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24 Cards in this Set
- Front
- Back
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What is the role of lab tests for rheumatology?
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1. diagnosis
2. evaluation of disease activity 3. monitoring drug side effects |
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What is the first most basic lab test you do for rheumatology (as in with most things)?
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CBC with differential, platelets
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What are three examples of where you would see low hemoglobin in rheumatology?
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1. anemia of chronic disease
2. iron deficiency from NSAIDS 3. hemolytic anemia of SLE |
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When could you see high white blood cells?
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infection, inflammation
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When could you see low white blood cells?
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1. Lymphocytopenia in SLE
2. marrow suppression from drugs |
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When could platelets be high?
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Reactive thrombocytosis of RA
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When could platelets be low?
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Idiopathic thrombocytopenic purpura (of lupus)
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What five biochem tests should be done for rheumatology?
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1. liver enzymes
2. CK 3. Creatinine 4. Urinalysis 5. Uric acid |
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What are the liver enzymes?
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AST, ALT, LDH, Alkaline Phosphatase
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What could affect liver enzymes?
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drugs (like methotrexate)
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What could affect CK?
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Inflammatory muscle disease
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What could affect creatinine?
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Lupus, vasculitis
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What two lab tests are used as an index of inflammation/infection in rheumatology?
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1. Erythrocyte sedimentation rate (ESR)
2. C-reactive protein (CRP) |
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Is ESR more sensitive or specific?
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sensitive
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What is rheumatoid factor (RF)?
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An antibody (usually IgM) to the Fc portion of IgG
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How much of RA is actually RF positive?
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~50%
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Does the measure of RF change with the disease?
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No. Therefore it is not worth following.
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What are some examples of other conditions that may be RF positive?
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SLE, Sjorgen's, Cryoglobulinemia, Cancer
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What is cyclic citrullinated peptide (CCP)?
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A peptide produced in the immune cascade of RA.
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Is CCP more sensitive or specific?
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Specific (~95%)
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When would you order anti-nuclear antibody (ANA)?
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Only when you have a high clinical suspicion of SLE.
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When is ANA present?
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1/3 RA
2/3 Sjogren's 95% of SLE |
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What are three instances of when you would order ANA (suspicious of SLE)?
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1. inflammatory polyarthritis
2. some photosensitive/malar rash 3. glomerular nephritis |
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What are the four main patterns of ANA?
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1. homogeneous (SLE)
2. speckled (SLE, Sjogren's) 3. nuclear (scleroderma, controls) 4. rim/peripheral (SLE) |
