EXPERIMENT 8

Question 1

is a protein found in blood plasma that shows increased levels in response to inflammation

Answer 1

C- reactive protein (CRP)

Question 2

CRP is synthesized in the liver and has a half – life of (?).

Answer 2

20 to 30 hours

Question 3

CRP belongs to a group of proteins known as acute phase reactants whose concentrations increase during the course of a general, nonspecific response to (?).

Answer 3

infectious and inflammatory processes, cellular necrosis, and malignant neoplasia

Question 4

CRP contributes to non – specific immunity by (?).

Answer 4

activating complement and stimulating phagocytosis

Question 5

Comparing to other acute phase reactants, CRP has the (?).

Answer 5

fastest response time

Question 6

PRINCIPLE:

Answer 6

Mainly, agglutination.

Question 7

The C – reactive protein test reagent contains white latex particles coated with (?) and agglutinates in the presence of C – reactive protein in the patient’s serum.

Answer 7

specific antihuman C – reactive protein antibodies

Question 8

This is a (?) for the qualitative and semi – quantitative detection of C – reactive protein.

Answer 8

rapid slide agglutination test

Question 9

Example, patient A has CRP present (serve as the antigen) in the serum, if we are going to test the presence of CRP in a patient’s serum, use the reagent (?) with antibodies.

Answer 9

white latex particles that is coated with specific antihuman C- Reactive protein

Question 10

Since they are specific with each other, (?) will happen.

Answer 10

agglutination

Question 11

Another example, in Patient B’s serum there is (?).

Answer 11

no CRP

Question 12

Test the presence of CRP in a patient’s serum, use the reagent (?) with antibodies.

Answer 12

white latex particles that is coated with specific antihuman C-Reactive protein

Question 13

Since there is no antigen, only the antibody, (?) will happen.

Answer 13

no reaction/ agglutination

Question 14

Qualitative Test: report if

Answer 14

negative or positive (w/ agglutination)

Question 15

1. Qualitative Test
    CRP is found in (?) that is increased in significant levels once there is inflammation or infection
    Prepare Reagent (?) and slide
    Label the slide as (?)
    Bring the reagents and sample to (?) because they are stored at refrigerator temperature
    Follow the procedure below

Answer 15

plasma

white latex

positive control, negative control and patient’s sample (serum)

Question 16

Follow the procedure below
a. Bring the reagents and samples to (?)
b. Place (?) of the control (positive and negative) and (?) of the sample into separate circles on the test card or agglutination slide
c. Resuspend the (?) gently
d. Add (?) to each circle containing the controls and sample/s
e. Mix with disposable (?) and spread over the entire area enclosed by the ring on the test card or agglutination slide. Use a new stirrer for each sample.
f. Rotate the test cards or agglutination slides at (?) (using a mechanical rotator with a tape to hold the slide)
g. Read and interpret results

Answer 16

room temperature

one (1) drop; 50 μL

latex reagent

one (1) drop latex reagent

pipette or stirrer

100 rpm for 2 minutes

Question 17

Note: if it’s negative, results may be released. But if it’s positive, proceed to the (?) of CRP. Report the titer in semi-quantitative test (actual value of CRP)

Answer 17

semi-quantitative test

Question 18

Positive sera may be titrated. To titrate, make two – fold serial dilution in normal (?) using the Quantitative Test procedure

Answer 18

saline solution (9g/L saline)

Question 19

Results:
 Positive control has
 Negative control and patient’s sample has

Answer 19

clumps

no clumps (homogenous mixture)= no agglutination/ negative

Question 20

Quantitative Test:
a. Using a semi – automatic pipette, add (?) of normal saline solution to circles (?). Do not spread the saline.
b. Add (?) of patient sample to circle (?)
c. Add (?) of patient sample to circle (?). Mix the sample and saline in circle 2 by drawing the mixture up and down being careful to avoid the formation of any bubbles.
d. Transfer (?) of mixture from circle (?) to the saline in circle (?).

