Synovial fluid aspiration and microscopy

1 question of gout. Initial investigation asked
SYNOVIAL FLUID ASPIRATION AND MICROSCOPY. JM 372
the only real diagnostic test is synovial fluid aspirate
elevated uric acid level (but is normal in 30 percent)
x ray will u show erosions
1.Chicken pox exposure of pregnant lady not vaccinated.
Give IG (Do serology not mentioned) If you’re found to be non-immune to chickenpox and you’ve been exposed to the virus, your doctor will recommend that you have an injection of VZIG. VZIG stands for varicella-zoster immune globulin (VZIG). It’s a blood product that contains antibodies against the virus.

VZIG won’t help you or your baby if you’ve already developed the chickenpox rash. It only works if you have it before you develop symptoms. This means it needs to be given as soon as possible after any exposure to the virus.

Given at the right time, VZIG can make chickenpox much milder and last for a shorter time. There is also evidence that VZIG may protect your baby from catching the virus in the womb.

Ideally, you should have the VZIG injection within 72 hours of exposure to chickenpox, or at the very latest within 10 days, for it to work.

If you develop a rash despite having VZIG, your doctor may offer you an anti-viral drug called acyclovir. This will reduce your fever and other symptoms, and may make the rash milder. Acycolvir has a good safety record in pregnancy.

Treatment with acyclovir should happen as soon as possible after chickenpox symptoms have appeared, ideally within 24 to 48 hours. If you