Inflammatory Markers

Question 1

What is the erythrocyte sedimentation rate (ESR)?

Answer 1

= rate it which RBCs sediment in one hour

Question 2

What is the erythrocyte sedimentation rate (ESR)?

Answer 2

= rate it which RBCs sediment in one hour

Question 3

ESR is a marker for..?

Answer 3

Non specific measure of inflammation and malignant disease

Question 4

What is the principle behind ESR?

Answer 4

• ESR is governed by the balance between pro-sedimentation factors (mainly fibrinogen) and factors resisting sedimentation
• presence of an inflammatory process, a higher proportion of fibrinogen in the blood -> RBCs stick together forming “Rouleaux” stacks
• therefore the RBCs sediment quicker

Question 5

What is the lag phase between onset of inflammatory stimulation and production proteins that increase ESR?

Answer 5

24-48 hours

Question 6

What ESR value normally excludes inflammation?

Question 7

What is C-reactive protein?

Answer 7

CRP is considered the most accurate measure of the acute phase response and therefore tissue inflammation and neoplastic disease

Question 8

CRP rises within how many hours of inflammation?

Answer 8

6 hours and may double every 8 hour reaching a peak in 50 hours

Question 9

What are the CRP rules of inflammation (thresholds for inflammation severity)?

Answer 9

4-10 mild inflammation
10-20 moderate inflammation (e.g. viral infection)
> 40 marked inflammation (bacteria infection)

Question 10

What level of CRP is associated with bacterial infection?

Answer 10

> 100 mg/L

Question 11

What is the normal value of CRP?

Answer 11

> 10 mg/L

Question 12

ESR is a marker for..?

Answer 12

Non specific measure of inflammation and malignant disease

Question 13

What is the principle behind ESR?

Answer 13

• ESR is governed by the balance between pro-sedimentation factors (mainly fibrinogen) and factors resisting sedimentation
• presence of an inflammatory process, a higher proportion of fibrinogen in the blood -> RBCs stick together forming “Rouleaux” stacks
• therefore the RBCs sediment quicker

Question 14

What is the lag phase between onset of inflammatory stimulation and production proteins that increase ESR?

Answer 14

24-48 hours

Question 15

What ESR value normally excludes inflammation?

Question 16

What is C-reactive protein?

Answer 16

CRP is considered the most accurate measure of the acute phase response and therefore tissue inflammation and neoplastic disease

Question 17

CRP rises within how many hours of inflammation?

Answer 17

6 hours and may double every 8 hour reaching a peak in 50 hours

Question 18

What are the CRP rules of inflammation (thresholds for inflammation severity)?

Answer 18

4-10 mild inflammation
10-20 moderate inflammation (e.g. viral infection)
> 40 marked inflammation (bacteria infection)

Question 19

What level of CRP is associated with bacterial infection?

Answer 19

> 100 mg/L

Question 20

What is the normal value of CRP?

Answer 20

> 10 mg/L

Question 21

What is C-reactive protein?

Answer 21

CRP is considered the most accurate measure of the acute phase response and therefore tissue inflammation and neoplastic disease

• CRP is considered superior in terms of rapidity of response and specificity for inflammation

Question 22

What is the normal value of CRP?

Answer 22

> 10 mg/L

Question 23

Which rises faster - CRP or ESR?

Answer 23

CRP

Question 24

Which falls faster - CRP or ESR?

Answer 24

CRP

Question 25

The levels of CRP and ESR are similar after how many hours?

Answer 25

app 24 hours

Question 26

What diseases presents with v high ESR but normal CRP?

Answer 26

Giant Cell Arteritis

Polymyalgia Rheumatica