Answer 20

50 μL; 2, 3, 4 and 5

50 μL; 1

50 μL; 2

50 μL; 2; 3

Question 21

Quantitative Test:
e. Perform serial dilution in the same manner until the last circle, discarding (?) at the end
f. Using the disposable pipette or stirrer, spread the diluted sample over the entire area of each circle starting at circle (?) and moving backwards to the next, reaching until circle (?)
g. Resuspend the latex reagent gently
h. Add (?) latex reagent to each circle containing the sample
i. Mix with disposable pipette or stirrer and spread over the entire area enclosed by the ring on the test card or agglutination slide. Use a new stirrer for each sample.
j. Rotate the test cards or agglutination slides at (?)
k. Read and interpret results.

Answer 21

50 μL

5; 1

one (1) drop

100 rpm for 2 minutes

Question 22

Guide in the Interpretation of Results:
Examine macroscopically for the presence or absence of clumps or agglutination within (?) after removing the test card or agglutination slide from the rotator
Normal Levels of CRP in Adults: (?)
 Negative result: (?)
 Positive result: (?)

Answer 22

1 minute

> 6 mg/L

No agglutination would indicate a level of < 6 mg/L

The presence of agglutination indicates a level of ≥ 6 mg/L

Question 23

CRP concentration (mg/dL) =

Answer 23

limit of sensitivity x titer Limit of sensitivity = 6 mg/L

Question 24

The (?) is defined as the highest dilution showing macroscopic agglutination

Answer 24

serum titer

Question 25

 CRP has been detected in serum obtained from apparently (?).

Answer 25

healthy adults and children

Question 26

 The reported mean value ranged from (?) in newborns and (?) in male adults.

Answer 26

0.1 mg/L

0.5 mg/L

Question 27

The CRP level can increase significantly above the normal levels with the onset of

Answer 27

substantial inflammatory stimulus

Question 28

CRP
Traditionally it has been used for monitoring infection autoimmune disorders and, more recently, healing after

Answer 28

myocardial infarction

Question 29

CRP
- It increases rapidly within 4 to 6 hours following (?)

Answer 29

infection, surgery, or other trauma to the body

Question 30

• Example of an acute phase protein

Answer 30

CRP

Question 31

Describe methods used to determine CRP levels

Answer 31

C-reactive protein rapid latex agglutination test

Question 32

o Based on the reaction between patient serum containing CRP as the antigen and the corresponding antihuman (CRP) antibody coated to the treated surface of latex particle

Answer 32

C-reactive protein rapid latex agglutination test

Question 33

o Sample used is serum that contains antibodies. The reagent will serve as the antigen (antihuman CRP coated to a latex particle). If the CRP antibody is present in the serum it will bind to the antihuman CRP present in the reagent that will lead to a positive reaction (agglutination). Whereas, if the CRP is absent the antihuman CRP will not bind to anything, therefore the reaction is negative

Answer 33

C-reactive protein rapid latex agglutination test

Question 34

C-reactive protein rapid latex agglutination test Report if the result is

Answer 34

positive or negative

Question 35

Uses scattered light in order to test a particular substance

Answer 35

Nephelometry-quantitative determination of CRP levels

Question 36

Utilize quantitative determination so it is reported in numbers

Answer 36

Nephelometry-quantitative determination of CRP levels

Question 37

Elevations of the CRP level occur in about 70 disease states, including

Answer 37

septicemia and meningitis in neonates, infections in immunosuppressed patients, burns complicated by infection, serious postoperative infections, MI, malignant tumors, and rheumatic disease

Question 38

even though there are a lot of diseases where CRP level is elevated, CRP is (?) for testing the diseases mentioned above.

Answer 38

non- specific test

Question 39

is side by side requested with the other laboratory test that will narrow down diseases

Answer 39

CRP

Question 40

For example, if the physician suspects a bacterial infection, aside from CRP that is being requested, the physician will also request the (?).

Answer 40

culture and sensitivity

Question 41

is not a sensitive marker when it comes to diagnosing diseases.

Answer 41

CRP

Question 42

An extremely elevated CRP level suggests a possible

Answer 42

bacterial infection

Question 43

is non- specific unlike culture and sensitivity wherein it cand determine the specific bacteria causing bacterial infection. It will only tell if CRP levels are elevated or not

Answer 43

CRP

Question 44

In general, (?) is advocated as an indicator of bacterial infection in at-risk patients in whom the clinical assessment of infection is difficult to make

Answer 44

CRP

Question 45

CRP is not sensitive and non-specific in bacterial infection. It is increased in

Answer 45

inflammation