Serology and Lab Testing - Johnston Flashcards
(44 cards)
Diagnostic labs for arthritis (7)
- RF
- Anti-CCP
- ANA
- ESR
- CRP
- ASOT (anti-streptolysin titer)
- Uric acid
RF + Anti-CCP = ____
RA (99.5% confidence)
ANA - means what alone?
Little - many people have them
ASOT - means what?
Previous streptococcal infection
List of acute phase reactants (7)
- ESR
- CRP
- Leukocytosis
- Thrombocytosis
- Ferritin
- Fibrinogen
- Complement
Which one is higher in women?
Also higher in who?
Diseases that this is especially good for? (2)
ESR
Older
Polymyalgia rheumatica, giant cell arteritis
CRP is a good marker for ___
Made where?
Does what?
Any inflammation (pro-inflammatory cytokines)
Liver
Activates complement, promotes phagocytosis
**CRP vs. ESR levels over time
CRP – rises and falls faster than ESR
CRP > ___ = inflammatory
8
RF is MOST commonly what?
Produced by what?
IgM – against Fc of IgG
B cells in synovial joints
Patients with _____ will 100% have RF antibodies
RA subQ nodules
Other autoimmune diseases that can have RF
Sjogrens, SLE, Cryoglobulinemia, Primary Biliary Cirrhosis, MCT disease, Endocarditis, Sarcoidosis, malignancy
Patients w/ RF are most likely to have what antibody?
Associated with?
Anti-CCP
Aggressive, erosive disease
Homogenous pattern of ANA immunofluorescence
Which ones? (3)
Drug-induced
Phenytoin, Procainamide, Hydralazine
Anti-Smith antibodies
SLE ONLY
Criteria for SLE (11)
Malar rash Discoid rash Photosensitivity Oral/nasal ulcers - painless Arthritis - 2+ peripheral joints Serositis - pleuritis, pericarditis Neurologic issue - seizure/psych Renal issue - proteinuria or casts ***Blood disorder - HA + reticulocytosis, low WBC (under 4000), low platelets (under 100,000) Immunologic issue - antibodies ANAs
False positive RPR (test for syphilis)
SLE
ASO titer
Previous Group A strep infection
Acute rheumatic fever - criteria
JONES criteria
- Joints (arthritis)
- Carditis
- Nodules (subQ)
- Erythema marginatum
- Sydenham chorea
Digital radiography is good for looking at what?
Joint erosions, osteopenia, etc.
Ultrasonography is good for looking at what?
Aid in doing what?
Soft tissue abnormalities - synovitis, tendonitis, bursitis
Injecting/aspirating joint
MRI is good for what?
Don’t use Gadolinium if…?
Soft tissue abnormalities - spine, SI, synovitis, tenosynovitis, erosions
Kidney disease - will cause nephrogenic systemic fibrosis
CT is good for what?
Bony abnormalities, erosions, fractures, degenerative or inflammatory arthritis
Pitting of nails
Psoriasis
Reactive arthritis
