WorksheetsCM-19
Total questions: 127
Worksheet time: 1hrs 4mins
Name
Class
Date
1.
What is the method of collection for pleural fluid?
a)
Arthrocentesis
b)
Pericardiocentesis
c)
Paracentesis
d)
Thoracentesis
2.
What is the method of collection for pericardial fluid?
a)
Arthrocentesis
b)
Pericardiocentesis
c)
Paracentesis
d)
Thoracentesis
3.
What is the method of collection for peritoneal fluid?
a)
Arthrocentesis
b)
Pericardiocentesis
c)
Paracentesis
d)
Thoracentesis
4.
What is the method of collection for synovial fluid?
a)
Arthrocentesis
b)
Pericardiocentesis
c)
Paracentesis
d)
Thoracentesis
5.
What is the normal amount of synovial fluid?
a)
<1.5 mL
b)
<2.5 mL
c)
<3.5 mL
d)
<4.5 mL
6.
Viscosity of synovial fluid is due to polymerization of?
a)
Sialic acid
b)
Hyaluronic acid
c)
Synoviocytes
d)
Acetic acid
7.
Which type of synoviocytes is responsible for polymerization of the hyaluronic acid in synovial fluid?
a)
Type A Synoviocytes
b)
Type B Synoviocytes
8.
Which type of synoviocytes is responsible for phagocytosis in synovial fluid?
a)
Type A Synoviocytes
b)
Type B Synoviocytes
9.
Amount of synovial fluid that indicate inflammation:
a)
>20 mL
b)
>25 mL
c)
>35 mL
d)
>50 mL
10.
Tube used for chemical and immunologic evaluation of synovial fluid:
a)
Blue top
b)
Purple top
c)
Gray top
d)
Red top
11.
Tube used for glucose analysis of synovial fluid:
a)
Blue top
b)
Purple top
c)
Gray top
d)
Red top
12.
Which of the ff. interferes with crystal identification in synovial fluid?
a)
Sodium heparin
b)
Ammonium heparin
c)
Lithium heparin
d)
All of the choices
13.
Refrigeration of synovial fluid samples is not recommended as it can produce additional crystals that may interfere with the results.
a)
True
b)
False
c)
Either
d)
Neither
14.
What is the normal color of synovial fluid?
a)
Colorless to pale yellow
b)
Deeper yellow
c)
Greenish tinge
d)
Red
e)
Turbid
15.
Color of synovial fluid that indicate inflammation:
a)
Colorless to pale yellow
b)
Deeper yellow
c)
Greenish tinge
d)
Red
e)
Turbid
16.
Color of synovial fluid that indicate bacterial infection:
a)
Colorless to pale yellow
b)
Deeper yellow
c)
Greenish tinge
d)
Red
e)
Turbid
17.
Color of synovial fluid that indicate traumatic tap and/or hemorrhagic arthritis:
a)
Colorless to pale yellow
b)
Deeper yellow
c)
Greenish tinge
d)
Red
e)
Turbid
18.
Color of synovial fluid that indicate WBCs, synovial cell debris, or fibrin:
a)
Colorless to pale yellow
b)
Deeper yellow
c)
Greenish tinge
d)
Red
e)
Turbid
19.
Milky synovial fluid indicate:
a)
WBCs, synovial cell debris or fibrin
b)
Inflammation
c)
Presence of crystals
d)
Normal
20.
Normal viscosity of synovial fluid is high; and forms a string that is:
a)
2 to 4 cm long
b)
4 to 6 cm long
c)
4 to 6 mm long
d)
2 to 4 mm long
21.
Normal hyaluronic acid level:
a)
0.1 to 0.3 g/dL
b)
0.3 to 0.4 mg/dL
c)
0.3 to 0.4 g/L
d)
0.3 to 0.4 g/dL
22.
Reagent used in ropes or mucin clot test (hyaluronate polymerization test)
a)
1 to 2% acetic acid
b)
2 to 3% acetic acid
c)
2 to 4% acetic acid
d)
2 to 5% acetic acid
23.
