Clinical Serology and Lab Testing (Johnston)

Question 1

ESR and CRP are?

Answer 1

Acute phase reactants (immediate response to inflammatory stimuli)

Question 2

ESR rises with?

It is higher in what sex?

What is its purpose?

Answer 2

1) Age
2) Women
3) Monitor disease activity

Question 3

What is the purpose of CRP?

Where is it synthesized?

What increases it?

What can it activate?

Answer 3

1) Assessment of disease activity
2) Liver
3) Proinflammatory cytokines
4) Complement and phagocytosis

Question 4

What is Rheumatoid Factor (RF)?

What does it target?

Answer 4

1) IgM autoantibody

2) Fc portion of IgG

Question 5

While IgM is the most common Ig subclass for RF, what other subclass can it be?

Answer 5

IgA and IgG

Question 6

What is RF produced by and were?

Answer 6

B cells in synovial joints

Question 7

What is Anti-CCP?

Answer 7

Antibodies to citrullinated proteins

Question 8

Anti-CCP is present in 70% of patients with?

Answer 8

RA

Question 9

What labs are 99.5% specificity for RA?

Answer 9

Positive for Anti CCP and RF

Question 10

ANA is directed against?

Answer 10

Nuclear antigens

Question 11

Antistreptolysin O antibody (ASO titer) and anti DNAase B titers is evidence of what previous infection?

Answer 11

Group A streptococcal infection

Question 12

What is 100% positive in the nodules in RA patients?

Answer 12

RF

Question 13

What labs can be a false positive result in RA patients?

Answer 13

ANA

Question 14

A flare of RA is associated with elevations of what levels?

Answer 14

ESR

Question 15

Hyperuricemia is defined as?

Answer 15

Uric acid > 6.8 mg/dl

Question 16

Which imaging study is better for viewing RA symmetrical involvement of MCP, periarticular osteopenia, and erosions?

Answer 16

Radiographs

Question 17

Which imaging studies is best for viewing soft tissue abnormalities (synovitis, tendonitis, bursitis)?

Which study can also be used?

Answer 17

1) Ultrasonography

2) MRI

Question 18

Which imaging study is best for bony abnormalities?

Answer 18

CT

Question 19

What arthritic symptom can be seen in endocrine issues involving the thyroid?

Answer 19

Carpal tunnel syndrome

Question 20

What arthritic symptom can be seen in diabetes?

Answer 20

1) Charcot’s

2) Cheiroarthropathy