CRP Flashcards
THE______ IS A FACET OF THE INNATE IMMUNE SYSTEM THAT OCCURS IN RESPONSE TO INFECTION, TRAUMA OR OTHER INSULTS.
ACUTE PHASE RESPONSE
CERTAIN MEDIATORS, KNOWN AS_______, ARE INCREASED OR DECREASED IN THE CONTEXT OF ACUTE INFLAMMATION.
ACUTE PHASE REACTANTS
THESE MARKERS ARE COMMONLY MEASURED IN CLINICAL PRACTICE AS INDICATORS OF ACUTE ILLNESS.
Acute phase reactants
• AN ACUTE PHASE REACTION CLASSICALLY PRESENTS WITH (3)
FEVERS
RIGOR
TACHYCARDIA
• ACUTE PHASE REACTANTS INCLUDES:
POSITIVE ACUTE PHASE REACTANTS-
INCREASES DURING INFLAMMATION:
• C-REACTIVE PROTEIN
• FIBRINOGEN
• ANTI-CHYMOTRYPSIN
• CERULOPLASMIN
• HAPTOGLOBIN
• COMPLEMENT C3/C4
• SERUM AMYLOID A
NEGATIVE ACUTE PHASE REACTANTS-DECREASES DURING INFLAMMATION
• ALBUMIN
• TRANSFERRIN
• ALPHA-FETOPROTEIN
Inflammatory stimulus
(e.g., tissue injury, infection, heat stress, muscle breakdown, psychological stress)
Flow of CRP production
Stimulus
Activation of macrophage
Macrophage will release cytokines (Interleukin 6)
Activate liver to produce CRP, a-1 antichymotrypsin, fibrinogen, haptoglobin, complement components, ceruloplasmin, serum amyloid and DECREASES albumin, transferrin
CRP OR C-REACTIVE PROTEIN IS A CLASSIC ACUTE-PHASE OF HUMAN SERUM, IS SYNTHESIZED BY_______.
HEPATOCYTES
CRP
NORMALLY, IT IS PRESENT ONLY IN TRACE AMOUNTS IN SERUM, BUT IT CAN INCREASE AS MUCH AS____-FOLD IN RESPONSE TO_____
1,000
INJURY OR INFECTION.
THE CLINICAL MEASUREMENT OF CRP IN SERUM THEREFORE APPEARS TO BE A VALUABLE______ TEST FOR ORGANIC DISEASE AND A SENSITIVE INDEX OF DISEASE ACTIVITY IN INFLAMMATORY, INFECTIVE AND ISCHEMIC CONDITIONS.
SCREENING
CRP IS A MEMBER OF _______FAMILY.
IT IS NAMED SINCE IT BINDS TO THE______ OF THE PNEUMOCOCCUS.
IT APPEARS NORMAL IN THE BLOOD OF HEALTHY INDIVIDUALS BUT ELEVATED DURING THE SIGNS OF_______.
PENTRAXIN PROTEIN FAMILY
C-POLYSACCHARIDE
INFLAMMATION
_______ and ______ FOUND THAT ANTIBODY PRODUCED AGAINST PURIFIED CRP PROVIDED A MORE SENSITIVE TEST THAN THE C-POLYSACCHARIDE ASSAY.
SINCE THAT TIME A NUMBER OF IMMUNOLOGICAL ASSAYS HAVE BEEN DEVISED TO MEASURE CRP SUCH AS
(3)
MACLEOD AND AVERY
CAPILLARY PRECIPITATION, DOUBLE
IMMUNODIFFUSION AND RADIAL IMMUNODIFFUSION
CRP IS ALSO USED TO IDENTIFY EARLY WARNING SIGNS OF PEOPLE AT RISK FOR…
CORONARY HEART DISEASE
CRP IS ELEVATED DURING:
• VIRAL AND BACTERIAL INFECTIONS
• GOUT
• RHEUMATOID ARTHRITIS
• MYOCARDIAL INFARCTION
• ACUTE RHEUMATIC FEVER
PRINCIPLE Of CRP
REVERSE PASSIVE AGGLUTINATION
• THE CRP AGGLUTINATION TEST IS BASED ON THE REACTION BETWEEN PATIENT SERUM CONTAINING CRP AS THE ANTIGEN AND THE CORRESPONDING ANTIHUMAN (CRP) ANTIBODY COATED TO THE TREATED SURFACE OF LATEX PARTICLES.
THE COATED PARTICLES ENHANCE THE DETECTION OF AN AGGLUTINATION REACTION WHEN ANTIGEN IS PRESENT IN THE SERUM BEING TESTED.
