Diagnostic Tests Flashcards
Testing for various autoimmune conditions
- Increased erythrocyte sedimentation rate (ESR)
- Increased C-Reactive Protein (CRP)
- (+) rheumatoid factor antibodies (RF)
- (+) anti-nuclear antibody (ANA)
Testing for Rheumatoid Arthritis
- Increased ESR, increased CRP, (+) RF, (+) ANA
- (+) anti-citrullinated peptide antibody (ACPA)
Testing for Systemic Lupus Erythematous (SLE)
- Increased ESR, increased CRP, (+) RF, (+) ANA
- (+) anti-dsDNA antibodies
Testing for Multiple Sclerosis
MRI
Testing for Anemia
-Low Hgb, Hct, RBCs
Microcytic Anemia
Aka Iron Deficiency
- Decreased MCV (smaller cell sizes: < 80 fL)
Macrocytic Anemia
AKA B12 or Folate Deficiency
- Increased MCV (larger cell sizes: > 100 fL)
- Schilling test
VTE
D-dimer test
DVT
*Ultrasound
Venography, MRI
PE
pulmonary computed tomographic angiography (CTA)
Stroke Prevention
CHA2DS2-VASC
Heparin Induced thrombocytopenia (HIT)
- Decreased platetes (>50% drop from baseline) 0 5-14 days after starting heparin
- (+) antibodies based on ELISA or serotonin release assay
Acute Coronary Syndromes
Electrocardiogram (ECG or EKG)
Cardiac Enzymes: Creatine kinase muscle/brain (CK-MB), troponin
Arrhythmias
electrocardiogram ECG or EKG
Holter monitor (portable ECG)
Heart rate
Cerebrovascular Accident (CVA/Stroke)
Computed Tomography (CT)
MRI
Chronic Heart Failure
Echocardiogram (Echo) ~ultrasound
-Increased B-Type natriuretic peptide (BNP)
- Increased N-Terminal proBNP (NT-proBNP)
Stable Ischemic Heart Disease (SIHD)/ Chronic Stable Angina
Cardiac Stress Test
Angiography
Dyslipidemia
- Increased TC, Non-HDL, LDL and TGs
- Coronary Artery Calcium (CAC) ~ non-invasive CT scan
Hypertension
Increased SBP/DBP
Hypertensive Emergency
Increased BP: >/= 180/120 mmHg with acute TOD
Hypertensive Urgency
Increased BP: >/= 180/120 mmHg without acute TOD
ASCVD
ASCVD 10 year risk tool; used if no history of ASCVD
Diabetes/Prediabetes
Fasting Plasma Glucose
Oral Glucose Tolerance Test
A1C
Hyperthyroidism
- Decreased TSH
- Increased FT4
Hypothyroidism
- Increased TSH
- Decreased FT4
Ovulation
Leutinizing hormone
Pregnancy
(+) hCG in urine or blood
Bacterial Vaginitis
- Clear, white or gray vaginal discharge
- Fishy odor
- pH > 4.5
- Little or no pain
Candida Vaginitis
- White, thicker, vaginal discharge
- Pruritis
Trichomoniasis
-Yellow, green frothy, foul-smelling discharge
- pH > 4.5
- soreness/pain with intercourse
Peptic Ulcer Disease
Upper GI endoscopy (mouth - small intestine)
Duodenal ulcer
Pain 2-3 hours after eating (without food in stomach)
Pain relief with food and antacids
Gastric ulcer
Pain right after eating (food in stomach)
Little-no pain relief with food and antacids
GERD
Esophageal pH monitoring
Endoscopy
H. Pylori
Urea breath test (UBT)
Fecal antigen testI
Inflammatory Bowel Disease (UC, CD)
Both: colonoscopy, biopsy, CT, MRI
CD: Endoscopy
UC: Sigmoidoscopy
Bronchospastic Diseases
Spirometry
FEV1
FVC
FEV1/FVC
Asthma
FVC
FEV1
Peak expiratory flow rate
Skin test for allergic asthma
COPD
Post bronchodilator FEV1/FVC < 0.7
Acid Base Disorders
Arterial blood gas –> pH, pCO2, HCO3
Metabolic Acidosis
Low pH, low bicarbonate
Compensation: Respiratory alkalosis
Respiratory Acidosis
Low pH, High pCO2
Compensation: Metabolic alkalosis
Metabolic Alkalosis
