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NAPLEX > Diagnostic Tests > Flashcards

Diagnostic Tests Flashcards

1
Q

Autoimmune, Various

A

↑erythrocyte sedimentation rate (ESR)
↑C-reactive protein (CRP)
(+)rheumatoid factor (RF) antibodies
(+)anti-nuclear antibody (ANA)

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2
Q

Rheumatoid Arthritis (RA)

A

↑erythrocyte sedimentation rate (ESR)
↑C-reactive protein (CRP)
(+)rheumatoid factor (RF) antibodies
(+)anti-nuclear antibody (ANA)
(+) anti-citrullinated peptide antibody (ACPA)

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3
Q

Systemic Lupus Erythematosus (SLE)

A

↑erythrocyte sedimentation rate (ESR)
↑C-reactive protein (CRP)
(+)rheumatoid factor (RF) antibodies
(+)anti-nuclear antibody (ANA)
(+)anti-citrullinated peptide antibody (ACPA)
(+)anti-dsDNA antibodies

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4
Q

Multiple Sclerosis

A

magnetic resonance imaging (MRI)

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5
Q

Anemia

A

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

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6
Q

Venous Thromboembolism (VTE)

A

D-dimer test (marker of fibrinolysis)
Deep vein thrombosis (DVT): ultrasound (US), venography, MRI
Pulmonary embolism (PE): pulmonary computed tomographic angiography (CTA)

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7
Q

Stroke Prevention

A

CHA2DS2-VASc scoring system (score directs need for anticoagulation in patients with atrial fibrillation)

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8
Q

Heparin-Induced Thrombocytopenia (HIT)

A

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)

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9
Q

Acute Coronary Syndrome (ACS)

A

electrocardiogram (ECG or EKG)
cardiac enzymes [creatinine kinase muscle/brain (CK-MB), troponin I, T]

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10
Q

Arrhythmias

A

ECG (or EKG)
Holter monitor (portable ECG device)
heart rate (HR)

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11
Q

Cerebrovascular Accident (CVA or Stroke)

A

computed tomography (CT)
MRI

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12
Q

Chronic Heart Failure

A

echocardiogram (echo)
↑B-type natriuretic peptide (BNP)
↑N-terminal proBNP (NT-proBNP)

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13
Q

Stable Ischemic Heart Disease (SIHD)/Chronic Stable Angina

A

cardiac stress test
angiography

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14
Q

Dyslipidemia

A

↑TC, Non-HDL, LDL, TGs
coronary artery calcium (CAC, a non-invasive CT scan of the heart that measures calcium-containing plaque)

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15
Q

Hypertension

A

↑systolic blood pressure (SBP)/diastolic blood pressure (DBP)

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16
Q

Hypertensive Emergency or Urgency

A

Emergency: ↑BP (≥180/120 mmHg) with acute target organ damage
Urgency: ↑BP (≥180/120 mmHg) without acute target organ damage

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17
Q

10-Year Risk for Atherosclerotic Cardiovascular Disease (ASCVD)

A

10-year ASCVD risk tool [use if no history of ASCVD (ACS/IHD, stroke, PAD)]

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18
Q

Diabetes, Prediabetes

A

fasting plasma glucose (FPG), oral glucose tolerance test (OGTT), hemoglobin A1C (A1C)

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19
Q

Hyperthyroidism

A

↓thyroid stimulating hormone (TSH)
↑free T4 (FT4)

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20
Q

Hypothyroidism

A

↑TSH
↓FT4

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21
Q

Ovulation

A

luteinizing hormone (LH), peak value provides optimal timing for intercourse to become pregnant

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22
Q

Pregnancy

A

positive human chorionic gonadotropin (hCG) in urine (outpatient test kit) or in blood

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23
Q

Bacterial Vaginitis

A

clear, white or gray vaginal discharge with a fishy odor and pH >4.5, little or no pain

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24
Q

Candida Vaginitis

A

white, thicker vaginal discharge, pruritus

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25
Q

Trichomoniasis

A

yellow, green frothy, foul-smelling vaginal discharge, pH >4.5, soreness and pain with intercourse

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26
Q

Peptic Ulcer Disease

A

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

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27
Q

GERD

A

esophageal pH monitoring
endoscopy

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28
Q

H. pylori

A

urea breath test (UBT)
fecal antigen test

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29
Q

Inflammatory Bowel Disease (Ulcerative Colitis, Crohn’s Disease)

A

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

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30
Q

Bronchospastic Diseases

A

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

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31
Q

Asthma

A

FVC, FEV1 and peak expiratory flow rate (PEFR)
allergic asthma: skin test (to detect an allergan)

32
Q

Chronic Obstructive Pulmonary Disease (COPD)

A

post-bronchodilator FEV1/FVC <0.7
eosinophils ≥300 cells/uL indicated inflammation & better response to ICS

33
Q

Metabolic Acidosis

A

arterial blood gas, measures pH, pCO2, HCO3
↓pH, ↓HCO3; compensation: respiratory alkalosis

