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Synovial Fluid (SF) Quiz
  • Evaluation tool to enhance SF teaching curriculums
  • Developed by Lan Chen, Gilda Glayburne,
  • H. Ralph Schumacher, Brian Mandell
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1. A wet preparation for crystal analysis is ideally performed by placing
how many drops on the slide and then covering with a cover slip?
  • A.  1
  • 3
  • C.  5
  • D. 10
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2. The ideal way to preserve synovial fluid for crystal analysis is to
 immediately mix it with:
  • A.  Lithium heparin
  • B.  EDTA
  • C.  Ammonium oxalate
  • D.  Saline
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3.The Synovial Fluid in the picture is most likely:

A. Normal.
B. Gouty.
C. Septic 
D. Rheumatoid Arthritis
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4. If one polarizing filter is absent, when you place the red compensator
in place the background is :

A.  Dark
B.  Almost normal light
C.  Pink (magenta)
D.  Blue
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5. This synovial fluid sample is being examined for crystals under polarized light with a red compensator in place.  The direction of the slow axis of the compensator is shown by the black arrow.
  • These crystals are:
  • Cornstarch (from surgical gloves)
  • Monosodium Urate
  • Calcium Pyrophosphate
  • Hydroxyapatite
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6. This view using compensated polarized light shows
  • Depot corticosteroid crystal
  • MSU Crystal
  • CPPD
  • Hydroxyapatite
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7.  The Alizarin red S stain is used to identify crystals
      containing:
  • Urate
  • Calcium
  • Lipid (cholesterol)
  • Phosphate
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8. Which are more numerous in this picture:
  • RBC
  • WBC
  • Fat droplets
  • Hydroxyapatite
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9. Which one of the following is usually not birefringent:
  • Calcium Pyrophosphate
  • Monosodium Urate
  • Hydroxyapatite
  • Depot corticosteroid
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10. From which kinds of specimens can urate crystals be easily identified?
  • A.  Synovial fluid pellets
  • B.  Gram Stained Smears
  • Formalin fixed tissue
  • A and B
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11. What number of WBC/40x HPF in a fresh wet preparation of synovial fluid is expected in the typical patient with osteoarthritis:
  • A.  1-2
  • 10-20
  • 50-150
  • >200
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12. The pictured crystals are seen following aspiration of fluid from a chronically swollen olecranon bursa.  The most likely etiology of the the chronic bursitis is:
  • A.  Pseudogout
  • B.  Type 4 hyperlipoproteinemia
  • C.  Myositis with calcinosis
  • D.  Rheumatoid arthritis
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Score Sheet
  • Name ______________________


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