(S7THeD); Synovial fluid: Solid or compact clot, clear solution
a)
Good
b)
Fair
c)
Low
d)
Poor
24.
(S7THeD); Synovial fluid: Soft clot
a)
Good
b)
Fair
c)
Low
d)
Poor
25.
(S7THeD); Synovial fluid: Friable clot, cloudy solution
a)
Good
b)
Fair
c)
Low
d)
Poor
26.
(S7THeD); Synovial fluid: No clot
a)
Good
b)
Fair
c)
Low
d)
Poor
27.
Friable clot (Synovial fluid) S3rded
a)
Good
b)
Fair
c)
Poor
d)
Very poor
28.
Which of the ff. cannot be used as a WBC diluting fluid for synovial fluid cell count as it can cause clot formatio?
a)
NSS with methylene blue
b)
Hypotonic saline (0.3%)
c)
Saline with saponin
d)
Hyaluronic acid
e)
Acetic acid
29.
Concentration of hyaluronidase on 1 drop added in phosphate buffer per mL of fluid:
a)
0.5% hyaluronidase
b)
0.05% hyaluronidase
c)
0.005% hyaluronidase
d)
0.0005% hyaluronidase
30.
How long would you incubate very viscous synovial fluids?
a)
5 minutes
b)
10 minutes
c)
15 minutes
d)
25 minutes
31.
Normal value of RBCs in synovial fluid (Turgeon = absent)
a)
<2,000/uL
b)
<200/uL
c)
<20/uL
32.
Normal value of WBCs in synovial fluid (Turgeon = absent)
a)
<2,000/uL
b)
<200/uL
c)
<20/uL
33.
What makes up majority (65%) of normal cells in synovial fluid differential count?
a)
Monocytes and macrophages
b)
Neutrophils
c)
Lymphocytes
d)
Eosinophils
34.
What makes up <25% of normal cells in synovial fluid differential count?
a)
Monocytes and macrophages
b)
Neutrophils
c)
Lymphocytes
d)
Eosinophils
35.
What makes up <15% of normal cells in synovial fluid differential count?
a)
Monocytes and macrophages
b)
Neutrophils
c)
Lymphocytes
d)
Eosinophils
36.
Polymorphonuclear leukocyte
a)
Neutrophil
b)
Lymphocyte
c)
Macrophage
d)
Hemosiderin
37.
Mononuclear leukocyte
a)
Neutrophil
b)
Lymphocyte
c)
Macrophage
d)
Hemosiderin
38.
Mononuclear leukocyte
a)
Neutrophil
b)
Lymphocyte
c)
Macrophage
d)
Hemosiderin
39.
Seen in nonseptic inflammation
a)
Neutrophil
b)
Lymphocyte
c)
Macrophage
d)
Hemosiderin
40.
Normal; can be seen in viral infections
a)
Neutrophil
b)
Lymphocyte
c)
Macrophage
d)
Hemosiderin
41.
Normal synovial fluid should NOT contain any crystal
a)
True
b)
False
c)
Either
d)
Neither
42.
Seen in bacterial sepsis and crystal-induced inflammation
a)
Neutrophil
b)
Lymphocyte
c)
Macrophage
d)
Hemosiderin
43.
Large mononuclear leukocyte that may be vacuolated
a)
Neutrophil
b)
Lymphocyte
c)
Macrophage
d)
Hemosiderin
44.
Inclusions within clusters of synovial cells
a)
Neutrophil
b)
Lymphocyte
c)
Macrophage
d)
Hemosiderin
45.
Vacuolated macrophage with ingested neutrophils
a)
LE cell
b)
Reiter cell (neutrophage)
c)
RA cell (ragocyte)
d)
Rice bodies
e)
Ochronotic shards
46.
Neutrophil containing ingested "round body"
a)
LE cell
b)
Reiter cell (neutrophage)
c)
RA cell (ragocyte)
d)
Rice bodies
e)
Ochronotic shards
47.
