ESR Flashcards by mti era

Q

ERYTHROCYTE SEDIMENTATION RATE (ESR) is also known as ____

A

Sed Rate

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Q

The distance in millimeter (mm) at which the RBCs fall in 1 hour

A

ERYTHROCYTE SEDIMENTATION RATE (ESR)

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Q

A non-specific marker of underlying inflammation

A

ERYTHROCYTE SEDIMENTATION RATE (ESR)

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Q

The manner of reporting in ESR

A

mm/hr

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Q

↑ (+) Acute Phase Reactant (Plasma Proteins) will cause an increase or decrease in ESR?

A

↑ ESR

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Q

Enumerate the materials used in ESR

A

EDTA Whole Blood
Wintrobe tube
Wintrobe tube stand
Westergren tube
Westergren tube stand
Long-tipped Pasteur pipette - for Wintrobe Method
Rubber Aspirator
NSS

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Q

Percent of Normal Saline Solution (NSS) used in ESR

A

0.85% NaCl Solution

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Q

This method uses a wintrobe tube

A

WINTROBE-LANDSBERG METHOD

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Q

This method uses a wintrobe tube

A

WINTROBE-LANDSBERG METHOD

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Q

bore of wintrobe tube

A

3.0

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Q

Calibrations of wintrobe tube

A

up to 100 mm (10 cm)

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Q

Length of wintrobe tube

A

115mm

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Q

T/F
Wintrobe Tube is used for Microhematocrit

A

False; macrohematocrit

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Q

How many markings does the wintrobe tube contain

A

2

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Q

What are the two markings of the wintrobe tube?

A

0 to 100 – red, ESR
100 to 0 – white, macrohematocrit method

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Q

What are the specimens used in WINTROBE-LANDSBERG METHOD

A

EDTA whole blood
Citrated Blood (3.8% Sodium Citrate)

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Q

State the procedure of the WINTROBE-LANDSBERG METHOD

A

Fill up the Wintrobe tube to the 0 mark with EDTA whole blood/oxalated blood using long-tipped Pasteur pipette
Allow to stand in a vertical position for one hour at room temperature
Take and record reading in mm/hr.

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Q

T/F (WINTROBE-LANDSBERG METHOD)

Avoid bubbles because it can affect the result of ESR

A

True

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Q

T/F (WINTROBE-LANDSBERG METHOD)

If there are bubbles, repeating the procedure is not necessary

A

False; If there are bubbles, repeat the procedure

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Q

T/F (WINTROBE-LANDSBERG METHOD)

Allow to stand in a complete horizontal position, not tilted because it can affect the ESR result.

A

False; Allow to stand in a complete VERTICAL position, not tilted because it can affect the ESR result.

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Q

T/F (WINTROBE-LANDSBERG METHOD)

Should be performed at room temperature only, if less than or more than room temperature, it can affect the ESR result.

A

True

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Q

T/F (WINTROBE-LANDSBERG METHOD)

Should be performed near from the sunlight

A

False; Should be performed AWAY from the sunlight because it can affect the temperature.

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Q

T/F (WINTROBE-LANDSBERG METHOD)

Should be away from any type of vibrations because it can affect the ESR result.

A

True

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Q

When reading the result, the buffy coat should not be included because?

A

It could cause:
ESR: false decrease
Hematocrit: false increase

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More commonly used ESR method

WESTERGREN METHOD

Uses Westergren Tube

WESTERGREN METHOD

Bore of Westergren tube

2.5 mm

Calibration of Westergren tube

200 mm

Length of Westergren tube

300 mm

Marking of Westergren tube

0 to 200

The specimen used in Westergren method

Whole blood (3.8% Sodium Citrate) EDTA Whole Blood

Diluent in EDTA Whole blood used in westergren method

3.8% Na Citrate or 0.85% NSS

Dilution in EDTA Whole blood used in westergren method

4 parts blood to 1 part diluent (4:1)

State the procedure of Westergren method

1. Mix blood by gentle inversion 2. Insert Westergren tube into the tube containing blood 3. Allow to stand in a vertical position for one hour 4. Take and record reading in mm/hr

