ESR (sed rate) Flashcards
The erythrocyte sedimentation rate is a nonspecific test used to detect and monitor any ____________ response to tissue injury. Aka an acute phase response 
Inflammatory
What are the units for the ESR test?
mm/hr.
The test is performed in a one hour period 
What factors affect ESR?
-size and shape of RBCs
-The plasma protein composition
-The total RBC concentration
-Other mechanical and technical factors
RBCs fall because they lineup in __________ formation. 
Rouleaux
Anything that overcomes the ________ potential will increase the chances that rouleaux will form and thus increase the ESR. 
Zeta
The measurable charge of RBCs, innate repulsion from each other, caused by electrostatic forces
Zeta potential
Increased Rouleaux = ___________ ESR
Increased
What can significantly alter the ESR up or down?
Plasma protein ratio
Conditions which increase plasma viscosity _________ the ESR. 
Increase
*BUT Increased whole blood viscosity decreases the ESR

When reading an ESR, what do you not include in the reading?
Do not include the whitish buffy coat (Leukocytes and platelets)
What is the Westergren ESR reference ranges for males and females? 
Males 0-15mm/hr
Females 0-20 mm/hr
The ESR is an extremely ____________ indicator of inflammation. It is increased in almost any type of infection or inflammation due to the rise in acute phase reactants. 
Nonspecific
ESR can sometimes be associated with what conditions?
-autoimmune conditions such as lupus and RA
-Increase plasma proteins or plasma viscosity conditions
What conditions can cause a decreased ESR?
-polycythemia
-Congestive heart failure
-hypofibrinogenenemia
-And severe RBC morphological abnormalities
The larger the cell the _________ its rate of fall.
Faster
- Macrocytes tend to fall more rapidly than microcytes
Why is ESR decreased in conditions such as sickle cells or spherocytes?
Where are unable to form rouleaux readily 
Can severe anemia cause an increase or decrease ESR?
Increased
- Think of trying to line up three people in an elevator versus a large group
Does polycythemia increase or decrease ESR?
Decrease
 * Think of trying to line up three people in an elevator versus a large group
Is ESR In Polycythemia vera increased or decreased?
May be normal or decreased depending on the severity of the condition
Every degree off from vertical during the ESR test can increase the rate by _____%
10
What are the two standardized methods used for ESR?
-Westergren
-Wintrobe
How long do the newest rapid optical ESRs take? 
20 min
They are semi-automated instruments that tilt the ESR tubes at a slight angle
What are the three stages of ESR for the new rapid optical methodologies? 
- Initial aggregation- Sedimentation is minimal, Rouleaux begins
-  fast settling- Constant rate of settling for about 40 minutes
- Final packing- Occurs mainly at the bottom of tube (last 10 min) 
What do the newest rapid optical ESR measure?
The change in Turbidy of the blood as sedimentation progresses
