How do sickle cells or spherocytes interfere with the ESR?
a. Prevent rouleaux formation, so falsely decrease
b. Encourage rouleaux formation, so falsely increase
c. Agglutinate and increase red cell mass, so falsely increase
d. Decrease plasma viscosity, so falsely decrease
ANS: A
Abnormally shaped red cells such as sickle cells or spherocytes interfere with rouleaux formation, so they falsely decrease the ESR result.
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