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CLINICAL MICROSCOPY > Synovial Fluid > Flashcards

Synovial Fluid Flashcards

(46 cards)

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1
Q

indicate nonspetic inflammation (Inflammatory, non-inflammatory, hemorraghic)

A

Increased lymphocytes

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2
Q

rheumatic fever, parasitic infections, metastatic carcinoma, post radiation therapy or arthrography

A

Increased eosinophils

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3
Q

patients with lupus erythematosus

A

LE cells

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4
Q

macrophages with ingested neutrophils

A

Reiter cells

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5
Q

precipitated rheumatoid factor appearing as cytoplasmic granules in neutrophils

A

RA cells (ragocytes

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6
Q

due to hemorrhagic process or cases of pigmented villonodular synovitis

A

Hemosiderin granules

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7
Q

observed in cases of osteoarthritis

A

Cartilaginous cells

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8
Q

found in septic and rheumatoid arthritis and Tuberculosis

A

Rice bodies

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9
Q

– indicate traumatic injury

A

Fat droplets

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10
Q

Crystals aligned parallel to the compensator

appear__________?

A

yellow (negative birefringence)

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11
Q

In MSU Crystals aligned perpendicular to the

compensator appear ___________

A

Blue ( positive birefringence)

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12
Q

Indicate gouty arthritis due to

A

Monosodium Urate Crystals (MSU

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13
Q

§ Increased serum uric acid

§ Decreased renal excretion of uric acid

§ Impaired metabolism of nucleic acid

A

gouty arthritis

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14
Q

Acute stages

A

Intracellular

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15
Q

strongly birefringent in MSU

A

Polarized light

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16
Q

yellow when parallel blue when perpendicular

A

Compensated polarized lightin MSU

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17
Q

Needle shaped crystal

A

Monosodium Urate Crystals (MSU

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18
Q

Indicates pseudogout

A

Calcium pyrophosphate (CCPD

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19
Q

Degenerative arthritis
Endocrine disorders with increased serum calcium
Calcification of cartilage

20
Q

Blunt rods or rhombic shapes

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A

Calcium pyrophosphate (CCPD)

21
Q

weakly birefringent

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A

Polarized light in CCPD

22
Q

– blue when parallel (yellow when perpendicular)

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A

Compensated polarized light in CCPD

23
Q

Nonspecific indications
Associated with chronic inflammation

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A

Cholesterol crystal

24
Q
  • Usually seen extracellularly
  • Polarized light – strongly birefringence
  • Rhombic plates
25
- Associated with calcific deposition conditions - May produce an acute inflammatory reaction
Hydroxyapatite (HA) (Calcium phosphate)
26
- Can closely resemble MSU and CCPD - Flat, variable shaped plates - Associated with intra-articular injections, NO clinical significance
Corticosteroid
27
Following renal dialysis
• Calcium Oxalate
28
can be misidentified as crystals
Birefringent Artifacts
29
- Anticoagulant crystals (calcium oxalate, lithium heparin) - Starch granules - Prosthesis fragments - Collagen fibers - Fibrin - Dust particles
Birefringent Artifacts
30
Done simultaneously with blood sample (prefer 8 hour fast)
Glucose
31
Draw in sodium fluoride – prevents ______
Glycolysis
32
Not routinely performed in chemistry test in synovial fluid
Total protein
33
§ Changes in membrane permeability § Increased joint synthesis Caused of?
- Increased protein
34
Alone, not diagnostic May determine gout in conjunction with plasma uric acid, esp. when crystals are undetectable
Uric acid
35
If the lactate of synovial fluid is >250 mg/dL what condition?
Septic arthritis
36
If the lactate of synovial fluid is normal to low levels
Gonococcal arthritis
37
May differentiate between inflammatory and septic arthritis
Lactate
38
Performed on all specimens
Gram stain
39
Most septic joint disorders are____________
microbial/bacterial in nature
40
Autoantibody detection (same as found in serum
Serologic test
41
Organism that Causative agent of Lyme disease Cause of arthritis
Borrelia burgdorferi
42
Cloudy, yellow-green fluid Poor viscosity WBCs 10,000-200,000 µL Neutrophils > 90% Decreased glucose level Positive culture and Gram stain
Septic Microbial infection
43
Cloudy, red fluid Poor viscosity WBCs < 5000 µL Neutrophils > 50% Normal glucose level RBCs present
Hemorrhagic Traumatic injury Coagulation deficiencies
44
Cloudy or milky fluid Poor viscosity WBCs up to 50, 000 µL Neutrophils < 90% Decreased glucose level Elevated uric acid level Crystals present
Crystal-induced gout and pseudogout
45
Cloudy, yellow fluid Poor viscosity WBCs 2000-5000 µL Neutrophils > 50% Decreased glucose level Possible autoantibodies present
Immunologic problems, including rheumatoid arthritis and lupus erythematosus
46
Clear, yellow fluid Good viscosity WBCs < 2000 µL Neutrophils < 30% Normal glucose (similar to blood glucose)
Degenerative joint disorders Non inflammatory

CLINICAL MICROSCOPY (7 decks)

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