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Rheumatology > Interpretation of Rheum Tests > Flashcards

Interpretation of Rheum Tests Flashcards

1
Q

proportion of patients with positive test who have the disease…. So a negative test will effectively “rule out” disease

A

sensitivity (SNOUT)

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2
Q

proportion of patients with negative test who do not have the disease….. So a positive test will effectively “rule in” a disease.

A

specificity (SPIN)

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3
Q

indirect measurement of serum APR concentrations, particularly fibrinogen. Influenced by the size, shape, and number of RBC’s. Changes relatively slowly

A

ESR

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4
Q

What happens to the ESR with anemia and polycythemia vera?

A

increased in anemia and decreased in polycythemia

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5
Q

Elevated in obesity due to IL-6 secretion by adipose tissue

A

ESR and CRP

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6
Q

“Normal” ESR values

A

Male <10mm/hr

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7
Q

For what two rheumatic conditions is an elevated ESR most helpful?

A

Polymyalgia Rheumatica and Giant Cell Arteritis

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8
Q

Produced in response to inflammation. Enhances complement binding and phagocytosis. Acute increase within 6 hours; peaks at 48 hours

A

CRP

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9
Q

Normal CRP values for adults

A

adults: normal is less than 1mg/L and abnormal is greater than 10.

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10
Q

An AUTO ANTIBODY directed against Fc portion of IgG

A

Rheumatoid factor

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11
Q

Percent of patients with RA who are RF negative early in the disease

A

30%

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12
Q

Normal RF value

A

<1:80 considered negative

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13
Q

correlates with severe articular disease and extra-articular manifestations

A

RF (rheumatoid factor)

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14
Q

Antibody directed against “citrullinated” peptide residues present within inflammatory sites. Mostly associated with RA

A

Anti-CCP (citrulline antibody, CCP antibodies)

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15
Q

Greater specificity than RF, useful when RF is negative

A

Anti-CCP (citrulline antibody, CCP antibodies)

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16
Q

Autoantibodies directed at nuclear antigens (or contents of cell nucleus). Hallmarks of systemic autoimmune disease

A

Anti-nuclear Antibodies (ANA)

17
Q

Provide further diagnostic and prognostic data concerning pts who have minimal sx’s or who have clinical features of more than 1 autoimmune disease

A

Anti-nuclear Antibodies (ANA)

18
Q

How many criteria for lupus should be met before ordering an ANA?

A

3 of the 11

19
Q

Specific for SLE (60-70%). Single stranded DNA nonspecific. May fluctuate with disease activity

A

Anti-dsDNA

20
Q

Highly specific for SLE (but not sensitive)

A

Anti-Sm (smith antigen)

21
Q

Associated with CREST, and scleroderma

A

Anti-centromere antibody (ACA)

22
Q

Associated with diffuse scleroderma

A

Anti-topoisomerase I (Scl-70)

23
Q

Associated with Sjogren’s. Can be seen in SLE. May be associated with neonatal heart block in babies of mothers with this antibody

A

Anti-Ro (SS-A) and La (SS-B)

24
Q

Part of criteria for mixed connective tissue disease.

A

Anti-U1 snRNP

25
Q

Specific for myositis associated with interstitial lung disease and Raynaud’s

A

Anti-Jo-1 (anti-histidyl-tRNA synthestase)

26
Q

useful for monitoring disease activity in SLE. Low levels indicate activation of complement cascade and consumption of complement

A

serum complements

27
Q

Group of autoantibodies mainly of the IgG type directed against antigens in the cytoplasm of neutrophil granulocytes and monocytes

A

Antineutrophil Cytoplasmic Antibodies (ANCA)

28
Q

most strongly associated with vasculitis

A

ANCA

29
Q

Syndrome associated most with HLA-B27

A

ankylosing spondylitis

30
Q

Normal Uric acid levels for adults

A

men: 4-8.5 mg/dL. women: 2.7-7.3 mg/dL

31
Q

What type of antineutrophil cytoplasmic antibody is associated with Churg-Strauss vasculitis

A

p-ANCA

32
Q

What syndrome is associated with a positive ANA and anti-centromere AB?

A

CREST

33
Q

What autoimmune disease is associated with eosinophilia, a positive ANA (either anti-Scl or nucleolar), and sometimes a positive RF?

A

systemic sclerosis (scleroderma)

34
Q

What syndrome is associated with positive anti-Ro (SS-A) or anti-La (SS-B) antibodies?

A

Sjogren’s

35
Q

What syndrome is associated with a low titer of ANA, but presence of nuclear RNP antibodies?

A

mixed connective tissue disorder

36
Q

What disorder is associated with positive ANA, anti-PM-Scl and increased CPK/aldolas enzymes?

A

dermatomyositis

Rheumatology (8 decks)

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