Clinical Serology and Lab Testing (Johnston)

Question 1

ESR and CRP are?

Answer 1

Acute phase reactants (immediate response to inflammatory stimuli)

Question 2

ESR rises with?

It is higher in what sex?

What is its purpose?

Answer 2

1) Age
2) Women
3) Monitor disease activity

Question 3

What is the purpose of CRP?

What level is considered inflammatory?

What increases it?

What can it activate?

What is unique about this?

Answer 3

1) Assessment of disease activity
2) >8mg/ L
3) Proinflammatory cytokines
4) Complement and phagocytosis
5) Rise and fall faster than ESR

Question 4

What is Rheumatoid Factor (RF)?

What does it target?

Answer 4

1) IgM autoantibody

2) Fc portion of IgG

Question 5

While IgM is the most common Ig subclass for RF, what other subclass can it be?

Answer 5

IgA and IgG

Question 6

What is RF produced by and were?

Answer 6

B cells in synovial joints

Question 7

What is Anti-CCP?

Answer 7

Antibodies to citrullinated proteins

Question 8

Anti-CCP is present in 70% of patients with?

Answer 8

RA

Question 9

What labs are 99.5% specificity for RA?

Answer 9

Positive for Anti CCP and RF

Question 10

ANA is detected against?

What is homogenous pattern seen with

What is Anti-centromere antibody seen with?
(Anti Scl 70)

Answer 10

• Nuclear antigens
• Drug induced lupus (Histone Ab)
• Scleroderma (CREST)

Question 11

Group A Streptococcal infection can cause what to increase?

Answer 11

Antistreptolysin O antibody (ASO titer)

anti DNAase B titers

Question 12

What is 100% positive in the nodules in RA patietns?

Answer 12

RF

Question 13

What labs can be a false positive result in RA patients?

Answer 13

ANA

Question 14

SLE Hematologic Criteria include

Answer 14

Hemolytic anemia
Leukopenia
Lymphoma
or Thrombocytopenia

Question 15

Hyperuricemia is defined as?

Answer 15

Uric acid > 6.8 mg/dl

Question 16

Which imaging study is better for viewing RA symmetrical involvement of MCP, periarticular osteopenia, and erosions?

Answer 16

Radiographs

Question 17

Which imaging studies is best for viewing soft tissue abnormalities (synovitis, tendonitis, bursitis)?

Which study can also be used?

Answer 17

1) Ultrasonography

2) MRI

Question 18

Which imaging study is best for bony abnormities?

Answer 18

CT

Question 19

What arthritic symptom can be seen in endocrine issues involving the thyroid?

Answer 19

Carpal tunnel syndrome

Question 20

What arthritic symptom can be seen in diabetes?

Answer 20

1) Charcot’s

2) Cheiroarthropathy