Erythrocyte Sedimentation Rate Flashcards
It is a non-specific measurement to detect and monitor an inflammatory response to tissue injury in which there is a change in the plasma concentration of acute phase proteins.
ESR
ESR is reported in _____
mm/hour
ESR is affected by 3 factors which are:
Red Cells
Plasma Compositions
Mechanical/Technical Factors
Red cells repel each other because of their _____
Net negative charge
In disease states, plasma protein concentration changes, causing _____ and _____
Reduction in the net negative charge of the RBCs
Consequent formation of rouleaux
True or False
The larger the particle, the slower the rate of fall.
False
The larger the particle, the faster the rate of fall.
True or False
Microcytes settle more rapidly than macrocytes.
False
Macrocytes settle more rapidly than microcytes.
_____ and _____ are unable to form rouleaux which causes decreased ESR.
Sickle Cells
Spherocytes
_____ and _____ causes reduced ability of the RBCs to form large aggregates which leads to decreased ESR.
Anisocytosis
Poikilocytosis
A condition which leads to an increased ESR.
Severe Anemia
Single most important factor determining the ESR
Plasma Factors
_____ and _____ are controlled primarily by levels of Acute Phase Proteins
Rouleaux
Aggregation
Rouleaux and aggregation are controlled primarily by levels of acute phase proteins which are the:
Fibrinogen
Alpha-1 Globulin
Alpha-2 Globulin
A tilt of _____ can cause error up to _____.
3 degrees
30%
_____ Temperature = Increased ESR
Increased Temperature
Conditions with Elevated ESR:
Pregnancy (after 3rd month)
Acute and Chronic Infections
Rheumatic Fever
Rheumatoid Arthritis
Myocardial Infarction
Nephrosis
Acute Hepatitis
Menstruation
Tuberculosis
Macroglobulinemia
Cryoglobulinemia
Hypothyroidism
Hyperthyroidism
Conditions with Decreased ESR:
Polycythemia
Congestive Heart Failure
Hypofibrinogenemia
Presence of Red Cell Abnormalities (Poikilocytosis, Spherocytes, and Sickle Cells)
Other term for ESR Wintrobe Method.
Landsberg Method
Specimen of choice for ESR Wintrobe Method:
EDTA Anticoagulated Blood
Procedure for ESR Wintrobe Method:
- Mix the blood.
- With a long stem pipette, fill the wintrobe tube up to 0 mark (no air bubbles).
- Place the tube in a vertical position on the rack for 60 minutes.
- Record the level of sedimented ESR from the scale on the left side (red) of the tube. Read downward.
Specimen of choice for Westergen Method:
Citrated Blood (0.109 Trisodium Citrate)
Reference Values for Westergren ESR: (Women)
0-15 mm/hr
Reference Values for Westergren ESR: (Men)
0-10 mm/hr
Reference Values for Westergren ESR: (Children)
0-10 mm/hr
Reference Values for Wintrobe and Landsberg ESR: (Women)
0-20 mm/hr
Reference Values for Wintrobe and Landsberg ESR: (Men)
0-9 mm/hr
A stage of ESR wherein the sedimentation rate is slight.
Initial Rouleaux Formation/Lag Phase
A stage of ESR wherein the sedimentation is more rapid and constant.
Rapid Settling of RBCs/Rapid Packing of Cells/Decantation
A stage of ESR wherein the sedimentation rate is slow because of the accumulation of RBCs at the bottom of the tube.
Final Sedimentation of RBCs
How many minutes is the Initial Rouleaux Formation or the Lag Phase?
10 minutes
How many minutes is the Rapid Settling of RBCs/Rapid Packing of Cells/Decantation?
40 minutes
How many minutes is the Final Sedimentation of RBCs?
10 minutes
How long is the Standard or Original Westergren Tube?
300.5 mm long (± 0.5mm)
What is the size of the tube bore in a Standard or Original Westergren?
2.65 mm (± 0.15mm)
How long is the Wintrobe and Landsberg Tube?
115 mm
What is the size of the tube bore in Wintrobe and Lansberg Method?
3 mm
If concentration of EDTA is greater than recommended, the ESR will be _____
Falsely Low
If the ESR stands for more than 60 minutes, the results will be _____
Falsely Elevated
_____ Temperature = Increased ESR
Increased
_____ Temperature = Decreased ESR
Decreased
Sources of Error for ESR:
- If concentration of EDTA is greater than recommended, the ESR will be falsely low
- If the ESR stands for more than 60 minutes, the results will be falsely elevated
- If it is timed for less than 60 minute, ESR will be low
- Marked increase in temperature = Increased ESR
- Marked decrease in temperature = Decreased ESR
- Tilting increases sedimentation rate
- Bubbles cause invalid results
- Fibrin clots invalidate results