Seen in reactive arthritis:
a)
LE cell
b)
Reiter cell (neutrophage)
c)
RA cell (ragocyte)
d)
Rice bodies
e)
Ochronotic shards
48.
Neutrophil with dark cytoplasmic granules containing precipitated rheumatoid factor
a)
LE cell
b)
Reiter cell (neutrophage)
c)
RA cell (ragocyte)
d)
Rice bodies
e)
Ochronotic shards
49.
Macroscopically resemble polished rice
a)
LE cell
b)
Reiter cell (neutrophage)
c)
RA cell (ragocyte)
d)
Rice bodies
e)
Ochronotic shards
50.
Microscopically show collagen and fibrin
a)
LE cell
b)
Reiter cell (neutrophage)
c)
RA cell (ragocyte)
d)
Rice bodies
e)
Ochronotic shards
51.
Seen in tuberculosis, septic, and rheumatoid arthritis:
a)
LE cell
b)
Reiter cell (neutrophage)
c)
RA cell (ragocyte)
d)
Rice bodies
e)
Ochronotic shards
52.
Seen in rheumatoid arthritis and immunologic inflammation:
a)
LE cell
b)
Reiter cell (neutrophage)
c)
RA cell (ragocyte)
d)
Rice bodies
e)
Ochronotic shards
53.
Debris from metal and plastic joint prosthesis; "Ground pepper" appearance
a)
LE cell
b)
Reiter cell (neutrophage)
c)
RA cell (ragocyte)
d)
Rice bodies
e)
Ochronotic shards
54.
Seen in alkaptonuria, ochronotic arthropathy, ochronosis:
a)
LE cell
b)
Reiter cell (neutrophage)
c)
RA cell (ragocyte)
d)
Rice bodies
e)
Ochronotic shards
55.
Large, multinucleated cells
a)
Cartilage cells
b)
Synovial lining cell
c)
Fat droplets
d)
Hemosiderin
56.
Similar to macrophage, but may be multinucleated, resembling a mesothelial cell
a)
Cartilage cells
b)
Synovial lining cell
c)
Fat droplets
d)
Hemosiderin
57.
Normal; indicate disruption from arthrocentesis:
a)
Cartilage cells
b)
Synovial lining cell
c)
Fat droplets
d)
Hemosiderin
58.
Refractile intracellular and extracellular globules; stains with sudan dyes
a)
Cartilage cells
b)
Synovial lining cell
c)
Fat droplets
d)
Hemosiderin
59.
Seen in traumatic injury and chronic inflammation
a)
Cartilage cells
b)
Synovial lining cell
c)
Fat droplets
d)
Hemosiderin
60.
Seen in pigmented villonodular synovitis
a)
Cartilage cells
b)
Synovial lining cell
c)
Fat droplets
d)
Hemosiderin
61.
Seen in osteoarthritis:
a)
Cartilage cells
b)
Synovial lining cell
c)
Fat droplets
d)
Hemosiderin
62.
Monosodium urates:
a)
Positive birefringence
b)
Negative birefringence
c)
Variable birefringence
d)
No birefringence
63.
Cholesterol crystals:
a)
Positive birefringence
b)
Negative birefringence
c)
Variable birefringence
d)
No birefringence
64.
Calcium oxalate:
a)
Positive birefringence
b)
Negative birefringence
c)
Variable birefringence
d)
No birefringence
65.
Apatite:
a)
Positive birefringence
b)
Negative birefringence
c)
Variable birefringence
d)
No birefringence
66.
Calcium phosphate:
a)
Positive birefringence
b)
Negative birefringence
c)
Variable birefringence
d)
No birefringence
67.
Calcium pyrophosphate:
a)
Positive birefringence
b)
Negative birefringence
c)
Variable birefringence
d)
No birefringence
68.
Corticosteroid:
a)
Positive birefringence
b)
Negative birefringence
c)
Variable birefringence
d)
No birefringence
69.
Needle-shaped
a)
Monosodium urate
b)
Calcium pyrophosphate
c)
Cholesterol
d)
Corticosteroid
70.
