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13 Cards in this Set

  • Front
  • Back
(Gold Folder)
Which of the following is incorrect regarding joint aspirates?
A. In early Septic arthritis, the White cell count (WCC) can be < 50,000
B. Gout has positively birefringent crystals.
C. A non-inflammatory joint has WCC < 2000
D. A PMN count > 50% is more likely Inflammatory OR Septic.
B. Gout has NEGATIVELY BIREFRINGENT

"NEEDLE-LIKE" crystals
(Gold Folder)
In regards to Joint aspirates, which of the

following is correct?
A. Pseudogout has rhomboid, negatively birefringent crystals.
B. The gram stain is positive in 25% of septic arthritis.
C. A PMN count < 25% can be normal.
D. A White cell count of 2000 - 50,000 is more likely Septic arthritis.
C.

A = Pseudogout = rhomboid - Positively

birefringent
B = 75%
D = WCC 2000-50,000 = inflammatory
(Gold Folder)
Which of the following is incorrect regarding joint aspirates?
A. A PMN > 50% and WCC > 50,000 is supportive for septic arthritis
B. A non-inflammatory aspirate will typically have WCC < 2000 and PMN < 25%.
C. A normal aspirate typically has WCC < 200 and PMN < 25%
D. An inflammatory aspirate typically has WCC < 2000 and PMN > 50%
D. Inflammatory Aspirate = WCC 2000 - 50,000 and PMN > 50%.
(Cameron)
In regards to Joint aspirates, which of the

following is correct?
A. A yellow, turbid aspirate is supportive of septic arthritis.
B. A clear aspirate is supportive for a septic arthritis.
C. White cells can range from 5000 -10,000 for a Non-septic arthritis
D. White cells of < 1000 is suggestive of a "non-septic" arthritis .
C.

A = "non-septic " arthritis
B = Non-inflammatory effusion
D = Non-inflammatory effusion
(Cameron)
What are the synovial fluid characteristics of a Septic arthritis ?
( ie. colour + turbidity + Leukocytes +

Predominant cell type)

Septic Arthritis :

Colour: yellow-green
Turbidity: purulent , turbid
Leukocytes : 10,000 - 100,000 / uL
Predominant cell type : PMN
(Cameron)
What are the characteristics of a Non-septic arthritis ?
( Colour / turbidity / Leukocytes / Predominant cell type)

Non-Septic Arthritis :



Colour: Yellow
Turbidity : Turbid
Leukocytes : 5000 -10,000
Predominant cell type: PMN
(Cameron)
What re the characteristics of a

Non-inflammatory effusion ?
(Colour / turbidity / Leukocytes / Predominant cell type)
Colour: colourless
Turbidity: clear
Leukocytes : < 1000
Predominant cell type : Monocyte
(Cameron)
In regards to Septic arthritis, which of the

following is incorrect?
A. The pathophysiology leads to synovial abscess formation and cartilage necrosis.
B. The majority of septic arthritis occurs in the older age group.
C. The most common joints are the hip and knee.
D. A polyarticular presentation is more common in gonococcal infection.
B. Septic Arthritis more common in Children and young adults.
(Cameron)
In regards to the bacterial causes of

septic arthritis, which of the following


age-related links is incorrect?
A. Neisseria gonorrhoeae - young adults
B. Gram negative species - Children
C. Group A Streptococci - Children and Older Adults
D. Staphylococcus aureus - All groups.
B. Gram negative species = Older Adults
(Cameron)
In regards to Septic arthritis, which of the

following is incorrect?
A. Mortality can be as high as 15% in Septic arthritis
B. The commonest causative organisms for Septic arthritis are


Staphylococci and Streptococci.
C. Joint prosthesis is not a risk factor for septic arthritis.
D. The Likelihood of septic arthritis increases from 3% with a synovial WCC of 25,000, to 30% with a WCC of > 100,000 u/L
C. Joint Prosthesis IS A Risk factor for Septic Arthritis


Skin infection overlying a Prosthetic joint


increases the infection risk by 15-fold.
(Cameron)
In regards to Joint aspirates and Infection, which of the following is incorrect?
A. Gram stain has a sensitivity of 50%
B. Aspirate Culture has a sensitivity of 50%
C. The presence of a high synovial white cell count PLUS micro-organisms are diagnostic of Septic arthritis.
D. There is actually no "Gold Standard " test for Septic arthritis.
B. Joint aspirate culture has a higher sensitivity than gram stain : 80%
(Cameron)
In regards to Gout, which of the following is

incorrect?
A. It is an " intra-articular inflammatory response to monosodium urate crystal deposition".
B. Hyperuricaemia is the strongest predictor of gout.
C. The joint aspirate may typically appear turbid, with between


5000-10,000 Leukocytes and PMN predominance - potentially similar to septic arthritis.
D. The serum urate is typically elevated in an acute attack.
D. Serum urate may be Normal or elevated.
(Cameron)
In regards to Joint aspirate for the hot swollen joint, which of the following is incorrect?
A. Polarising light microscopy may show the presence of urate or calcium pyrophosphate crystals.
B. Calcium pyrophosphate crystals are weakly positively birefingent.
C. Urate crystals are strongly negatively birefingent.
D. Synovial glucose and Protein are important aspirate tests to perform.
D. Unhelpful tests.