CM LEC - Synovial fluid Part 2 Flashcards

1
Q

most frequently performed cell

count on synovial fluid

A

Total leukocyte count

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2
Q

When is RBC count requested

A

when there is traumatic tap

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3
Q

what to do if there is a delay in processing/testing of sx

A

refrigerate

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4
Q

Very viscous fluid may be pretreated by adding

2

A

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

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5
Q

dilution of clear fluids

A

none

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6
Q

dilution is needed in what kind of fluids (2)

A

bloody or turbid fluids

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7
Q

diluting fluid not suitable for synovial fluid cell count

A

traditional WBC dil. fluid or acetic acid

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8
Q

Traditional WBC diluting fluid cannot be used – acetic

acid will cause formation of ___

A

mucin clot

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9
Q

recommended diluent for synovial fluid cell counts

A

normal saline

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10
Q

To lyse RBCs use: (2)

A
hypotonic saline (0.3%) or saline that
contains saponin as diluent
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11
Q

stain WBC nuclei permitting separation of RBCs & WBCs on mixed specimens

A

Methylene blue + normal saline

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12
Q

disadv of automated cell counters (2)

A

Highly viscous fluid may block the apertures
Presence of debris & tissue cells may falsely elevate
counts

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13
Q

differential counts must be performed on __
OR
specimen preparation used for diff count

A

 Cytocentrifuged preparations or thinly smeared slides

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14
Q

in diff count, fluid should be incubated with ______ prior to
slide preparation

A

hyaluronidase

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15
Q

 Primary cells seen in normal synovial fluid:

A

 Monocytes
 Macrophages
 Synovial tissue cells

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16
Q

diff count

neutrophil %

A
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17
Q

diff count

lymphocyte %

A
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18
Q

Increased neutrophils means there is

A

septic condition

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19
Q

Increases lymphocytes = means

A

nonseptic inflammation

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20
Q

in diff count, in normal and abnormal specimen, cells may appear

A

more vacuolated than on a blood smear

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21
Q

lipid droplets may be present following ____

A

crash injuries

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22
Q

found in cases of pigmented villonodular synovitis

A

hemosiderin granules

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23
Q

Hemosiderin granules found in cases of ___

A

pigmented villonodular synovitis

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24
Q

other cell abnormalities (4)

A
  • eosinophils
  • LE cells
  • Reiter cells
  • RA cells or ragocytes
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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
- Demostration of antibodies to the causative agent Borrelia burgdorgeri in the patient’s serum can
confirm the cause of the arthritis