Tests for arthritis/autoimmune diseases Flashcards

(33 cards)

1
Q

an immunoglobulin that is ABNORMALLY directed against IgG antibodies

A

rheumatoid factor

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2
Q

the RF measured in most labs is ____

A

IgM

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3
Q

RF is most commonly associated with _____ (but is not specific for this disease)

A

rheumatoid arthritis

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4
Q

RF is also present in healthy individuals

T/F

A

true

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5
Q

Older or younger people have more RF?

A

RF increases as we age

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6
Q

RF can also be present in nonrheumatic diseases. Name 3

A
bacterial endocarditis
hepatitis
parasites
viral infection
cirrhosis
malignancy
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7
Q

a heterogeneous group of autoantibodies directed against nucleic acids and nucleoproteins, e.g. DNA, histones

A

Antinuclear antibodies (ANA)

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8
Q

When is ANA test indicated?

A

When patient has a clinical syndrome suggesting systemic lupus erythematosus (SLE) or other connective tissue disease

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9
Q

negative ANA test excludes ____

A

systemic lupus erythematosus (SLE)

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10
Q

What are two different tests that measure acute phase reactants?

A

ESR

C-reactive protein

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11
Q

To perform this test, place anticoagulated blood in a vertical tube and measure the rate of fall of erythrocytes in mm/hr

A

ESR, erythrocyte sedimentation rate

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12
Q

In response to a stimulus such as injury or infection, this can increase up to 1000 times its baseline concentration

A

C-reactive protein

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13
Q

factors unrelated to inflammation that may result in an increased ESR

A

obesity
increasing age
drugs

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14
Q

two rheumatic diseases that are almost always associated with an elevated Westergren ESR

A

polymyalgia rheumatica

giant cell arteritis (temporal arteritis)

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15
Q

use of ESR in rheumatic disease?

A

assess therapy/treatment effectiveness

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16
Q

this antigen is present in 95% of people with ankylosing spondylitis

17
Q

HLA-B27 may be ordered to confirm a diagnosis of ____, ____, or ____

A

ankylosing spondylitis
Reiter syndrome
anterior uveitis

18
Q

an ultrafiltrate of plasma to which synovial cells add hyaluronate

A

synovial joint fluid

19
Q

normal synovial fluid does not clot because:

A

because fibrinogen and clotting factors don’t enter the joint space from the vascular space

20
Q

Arthrocentesis is indicated for diagnosis when one of the following three conditions is suspected:

A
  1. septic arthritis
  2. hemarthrosis
  3. crystal-induced arthritis
21
Q

synovial fluid is analyzed for the following 8 characteristics:

A
viscosity
color
clarity
WBC count
PMN
culture
glucose
protein
22
Q

synovial fluid is reported from the lab as one of these 4 things

A

normal
non-inflammatory
inflammatory
septic

23
Q

opaque synovial fluid =

24
Q

inflammatory synovial fluid = (color)

25
inflammatory synovial fluid = (this viscosity)
low (normal is high)
26
normal synovial fluid = (glucose level as compared to blood)
about the same as blood
27
inflammatory or septic synovial fluid = (glucose level as compared to blood)
LOWER!! | inflammatory glucose level is lower than blood, septic is MUCH lower than blood
28
protein level of inflammatory or septic synovial fluid is (lower, higher) than that of normal synovial fluid
HIGHER protein in synovial fluid if inflammatory or septic
29
WBC count for normal, inflammatory, and septic synovial fluid
normal: < 200 inflammatory: 3,000 - 50,000 septic: > 50,000 (above is from lab book)
30
PMNs for normal, inflammatory, and septic synovial fluid
normal: < 25% inflammatory: > 50% septic: > 75%
31
ANCA testing is for what diseases?
vasculitic disease! | e.g. Wegener granulomatosis
32
Normal synovial fluid will have firm, stable clot (hyaluronic, not blood) formation within minutes. What are the mucin clot test results for inflammatory and septic fluid?
inflammatory: variable septic: friable
33
contraindications for arthrocentesis:
main contraindication for arthrocentesis: overlying skin lesion or infection others: coagulopathy, joint prosthesis