Lecture 12 Hormones
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What are the four autoimmune laboratory tests?
erythrocyte sedimentation rate, c-reactive protein, antinuclear antibody, rheumatoid factor
What are the four autoimmune laboratory tests?
erythrocyte sedimentation rate, c-reactive protein, antinuclear antibody, rheumatoid factor
What are the indications for an ESR?
erythrocyte sedimentation rate; sed rate; does not tell you a diagnosis just tells you that something is wrong; marker for inflammation, infection, neoplasm, and tissue necrosis
What is the pathophysiology behind ESR test?
erythrocytes are negatively charged and therefore repel eachother; inflammation and infection can increase release of acute phase reactants therefor increasing the positive charge; the RBCs start to stack in the test tube making the ESR higher
In the case of inflammation and infection what are the two acute phase reactants that the body releases?
fibrinogen and immunoglobulin’s
What is the normal value for an ESR?
0-20 mm/h
What is the normal value for C-reactive protein?
0-10 mg/dL
What is the function of C-reactive protein?
recognizes and responds to inflammatory mediators and target damages tissue for clearance
What is the purpose of CRP-HS?
can detect small enough amounts of CRP to stratify risk for cardiac disease or future cardiovascular events
What is the ANA test important for diagnosing?
systemic lupus erythematosus (SLE)
What are the manifestations of SLE?
butterfly rash!, fatigue, weight loss, arthralgia. myalgias, lymphadenopathy, multiple organ involvement
What are the negative and positive values for ANA?
less than 1:40 dilution is negative… greater than 1:160 is positive
What are some of the other diseases one could have with a positive ANA test?
SLE, progressive systemic sclerosis, rheumatoid arthritis, siogren syndrome, dermatomyoaitia, polyarteritis
What are the manifestations of scleroderma?
fatigue, arthralgia, myalgia, skin thickening and hardening, digital ulcers
What percent of people with a positive ANA will actually have lupus?
11-13%; shows that people with other disease can present with a positive ANA test
What are the systemic manifestations of rheumatoid arthritis?
fatigue, cardiovascular, renal, and others…
What is the normal value for rheumatoid factor?
How does rheumatoid arthritis differ from osteoarthritis?
it is caused by autoantibody destruction of joint tissue and has systemic manifestations
What is the rheumatoid factor predominantly composed of?
IgM antibodies that are directed against the portion of IgG antibody known as the Fc fragment
What disease is the rheumatoid factor increased with?
rheumatoid arthritis, other autoimmune disease, chronic infections, such as hepatitis, malignancy
What are the lab tests ordered for the thyroid gland?
TSH, T4, Free T4, T3, Free T3
What are the normal values for the thyroid stimulating hormone?
0.5-5.0 uIU/ mL
What is control of the thyroid gland controlled by?
hypothalamus and pituitary gland
What are the indications for an ESR?
erythrocyte sedimentation rate; sed rate; does not tell you a diagnosis just tells you that something is wrong; marker for inflammation, infection, neoplasm, and tissue necrosis