Diagnostic Tests Flashcards
Autoimmune, Various
↑erythrocyte sedimentation rate (ESR)
↑C-reactive protein (CRP)
(+)rheumatoid factor (RF) antibodies
(+)anti-nuclear antibody (ANA)
Rheumatoid Arthritis (RA)
↑erythrocyte sedimentation rate (ESR)
↑C-reactive protein (CRP)
(+)rheumatoid factor (RF) antibodies
(+)anti-nuclear antibody (ANA)
(+) anti-citrullinated peptide antibody (ACPA)
Systemic Lupus Erythematosus (SLE)
↑erythrocyte sedimentation rate (ESR)
↑C-reactive protein (CRP)
(+)rheumatoid factor (RF) antibodies
(+)anti-nuclear antibody (ANA)
(+)anti-citrullinated peptide antibody (ACPA)
(+)anti-dsDNA antibodies
Multiple Sclerosis
magnetic resonance imaging (MRI)
Anemia
All: ↓Hgb/Hct/RBCs
Microcytic (or Fe-deficiency): ↓MCV (cell size is smaller, MCV <80 fL)
Macrocytic (or B12 or folate deficiency): ↑MCV (cell size is larger, MCV >100 fL), Schilling test
Venous Thromboembolism (VTE)
D-dimer test (marker of fibrinolysis)
Deep vein thrombosis (DVT): ultrasound (US), venography, MRI
Pulmonary embolism (PE): pulmonary computed tomographic angiography (CTA)
Stroke Prevention
CHA2DS2-VASc scoring system (score directs need for anticoagulation in patients with atrial fibrillation)
Heparin-Induced Thrombocytopenia (HIT)
Unexplained ↓platelets (>50% drop from baseline) 5-14 days after starting heparin
Positive antibodies based on a heparin platelet factor (PF4) ELISA and/or serotonin release assay (SRA)
Acute Coronary Syndrome (ACS)
electrocardiogram (ECG or EKG)
cardiac enzymes [creatinine kinase muscle/brain (CK-MB), troponin I, T]
Arrhythmias
ECG (or EKG)
Holter monitor (portable ECG device)
heart rate (HR)
Cerebrovascular Accident (CVA or Stroke)
computed tomography (CT)
MRI
Chronic Heart Failure
echocardiogram (echo)
↑B-type natriuretic peptide (BNP)
↑N-terminal proBNP (NT-proBNP)
Stable Ischemic Heart Disease (SIHD)/Chronic Stable Angina
cardiac stress test
angiography
Dyslipidemia
↑TC, Non-HDL, LDL, TGs
coronary artery calcium (CAC, a non-invasive CT scan of the heart that measures calcium-containing plaque)
Hypertension
↑systolic blood pressure (SBP)/diastolic blood pressure (DBP)
Hypertensive Emergency or Urgency
Emergency: ↑BP (≥180/120 mmHg) with acute target organ damage
Urgency: ↑BP (≥180/120 mmHg) without acute target organ damage
10-Year Risk for Atherosclerotic Cardiovascular Disease (ASCVD)
10-year ASCVD risk tool [use if no history of ASCVD (ACS/IHD, stroke, PAD)]
Diabetes, Prediabetes
fasting plasma glucose (FPG), oral glucose tolerance test (OGTT), hemoglobin A1C (A1C)
Hyperthyroidism
↓thyroid stimulating hormone (TSH)
↑free T4 (FT4)
Hypothyroidism
↑TSH
↓FT4
Ovulation
luteinizing hormone (LH), peak value provides optimal timing for intercourse to become pregnant
Pregnancy
positive human chorionic gonadotropin (hCG) in urine (outpatient test kit) or in blood
Bacterial Vaginitis
clear, white or gray vaginal discharge with a fishy odor and pH >4.5, little or no pain
Candida Vaginitis
white, thicker vaginal discharge, pruritus
Trichomoniasis
yellow, green frothy, foul-smelling vaginal discharge, pH >4.5, soreness and pain with intercourse
Peptic Ulcer Disease
Upper gastrointestinal endoscopy (mouth to small intestine)
Duodenal ulcer: pain 2-3 hours after eating (without food in stomach), pain relief with food/antacids
Gastric ulcer: pain right after eating (with food in stomach), little/no pain relief with food/antacids
GERD
esophageal pH monitoring
endoscopy
H. pylori
urea breath test (UBT)
fecal antigen test
Inflammatory Bowel Disease (Ulcerative Colitis, Crohn’s Disease)
endoscopy (for Crohn’s disease, which affects more of the GI tract)
sigmoidoscopy (for ulcerative colitis, which affects the colon & rectum)
for both: colonoscopy, biopsy, CT, MRI
Bronchospastic Diseases
Spirometry, measures three main variables:
FEV1: how much air can be forcefully exhaled in one second
FVC: the maximum amount of air that can be forcefully exhaled
FEV1/FVC: percentage of total air capacity (vital capacity) that can be forcefully exhaled in one second
Asthma
FVC, FEV1 and peak expiratory flow rate (PEFR)
allergic asthma: skin test (to detect an allergan)
Chronic Obstructive Pulmonary Disease (COPD)
post-bronchodilator FEV1/FVC <0.7
eosinophils ≥300 cells/uL indicated inflammation & better response to ICS
Metabolic Acidosis
arterial blood gas, measures pH, pCO2, HCO3