Rhombic square, rods:
a)
Monosodium urate
b)
Calcium pyrophosphate
c)
Cholesterol
d)
Corticosteroid
71.
Notched, rhombic plates:
a)
Monosodium urate
b)
Calcium pyrophosphate
c)
Cholesterol
d)
Corticosteroid
72.
Flat, variable-shaped plates:
a)
Monosodium urate
b)
Calcium pyrophosphate
c)
Cholesterol
d)
Corticosteroid
73.
Seen in injections:
a)
Monosodium urate
b)
Calcium pyrophosphate
c)
Cholesterol
d)
Corticosteroid
74.
Seen extracellularly
a)
Monosodium urate
b)
Calcium pyrophosphate
c)
Cholesterol
d)
Corticosteroid
75.
Seen in gout
a)
Monosodium urate
b)
Calcium pyrophosphate
c)
Cholesterol
d)
Corticosteroid
76.
Seen in pseudogout
a)
Monosodium urate
b)
Calcium pyrophosphate
c)
Cholesterol
d)
Corticosteroid
77.
Apatite
a)
Calcium oxalate
b)
Calcium phosphate
78.
Small particles; requires use of electron microscopy
a)
Calcium oxalate
b)
Calcium phosphate
79.
Seen in renal dialysis
a)
Calcium oxalate
b)
Calcium phosphate
80.
detects for the presence or absence of birefringence
a)
Brightfield microscope
b)
Polarizing microscope
c)
Compensated polarizing microscope
d)
Darkfield microscope
81.
Confirms the type of birefringence (positive or negative BR)
a)
Brightfield microscope
b)
Polarizing microscope
c)
Compensated polarizing microscope
d)
Darkfield microscope
82.
Color of compensator placed between crystal and analyzer
a)
Blue compensator
b)
Pink compensator
c)
Purple compensator
d)
Red compensator
83.
A control slide for MSU polarization can be prepared using betamethasone acetate corticosteroid
a)
True
b)
False
84.
MSU molecules run __ to the long axis of the crystal
a)
Parallel
b)
Perpendicular
85.
CPPD crystals run __ to the long axis of the crystal
a)
Parallel
b)
Perpendicular
86.
What is the color of MSU crystals?
a)
Yellow
b)
Red
c)
Blue
d)
Purple
87.
What is the color of CPPD crystals?
a)
Yellow
b)
Red
c)
Blue
d)
Purple
88.
Normal amount of blood glucose - SF glucose
a)
<10 g/L
b)
<10 mg/L
c)
<10 g/dL
d)
<10 mg/dL
89.
Normal value of synovial fluid lactate (increased in infection):
a)
<25 g/L
b)
<25 mg/L
c)
<25 mg/dL
d)
<25 g/dL
90.
Normal value of protein (~1/3 of plasma protein) in synovial fluid (increased in inflammatory and hemorrhagic disorders
a)
<3 g/L
b)
<3 mg/L
c)
<3 mg/dL
d)
<3 g/dL
91.
Normal value of this analyte in SF is the same as blood:
a)
Lactate
b)
Glucose
c)
Protein
d)
Uric acid
92.
Which agent in SF infects young and middle-aged adults?
a)
S. aureus
b)
Streptococcus spp.
c)
Haemophilus spp.
d)
N. gonorrhoeae
93.
Which agent in SF infects older adults?
a)
S. aureus
b)
Streptococcus spp.
c)
Haemophilus spp.
d)
N. gonorrhoeae
94.
Which agent in SF infects children?
a)
S. aureus
b)
Streptococcus spp.
c)
Haemophilus spp.
d)
N. gonorrhoeae
95.
Seen in osteoarthritis
a)
Calcium oxalate
b)
Calcium phosphate
96.
Degenerative joint disorders (OA)
a)
Non-inflammatory joint disorder
b)
Inflammatory (Immunologic)
c)
Inflammatory (Crystal-induced)
97.
Color & Clarity: Clear, yellow fluid
a)
Non-inflammatory joint disorder
b)
Inflammatory (Immunologic)
c)
Inflammatory (Crystal-induced)
98.
