Erythrocyte Sedimentation Rate

Question 1

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.

Answer 1

ESR

Question 2

ESR is reported in _____

Answer 2

mm/hour

Question 3

ESR is affected by 3 factors which are:

Answer 3

Red Cells
Plasma Compositions
Mechanical/Technical Factors

Question 4

Red cells repel each other because of their _____

Answer 4

Net negative charge

Question 5

In disease states, plasma protein concentration changes, causing _____ and _____

Answer 5

Reduction in the net negative charge of the RBCs
Consequent formation of rouleaux

Question 6

True or False

The larger the particle, the slower the rate of fall.

Answer 6

False

The larger the particle, the faster the rate of fall.

Question 7

True or False

Microcytes settle more rapidly than macrocytes.

Answer 7

False

Macrocytes settle more rapidly than microcytes.

Question 8

_____ and _____ are unable to form rouleaux which causes decreased ESR.

Answer 8

Sickle Cells
Spherocytes

Question 9

_____ and _____ causes reduced ability of the RBCs to form large aggregates which leads to decreased ESR.

Answer 9

Anisocytosis
Poikilocytosis

Question 10

A condition which leads to an increased ESR.

Answer 10

Severe Anemia

Question 11

Single most important factor determining the ESR

Answer 11

Plasma Factors

Question 12

_____ and _____ are controlled primarily by levels of Acute Phase Proteins

Answer 12

Rouleaux
Aggregation

Question 13

Rouleaux and aggregation are controlled primarily by levels of acute phase proteins which are the:

Answer 13

Fibrinogen
Alpha-1 Globulin
Alpha-2 Globulin

Question 14

A tilt of _____ can cause error up to _____.

Answer 14

3 degrees
30%

Question 15

_____ Temperature = Increased ESR

Answer 15

Increased Temperature

Question 16

Conditions with Elevated ESR:

Answer 16

Pregnancy (after 3rd month)
Acute and Chronic Infections
Rheumatic Fever
Rheumatoid Arthritis
Myocardial Infarction
Nephrosis
Acute Hepatitis
Menstruation
Tuberculosis
Macroglobulinemia
Cryoglobulinemia
Hypothyroidism
Hyperthyroidism

Question 17

Conditions with Decreased ESR:

Answer 17

Polycythemia
Congestive Heart Failure
Hypofibrinogenemia
Presence of Red Cell Abnormalities (Poikilocytosis, Spherocytes, and Sickle Cells)

Question 18

Other term for ESR Wintrobe Method.

Answer 18

Landsberg Method

Question 19

Specimen of choice for ESR Wintrobe Method:

Answer 19

EDTA Anticoagulated Blood

Question 20

Procedure for ESR Wintrobe Method:

Answer 20

1. Mix the blood.
2. With a long stem pipette, fill the wintrobe tube up to 0 mark (no air bubbles).
3. Place the tube in a vertical position on the rack for 60 minutes.
4. Record the level of sedimented ESR from the scale on the left side (red) of the tube. Read downward.

Question 21

Specimen of choice for Westergen Method:

Answer 21

Citrated Blood (0.109 Trisodium Citrate)

Question 22

Reference Values for Westergren ESR: (Women)

Answer 22

0-15 mm/hr

Question 23

Reference Values for Westergren ESR: (Men)

Answer 23

0-10 mm/hr

Question 24

Reference Values for Westergren ESR: (Children)

Answer 24

0-10 mm/hr

Question 25

Reference Values for Wintrobe and Landsberg ESR: (Women)

Answer 25

0-20 mm/hr

Question 26

Reference Values for Wintrobe and Landsberg ESR: (Men)

Answer 26

0-9 mm/hr

Question 27

A stage of ESR wherein the sedimentation rate is slight.

Answer 27

Initial Rouleaux Formation/Lag Phase

Question 28

A stage of ESR wherein the sedimentation is more rapid and constant.

Answer 28

Rapid Settling of RBCs/Rapid Packing of Cells/Decantation

Question 29

A stage of ESR wherein the sedimentation rate is slow because of the accumulation of RBCs at the bottom of the tube.

Answer 29

Final Sedimentation of RBCs

Question 30

How many minutes is the Initial Rouleaux Formation or the Lag Phase?

Answer 30

10 minutes

Question 31

How many minutes is the Rapid Settling of RBCs/Rapid Packing of Cells/Decantation?

Answer 31

40 minutes

Question 32

How many minutes is the Final Sedimentation of RBCs?

Answer 32

10 minutes

Question 33

How long is the Standard or Original Westergren Tube?

Answer 33

300.5 mm long (± 0.5mm)

Question 34

What is the size of the tube bore in a Standard or Original Westergren?

Answer 34

2.65 mm (± 0.15mm)

Question 35

How long is the Wintrobe and Landsberg Tube?

Answer 35

115 mm

Question 36

What is the size of the tube bore in Wintrobe and Lansberg Method?

Answer 36

3 mm

Question 37

If concentration of EDTA is greater than recommended, the ESR will be _____

Answer 37

Falsely Low

Question 38

If the ESR stands for more than 60 minutes, the results will be _____

Answer 38

Falsely Elevated

Question 39

_____ Temperature = Increased ESR

Answer 39

Increased

Question 40

_____ Temperature = Decreased ESR

Answer 40

Decreased

Question 41

Sources of Error for ESR:

Answer 41

• 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