American Board of Internal Medicine (ABIM) Certification Practice Exam

What is elevated ESR primarily used to monitor in rheumatologic diseases?

1. Kidney function

2. Disease activity

3. Infection presence

4. Blood sugar levels

The correct answer is: Disease activity

Elevated erythrocyte sedimentation rate (ESR) is primarily used to monitor disease activity in rheumatologic diseases. The ESR is a nonspecific marker that reflects inflammation in the body. In conditions like rheumatoid arthritis, systemic lupus erythematosus, and other autoimmune disorders, higher levels of ESR indicate increased disease activity and may correlate with flares of the disease. Monitoring ESR can help clinicians assess the effectiveness of treatments and the progression of the disease over time. For example, if a patient’s ESR decreases after starting a new therapy, this may indicate a reduction in inflammation and an improvement in disease control. Conversely, if the ESR rises, it could suggest a worsening of the disease or inadequate response to treatment. The other options do not align with the primary use of ESR in rheumatology. While kidney function, infection presence, and blood sugar levels are important clinical parameters, they are typically assessed using other specific tests such as creatinine levels, blood cultures, and glucose testing, respectively. Therefore, utilizing ESR as a marker specifically for monitoring disease activity in rheumatologic conditions underscores its role in guiding clinical decision-making and management.