34
Q

Respiratory Acidosis

A

↓pH, ↑pCO2; compensation: metabolic alkalosis

35
Q

Metabolic Alkalosis

A

↑pH, ↑HCO3; compensation: respiratory acidosis

36
Q

Respiratory Alkalosis

A

↑pH, ↓pCO2; compensation: metabolic acidosis

37
Q

Anion Gap Metabolic Acidosis

A

anion gap >12 mEq/L

38
Q

General Infection

A

fever (temp ≥100.4F or 38C)
↑WBC count
left shift (↑bands or immature neutrophils)

39
Q

C. difficile

A

(+) C. difficile stool toxin [enzyme immunoassay + glutamate dehydrogenase (GDH) test] or PCR

40
Q

HIV

A

HIV antigen/antibody immunoassay, HIV-1/HIV-2 antibody differentiation immunoassay, HIV RNA viral load, nucleic acid test

41
Q

Infective Endocarditis

A

echo (to check for vegetation)
blood culture (to identify causative organism)

42
Q

Lyme Disease

A

round, red bullseye rash, enzyme-linked immunosorbent assay (ELISA) test

43
Q

Meningitis

A

lumbar puncture (LP) + symptoms of severe headache, stiff neck & altered mental status

44
Q

Onychomycosis (Fungal Infection of Toenail or Fingernail)

A

20% KOH smear

45
Q

Lice (Pediculosis)

A

Pruritus, visible lice on the scalp and nits (eggs) on hair shafts

46
Q

Pinworm (Vermicularis)

A

tape test (on skin adjacent to anus to check presence of eggs)
helminths (worms) in blood, feces or urine

47
Q

Pneumonia

A

chest x-ray showing infiltrates, consolidations or opacities

48
Q

Syphilis

A

(+) nontreponemal assay [rapid plasma reagin (RPR) or Venereal Diseases Research Laboratory (VDRL) blood test] & treponemal assay

49
Q

Toxoplasma gondii Encephalitis

A

Toxoplasma IgG test

50
Q

Tuberculosis (TB)

A

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

51
Q

Urinary Tract Infection (UTI)

A

urinalysis (positive leukocyte esterase or WBC >10 cells/mm3, nitrites, bacteria), urine culture

52
Q

Breast Cancer

A

mammogram, ultrasound, MRI

53
Q

Cervical Cancer

A

pap smear, HPV test

54
Q

Colon Cancer

A

colonoscopy, sigmoidoscopy, double-contrast barium enema, CT colonography, stool DNA, fecal occult blood test (FOBT), fecal immunochemical test

55
Q

Lung Cancer

A

CT chest

56
Q

Skin Cancer

A

skin biopsy

57
Q

Prostate

A

digital rectal exam (DRE), prostate-specific antigen (PSA)

58
Q

General Cancer

A

carcinoembryonic antigen (CEA) test (a marker to identify cancer), positron emission tomography (PET)

59
Q

Allergic Reactions

A

skin prick (scratch) test (immediate)
immunoglobulin E (IgE) antibodies (blood)

60
Q

Bleeding

A

↓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)

61
Q

Cholestasis (Bile Duct Blockage)

A

↑alkaline phosphatase (Alk Phos)
↑total bilirubin (Tbili)
↑gamma-glutamyltransferase (GGT)

62
Q

Cognitive Impairment (i.e. Alzheimer’s)

A

mini-mental state exam (MMSE), score <24 indicates impairment

63
Q

Cystic Fibrosis

A

sweat test

64
Q

Glaucoma

A

↑intraocular pressure (IOP), visual field test (to identify optic nerve damage)

65
Q

Gout

A

↑uric acid (UA) level

66
Q

Liver Disease

A

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)

67
Q

Movement Disorders (e.g. Parkinson Disease)

A

abnormal involuntary movement scale (AIMS), rating scale used to measure involuntary movements, or tardive dyskinesias, as monitoring for patient improvment

68
Q

Myopathy

A

↑creatine kinase or creatine phosphokinase (CPK)

69
Q

Neuropathy, Peripheral

A

assess sensation with 10-g monofilament, pinprick, temperature and/or vibration tests

70
Q

Osteoarthritis

A

X-ray, MRI

71
Q

Osteoporosis

A

bone mineral density (BMD) using dual energy X-ray absortiometry (DEXA or DXA), T-score ≤-2.5
Osteopenia: T-score -1 to -2.4

72
Q

Pain

A

pain scales, non-verbal signs (e.g. moaning, grimacing, agitation

73
Q

Pancreatitis

A

↑amylase/lipase

74
Q

Psychiatric Disease (e.g. Depression, Schizophrenia)

A

DSM-5 diagnostic criteria
Depression-specific: Ha-D or HDRS assessment scale

75
Q

Renal Disease

A

↑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)

76
Q

Seizures/Epilepsy

A

Electroencephalogram (EEG)

77
Q

Weight: Underweight, Normal Weight, Overweight, Obesity

A

BMI (plus waist circumference for risks associated with overweight/obesity), ideal body weight (IBW), total body weight (TBW)

NAPLEX (9 decks)

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