Acute phase reactants

Question 1

Acute phase reactants are “proteins produced in abundance with inflammation”

List them

Answer 1

Fibrinogen
clotting factors
complement proteins
amyloid A
C reactive protein
hepcidin
ferritin
alpha-1-antitrypsin
antiproteases

Question 2

Serum Amyloid A

Answer 2

plays a role in recycling and reusing cholesterol from destroyed and damaged cells

Question 3

Fibrinogen

ERS is a poor test for inflammation because its sensitivity and specificity is low

Answer 3

makes RBCs sticky

increases their erythrocyte sidementation rate ERS
“sed rate” so they sink faster
ERS is higher in inflammation, increasing age, and women in general

Question 4

C reactive protein (CRP)

Answer 4

binds phosphocholine residues found only on bacteria
CRP bound to it> a ligand for C1 to bind
initiating the classical compliment cascade

Question 5

C REactive protein levels

Answer 5

increase with bacterial infection only
change up and down all the time (no age conn)
normal 1mg/L
IL 6 is main one to induce liver to produce CRP

Question 6

Which cytokines induce a left shift?

Answer 6

TNF and IL1

A LEFT SHIFT is an increased number of immature granulocytes in blood. Caused by inflammation.
A left shift isn’t present in steroid use.

Question 7

Systemic inflamm resp syndrome (SIRS)
and
Sepsis= SIRS in response to infection

The MAJORITY OF PATIENTS WITH sepsis have a negative blood culture (experience diagnosis)

Answer 7

Original criteria included two or more of these

1. temperature >38 or 90/min
2. respiratory rate >20/min or pCo2 < 32 mmHg
3. WBC count >12,000 or >10% bands or <4,000

Question 8

Sepsis can only be diagnosed with experience

expanded characteristics include

Answer 8

• edema
• altered mental state
• positive fluid balance
• hyperglycemia
• elevated C reactive protein
• procalcitonin