Part 2

Question 1

Intro

1. increase ____ alters protein composition of plasma leading to rouleaux formation = increase ESR
2. degree of settling of erythrocytes in plasma in an ______ during a specified period of time
   - period of time

Stages of ESR
1. occurs during the first 10 minutes
- aka
2. occurs within 40 minutes
- aka
3. occurs during the last 10 minutes
- aka

Answer 1

1. acute phase reactant
2. anticoagulated whole-blood
   - 60mins

Stages of ESR
1. Lag phase
- Initial rouleaux
2. Decantation phase/
- Period of rapid settling
3. Final settling
- Final packing

Question 2

Factors affecting settling of RBC:

Erythrocyte Factor:
1. rbc size/mass
2. # of rbc
3. presence or anisocytes & poikilocytes

Plasma factors
1. plasma viscosity
2. plasma composition
- increased ESR
- decreased ESR

Answer 2

Erythrocyte Factor:
1. directly proportional
2. inversely proportional
3. slower settling

Plasma factors
1. inversely proportional
2. plasma composition
- Fibrinogen, ɑ-1 globulin, ɑ-2 globulin
- albumin & lecithin

Question 3

Factors affecting settling of RBC:

Mechanical/Technical factors
1. Position of the tube: should be exactly ____
- __ tilt = 30% error
2. incubation environment should be free from any ____
3. incubation temp should be
4. longer & wider tube = __ ESR
5. anticoagulant should not be over anticoagulated as it will result to = _____
6. time of setting up: first ___hrs from collection

Answer 3

1. vertical
   - 3 degrees
2. movement
3. room temp
4. increased
5. slower ESR
6. 2hrs

Question 4

______: ESR manual method

1. length of tube
2. blood volume
3. diameter
4. anticoagulant

Answer 4

WINTROBE AND LANDSBERG METHOD

1. 11cm
2. 10cm
3. 3mm
4. ammonium-potassium oxalate

Question 5

______: ESR standard method

1. length of tube
2. blood volume
3. diameter
4. anticoagulant original
5. anticoagulant modified
   - diluent (2)

Answer 5

WESTERGREN METHOD

1. 30cm
2. 20cm
3. 2.5cm
4. 3.8% sodium citrate
5. 2 ml of EDTA-anticoagulated blood
   - 0.5 ml NSS or
   - 3.8% sodium citrate

Question 6

Reference values (Westergren method):

Male
<50 years old
>50 years old
>85 years old

Female
<50 years old
>50 years old
>85 years old

Answer 6

Male
<0-15mm/hr
>0-20mm/hr
> 0-30mm/hr

Female
0-20mm/hr
0-30mm/hr
0-42mm/hr

Children
- 0-10mm/hr

Question 7

Decreased or Normal ESR in:
1.
2. conditions associated with __ & ___
3.
4.
5.

Answer 7

1. Polycythemia vera
2. Hb S & Hb C disease
3. congestive heart failure
4. hypofibrinogenemia
5. r ed cell abnormalities

Question 8

AUTOMATED ESR
1. optoelectronic sensor that measures the change in opacity of a column of blood as sedimentation occurs
- ESR is enhanced by inclining the tube at
2. infrared measurement
3. based on centrifugation; for pediatric and neonatal patients

Answer 8

1. Ves-Matic system
2. Sedimat 15
3. ESR STAT PLUS system

Question 9

______: how closely the erythrocytes approach one another under a specific standardized gravitational force

1. uses ____ that controls centrifugatioj of blood
2. uses special capillary tube:
   - in length
   - internal diameter
3. After centrifugation, zetacrit % is determined at the “_____” of curve
4. formula

Answer 9

ZETA SEDIMENTATION RATIO

1. zetafuge
   2.
   - 75mm
   - 2mm
2. “knee” of curve
3. (Hct/ Zetacrit) x 100

Question 10

REFERENCE VALUE OF ZETA SEDIMENTATION RATIO

1. normal
2. borderline normal
3. mildly elevated
4. moderately elevated
5. markedly elevated

Answer 10

1. 41 – 54%
2. 51-54%
3. 55-59%
4. 60-64%
5. > 65%