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Flashcards in Autoimmune Markers Deck (43):
1

ANA

anti-nuclear antibody

2

RF

rheumatoid factor

3

CRP

C-reactive protein

4

ESR

erythrocyte sedementary rate

5

CTD

connective tissue disorder

6

why would you order an ANA?

-to exclude disorders in pts with uncertain clinical findings
-establish diagnosis in pt suspected of having autoimmune or CTD
-subclassify pt with established diagnosis of autoimmune or CTD (not always)
-monitor disease activity

7

ANA titer results

1:40 is negative results (some say 1:80)

8

what is the mechanism of the ANA?

a group of protein antibodies that react against cellular nuclear material

9

which disorder is ANA primarily used to diagnose?

SLE and other CTD

10

ANA homogenous pattern

shown in SLE, MCTD

11

ANA speckled patter

shown in SLE,
scheloderma
RA
MCTD
Sjorgen

12

ANA nucleolar pattern

shown in scleroderma
polymyositis

13

ANA outline pattern

shown in SLE

14

negative RF value

<60 u/mL

15

when would you order RF?

pt suspected of having RA
positive in 70-80% of people with established RA
sensitivity is low early on in the disease (only 50%)

16

C-reactive protein

non-specific indicator of inlammation
acute-phase reactant protein

17

when is the CRP elevated?

inflammation
tissue necrosis

18

why is CRP a good test to order?

-more sensitive and faster response than ESR
-may want to identify acute v chronic
-monitor disease process (how are they responding to treatment?)

19

ESR

measures acute and chronic infection, inflammation, neoplasm, tissue necrosis
-measures the rate at which RBCs settle in saline solution

20

why would you use a ESR?

can be used to monitor disease therapy
slower test

21

ACA

anticardiolipin antibody
-used to identify SLE (40% of SLE pts have it)

22

What are the clinical features of SLE?

-venous and arterial thrombosis
-neuropsychiatric disorder
-recurrent spontaneous abortion
-CVA
-thrombocytopenia

23

the ACA positively identifies SLE in how many percent of people?

40%

24

the presence of ACA indicates a SLE patient may be at greater risk for developing

antiphospholipid syndrome

25

anticentromere antibody

a form of ANA
-used to diagnose CREST sydrome
-differntiates schleroderm and CREST

26

when is anticentromere antibody test used?

pt suspected of having CREST syndrome (variant of schleroderma)
**not a marker of disease prognosis

27

antichromatin antibody (anti-NCS)

100% sensitive
97% specific for SLE

28

anticyclic-citrullinated peptide antibody (CCP IgC, anti-CCP)

used to diagnose RA (especially if RF is negative)
highly specific to RA (especially early on)
***marker for disease progression

29

anti-DNA antibody (anti ds DNA)

subtype of ANA

30

why order anti-DNA antibody?

65-80% sensitive with active SLE

31

anti-extractable nuclear antigen (anti-ENA)

also contains
anti-Jo-1
anti-RNP
anti-Smith

32

anti-Smith tells you what?

present in 30% of pts with SLE, but not present with other RA disorders

33

anti-RNP tells you what?

100% of pt with MCTD have it

34

anti-Jo-1 tells you what?

autoimmune interstitial pulmonary fibrosis
(specific)

35

antimitochondrial antibodies (AMA)

94% with biliary cirrhosis
liver biopsy is then performed (has to have tissue confirmation)

36

antineutrophil cytoplasmis antibody (ANCA)

usually elevated with UC, Wegener's glanulomatosis (WG), PSC (primary sclerosing colangitis)

37

why use ANCA?

follow therapy in UC

38

what are the two patterns of staining with the ANCA?

P-ANCA perinuclear (MPO-ANCA)
C-ANCA cytoplasmic (PR3-ANCA)

39

antiscleroderma antibody (Scl-70 antibody)

diagnoses scleroderma (PSS) (45% pt test positive)
fairly specific for PSS, but also seen in SLE, Sjorgen, RA

40

antismooth muscle antibody (ASMA)

used to diagnose autoimmune chronic active hepatitis

41

when would you order ASMA?

70-80% of pts with CAH (chronic active hepatitis)

42

positive titer for ASMA is

>1:160

43

Sjogren antibodies

ANA with subtypes
A (RO)
B (La)
C

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