Erythrocyte Sedimentation Rate Flashcards by Rae Anne Montealegre

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

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

How well did you know this?

Not at all

Perfectly

What diseases does ESR help in the diagnosis of?

Temporal arteritis
Polymyalgia rheumatica

How well did you know this?

Not at all

Perfectly

In what conditions is ESR elevated?

Plasma cell myeloma
Pregnancy
Anemia
Older age

How well did you know this?

Not at all

Perfectly

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

No because of its low specificity and sensitivity

How well did you know this?

Not at all

Perfectly

What is the ESR affected by?

RBC
Plasma
Mechanical and technical factors

How well did you know this?

Not at all

Perfectly

What is the result of the formation of rouleaux?

RBC settle more rapidly

How well did you know this?

Not at all

Perfectly

What macromolecules can produce the formation of rouleaux?

Fibrinogen
Beta-globulins
Pathologic immunoglobulins

How well did you know this?

Not at all

Perfectly

What are altered during a rouleaux formation?

Plasma fibrinogen
Globulins

How well did you know this?

Not at all

Perfectly

What is the most commonly used method for ESR today?

Modified Westergren method

How well did you know this?

Not at all

Perfectly

What is the advantage of using the modified Westergren method?

Allows the detection of highly elevated ESRs

How well did you know this?

Not at all

Perfectly

What is the anticoagulant of choice in erythrocyte sedimentation rate?

EDTA (Ethylenediaminetetraacetic acid)

How well did you know this?

Not at all

Perfectly

What is the length of the Westergren tube?

200 mm

How well did you know this?

Not at all

Perfectly

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

2.55 mm

How well did you know this?

Not at all

Perfectly

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

60 minutes at room temperature

How well did you know this?

Not at all

Perfectly

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

Oxalate-anti-coagulated whole blood

How well did you know this?

Not at all

Perfectly

What is the length of the Wintrobe tube?

115 mm

How well did you know this?

Not at all

Perfectly

What is the current specimen of choice for Wintrobe ESR?

EDTA-treated or citrated whole blood

How well did you know this?

Not at all

Perfectly

What is the advantage of using the wintrobe tube?

Increased sensitivity in detecting mildly elevated ESRs

How much blood is needed for the Wintrobe ESR?

Minimum of 2mL

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

3.2-3.8%

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

4:1

What is the calibration of the Wintrobe tube?

100 mm

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

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

What anticoagulants can cause the red blood cells to shrink?

Sodium or potassium oxalate
Heparin

What is the result when the red blood cells shrink?

Elevated ESR

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

Yes

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

Increased result

Within what hour should the specimen be examined?

4 hours

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

The rbc start to become spherical

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

24 hours at 4C

How long should the specimen be rewarmed?

15 minutes

What is the effect of vibrations to the ESR result?

Falsely increase ESR

What hematologic disorders prevent the formation of rouleaux?

Presence of sickle cells and spherocytes

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

Decrease ESR

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

Falsely elevated

Reference range for male:

0-10 mm/hr

Reference range for female:

0-15 mm/hr

Reference range for children:

0-10 mm/hr

Drugs that can increase ESR

ProDeMetOr Procainamide Dextran Methyldopa Oral contraceptives

Drugs that decrease ESR

Aspirin Cortisone Quinine

Pathological causes of LOW ESR reading:

Polycythemia Leukocytosis Sickle cell anemia Congestive cardiac failure

Non-pathologic causes of LOW ESR:

Albumin Defibrination Temp below 20C Long standing Short sedimentation rate

Pathological causes of HIGH ESR

Multiple myeloma Tuberculosis Malignancies Severe anemia

Non-pathologic causes if HIGH ESR

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