↓pH, ↓HCO3; compensation: respiratory alkalosis
Respiratory Acidosis
↓pH, ↑pCO2; compensation: metabolic alkalosis
Metabolic Alkalosis
↑pH, ↑HCO3; compensation: respiratory acidosis
Respiratory Alkalosis
↑pH, ↓pCO2; compensation: metabolic acidosis
Anion Gap Metabolic Acidosis
anion gap >12 mEq/L
General Infection
fever (temp ≥100.4F or 38C)
↑WBC count
left shift (↑bands or immature neutrophils)
C. difficile
(+) C. difficile stool toxin [enzyme immunoassay + glutamate dehydrogenase (GDH) test] or PCR
HIV
HIV antigen/antibody immunoassay, HIV-1/HIV-2 antibody differentiation immunoassay, HIV RNA viral load, nucleic acid test
Infective Endocarditis
echo (to check for vegetation)
blood culture (to identify causative organism)
Lyme Disease
round, red bullseye rash, enzyme-linked immunosorbent assay (ELISA) test
Meningitis
lumbar puncture (LP) + symptoms of severe headache, stiff neck & altered mental status
Onychomycosis (Fungal Infection of Toenail or Fingernail)
20% KOH smear
Lice (Pediculosis)
Pruritus, visible lice on the scalp and nits (eggs) on hair shafts
Pinworm (Vermicularis)
tape test (on skin adjacent to anus to check presence of eggs)
helminths (worms) in blood, feces or urine
Pneumonia
chest x-ray showing infiltrates, consolidations or opacities
Syphilis
(+) nontreponemal assay [rapid plasma reagin (RPR) or Venereal Diseases Research Laboratory (VDRL) blood test] & treponemal assay
Toxoplasma gondii Encephalitis
Toxoplasma IgG test
Tuberculosis (TB)
Latent TB: (+) tuberculin skin test (TST) (also known as a purified protein derivative (PPD)], or interferon-gamma release assay (IGRA) blood test
Active TB: (+) sputum acid-fast bacilli (AFB) stain & culture, chest X-ray with cavitation
Urinary Tract Infection (UTI)
urinalysis (positive leukocyte esterase or WBC >10 cells/mm3, nitrites, bacteria), urine culture
Breast Cancer
mammogram, ultrasound, MRI
Cervical Cancer
pap smear, HPV test
Colon Cancer
colonoscopy, sigmoidoscopy, double-contrast barium enema, CT colonography, stool DNA, fecal occult blood test (FOBT), fecal immunochemical test
Lung Cancer
CT chest
Skin Cancer
skin biopsy
Prostate
digital rectal exam (DRE), prostate-specific antigen (PSA)
General Cancer
carcinoembryonic antigen (CEA) test (a marker to identify cancer), positron emission tomography (PET)
Allergic Reactions
skin prick (scratch) test (immediate)
immunoglobulin E (IgE) antibodies (blood)
Bleeding
↓Hgb/Hct, visible blood or bruising, coffee groun emesis or dark/tarry stools (upper GI bleeding), red blood in stool (lower GI bleeding or hemorrhoid)
Cholestasis (Bile Duct Blockage)
↑alkaline phosphatase (Alk Phos)
↑total bilirubin (Tbili)
↑gamma-glutamyltransferase (GGT)
Cognitive Impairment (i.e. Alzheimer’s)
mini-mental state exam (MMSE), score <24 indicates impairment
Cystic Fibrosis
sweat test
Glaucoma
↑intraocular pressure (IOP), visual field test (to identify optic nerve damage)
Gout
↑uric acid (UA) level
Liver Disease
liver function tests (LFTs): ↑AST/ALT, ↑Alk Phos, ↑Tbili, ↑lactate dehydrogenase (LDH)
Cirrhosis (chronic liver disease): ↑PT/INR, ↓albumin
Alcoholic liver disease: ↑AST > ↑ALT, ↑GGT
Hepatic encephalopathy: ↑ammonia level (blood)
Movement Disorders (e.g. Parkinson Disease)
abnormal involuntary movement scale (AIMS), rating scale used to measure involuntary movements, or tardive dyskinesias, as monitoring for patient improvment
Myopathy
↑creatine kinase or creatine phosphokinase (CPK)
Neuropathy, Peripheral
assess sensation with 10-g monofilament, pinprick, temperature and/or vibration tests
Osteoarthritis
X-ray, MRI
Osteoporosis
bone mineral density (BMD) using dual energy X-ray absortiometry (DEXA or DXA), T-score ≤-2.5
Osteopenia: T-score -1 to -2.4
Pain
pain scales, non-verbal signs (e.g. moaning, grimacing, agitation
Pancreatitis
↑amylase/lipase
Psychiatric Disease (e.g. Depression, Schizophrenia)
DSM-5 diagnostic criteria
Depression-specific: Ha-D or HDRS assessment scale
Renal Disease
↑BUN/SCr, creatinine clearance (CrCl), glomerular filtration rate (eGFR), urine albumin
Dehydration: BUN/SCr ratio >20:1, plus symptoms (e.g. ↓urine output, dry mucus membranes, tachycardia)
Seizures/Epilepsy
Electroencephalogram (EEG)
Weight: Underweight, Normal Weight, Overweight, Obesity
BMI (plus waist circumference for risks associated with overweight/obesity), ideal body weight (IBW), total body weight (TBW)