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MSK > MSK Labs > Flashcards

MSK Labs Flashcards

1
Q

What are the inflammatory markers and characteristics of the test

A

-ESR and CRP

-high in acute and chronic inflammatory states
-sensitive but non-specific
-can monitor disease activity

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2
Q

What is the normal range for ESR

A

females <15-20 mm/hr
males <10 mm/hr

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3
Q

What does ESR and CRP stand for

A

erythrocyte sedimentation rate and c-reactive protein

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4
Q

What is the reference range for CRP?

A

0.0 - 8.0 mg/L

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5
Q

What does an abnormal WBC indicate?

A

infection or inflammation

-viral can have leukopenia
-bacterial can have leukocytosis with left shift
-sepsis = high or low

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6
Q

What does left shift mean?

A

relevant to bands = immature neutrophils

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7
Q

What disease is Hgb low in?

A

anemia, polymyalgia rheumatica

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8
Q

What are the normal ranges for Hgb?

A

Male: 13.5 - 17.5 g/dL
Female: 12.0 - 15/5 g/dL

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9
Q

What is it called when all CBC values are low?

A

pancytopenia

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10
Q

What condition is the HLA-B27 often abnormal in?

A

ankylosing spondylitis

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11
Q

What is elevated in gout and how is it checked?

A

Uric acid levels elevated, checked through joint aspirate (arthrocentesis) for needle-shaped negatively birefringent crystals

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12
Q

What is the gold standard for diagnosing gout?

A

Joint aspirate (arthrocentesis) for needle-shaped negatively birefringent crystals made of uric acid

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13
Q

What is present for pseudogout?

A

rhomboid shaped positively birefringent crystals made of calcium pyrophoshpate dihydrate crystals

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14
Q

What may elevate uric acid levels aside from gout?

A

high purine intake (after party or vacation)

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15
Q

How long does it take for antibodies to develop after a tick bite?

A

IgM antibodies to Borrelia burgdorferi: 1-2 weeks

IgG antibodies: 2-6 weeks

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16
Q

What is rheumatoid factor and what is it positive in?

A

IgM autoantibody

Positive in rheumatoid arthritis, Sjogren Syndrome, SLE, chronic infection, healthy individuals

17
Q

What is Anti-CCP antibody and what is it associated with?

A

it is a marker for progressive, erosive joint disease and is highly associated with rheumatoid arthritis (better than rheumatoid factor)

18
Q

What other labs might support a RA diagnosis?

A

CBC, ESR, CRP, joint aspirate

19
Q

What is ANA?

A

antibody present in many autoimmune disease, looking for a positive result or high titer

20
Q

What are the common ANA patterns observed under fluorescence?

A
21
Q

What lab values may be falsely positive and negative in SLE?

A

VDRL (syphilis) and RPR or T. Pallidum (syphilis)

22
Q

What would a CBC likely show in SLE?

A

pancytopenia

23
Q

What tests are typically positive in Sjogren’s?

A

SS-A (Ro) antibody, SS-B (la) antibody

also dry mouth and eyes

24
Q

What is Creatine Kinase and it’s subtypes?

A

muscle enzyme

CK-MM = skeletal
CK-MB = cardiac

25
Q

What is CK used for?

A

diagnosing and following a muscle problem (elevated in dermatomyositis, polymyositis, polyarteritis nodosa, rhabdomyolysis, regular exercise)

26
Q

What is aldolase and it’s characteristics?

A

enzyme found in skeletal muscle, liver, brain

-elevation can indicate muscle breakdown (less specific than CK)

27
Q

What is Lactate Dehydrogenase (LDH) indicative of?

A

Cell injury/tissue damage - involving liver, heart, muscles, kidneys, lungs, blood

inaccurate if blood sample hemolyzed

28
Q

What is the TB Gold test for and its limitations?

A

serum test for LATENT TB, not impacted by BCG vaccination

limitations: poor sensitivity and specificity for active TB, especially in the presence of HIV

29
Q

What may be used in multiple myeloma?

A

SPEP and UPEP (Serum/urine protein electrophoresis) - increase in gamma globulin M protein

30
Q

What is a D-Dimer indicative of?

A

Indicates thrombolysis (fibrin degradation product)

-sensitive but not specific
-high negative predictive value
-lots of false positives

31
Q

What factors are assessed in joint aspirate for infection?

A

WBC, crystals, gram stain, culture, color/clarity

32
Q

What is a DEXA scan used for?

A

determines bone mineral density and helps determine when to start treatment for osteoporosis vs osteopenia

-radiation exposure

33
Q

What are the 3 main parts of a CBC?

A

WBC, RBC, platelets

34
Q

what is reactive lymphocytosis as it relates to WBC?

A

viral infection

35
Q

What affects WBC other than infection/inflammation?

A

prednisone, cancer, chemo

36
Q

What are some causes of eosinophilia?

A

wheezes, sneezes, weird diseases

37
Q

What are bands and what are they associated with?

A

immature neutrophils associated with bacterial infection

MSK (9 decks)

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