Markers of inflammation Flashcards
What is the Erythrocyte Sedimentation rate?
Measures the settling “decent” of RBCs in Saline
Why does ESR help with inflammation?
When blood has Acute phase response proteins in it the density of it increases so it will sediment quickly
Is ESR specific?
no its not
What would be considered mild elevation of ESR?
normal up to 60 mm/hr
What would be considered moderate elevation of ESR?
60-100 mm/hr
What would extreme/severe elevation be?
> 100 mm/hr
What type of anemia would ESR increase with?
Macrocytic and normocytic
In polycythemia vera bone marrow overproduces RBCs which leads to increased viscosity of the blood, what effect would this have on the ESR?
It would decrease the ESR, because the increased viscosity of blood by definition is increased resistance to flow so it would not sediment quickly
What would cause ESR to decrease elevated WBCs or Pregnancy (fibrinogen increasing state)
Increased WBCs would decrease the ESR because they would slow down the RBCs from settling. Pregnancy would increase ESR because its a state that causes Fibrinogen to increase which would add density to the RBC and cause faster descent
Is ESR an effective acute response detection lab for inflammation?
No it is not specific
What would be a better lab value to evaluate for acute inflammation?
C-reactive protein
What 3 things does ESR specifically help DX?
Rheumatoid arthritis
Temporal arteritis
polymyalgia rheumatoid
What is C-reactive Protein?
a protein that helps to activate the complement and binds to necrotic tissue
Who would C-reactive protein naturally be higher in White or AA, older or younger, females or males?
AA
Older
Females
What is conventional C-RP used for vs high sensitivity C-RP
Conventional CRP is used for detecting acute and chronic inflammation
High sensitivity CRP is used to determine the risk of developing CVD by measuring the amounts of C-reactive protein released in atherosclerotic plaques
What would a normal C-RP be?
<1mg/dL
What would an elevated C-RP be?
> 10 mg/dL
What would be preferred in detecting acute inflammation? Conventional or high sensitivity CRP?
Conventional C-RP
How frequently should high sensitivity C-RP be measured? Then how is it calculated?
Measured 2x at least 2 weeks apart
then the results are averaged
1-3mg/L would be what level of risk for Hs_CRP?
Average Risk
What would be considered High risk for Hs_CRP?
> 3mg/L
What would be considered Severe with the likelihood of stroke, rupture, and MI for Hs_CRP
> 10 mg/L
What are some APR Proteins that increase with inflammation?
- C-reactive protein
- Fibrinogen, VWF
- Complement
- Feratin, haptoglobin, cerdoplasmin
- Alpha-1 antitrypsin
What Proteins decrease due to the inflammation process?
Albumin
Transferrin
Antithrombin
