Diagnostic Tests Flashcards
Papanicolauo (pap) test
Reasons why this test might be ordered
- To test for precancerous cells, as well as changes in cervical cells that may lead to cervical cancer in the future
- To test the presence of cervical cancer
- To test for HPV which is an STI that can lead to cervical cancer
Papanicolauo (pap) test
Normal values
Normal/ negative: no changes were found in cervical cells
Unclear/equivocal/inconclusive: cells look like they could be abnormal, but it was not clear
Papanicolauo (pap) test
Procedure
Patient prep: legs spread, feet in holders
Procedure: Insert the speculum Warm speculum and insert Doctor retrieved a small brush and rub it on cervix Transfer brush to a bag
Papanicolauo (pap) test
Related information
Recommended age 21-65 years old every 3 years
Barium swallow test
Reasons why this test might be ordered
- To test for cancer of head and neck, esophagus
- To test for hiatal hernia, which is a bulge in the stomach that develops due to weakened muscle tissue
- Abnormalities in the upper GI tract (polyps, narrowing, pouches)
Barium swallow test
Normal values
: no abnormalities were found in the digestive system
Barium swallow test
Procedure
Patient prep:
eat a low fibre diet 2-3 days before exam, night before no eating or smoking
Procedure:
Drink a Chalky white barium mixture-slightly radioactive
After ingestion fluoroscopy are taken
Patient will lie down or stand
Barium swallow test
Related information
Side effects:
Nausea, constipation, white stool
Can’t do this test if pregnant or have glaucoma
I’d have diabetes may skip first dose
Colonoscopy
Reasons why this test might be ordered
- To test for colon cancer
- To examine the colon in order to find causes to symptoms a patient might be experiencing (rectal bleeding, constipation, diarrhea)
- Examine colon for polyps, these are small clusters of cells that form in the lining of the colon
Colonoscopy
Normal results
No abnormalities were found in the colon
Colonoscopy
Procedure
Patient prep: Low fibre diet for 2-3 days Day before can only drink clear fluids May be prescribed laxatives to drink the night before May be given a sedation or pain meds Knees drawn towards chest
Procedure:
Insert the colonscope into the rectum
Will inspect the colon for abnormal bleeding, tumours or polyps - polyps will be removed during this procedure. Biopsies will be taken as well.
Colonoscopy
Related information
Risks:
Bad reaction to meds
Bleeding from biopsy site, or polyp removal site
Perforation of the colon or rectum due to mishandling
Recommended to get done 10 years
If negative result every 5 years of family history
Mammography
Reasons why this test might be ordered
- Screening- to look for cancer in patients who don’t have symptoms of breast cancer. Monitors changes over time
- Diagnostic- if patient finds a lump a dr would order this test
- The evaluate breast pain when physical examination and history are not conclusive
Mammography
Normal value
Density of breasts
Mammography
Procedure
Remove jewelry
Stand in front of machine and place breast on X-ray plate
A separate plate will come on top
Patient will hold breath
Mammography
Related information
Interfering factors: Breast implants Previous breast surgery Wearing deodorant Pregnancy
Lumbar puncture (spinal tap)
Reasons why this test might be ordered
- Collect CSF for lab analysis can help diagnose cancers involving brain for spinal cord
- Measure pressure of CSF in the space around the spinal cord and remove CSF if necessary to decrease pressure in that space
- Inject spinal anaesthetics, chemotherapy, drugs or meds. Can also inject dye or radioactive substance into CSF to make diagnostic images of the fluids flow
Lumbar puncture (spinal tap)
Normal values
Appearance is normally clear and colourless
Decreased white blood cells is normal
Lumbar puncture (spinal tap)
Procedure
Sit and lean forward or lie on side with knees to chest
Local anesthetic is injected into patients lower back
Thin hollow needle is inserted between 2 lumbar vertebrae into the spinal cord
CSF pressure is measured
Lumbar puncture (spinal tap)
Related information
Risk:
Bleeding at puncture site, back pain, post-lumbar puncture headaches
Brain stem herniation
Bone marrow Aspiration
Reasons why this test might be ordered
- Diagnose blood or bone marrow cancers such as luekemia or multiple myeloma
