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MSK > MSK labs > Flashcards

MSK labs Flashcards

1
Q

what are inflammatory marker tests + give examples

A

test that detects inflammation in body
high in acute and chronic inflammatory states like infection, surgery, arthritis, autoimmune disorders
ESR, CRP (sensitive, non-specific)

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2
Q

what influences inflammatory markers

A

age, gender (higher for women), obesity, chronic disease

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3
Q

ESR (what it stands for, what it does, specific or non specific)

A

erythrocyte sedimentation rate aka sed rate
measures height of erythrocytes that fall through plasma over a period of 1hr
non-specific

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4
Q

CRP (what it stands for, what it does)

A

C-reactive protein
an acute phase reactant protein that checks for inflammation

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5
Q

when else can ESR be elevated

A

anemia, renal disease, obesity

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6
Q

what is a normal ESR

A

<20mm/hr (<10 for men)

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7
Q

abnormal WBC indicates

A

infection or inflammation

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8
Q

what happens to neutrophils in settings of disease

A

morphologic change
immature neutrophils with bands

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9
Q

normal range for hemoglobin!!

A

male: 13.5-17.5
female: 12.0-15.5

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10
Q

what labs would you do to help diagnose gout

A

arthrocentesis, uric acid (elevated), WBC (should be close to normal unless septic arthritis)

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11
Q

gold standard for diagnosing gout

A

joint aspirate
gout - needle shaped negatively birefringent crystals
pseudogout - rhomboid shaped positively birefringent crystals

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12
Q

why might uric acid levels be high

A

overproduction, underexcretion (most common)

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13
Q

how long should you wait to test for IgM antibodies

A

1-2 weeks

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14
Q

how long should you wait to test for IgG antibodies

A

2-6 weeks

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15
Q

serology test is commonly done for

A

lyme disease
can remain elevated despite successful therapies
looking for IgM and IgG antibodies

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16
Q

rheumatoid factor (RF) is positive in what diseases

A

RA, sjogren syndrome, SLE

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17
Q

anti-CCP antibody (what it tests for, what condition its associated with)

A

marker for progressive, erosive joint disease
highly associated with RA (positive)
a neg RF and a neg anti CCP is better at excluding RF than either test alone

18
Q

tests that support RA diagnosis

A

ESR, CCP, CRP, CBC

19
Q

ANA

A

antibody present in various autoimmune diseases
strongly associated with active lupus cases
more dilute = stronger positive

20
Q

lab tests that support SLE diagnosis

A

CBC (pancytopenia), VDRL (false positive), RPR (negative), ESR

21
Q

what labs are positive in sjogrens syndrome

A

RF, SS-A, SS-B

22
Q

creatinine kinase (CK)

A

muscle enzyme/muscle test
elevations indicate muscle damage/breakdown (acute or chronic)

23
Q

what type of CK is found in skeletal muscle

A

MM-type (CK-MM)

24
Q

what type of CK is found in cardiac muscle

A

MB-type (CK-MB)

25
Q

in what conditions would you have an elevated CK

A

dermatomyositis, polymyositis (both problematic), PAN
exercise, muscle biopsy, iatrogenic (not problematic)

26
Q

aldolase (found where, what does it indicate)

A

enzyme found in skeletal muscle, liver and brain
elevation may indicate muscle breakdown
less specific and sensitive than CK

27
Q

lactate dehydrogenase

A

general indication of cell injury
enzyme with muscle and heart subunits

28
Q

when can LDH be inaccurate

A

if blood sample is hemolyzed

29
Q

TB gold

A

serum test for latent TB infection

30
Q

limitations of TB test

A

HIV infection, poor sensitivity + specificity for active TB, high cost

31
Q

what labs would you do for multiple myeolma

A

SPEP, UEP (24hr urine), CBC, ESR, CRP

32
Q

hemoglobin is decreased in what msk condition

A

polymyalgia rheumatica

33
Q

what does d-dimer indicate

A

thrombolysis
only used if you are NOT suspecting a blood clot
sensitive but not specific (lots of false positives)

34
Q

joint aspirate (what is it, what can it help diagnose)

A

diagnostic and therapeutic way to evaluate synovial fluid
gout, septic arthritis, RA

35
Q

DEXA scan

A

determines bone mineral density
helps determine when to start pharmacologic tx for osteoporosis

36
Q

what is measured in a DEXA scan

A

hip and lumbar spine

37
Q

what age do you have to be to get a DEXA scan

A

women - 65 or 10 years post menopause
men - 70 or if risk factors/significant loss of height

38
Q

reccommended repeat screening for DEXA

A

normal - q 10-15y
osteopenia - q 3-5y
osteoporosis - q 2y

39
Q

T scores for normal, osteopenia, and osteoporosis

A

normal = -1+
osteopenia = -1 to -2.5
osteoporosis = less than -2.5

40
Q

what affects WBC besides infection and inflammation

A

chemo, HIV

MSK (20 decks)

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