Further tests Flashcards
Antenatal exam - normal
Urine dip
BP
Routine scans
Bloods - FBC, LFTS…
Antenatal - Pre-ecampsia
Urine dip - Protein?
Bp - High
Bloods - Clotting (low platelets in HELLP), LFTs (deranged in HELLP), U+Es.. G+S ? C/section
Breast - Lump
Triple assessment - Clinical examination, imaging (Mammogram or U/S), Fine needle biopsy
Full systemic examination to look for evidence of metastatic disease
Cardio - AS
Review obs chart (?high BP)
ECG (LVH/strain pattern)
CXR
Echo - structural changes
Cardio - AF
Obs
ECG - no p waves, irreg irreg. Ambulatory to see if paroxysmal
CXR - (?structural cause Mitral valve or HF)
Bloods - Thyroid function, FBC, LFTs, U+Es, Coag (pre-warfarin)
Cardio - Replacement Valve
Obs
Review recent ECG
Echo - confirm valve working well?
Cardio - Syncope
Obs - Lying standing BP
ECG - Arrhythmia, Heart block? LVH (AS causes syncope)
CXR
Fasting blood glucose
Cardio - Heart Failure
Obs ECG Resp exam CXR Echo Bloods - FBC (anaemia), TFTs, U+Es, BNP urinalysis Lung function tests
ENT - Hearing loss
Refer to ENT (urgent if sensorineural)
Audiometry
CN exam
? MRI if acoustic neuroma
ENT - Polyps
Refer to ENT
Nasal endoscopy (Rhinoscopy)
if child - check for CF
CN - Stroke
CT head - urgent to distinguish between ischaemic and haemorrhagic Obs - High BP? Upper and lower limb neuro ECG - Arrhythmias? LVH? Bloods - FBC, Clotting, U+Es, ESR
CN - Bells Palsy
Obs
Serology - Lymes, herpes zoster (=Ramsey hunt)
Refer to Ophthalmology (protect eye)
CN - Visual field defect
Obs
Ophthalmology exam
Visual field mapping
MRI head (pituitary tumour)
MSK - sprains/trauma/pain
Examine joint above and below X-ray of joint/bone Bloods - FBC (WCC), ESR, CRP ?monoarthritis Pyrexia? - Blood cultures Consider joint aspiration MRI - soft tissue injury
Neuro exam - weakeness
Other neuro exams CT - acute stroke MRI flair- MS + cord compression Nerve conduction studies Bloods - FBC, TFTs, B12
PR - enlarged prostate
PSA - in 2 weeks Bloods - FBC + heamatinics, U+Es Fecal occult blood test Sigmoidoscopy/colonoscopy CT Abdo/pelvis?
Gastro - Pain/UC/Crohns
Obs External genitalia + PR + hernias Stool sample AXR Bloods - FBC, CRP, Lactate, Amylase
Gastro - appendicitis
Obs External genitalia, pr, hernias USS or abdo CT (more sensitive) Bloods - FBC, CRP, LActate, Amylase, G+S (?theatre) Urinalysis + Pregnancy test Diagnositc laperoscopy
Gastro - Hernia
Obs
External genitalia, PR
USS
Thyroid - lump
Bloods - TFT, FBC, U+Es
USS lump
Fine needle aspiration
Opthalmology
CN exam Retinal imaging / refer to ophthalmologist Visual field mapping Obs - BP? Bloods - glucose, FBC...
Peripheral arterial - ischaemia
Obs Doppler ABPI CT arteriogram Bloods - FBC, ESR, Glucose, Lipids
Embolism cause? ECG, Echo, Aorta/femoral US.
Peripheral venous - Varicose veins
Obs
Duplex US
PV - ? fibroid
Abdo exam
USS - trans vaginal?
Bloods - FBC,
?hysteroscopy and biopsies, or pipelle biopsy
Resp - COPD
Pulmonary function tests - Peak flow, spirometry
CXR
Bloods- FBC (polycythemia?) alpha-1-antitrypsin
?CT throax