- Collect a sample of bone marrow for medical procedures such as cell transplant
- Check response to treatment for bone marrow condition or cancer
Bone marrow Aspiration
Normal value
Normal bone marrow contains 0-5% blasts
Bone marrow Aspiration
Procedure
Numbing cream to iliac crest
Patient is prone or side lying
Sedative is given
Doctor makes a small incision, then insert a hallow needle through the bone into the bone marrow. A syringe is attached to the needle and bone marrow is extracted
Bone marrow Aspiration
Related information
Sharp pain or stinging
Complications are rare but include bleeding or long lasting discomfort at site of incision
CT-thorax
Reasons why this test might be ordered
- Detection and diagnosis- lung tumour/ shape size and location
- Metastasis- used to see if cancer has spread to the chest from distant sites
- Helps diagnosis other chest abnormalities
CT-thorax
Procedure
Iv contrast may be required
Camera moves around patient
3D image
CT-thorax
Related information
Low levels of ionizing radiation
MRI brain
Reasons why this test might be ordered
- Detection and diagnosis- brain tumours
- Signs/symptoms-chronic headaches
- Helps with diagnosis of a variety of brain conditions
MRI brain
Procedure
Like CT
Takes 30-45 minutes
MRI brain
Related information
Painless noninvasive
No risk
Ultrasound of breast
Reasons why this test might be ordered
- Screening tool
- Additional diagnostic evaluation
- Signs/symptoms- clear or bloody nipple discharge
Ultrasound (breast)
Procedure
Avoid applying powders and lotion
Gel is applied to breast
Images captured
Colposcopy
Reasons why this test might be ordered
- Patient experience bleeding after intercourse
- Follow up procedure to abnormal Pap test
- Help diagnose cervical cancer (and genital warts)
Colposcopy
Normal value
No inflammation of cervix, vagina, no visible warts
No abnormal cells found
Colposcopy
Procedure
Legs apart
Speculum is used
Vagina/cervix swabbed with iodine to highlight any abnormal areas and clear away mucous
Colposcope inserted and images take as needed
Colposcopy
Related information
10-20 minute procedure
Light bleeding and dark discharge
Bronchoscopy
Reasons why this test might be ordered
- Cough blood, or chronic coughing
- Diagnose lung infection, disease, cancer
- Allows to take biopsies for further testing- spread to lymph nodes
Bronchoscopy
Normal value
No trouble breathing, coughing
Clean airways, no blockage, cysts, or pus
Bronchoscopy
Procedure
Flexible or rigid bronchoscope Rigid- general anesthesia used Flexible- local anesthetic used, numbs - inserted through nose or mouth down trachea till bronchi - examine trachea, bronchi, lung - biopsy taken and sent to lab
Bronchoscopy
Related information
Can’t eat or drink after procedure
Side effects:
Bleeding, infection, trouble breathing, heart attack collapse lung
Fecal occult blood test (FOBT)
Reasons why this test be ordered
- Early screening test for colorectal cancer
- Help diagnose other conditions- ulcers hemorrhoids, polyps
- Symptoms: pain and difficultly passing feces blood in stool
Fecal occult blood test (FOBT)
Normal value
No blood in stool
No pain passing feces and regular bowel movements
Fecal occult blood test (FOBT)
Procedure
Common test: gFOBT (guiac smear test)
Use of a kit:
Collect sample from 3 separate bowel movements
Use provided applicator to smear stool sample
Date and seal
Mail to lab
Fecal occult blood test (FOBT)
Related information
7 days prior to testing: Don’t take non-steroidal, anti inflammatory dugs (NSAIDS) like ibuprofen No vitamin C 3 days prior: No red meat
All equals false results
Bone scintigraphy (bone scan)
Reasons why this test might be ordered
- Used to find bone metastasis and cancer that originated from bone
- Can be used to detect osteomyelitis
- Can be used to diagnose broken bones not visible on X-ray eg small stress fractures
Bone scintigraphy (bone scan)
Normal value
Abnormalities appear different than normal bone depending if they absorbed more or less of the radiotracer
Bone scintigraphy (bone scan)
Procedure
Radiotracer is given to patient through an injection in their arm, takes 4 hours to settle in bones
Radiotracer produces gamma radiation which is turned into a image via a gamma camera and SPECT
Bone scintigraphy (bone scan)
Related information
Patient should not take any medication that contains barium or bismuth before getting a bone scan they can affect the results.
