Diagnostic Tests for disorder/condition Flashcards
Autoimmune, various
Increased erythrocyte sedimentation rate (ESR), increased C-reactive protein (CRP), positive rheumatoid factor (RF) antibodies, positive anti-nuclear antibody (ANA)
Rheumatoid arthritis
Increased erythrocyte sedimentation rate (ESR), increased C-reactive protein (CRP), positive rheumatoid factor (RF) antibodies, positive anti-nuclear antibody (ANA), positive anti-citrullinated peptide antibody (ACPA)
Systemic Lupus Erythematosus (SLE)
Increased erythrocyte sedimentation rate (ESR), increased C-reactive protein (CRP), positive rheumatoid factor (RF) antibodies, positive anti-nuclear antibody (ANA), positive anti-dsDNA antibodies
Multiple sclerosis
Magnetic resonance imaging (MRI)
Anemia
All: decreased Hgb/Hct/RBCs
Microcytic (or iron deficiency): decreased MCV (MCV <80 fL)
Macrocytic (or B12 or folate deficiency): Increased MCV (MCV >100 fL), Schilling test
Venous thromboembolism (VTE)
D-dimer test (marker of fibrinolysis)
DVT: ultrasound, venography, MRI
PE: pulmonary computed tomographic angiography
Stroke Prevention
CHA2DS2VASc scoring system (directs need for anticoagulation in patients with atrial fibrillation)
Heparin-Induced Thrombocytopenia (HIT)
Unexplained decrease in platelets (> 50% drop from baseline) 5-14 days after starting heparin, positive antibodies based on a heparin-platelet factor 4 (PF4) enzyme-linked immunosorbent assay (ELISA) test and/or serotonin release assay (SRA)
Acute Coronary Syndromes (ACS)
Electrocardiogram (ECG or EKG), cardiac enzymes [creatine kinase muscle/ brain (CK-MB), troponin I and T]
Arrhythmias
ECG or EKG, Holter monitor (portable ECG device), heart rate
Cerebrovascular Accident (CVA, or stroke)
Computed tomography, MRI
Chronic heart failure
Echocardiogram, increased B-type natriuretic peptide (BNP), Increased N-terminal proBNP (NT-proBNP)
Stable Angina
Cardiac Stress test, angiography
Dyslipidemia
Increase in total cholesterol, non-HDL, LDL, TGs, coronary artery calcium (CAC, a non-invasive CT scan of the heart that measures calcium-containing plaque)
Hypertension
Increased systolic blood pressure/ diastolic blood pressure
Hypertensive emergency or Urgency
Emergency: increase BP (greater than or equal to 180/120 mmHg) with acute target organ damage
Urgency: Increase BP (greater than or equal to 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, oral glucose tolerance test, hemoglobin A1C
Hyperthyroidism
Decreased thyroid stimulating hormone, increased free T4
Hypothyroidism
Increased TSH, decreased FT4
ovulation
Luteinizing hormone, peak value provides optimal timing for intercourse to become pregnant
Pregnancy
Positive human chorionic gonadotropin in urine or in blood
Bacterial vaginitis
clear, white or gray vaginal discharge, with a fishy odor and pH > 4.5, little or no pain
Candida Vaginits
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 hrs 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, 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 and rectum)
For both: colonoscopy, biopsy, CT, MRI
Bronchospastic disease
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: the 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 allergen)
Chronic Obstructive Pulmonary Disease (COPD)
Post-bronchodilator FEV1/FVC <0.7
Eosinophils >300 cells/ uL indicates inflammation and better response to inhaled corticosteroids
Metabolic acidosis
Arterial blood gas, measures pH, pCO2, HCO3
decreased pH, decreased HCO3; compensation: respiratory alkalosis
Respiratory Acidosis
decreased pH, increased pCO2; compensation: metabolic alkalosis
Metabolic Alkalosis
increased pH increased HCO3; compensation: respiratory acidosis
Respiratory alkalosis
increased pH, decreased pCO2; compensation: metabolic acidosis
Anion Gap Metabolic Acidosis
Anion Gap >12 mEq/L
General infections
Fever (temperature > 100.4F or 38C) increased WBC, left shift (increased bands, or immature neutrophils)
C. difficile
Positive C.diff stool toxin [enzyme immunoassay plus 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, ELISA test
Meningitis
Lumbar puncture (LP), plus symptoms of headache, stiff neck and altered mental status
Onychomycosis (Fungal Infection of Toenail or Fingernail)
20% KOH (potassium hydroxide) smearL
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 the blood, feces, or urine
Pneumonia
Chest X-ray showing inflitrates, consolidations or opacities
Syphillis
Positive nontreponemal assay [rapid plasma reagin (RPR) or venereal diseases research laboratory (VDRL) blood test] and treponemal assay
Toxoplasma gondii Encephalitis
Toxoplasma IgM and IgG test
Tuberculosis (TB)
Latent TB: positive tuberculin skin test (TST) [also known as a purified protein derivative (PPD)], or interferon gamma release assay blood test
Active TB: positive sputum acid-fast bacilli (AFB) stain and culture, chest X-ray with cavitation
Urinary tract infection
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 biopdy
Prostate cancer
Digital rectal exam, prostate-specific antigen
General cancer
carcinoembryonic antigen test, positron emission tomography
Allergic reaction
skin prick (scratch) test (immediate), immunoglobulin E antibodies
Bleeding
decreased Hgb/Hct, visible blood or bruising, coffee ground emesis or dark/tarry stools (upper GI bleeding), red blood in stool (lower bleeding or hemorrhoid)
Cholestasis (bile duct blockage)
increase in alkaline phosphatase (Alk Phos), increased total bilirubin, increased gamma-glutamyl transferase
Cognitive impairment
Mini-mental state exam , score <24 indicates impairment
Cystic Fibrosis
Sweat test
Glaucoma
Increased intraocular pressure, visual field test (to identify optic nerve damage)
Gout
increase uric acid level
Liver disease
Liver function tests: increased AST/ALT, increased Alk Phos, Increased Tbili, increased lactate dehydrogenase
Cirrhosis: Increased PT/INR, decreased albumin
Alcoholic liver disease: increased AST>Increased ALT, Increased GGT
Hepatic encephalopathy: Increased ammonia level
Movement disorders
Abnormal involuntary movement scale, rating scale used to measure involuntary movement, or tardive dyskinesia, as monitoring for patient improvement
Myopathy
Increased creatine kinase or creatine phosphokinase
Neuropathy, peripheral
assess sensation with 10-g monofilament, pinprick, temperature and/or vibration tests
Osteoarthritis
X-ray, MRI
Osteoporosis
Bone mineral density using dual energy X-ray absorptiometry (DEXA or DXA), T-score <2.5
Osteopenia: T-score -1 to -2.4
Pain
pain scales, non-verbal signs (eg moaning, grimacing, agitation)
Pancreatitis
increased amylase/lipase
Psychiatric disease
DSM-5 diagnostic criteria
Depression-specific: Ham-D or HDRS assessment scale
Renal Disease
Increased BUN/SCr, creatinine clearance, glomerular filtration rate (eGFR), urine albumin
Dehydration: BUN/SCr ratio > 20:1, plus symptoms (decreased urine output, dry mucus membranes, tachycardia)
Seizures/ epilepsy
electroencephalogram
weight: underweight, normal weight, overweight, obesity
BMI (plus waist circumference for risks associated with overweight/obesity), ideal body weight, total body weight