REVERSE PASSIVE AGGLUTINATION
The PATIENT SERUM CONTAINING CRP is the…
ANTIGEN
The ANTIHUMAN (CRP) ______COATED TO THE TREATED SURFACE OF LATEX PARTICLES
ANTIBODY
IT IS ALSO A USEFUL INDICATOR IN SCREENING FOR ORGANIC DISEASE, BOTH INFLAMMATORY AND MALIGNANT DISEASES, AND IN MONITORING THERAPY IN INFLAMMATORY DISEASES BECAUSE CRP IS MORE RAPIDLY SYNTHESIZED THAN OTHER ACUTE PHASE PROTEINS, ASSAYS OF CRP ARE THE MEASUREMENT OF CHOICE IN SUSPECTED INFLAMMATORY
CONDITIONS.
REVERSE PASSIVE AGGLUTINATION
BLOOD SHOULD BE DRAWN BY AN ASEPTIC TECHNIQUE.
A MINIMUM OF_____ OF CLOTTED BLOOD (RED-TOP EVACUATED TUBE) IS REQUIRED.
THE SPECIMEN SHOULD BE CENTRIFUGED PROMPTLY AND AN ALIQUOT OF SERUM REMOVED.
2 ML
LIPEMIA, HEMOLYSIS, OR CONTAMINATION WITH BACTERIA RENDERS A SPECIMEN UNSUITABLE FOR TESTING.
ALTHOUGH ICTERIC AND TURBID SPECIMENS HAVE GIVEN VALID RESULTS,___________ IS RECOMMENDED FOR THE TEST.
FRESH NON-HEATED-INACTIVATED SERUM
• IF THE TEST CANNOT BE PERFORMED IMMEDIATELY, THE SPECIMEN SHOULD BE _______FOR NO LONGER THAN 24 HOURS.
IF ADDITIONAL DELAY OCCURS, THE SERUM SHOULD BE FROZEN AT____ OR BELOW.
FROZEN SERUM SHOULD BE THAWED RAPIDLY AT 37C.
REPEAT THAWING AND FREEZING MUST BE AVOIDED.
IF SPECIMEN IS TURBID ON THAWING, IT SHOULD BE CENTRIFUGED TO CLEAR IT BEFORE USE.
REFRIGERATED (2 TO 80C)
-20C
•_____ COLORED SUSPENSION OF CRP
LATEX REAGENT WITH DROPPER ASSEMBLY
BLUE
• ______\PARTICLES COATED WITH MONOSPECIFIC ANTIHUMAN CRP
ANTIBODIES PRODUCED IN_____
1% POLYSTYRENE
GOATS
A POSITIVE CONTROL (_____)
A NEGATIVE CONTROL (_____)
RED CAP
GREEN CAP
• BUFFER
GLYCINE-NACL
QUALITATIVE DETERMINATION (SCREENING TEST)
1. PIPETTE OR DROP ONTO SEPARATE CELLS OF THE SLIDE THE FOLLOWING:
-
-
-
- ADD EACH A DROP OF_____ ONTO ALL SAMPLE AND CONTROL CELLS.
- MIX WITH_____ AND SPREAD THE FLUID OVER THE ENTIRE AREA OF THE PARTICULAR CELL.
- TILT THE SLIDE BACK AND FORTH, SLOWLY AND EVENLY,____ TIMES PER MINUTE, FOR___ MINUTES SO THAT THE MIXTURE ROTATES SLOWLY INSIDE THE CELLS OR PLACE ON AN AUTOMATED ROTATOR AT____ RPM.
- AT THE END OF 2 MINUTES, READ RESULTS UNDER BRIGHT LIGHT.
A. SERUM SAMPLE (1DROP = 40 UL)
B. POSITIVE CONTROL 1 DROP
C. NEGATIVE CONTROL 1 DROP
LATEX REAGENT
SEPARATE STICKS
8 TO 10
2
100
Application: This method is often used to detect antigens such as bacterial toxins, hormones, or viruses.
Passive agglutination
DISTINCT AGGLUTINATION
INDICATES A CRP CONTENT OF MORE THAN______ IN THE NON-DILUTED SPECIMEN.
SERA WITH POSITIVE RESULTS IN THE SCREENING TEST SHOULD BE RETESTED IN THE TITRATION TEST.
(PROCEED PROCEDURE B).
6 IU/ML
Procedure (2)
Qualitative
Semi-Quantitative
RPR reporting
Reactive or non-reactive
What to report if precipitation?
Reactive or Nonreactive
What to report is agglutination?
Positive or Negative