Glucose: Decreased
a)
Non-inflammatory joint disorder
b)
Inflammatory (Immunologic)
c)
Inflammatory (Crystal-induced)
99.
Glucose is similar to blood glucose
a)
Non-inflammatory joint disorder
b)
Inflammatory (Immunologic)
c)
Inflammatory (Crystal-induced)
100.
Neutrophils <30%
a)
Non-inflammatory joint disorder
b)
Inflammatory (Immunologic)
c)
Inflammatory (Crystal-induced)
101.
WBC count <1,000/uL
a)
Non-inflammatory joint disorder
b)
Inflammatory (Immunologic)
c)
Inflammatory (Crystal-induced)
102.
Viscosity: Good
a)
Non-inflammatory joint disorder
b)
Inflammatory (Immunologic)
c)
Inflammatory (Crystal-induced)
103.
Color & Clarity: Cloudy, yellow fluid
a)
Non-inflammatory joint disorder
b)
Inflammatory (Immunologic)
c)
Inflammatory (Crystal-induced)
104.
Color & Clarity: milky fluid
a)
Non-inflammatory joint disorder
b)
Inflammatory (Immunologic)
c)
Inflammatory (Crystal-induced)
105.
Viscosity: Poor
a)
Non-inflammatory joint disorder
b)
Inflammatory (Immunologic)
c)
Inflammatory (Crystal-induced)
106.
Viscosity: Low
a)
Non-inflammatory joint disorder
b)
Inflammatory (Immunologic)
c)
Inflammatory (Crystal-induced)
107.
WBC count: Up to 100,000/uL
a)
Non-inflammatory joint disorder
b)
Inflammatory (Immunologic)
c)
Inflammatory (Crystal-induced)
108.
WBC count: 2,000 to 75,000/uL
a)
Non-inflammatory joint disorder
b)
Inflammatory (Immunologic)
c)
Inflammatory (Crystal-induced)
109.
Neutrophils: >50%
a)
Non-inflammatory joint disorder
b)
Inflammatory (Immunologic)
c)
Inflammatory (Crystal-induced)
110.
Neutrophils: <70%
a)
Non-inflammatory joint disorder
b)
Inflammatory (Immunologic)
c)
Inflammatory (Crystal-induced)
111.
Positive for autoantibodies
a)
Non-inflammatory joint disorder
b)
Inflammatory (Immunologic)
c)
Inflammatory (Crystal-induced)
112.
Positive for crystals
a)
Non-inflammatory joint disorder
b)
Inflammatory (Immunologic)
c)
Inflammatory (Crystal-induced)
113.
Microbial infection
a)
Septic
b)
Hemorrhagic
114.
Traumatic injury, coagulation deficiencies, etc.
a)
Septic
b)
Hemorrhagic
115.
Color & clarity: cloudy, yellow-green fluid
a)
Septic
b)
Hemorrhagic
116.
Viscosity: variable
a)
Septic
b)
Hemorrhagic
117.
Viscosity: low
a)
Septic
b)
Hemorrhagic
118.
WBC count: equal to blood
a)
Septic
b)
Hemorrhagic
119.
WBC count: 50,000 to 100,000/uL
a)
Septic
b)
Hemorrhagic
120.
Neutrophils: >75%
a)
Septic
b)
Hemorrhagic
121.
Positive for culture and gram stain
a)
Septic
b)
Hemorrhagic
122.
Glucose is normal
a)
Septic
b)
Hemorrhagic
123.
Positive for RBCs
a)
Septic
b)
Hemorrhagic
124.
Glucose is decreased
a)
Septic
b)
Hemorrhagic
125.
Neutrophils: equal to blood
a)
Septic
b)
Hemorrhagic
126.
Color & clarity: cloudy, red fluid
a)
Septic
b)
Hemorrhagic
127.
Immunologic disorders (RA, SLE..,)
a)
Non-inflammatory joint disorder
b)
Inflammatory (Immunologic)
c)
Inflammatory (Crystal-induced)
100 %
