucin clot
53
recommended diluent for synovial fluid cell counts
normal saline
54
To lyse RBCs use: (2)
hypotonic saline (0.3%) or saline that
contains saponin as diluent
55
stain WBC nuclei permitting separation of RBCs & WBCs on mixed specimens
Methylene blue + normal saline
56
disadv of automated cell counters (2)
Highly viscous fluid may block the apertures
Presence of debris & tissue cells may falsely elevate
counts
57
differential counts must be performed on __
OR
specimen preparation used for diff count
Cytocentrifuged preparations or thinly smeared slides
58
in diff count, fluid should be incubated with ______ prior to
slide preparation
hyaluronidase
59
Primary cells seen in normal synovial fluid:
Monocytes
Macrophages
Synovial tissue cells
60
diff count
neutrophil %
61
diff count
lymphocyte %
62
Increased neutrophils means there is
septic condition
63
Increases lymphocytes = means
nonseptic inflammation
64
in diff count, in normal and abnormal specimen, cells may appear
more vacuolated than on a blood smear
65
lipid droplets may be present following ____
crash injuries
66
found in cases of pigmented villonodular synovitis
hemosiderin granules
67
Hemosiderin granules found in cases of ___
pigmented villonodular synovitis
68
other cell abnormalities (4)
- eosinophils
- LE cells
- Reiter cells
- RA cells or ragocytes
69
(vacuolated macrophages with ingested
neutrophils)
Reiter cells
70
(neutrophils with small, dark, cytoplasmic granules that consist of precipitated rheumatoid factor)
RA cells or ragocytes
71
Additional crystals present:
-basic calcium phosphate
-calcified cartilage degeneration
hydroxyapatite
72
Additional crystals present
following injections
corticosteroids
73
Additional crystals present
renal dialysis patients
calcium oxalate crystals
74
Crystal examination should be performed soon after fluid collection to ensure crystals are not affected by changes in (2)
temperature & pH
75
fluid must be examined before or after WBC disintegration
before because there is a need to report MSU & CPPD crystals as being located extracellularly & intracellularly (within neutrophils)
76
crystal type
needle-shaped, appears extracellularly
& within the cytoplasm of neutrophils
MSU crystals
77
crystal type
more highly birefringent & brighter against a dark
background
MSU crystals
78
crystal type
rhombic-shaped, intracellular
inclusions
CPPD crystals
79
most frequently requested chemical test
glucose determination
80
- blood & synovial fluid samples should be obtained after ??? hours of fasting to allow equilibration between the two
8
81
blood & synovial fluid samples should be obtained after 8hours of fasting to ???
allow equilibration between the two
82
specimens for glucose det. should be analyzed within ??hr or
preserved with sodium fluoride
1
83
what to do if specimens for glucose det. not analyzed within 1 hr
preserve with sodium fluoride
84
chemistry test
provide rapid differentiation between
inflammatory & septic arthritis
Synovial fluid lactate
85
most important tests performed on synovial fluid
Gram stain & culture
86
microbio test performed on all specimens
Gram stain
87
most frequent infection of synovial fluid
bacterial
88
Most common organisms infecting synovial fluid:
Hemophilus species
Neisseria gonorrhoeae
89
are diagnosed by demonstrating the presence of their particular antibodies in the patient’s serum
Rheumatoid arthritis & lupus erythromatosus
90
- Demostration of antibodies to the causative agent _________ in the patient’s serum can confirm the cause of the arthritis
Borrelia burgdorgeri
91
MSU meaning
monosodium urate (uric acid)
92
CPPD
calcium pyrophosphate dihydrate
93
Crystal seen in cases of gout
MSU
94