CM LEC - Synovial fluid Part 2 Flashcards Preview

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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

- Demostration of antibodies to the causative agent Borrelia burgdorgeri in the patient’s serum can

confirm the cause of the arthritis

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