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22 Cards in this Set

  • Front
  • Back
what does an acute phase response occur in association with?
infection, trauma, infarction, inflammation and various neoplasms.
What is the response of ESR to a disease state?
ESR is slow to rise [days] and slow to decrease after resolution/treatment [days/weeks].
What are 4 causes of signficantly raised ESR? (>100mm/hour)
•1.Temporal arteritis,
•2.Polymyalgia rheumatica
•3.Infectious disease [Tuberculosis]
•4.Neoplasm [Multiple Myeloma]
what values of CRP indicate that an infection?
For most clinical purposes, CRP <3 mg/L can be regarded as normal and >10 mg/L as indicating clinically significant inflammation.
why may ESR be raised and CRP normal?
1. false positive
2. SLE (ESR may be a predictor or organ damage in SLE and of disease activity)
what is normal ESR?
<35 mm/hour
1. What is an improved test (better than RF) for rheumatoid disease?
2. what is the reference range for RF?
1. Anti-CCP (anti-cyclic citrillated peptide)
2. <20 IU/mL
How is ANF (anti-nuclear factor) interpreted?
1. Weak + (1:40 and 1:100) (only rarely associated with connective tissue disease
2. strong + (1:400 or more) need more testing (anti-DNA or ENA)
3. - result (SLE and connective tissue dz unlikely)
*interpretation is dependent on the clinical situation and age, sex of patient
what are the patterns of ANF?
1. homogenous (non-specific)
2. speckled, non-specific
3. centromere
4. nucleolar
what is typically positive in CREST? anything else?
anti-centromere (limitied dz). can also be + in billary cirrhosis
what is anti-nucleolar antibody pattern in?
scleroderma
also in autoimmune liver disease
anti-dsDNA is found in...
SLE
autoimmune hepatitis
*half life of IgM is 3 weeks, so measure monthly
PR3-ANCA:
vasculitis...esp Wegeners
MPO-ANCA:
pauclimmune glomerulonephritis
anti-cardiolipin:
anti-phospholipid syndrome. (arterial,venous thrombosis and pregnancy associated morbidity *miscarriages)
anti-smooth muscle antibodies:
type 1 autoimmune hepatitis (slowly progressing)
anti liver kidney microsomal antibodies:
type 2 autoimmunie hepatitis (can progress rapidly)
anti-mitrochonidrial antibody:
primary billiary cirrhosis
anti gastric parietal cell ab:
pernicious anaemia/atrophic gastritis
anti-intrinsic factor ab:
pernicious anaemia (check B12)
anti-endomsial antibodies:
celiacs
reduced C3, C4
active lupus