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Oto Board Pearls of Wisdom - Section II Diagnostic and Assessment Procedures > 22 Laboratory studies > Flashcards

22 Laboratory studies Flashcards

1
Q

What are the only Ag-specific for syphilis

A

FTA-ABS, MHA-TA

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2
Q

What test is used to screen for syphilis

A

VDRL

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3
Q

T/F: FTA-ABS become negative once pt has been adequately tx for syphilis

A

False

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4
Q

What are some common labs in pts with sarcoidosis

A

Hypergammaglobulinemia, elevated LFTs, Ca, ESR, and ACE

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5
Q

What is an abnl Schirmer test

A

Less than 5 mm wetting after 5 mins; less than 10 mm wetting after stimulation with 10% ammonia

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6
Q

What tests used to dx Sjogren’s

A

Minor salivary gland bx showing mononuclear cell infiltration, SSA, SSB, ANA, RF

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7
Q

What lab test is a/w lymphoproliferative malignancy in pts w/ Sjogrens

A

Decreased level of serum IgM

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8
Q

Lab findings in pt with relapsing polychondritis

A

Elevated ESR, moderate leukocytosis, mild-to-mod anemia

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9
Q

What lab test is most specific for Wegener’s

A

c-ANCA

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10
Q

What is the significance of a rising c-ANCA titer in pt w/ Wegener’s

A

Usu indicates a relapse of active dz

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11
Q

HLA-DW4 Ab are m/c seen in which autoimmune dz

A

RA

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12
Q

What auto-Ab is present in 75% of pts with RA

A

RF

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13
Q

What is the most specific test for the dx of autoimmune SNHL

A

Western blot assay for 68 kD inner ear antigen (Otoblot) (95% specific)

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14
Q

The 68 kDa Ag is thought to represent what protein

A

Heat shock protein 70

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15
Q

What percent of pts with immune-mediated Meniere’s dz will have a positive anti-68-kD western blot test

A

30-50%

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16
Q

What is the most specific test for the dx of Cogan’s syndrome

A

Western blot assay for 55 kD inner ear antigen

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17
Q

Pt w/ Cogan’s syndrome usu have elevated titers to what organism

A

Chlamydia

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18
Q

What is the latency period for developing antibodies to hepatitis C

A

up to 4 months

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19
Q

What is the latency period for seroconversion following exposure to HIV

A

6-12 months

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20
Q

What adjunctive test should be performed in a female with suspected JNA

A

chromosome analysis

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21
Q

What test is used to dx pertussis

A

Cx from NP using a Dacron or calcium alginate swab placed on a Regan-Lowe or Bordet-Gengou agar plate

22
Q

What is the sensitivity of this test

A

80% (less if already on antibiotics)

23
Q

What tests confirm the dx of infectious mono

A

Blood smear showing atypical mononuclear cells and a positive Paul-Bunnell test (elevated heterophile titer of EBV)

24
Q

What is most useful study of non-TB mycobacterial adenitis of H&N region in kids

A

Cx

25
Q

What test should be performed in a pt w/ suspected AFS who does not have classic findings on CT scan or + middle meatal cx

A

aspergillus skin test and precipitins

26
Q

How is congenital CMV dx in newborn

A

ID of serum anti-CMV IgM, “owl-eye” bodies in urinary sediment, and intracerebral calcifications on radiographs

27
Q

What is most accurate method of determining if otorrhea is CSF

A

B2 transferrin

28
Q

What are the characteristics of CSF in presence of meningitis

A

Elevated protein, WBC, and pressure; dec GLC

29
Q

What lab tests can be used to dx CSF leak

A

Measurement of GLC (nasal secretions are devoid of GLC), B2 transferrin

30
Q

What is the single best measure of nutritional status

A

serum albumin level

31
Q

What serum albumin level is a/w malnutrition

A

Less than 3 g/dL

32
Q

Which serum proteins can be used to assess short-term nutritional status

A

Transferrin (1/2 life 8-9 days), prealbumin (1/2 life 2 days), retinal-binding globulin (1/2 life 12 hrs)

33
Q

All pts w/ paraganglioma should be tested for mutations in which gene?

A

SDH (succinate dehydrogenase)

34
Q

What are the m/c immunologic findings among pts with NP CA

A

Elevated IgA and IgG Ab against the viral capsid Ag of EBV

35
Q

What is the role of EBV titers in pts with NP CA

A

“May be a valuable screening tool in high-risk populations and can help establish the diagnosis of NPC in the patient with an unknown primary. In patients with type I disease, EBV titers are not elevated and have no prognostic significance.

36
Q

“What percent of patients with WHO types II and III tumors have abnormally increased titers to EBV VCA and NA?

A

80-90%

37
Q

What test provides prognostic info in pts with NP CA

A

Antibody-dependent cellular cytotoxicity (ADCC) assay

38
Q

How does this assay predict survival

A

low levels are a/w worse prog

39
Q

How do you test for multiple myeloma in pt with extramedullary plasmacytoma

A

Measure serum M-protein and urine Bence Jones protein; bone survey; bone marrow bx

40
Q

What test is used to distinguish a hypothalamic defect from a pituitary defect in a pt w/ hypothyroidism

A

The thyrotopin-releasing hormone (TRH) stimulation test

41
Q

T/F: thyroglobulin levels should be obtained prior to performing FNA on a thyroid nodule

A

True: FNA will falsely elevate thyroglobulin levels

42
Q

What is the purpose of obtaining a thyroglobulin level prior to thyroidectomy

A

It has been shown to correlate well with histologic tumor type and is useful as a marker for tumor recurrence

43
Q

What test should be ordered in pt w/ elevated TSH

A

Antimicrosomal Ab (antithyroperoxidase level) to r/o Hashimoto’s thyroiditis

44
Q

What lab test should be obtained in pts with FMH of medullary thyroid carcinoma

A

Calcitonin

45
Q

What lab w/u is needed in pts with MTC

A

Basal and pentagastrin stimulated calcitonin levels, serum CA, 24 hr urine catecholamines, VMA, and metanephrine, +/- CEA

46
Q

What are the histochemical characteristics of MTC

A

Congo red dye positive, apple-green birefringence consistent with amyloid; immunohistochemistry positive for cytokeratins, CEA, and calcitonin.

47
Q

What is the false negative rate of RET analysis

A

5%

48
Q

What is the most accurate test for dx of primary HPTH

A

Measurement of intact PTH

49
Q

Why is measurement of C-terminal of PTH not accurate for dx of 2ndary HPTH

A

“C-terminal fragments are cleared by the kidney; elevation may indicate either renal insufficiency or hyperparathyroidism.”

50
Q

“What is the difference in the Ca/Cr clearance ratio in someone with FHH and someone with primary hyperparathyroidism?

A

“Ca/Cr clearance <0.01 in FHH; >0.02 in primary hyperparathyroidism.

Oto Board Pearls of Wisdom - Section II Diagnostic and Assessment Procedures (11 decks)

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