Cram Synovial Fluid

If synovial fluid clots it may be due to: (2)

1. Traumatic tap

2. Synovial membrane damage (Inflammation)

Tests to analyze the viscosity of synovial fluid: (2)

1. String test

2. Mucin test/ ropes test

For the mucin/ropes test we add:

Acetic acid

Causes of decreased viscosity: (2)

1. Decreased production of HA

2. Diluted HA (Damage or inflammation)

Group 4 arthritis:

Hemorrhagic

Rice bodies in synovial fluid are caused by:

RA

Black pepper in synovial fluid is caused by:

Prosthesis

Reiter cells are what and associated with?

Macrophage with ingested neutrophil

RA

What is the process to prep synovial fluid slide?

Add hyaluronidase

Incubate at 37 degrees for 5 min

what kind of microscope do we use to assess synovial fluid for crystals?

Compensating polarizing microscope

Uric acid indicates:

MSU/ gout

Calcium pyrophosphate indicates:

CPPD/ pseudogout

Cholesterol crystal is what shape and associated with: (2)

Notched plate

RA

Calcium oxalate is what shape and associated with:

Envelope

Kidney issue

String test value

> or = 5cm

Normal WBC count

<200/uL

Normal RBC count

NOT TESTED

1. To prepare the mucin clot analysis, synovial fluid is mixed with: 

   1. Hydrochloric acid 

   2. Sodium hydroxide 

   3. Glacial acetic acid 

   4. Trichloracetic acid 

1. Glacial acetic acid 

1. Which of the following results correlates with a normal synovial fluid sample?

   1. Strings 7 cm; positive mucin clot

   2. Stings 7 cm; negative mucin clot

   3. Single drops; positive mucin clot

   4. Single drops; negative mucin clot

1. Strings 7 cm; positive mucin clot

Define hyaluronic acid

Secreted by the synovial cells of the synovial membrane. Interacts with

synovial proteins to form a matrix (induces viscosity)

Name two conditions classified as Group II arthritis

Immunologic: Rheumatoid arthritis; Lupus; Rheumatic fever

Crystal: Gout; Pseudogout

1. Which of the following is the type of crystal associated with pseudogout?

   1. uric acid 

   2. cholesterol

   3. monosodium urate

   4. calcium pyrophosphate dihydrate

1. calcium pyrophosphate dihydrate