High pH, high bicarbonate
Compensation: Respiratory Acidosis
Respiratory Alkalosis
High pH, low pCO2
Compensation: Metabolic Acidosis
Anion Gap Metabolic Acidosis
Anion gap > 12 mEq/L
General Infection
Fever (>100.4 or 38)
Increased WBC
Left shift: increased bands AKA immature neutrophils
C.Difficile
Positive C. Diff stool toxin (immunoassay plus glutamate dehydrogenase (GDH) test)
PCR
HIV
HIV antigen/antibody immunoassay
HIV-1/HIV-2 antibody differentiation immunassay
HIV RNA viral load
Nucleic Acid Test
Infective Endocarditis
Echo (checks vegetation)
Blood culture
Lyme Disease
Round, red bullseye rash,
ELISA
Meningitis
Lumbar puncture (LP)
- Plus symptoms of: severe headache, stiff neck, AMS
Onychomycosis (Fungal infection of nail)
20% KOH smear
Lice (Pediculosis)
Pruritus
Visible lice on scalp
Nits (eggs) on hair shafts
Pinworm (Vermicularis)
Tape test on skin adjacent to anus to check for eggs
Helminths in blood, feces, urine
Pneumonia
Chest X-Ray: infiltrates, consolidations or opacities
Syphilis
(+) nontreponemal assay [Rapid plasma reagin (RPR) or Venereal Diseases Research Labortory (VDRL) blood test]
(+) Treponemal assay
Toxoplasma gondii Encephalitis
Toxoplasma IgG test
Tuberculosis (TB)
Latent: (+) TB skin test (TST) or PPD or interferon-gamma release assay (IGRA) blood test
Active: Positive sputum acid-fast bacilli (AFB) stain and culture and chest X-Ray with cavitation
UTI
Urinalysis - (+) 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 Cancer
Digital rectal exam (DRE)
Prostate Specific Antigen (PSA)
Cancer, general
Carcinoembryonic antigen (CEA) test
Positron emission tomography
Allergic Reactions
Skin prick test
IgE Antibodies
Bleeding
Low Hgb/Hct
Visible blood or bruising
Upper GI Bleed: coffee ground emesis, or dark/tarry stools
Lower GI/Hemorrhoid: red blood in stool
Cholestasis (Bile Duct Blockage)
Increased Alk Phos, Increased TBili, Increased gamma-glutamyltransferase (GGT)
Cognitive Impairment (Alzheimer’s)
Mini-mental state exam (MMSE) - <24 = impairment
Cystic Fibrosis
Sweat Test
Glaucoma
Increased IOP
Visual field test assess optic nerve damadge
Gout
Increased uric acid (UA) level
Liver disease
LFTs: increased AST/ALT, Alk Phos, TBili, LDH,
Cirrhosis: increased PT/INR, decreased albumin
Alcoholic liver disease: increased AST>ALT and increased GGT
Hepatic encephalopathy: increased blood ammonia
Movement Disorders (ie. Parkinsons)
Abnormal involuntary movement scale (AIMs) - used to measure involuntary movements or tardive dyskinesias as monitoring for improvement
Myopathy
Increased Creatine kinase or creatine phosphokinase (CPK)
Peripheral Neuropathy
10-g monofilament
Pinprick
Temperature
Vibration
Osteoarthritis
X-Ray, MRI
Osteoporosis
BMD using DEXA: T score </= -2.5
Osteopenia: T-score: -1 to -2.4
Pain
Pain scales
Non verbal signs
Pancreatitis
Increased amylase/lipase
Psychiatric Disease
DSM-5 diagnositic criteria
Depression
DSM-5
Ham-D or HDRS assessment scale
Renal Disease
Increased BUN/SCr
CrCl
eGFR
Urine albumin
Dehydration
BUN/SCr ratio >20:1 plus symptoms of decreased urine output, dry mucus membranes, tachycardia
Seizures/Epilepsy
Electroencephalogram (EEG)
Weight (Underweight, normal, overweight, Obesity)
BMI plus waist circumference for overweight/obesity risks
IBW
TBW