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Erythrocyte Sedimentation Rate Flashcards

1
Q

What is the purpose of ordering ESR along with other tests?

A

Detect and monitor the course of inflammatory conditions such as, rheumatoid arthritis, infections, or certain malignancies

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2
Q

What diseases does ESR help in the diagnosis of?

A

Temporal arteritis
Polymyalgia rheumatica

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3
Q

In what conditions is ESR elevated?

A

Plasma cell myeloma
Pregnancy
Anemia
Older age

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4
Q

Is ESR recommended as a screening test to detect inflammatory conditions in asymptomatic individuals? Why?

A

No because of its low specificity and sensitivity

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5
Q

What is the ESR affected by?

A

RBC
Plasma
Mechanical and technical factors

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6
Q

What is the result of the formation of rouleaux?

A

RBC settle more rapidly

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7
Q

What macromolecules can produce the formation of rouleaux?

A

Fibrinogen
Beta-globulins
Pathologic immunoglobulins

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8
Q

What are altered during a rouleaux formation?

A

Plasma fibrinogen
Globulins

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9
Q

What is the most commonly used method for ESR today?

A

Modified Westergren method

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10
Q

What is the advantage of using the modified Westergren method?

A

Allows the detection of highly elevated ESRs

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11
Q

What is the anticoagulant of choice in erythrocyte sedimentation rate?

A

EDTA (Ethylenediaminetetraacetic acid)

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12
Q

What is the length of the Westergren tube?

A

200 mm

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13
Q

What is the size of the bore of the Westergren tube?

A

2.55 mm

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14
Q

How long should you stand the Westergren tube for and at what temperature?

A

60 minutes at room temperature

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15
Q

What was the specimen used when the Wintrobe method was first introduced?

A

Oxalate-anti-coagulated whole blood

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16
Q

What is the length of the Wintrobe tube?

A

115 mm

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17
Q

What is the current specimen of choice for Wintrobe ESR?

A

EDTA-treated or citrated whole blood

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18
Q

What is the advantage of using the wintrobe tube?

A

Increased sensitivity in detecting mildly elevated ESRs

19
Q

How much blood is needed for the Wintrobe ESR?

A

Minimum of 2mL

20
Q

What is the percentage of the sodium citrate in the black vacutainer?

21
Q

What is the blood to anticoagulant ration of the black vacutainer tube?

22
Q

What is the calibration of the Wintrobe tube?

23
Q

What will be the result if the concentration of anticoagulant is increased?

A

Falsely low as a result of sphering of the RBCs which inhibits rouleaux formation

24
Q

What anticoagulants can cause the red blood cells to shrink?

A

Sodium or potassium oxalate
Heparin

25
Q

What is the result when the red blood cells shrink?

A

Elevated ESR

26
Q

Can the significant change in the temperature alter the result of the ESR?

27
Q

What will happen to the ESR result when there is a slight tilt of the pipette?

A

Increased result

28
Q

Within what hour should the specimen be examined?

29
Q

What happens if the specimen is allowed to sit for more than 4 hours?

A

The rbc start to become spherical

30
Q

How long can blood specimens be stored and at what temperature?

A

24 hours at 4C

31
Q

How long should the specimen be rewarmed?

A

15 minutes

32
Q

What is the effect of vibrations to the ESR result?

A

Falsely increase ESR

33
Q

What hematologic disorders prevent the formation of rouleaux?

A

Presence of sickle cells and spherocytes

34
Q

What is the effect of hematologic disorders on the ESR result?

A

Decrease ESR

35
Q

What is the effect of severe anemia on the ESR result?

A

Falsely elevated

36
Q

Reference range for male:

A

0-10 mm/hr

37
Q

Reference range for female:

A

0-15 mm/hr

38
Q

Reference range for children:

A

0-10 mm/hr

39
Q

Drugs that can increase ESR

A

ProDeMetOr

Procainamide
Dextran
Methyldopa
Oral contraceptives

40
Q

Drugs that decrease ESR

A

Aspirin
Cortisone
Quinine

41
Q

Pathological causes of LOW ESR reading:

A

Polycythemia
Leukocytosis
Sickle cell anemia
Congestive cardiac failure

42
Q

Non-pathologic causes of LOW ESR:

A

Albumin
Defibrination
Temp below 20C
Long standing
Short sedimentation rate

43
Q

Pathological causes of HIGH ESR

A

Multiple myeloma
Tuberculosis
Malignancies
Severe anemia

44
Q

Non-pathologic causes if HIGH ESR

A

Increased dilution of blood
Presence of air bubbles
Tilting of tube
Temp above 27C
Cholesterol

HEMA311 (5 decks)

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