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Test 2
what does ESR test measure
the rate at which RBCs settle out of diluted human plasma over a certain period of time
what units of measurement are used to report ESR
mm/Hr
When should an ESR be set up following collection
within 3 hours
how long should the ESR tube sit before reading (Westergren manual method)
60 minutes
what is formed in the ESR column that help with the settling of RBCs
Rouleaux
what term indicates a high fibrinogen level in the blood
hyperfibrinogenemia
what term indicates a high immunoglobulin level in the blood
hyperimmunoglobulinemia
why can you not subtract and get the difference in an ESR reading
because RBCs dont fall at a constant rate, they fall faster at the beginning and slow down over time
sample type for ESR test
freshly collected in EDTA via venipuncture
safety rule when plunging the ESR tube into the reservoir
use both hands to control the blood flow up the tube
patients with elevated ESR levels
temporal arthritis, rheumatoid arthritis, chronic infections, some anemias, pregnancy
example of rouleaux forming conditions
multiple myeloma
diseases with abnormal red cell morphology that are associated with decreased ESR levels
iron deficiency anemia, sickle cell anemia, spherocytes
is ESR a specific or nonspecific test
non-specific
what is used to diagnose temporal arthritis
ESR
what method is used to measure ESR
Westergren/Winterobe ESR method
if doing an automated ESR method, what colour tube is used
black stopper
what additive is in black topped tubes
Na citrate anticoagulant
how is blood stored
blood can be kept at RT for up to 24 hours (can be refrigerated but warmed up before use)
commercial kit that measures ESR
MiniCube by Diesse
what tube is used in thte MiniCube and how many samples at once
uses EDTA tubes, 4 samples at one time
what is a better, more sensitive alternative to ESR
C-Reactive Protein (CRP)
why is it better to use CRP than ESR
because it is a more sensitive and accurate reflection of inflammation
what does CRP measure
it measures the level of the C reactive protein in the blood to help detect inflammation and monitor conditions that cause it
what does agglutination in the latex agglutination test indicate
visible agglutination indicates the presence of CRP in serum
what are the downsides to latex agglutination test
the test does not specify the cause or location of the inflammation
how does the latex agglutination test work
latex particles are coated with CRP specific antibodies, when latex particles are mixed with serum containing CRP, an agglutination reaction happens
half life of CRP
stable half life of 19 hours
what kind of inflammation is ESR most useful for
chronic inflammation and general indication of inflammatory status
what kind of inflammation is CRP most useful for
detection and monitoring of acute inflammation
in the first 24 hours of disease progress, the ESR may be ____ and the CRP may be ____
ESR is normal while CRP is elevated
what produces CRP
the liver (in response to inflammation)
define hematocrit
the volume of packed red blood cells that occupies a specific volume of whole blood
what is another name for hematocrit
packed cell volume (PCV)
what are the units of measurement for hematocrit
L/L
what end of the capillary tube faces towards the outside of the centrifuge for manual hematocrits
the clay end points towards the outside
what is HCT a good indicator for
RBC volume (oxygen carrying capacity)
Low HCT
anemia
high HCT
polycythemia or dehydration
what quality control is in place to ensure you are reporting an accurate manual HCT
running tubes in duplicate
what is the calculation for HCT
(RBC) x (MCV/1000) = HCT (in L/L)
what is the rule of 3
Hematocrit value should be 3 times the value of hemoglobin
what should you do if the rule of 3 does not agree
rerun, if the same then report
when does the rule of 3 apply
only to specimens that have normocytic and normochromic RBCs
how to find HGB if you have a HCT value
divide HCT by 3
how to find HCT if you have a HGB value
multiply HGB by 3
what is reported as a number in the hundreds (or high tens)
HGB
what is reported as a decimal number (to 3 decimals)
HCT
the HCT is 0.450 L/L, what is the HGB
HGB = 150 g/L
if an EDTA tube was used for an ABO, then an HCT was added on, how would the HCT result be
falsely increased (because some plasma was removed in ABO, causing more concentrated red cells)
percent certainty in manual HCT
1-2%
what does the buffy coat contain, and is it included in a hematocrit determination
the buffy coat contains WBCs and PLTs and is excluded in the hematocrit determination
Note 
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