Lecture 1: Clinical Serology and Lab Testing in Rheumatic Disease Flashcards
ESR is a good marker for monitoring disease activity, especially in what 2 conditions?
Polymyalgia rheumatica and Giant Cell arteritis
Between ESR and CRP, which rises and falls quicker?
CRP
A CRP >____ mg/L is inflammatory
>8 mg/L
In which type of RA will rheumatoid factor (RF) be present 100% of the time?
“Nodular” RA
Rheumatoid Factor (RF) can positive in which conditions?
- Healthy pt’s and pt’s >60 y/o
- Sjogrens syndrome and SLE
- Sarcoidosis, malignancy, and lung disease
- Cryoglobulinemia
- Primary biliary cirrhosis
- Mixed CT diseases
How does the the levels of Rheumatoid Factor (RF) correlate with a disease process?
High levels associated with aggressive dz, joint erosions, and worse prognosis
Which markers, if positive, have a 99.5% specificity for RA?
Anti-CCP + RF (+)
Anti-DS DNA antibody is seen in 50% of what?
SLE
What are 4 hematologic (CBC) indicators of SLE?
- Hemolytic anemia w/ reitculocytosis
or
- Leukopenia (<4000/mm3 total)
or
- Lymphopenia (<1500/mm3 total) on 2+ occasions
or
- Thrombocytopenia (<100,000/mm3)
Which imaging modality is sensitive for soft tissue abnormalities (synovitis, tendonitis, bursitis) and erosions; can also be used to aid in injecting/aspirating a joint?
Ultrasonography
Which imaging modality is most sensitive for detecting bone erosions?
CT
Which imaging modalty is the best for bony abnormalities (trabecular, cortical bone), erosions, fractures, degenerative or inflammatory arthritis?
CT
What is MRI good for and what is one of the cons to using it?
- Useful for soft tissue abnormalities
- Good for spine, SI, synovitis, tenosynovitis, erosions, joint inflammation
- Gadolinium contrast taken up in inflammed synovium –> can cause nephrogenic systemic fibrosis in pt’s with kidney disease
What are 2 arthritic complications associated with Diabetes?
- Charcot’s
- Cheiroarthropathy