T/F Westergren Method has the same consideration as the Wintrobe Method

True 1. Avoid bubbles 2. Vertical position 3. Room temperature 4. Away from sunlight (affects temp) 5. Avoid any vibrations 6. When reading the result, the buffy coat should NOT be included: ESR: false decrease Hematocrit: false increase

Reference value (WESTERGREN METHOD) 0-50-year-old men:

0-15 mm/hr

Reference value (WESTERGREN METHOD) > 50-year-old men:

0-20 mm/hr

Reference value (WESTERGREN METHOD) 0-50-year-old women:

0-20 mm/hr

Reference value (WESTERGREN METHOD) > 50-year-old women:

0-30 mm/hr

T/F The ESR of female individuals are more consistent compared to men

False; The ESR of MALE individuals are more consistent compared to WOMEN

Consideration for women (Westergren method)

Pregnant: ↑ ESR during 3rd and 4th trimester. After giving birth: ↑ ESR up to 3rd to 4th month

Enumerate the 3 stages of ESR

Agglomeration Phase/ Lag Phase Rapid/Fast Settling Phase Final Sedimentation Phase

STAGES OF ESR first 10 minutes

Agglomeration Phase/ Lag Phase

STAGES OF ESR 40 minutes

Rapid/Fast Settling Phase

STAGES OF ESR 10 minutes

Final Sedimentation Phase

Initial rouleaux formation occurs (slow)

Agglomeration Phase/ Lag Phase

Why is there an initial rouleaux formation in the Agglomeration phase/lag phase?

Because cells are spherocytic

Few cells sink under gravity but majority form agglomerates

Agglomeration Phase/ Lag Phase

“Initial period of aggregation/rouleaux phase”

Agglomeration Phase/ Lag Phase

“Period of fast settling”

Rapid/Fast Settling Phase

Aka Decantation Phase

Rapid/Fast Settling Phase

More rapid and constant RBC sedimentation

Rapid/Fast Settling Phase

Aka Final settling Phase/Final Period of Packing

Final Sedimentation Phase

RBC sedimentation is slow

Final Sedimentation Phase

Conditions characterized by High ESR

Rheumatoid Arthritis Lupus Anemia Endocarditis Kidney Disease Osteomyelitis Tuberculosis Syphilis Thyroid Disease

Conditions characterized by Low ESR

Sickle cell anemia Polycythemia Blood hyperviscosity Hypofibrinogenemia Congestive heart failure

↑ in all types of blood cells, ↓ESR

Polycythemia

T/F ESR is increased in polycythemia

False; decreased

Enumerate the factors affecting ESR

Old Specimen (> 2hrs) Plasma Proteins Sickle Cell and Spherocytes Plasma Viscosity Temperature (Optimal: 22-27 C) Inclination Bubbles Anticoagulant concentration Vibration Pregnancy Thalassemia

↑ or ↓: ESR in old specimens (>2 hrs)

↓

↑ or ↓: ESR in all plasma proteins

↑

↑ or ↓: ESR in albumin

↓

↑ or ↓: More viscous will result to _ ESR

↓

↑ or ↓: Less viscous will result in _ ESR

↑

↑ or ↓: <22 C: _ ESR

↓

↑ or ↓: >27 C: _ ESR

↑

↑ or ↓: ESR in inclination

↑

↑ or ↓: ESR in bubbles

↓

↑ or ↓: ESR in increased anticoagulant concentration

↓

↑ or ↓: ESR during vibration

↑

↑ or ↓: ESR during pregnancy

↑

↑ or ↓: ESR in the presence of thalassemia

↓

Room temp

within 4 hours

Refrigerator

within 24 hrs

Increased plasma protein = _ ESR

increased

High albumin = _ ESR

low

T/F Plasma protein is directly proportional to ESR

true

T/F Albumin is indirectly proportional to ESR

true

Sickle cell found in _, _, _

HbSS, HbCS, HbAS

In inclination, Tilt (_°) up to _% error

3° up to 30% error

T/F top of Refrigerator: may cause a false increase in ESR due to vibration and temperature

True

Cell found in thalassemia

The cells found in thalassemia.

Target Cells, Mexican Hat Cells, Codocytes