Skip to content
Search
Home
About Us
About APLAR
APLAR Milestones
President Message
Committees
APLAR Directors
Executive Committee
Other Committees
Membership
Member National Organizations
Constitution & Terms of Reference
Membership Application
Membership Update
Academy
APLAR Academy
Governance
Membership
Short Course
Upcoming Course
Past Course
Academy Webinar
Upcoming Webinar
Past Webinar
Grand Round
Upcoming Grand Round
Past Grand Round
Discussion Forum
Grand Round Blackboard
ASPIRE Grant
About APLAR ASPIRE
ASPIRE Core Training Modules
ASPIRE Implementation Toolkit
About SIG
AYR
ABOUT AYR
AYR Board
Committee
AYR Membership
AYR Webinar
Upcoming Webinar
Past Webinar
AYR Blackboard
Discussion Forum
Collaboration
APLAR ESOR
ESOR Application
Post Event Submission
Online Submission
EULAR School of Rheumatology
Exchange Programme
Exchange Programe Application
Online Submission
EULAR Exchange Program
APLAR MNO Patronage
Patronage Application
Online Submission
EULAR Collaborations
Center Of Excellence
APLAR CoEs
New Application
Renew CoE Application
Online Submission
Grants and Awards
Grant
COPCORD Grant
Congress Travel Grant
Research Grant
Fellowship Grant
Award
Master Award
Events
Congress
Upcoming Congress
Past Congress
Events
Upcoming Events
Past Events
Gallery
Publications
Published Journal
SIG Publication
COVID – 19 Publication
IJRD
Voice Of APLAR
Patient Education
APLAR Grand Round Blackboard Test Infection and arthritis
Name
(Required)
Phone
(Required)
Email
(Required)
Enter Email
Confirm Email
Question 1: Which of the following is the most appropriate diagnostic test for Chikungunya virus infection during the first 5 days of symptom onset?
Question 1
(Required)
A. ELISA for IgM
B. ELISA for IgG
C. Real-time PCR
D. Viral culture
E. Rheumatoid factor
Answer with a detailed explanation
C. Real-time PCR
During the acute phase (<5 days of illness onset), real-time PCR is the preferred method for detecting Chikungunya virus RNA. Serology (IgM) becomes more reliable after day 5–7, especially in atypical or chronic presentations.
References:
Andrew A, Navien TN, Yeoh TS, Citartan M, Mangantig E, Sum MSH, et al. Diagnostic accuracy of serological tests for the diagnosis of Chikungunya virus infection: A systematic review and meta-analysis. PLoS Negl Trop Dis. 2022;16(2):e0010152. doi:10.1371/journal.pntd.0010152
Marques CDL, Duarte ALBP, Ranzolin A, Dantas AT, Cavalcanti NG, Gonçalves RSG, et al. Recommendations of the Brazilian Society of Rheumatology for diagnosis and treatment of Chikungunya fever. Part 1 – Diagnosis and special situations. Rev Bras Reumatol. 2017;57(S2):S421–37. doi:10.1016/j.rbre.2017.05.006
Your Answer is Incorrect
Your Answer is Incorrect
Your Answer is Incorrect
Your Answer is Incorrect
Question 2: Which of the following synovial fluid analysis findings is most specific for acute septic arthritis, particularly when the total white blood cell (WBC) count is not significantly elevated?
Question 2
(Required)
A. Polymorphonuclear (PMN) cell percentage greater than 90%.
B. Negative Gram stain result.
C. Synovial fluid LDH > 250 U/L.
D. Synovial fluid protein level of 2 g/dL.
Answer with a detailed explanation
A. Polymorphonuclear (PMN) cell percentage greater than 90%.
A very high percentage of neutrophils (PMNs) is a strong indicator of a bacterial infection. This finding maintains high specificity for septic arthritis even when the total WBC count is below the classic diagnostic thresholds, which can occur in immunocompromised patients or very early in the infection. A negative Gram stain is common and does not rule out infection, the presence of crystals indicates gout, and a low protein level is not typical for septic arthritis.
Reference:
Margaretten, M. E., et al. (2007). Does this adult patient have septic arthritis?. JAMA. The study emphasizes that a synovial fluid PMN percentage of >90% has a high positive likelihood ratio for septic arthritis, making it a more reliable indicator than any single WBC count threshold.
Your Answer is Incorrect
Your Answer is Incorrect
Your Answer is Incorrect
Δ
