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hematology lab > ESR > Flashcards

ESR Flashcards

1
Q

HOW THE ERYTHROCYTE SEDIMENTATION RATE TEST WORKS?

A
  1. phlebotomist draws blood into tube
  2. test measures how fast red blood cells fall to bottom of tube in an hour
  3. inflammation causes red blood cells to stick together and sink faster
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2
Q

Non-specific measurement to detect and monitor an inflammatory response to tissue injury in which there is a change in the plasma concentration of acute phase proteins

A

ERYTHROCYTE SEDIMENTATION RATE

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3
Q

ESR is a non specific test which depends on the changes of what?

A

plasma concentration of acute phase reactants

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4
Q

how long do we need to stand the blood vertically?

A

1 hour

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5
Q

ESR values are reported as/in

A

mm/hr

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6
Q

ESR is affected by 3 factors, what are those

A

Red cells
plasma composition
mechanical/technical factors

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7
Q

Red cells repel each other because of their ___

A

net negative charge

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8
Q

In disease states, plasma protein concentration changes, causing a reduction in the negative charge of the RBCs and consequent formation of ___

A

rouleaux

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9
Q

true or false

The larger the particle, the faster its rate of fall

A

true

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10
Q

Macrocytes settle more rapidly than microcytes

true or false

A

macrocytes - it’s always the biggest and largest falls faster

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11
Q

ESR decrease or increase

sickle cells

A

decrease

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12
Q

ESR decrease or increase

spherocytes

A

decrease

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13
Q

can sickle cells and spherocytes form rouleaux?

A

nope, they can’t. Esr decrease

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14
Q

ESR decrease or increase

anisocytosis

A

decrease

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15
Q

ESR decrease or increase

poikilocytosis

A

decrease

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16
Q

two conditions in which the rbc’s capability to form larger aggregates is reduced?

A

anisocytosis and poikilocytosis

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17
Q

ESR decrease or increase

sever anemia

A

increase

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18
Q

why do anemia has an elevated ESR?

A

it didn’t take long for all the rbc to settle as they have more space and they are only few.

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19
Q

Single most important factor determining the ESR

A

plasma factors

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20
Q

Rouleaux and aggregation are controlled primarily by levels of a___

A

acute phase proteins

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21
Q

Rouleaux and aggregation are controlled primarily by levels of acute phase proteins

what are those acute phase proteins?

A

fibrinogen, alpha-1 globulin, alpha-2 globulin

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22
Q

examples of mechanical or technical factors?

A

angle/tilt
rack holding the tubes
temperature

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23
Q

A tilt of 3 degrees can cause errors up to how many percent?

A

30%

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24
Q

The rack holding the tubes should not be subject to any movement of ___

A

vibrations

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25
Q

Large changes in temperature – Increased temp = Increased ESR

true or false

A

true

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26
Q

The ESR represents a NONSPECIFIC response to tissue damage and inflammation and denotes the presence of disease, but NOT ITS SEVERITY

true or false

A

true

27
Q

ESR decrease or increase

pregnancy after 3rd month

A

increase

28
Q

ESR decrease or increase

acute or chronic infection

A

increase

29
Q

ESR decrease or increase

polycythemi veraa

A

decrease

30
Q

ESR decrease or increase

rheumatic fever

A

increase

31
Q

ESR decrease or increase

rheumatoid arthritis

A

increase

32
Q

ESR decrease or increase

congestive heart failure

A

decrease

33
Q

ESR decrease or increase

myocardial infarction

A

increase

34
Q

ESR decrease or increase

nephrosis

A

increase

35
Q

ESR decrease or increase

hypofibrinogenemia

A

decrease

36
Q

ESR decrease or increase

menstruation

A

increase

37
Q

ESR decrease or increase

tuberculosis

A

increase

38
Q

ESR decrease or increase

macroglubinemia

A

increase

39
Q

ESR decrease or increase

presence of red cell abnormalities

A

decrease

40
Q

ESR decrease or increase

cryoglobunemia

A

increase

41
Q

ESR decrease or increase

hypothyroidisim

A

increase

42
Q

ESR decrease or increase

hyperthyroidism

A

increase

43
Q

2 methods we can use for est

A

wintrobe and landsberg methos
westergren method

44
Q

specimen used for wintrobe and landsberg method

A

EDTA anticoagulated blood

45
Q

procedure for wintrobe and landsberg method

A

Procedure:
1. Mix the blood
2. With a long stem pipette, fill the wintrobe tube up to 0 mark (no air bubbles)
3. Place the tube in a vertical position on the rack for 60 minutes
4. Record the level of sedimented ESR from the scale on the left side (red) of the tube. Read downward

46
Q

do we read the tube for the result upward or downward?

A

downward

47
Q

In wintrobe and lansberg method, we fill the tube up to what mark?

A

0 mark

48
Q

specimen used for westergren method

A

Specimen: Citrated blood (0.109M trisodium citrate)

49
Q

which top is an ideal top for westergren method?

A

the black top with 9% citrate

50
Q

procedure for westergren method

A

Procedure:
Mix the blood
Place the Westergren tube into the blood sample, making sure that the blood reaches the 0 mark on the tube
Place in a rack for 60 minutes
Read the graduations downward

51
Q

reference values for wintrobe and landsberg esr

A
  • Women: 0-20 mm/hr
    • Men: 0-9 mm/hr
52
Q

reference values for westergren method

A
  • Women: 0-15 mm/hr
    -Men: 0-10 mm/hr
    -Children: 0-10 mm/hr
53
Q

what are the 3 stages of EST

A
  • INITIAL ROULEAUX FORMATION/ LAG PHASE
  • RAPID SETTLING OF RBCs/RAPID PACKING OF CELLS/DECANTATION
  • FINAL SEDIMENTATTION OF RBC’s
54
Q

a stage of ESR in which the sedimentation is only slight and only taks 10 minutes

A

Initial rouleaux formation/lag phase (10 minutes

55
Q

Initial rouleaux formation is also known as

A

lag phase

56
Q

a stage of esr in which sedimentation is more rapid and constant

A

Rapid settling of RBCs/Rapid packing of cells/decantation (40 minutes)

57
Q

how many minutes does the 2nd stage occurs

A

40 minutes

58
Q

the stage of ESR in which sedimentation rate is slow because of the accumulation of RBCs at the bottom of the tube

A

Final sedimentation of RBCs

59
Q

what are the sources of errors in conducting ESR test?

A

If concentration of EDTA is greater than recommended, the ESR will be falsely low
If the ESR stands for more than 60 minutes, the results will be falsely elevated
If it is timed for less than 60 minute, ESR will be low
Marked increase in temperature = Increased ESR
Marked decrease in temperature = Decreased ESR
Tilting increases sedimentation rate
Bubbles cause invalid results
Fibrin clots invalidate results

60
Q

If concentration of EDTA is greater than recommended, the ESR will be __

explain why?

A

falsely low

the anticoagulant will dilute the blood, making it harder for the blood to form rouleaux, also, it’s a anticoagulant so it will literally prevent clotting which is a thing for making rouleaux

61
Q

If the ESR stands for more than 60 minutes, the results will be ___

explain why

A

falsely elevated

more rbc will sediment at the bottom

62
Q

Bubbles cause __ results

A

invalid

63
Q

Fibrin clots ___results

A

invalidate

hematology lab (6 decks)

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