May cause allergic reaction
Cystoscopy
Reasons why this test might be ordered
- Can be used to diagnose an enlarged prostate where the cytoscope passes prostate gland
- Patient is presenting symptoms: blood in urine, painful urination
- Diagnostic tool for bladder cancer, blockage, cytitis, and bladder stones
Cystoscopy
Procedure
Patient takes a course of antibiotics before procedure
Local anesthesia is used on urethra and given a general anesthetic
Bladder is filled with sterile solution to inflate it
A camera is inserted
Examines the lining of bladder
Cystoscopy
Related information
Risk of infection
Can cause blood in urine
Painful urination after procedure
Drink lots of water afterwards 500ml every 2 hrs
Digital rectum exam DRE
reasons why this test might be ordered
- Diagnostic test for prostate cancer
- Blood in stool, suspect change in bowel habits or rectal bleeding
- Also used to check uterus and ovaries as part of a pelvic exam
Digital rectum exam DRE
Normal value
If prostate not enlarged
No growths or tumours present in rectum
Digital rectum exam DRE
Procedure
Patient will lie on side in fetal position or bend forward
Dr will insert digit into rectum and will feel for bumps, hardening or abnormalities of the prostate
Digital rectum exam DRE
Related information
Urge to urinate whole procedure is done
Multi gated acquisition cardiac scan (MUGA)
Reasons why this test might be ordered
- Some types of chemo may damage heart
- May cause congestive heart failure (CHF)
- Long term effects due to radiation therapy to the chest
Multi gated acquisition cardiac scan (MUGA)
Normal values
A result of 50% or higher is considered normal
Multi gated acquisition cardiac scan (MUGA)
Procedure
Attach electrodes to patients chest monitor heart rate on EKG
IV is inserted into arm
Patient is laying on table with a radioactive tracer is injected
Gamma camera is placed above heart to analyze the radioactive red blood cells being pumped through the heart
Images are taken and used to calculate your ejection fraction
Multi gated acquisition cardiac scan (MUGA)
Related information
Possible allergies
Very small dose
Positron emission tomography
Reasons why this test might be ordered
- Help diagnose certain cancers
- See if the cancer has spread throughout the body
- Measure vital functions (blood flow and sugar, oxygen use)
Positron emission tomography
Normal values
Less hot spots, malignant cells use sugar as energy source
Positron emission tomography
Procedure
No food or drink 4-6 hours prior
Avoid tobacco alcohol caffeine and exercise for 24 hours
Inject radioactive material into vein, requires about 1 hour to travel through body and get absorbed by cells
Sit or lie down
Exam table moves through scanner
Scanner detects radioactive material and creates 3D images
Positron emission tomography
Related information
Allergic reaction may occur
May expose fetus of pregnant women to radiation
Laryngoscopy
Reasons why this test might be ordered
- Used to obtain biopsy samples of vocal cords/ areas of throat
- Treat problems early cancers with small laser
- Throat/voice problems
Laryngoscopy
Normal value
No evidence of growths
No signs of inflammation or larynx
Looks normal
Laryngoscopy
Procedure
Indirect:
Local anesthetic sprayed onto throat to numb and prevent gagging, dr wears head mirror with a light
Direct: anesthetic spray inserts a thin and flexible scope into your nose and moves it down your throat
Direct rigid: general anesthetic and used to do I biopsy, remove polyps or laser treatment. Once unconscious, doctor inserts a rigid laryngoscope down throat to remove tissue
Laryngoscopy
Related information
Bleeding in the throat Hoarseness Infection Reactions to anesthesia Swelling
