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JG EMQ revision > Investigations > Flashcards

Investigations Flashcards

1
Q

BPH/prostatic carcinoma

A

PSA

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2
Q

SLE

A

anti-dsDNA antibody

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3
Q

Goodpasture’s syndrome

A

anti-GBM antibody

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4
Q

APCKD

A

USS renal tract

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5
Q

Multiple myeloma

A

Plasma electrophoresis (monoclonal gammopathy)

Urine analysis (Bence-Jones protein)

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6
Q

Motor Neuron Disease

A

EMG = single best

MRI = exclude cord compression + visualise bulbar palsy

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7
Q

Horner’s syndrome

A

Apraclonidine hydrochloride

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8
Q

Huntington’s disease

A

Genetic analysis (>39 CAG repeats)

CT/MRI –> symmetrical atrophy of stratum + butterfly dilation of lateral ventricles

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9
Q

Idiopathic pulmonary fibrosis

A

High resolution CT

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10
Q

Cystic fibrosis

A

Sweat test (80-125mmol/L)

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11
Q

COPD

A

Lung function test

FEV1/FVC <70%

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12
Q

TB

A

Sputum culture

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13
Q

Lung cancer

A

Bronchoscpoy + biopsy

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14
Q

Blood in pleural aspirate

A

Pleural biopsy

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15
Q

What test is used to diagnose a SYMPTOMATIC suspected diabetic patient?

A

Fasting venous blood glucose >7.0mmol/L

OR

Random blood glucose >11.0mmol/L

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16
Q

What test is used to diagnose an ASYMPTOMATIC suspected diabetic patient?

A

The same as with symptomatic patients but on TWO occasions

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17
Q

What result from an oral glucose tolerance test confirms diabetes?

A

Venous BG > 11.1mmol/L 2 houts after a 75g glucose bolus

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18
Q

What result from an OGTT diagnoses impaired glucose tolerance?

A

Venous BG between 7.8 and 11.1 mmol/L

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19
Q

What investigation would you do with a patient with suspected WILSON’S DISEASE?

A

Ceruloplasmin level +++

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20
Q

What investigation would you do with a patient with suspected HAEMOCHROMATOSIS?

A

Total iron-binding capacity —

i.e. HAEMATINICS

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21
Q

What is the earliest serological marker of acute HepA infection?

A

Hepatitis A IgM

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22
Q

What serological marker can confirm CHRONIC (>3months) HepC infection?

A

Hepatitis C Ab

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23
Q

What test for phaeochromocytoma?

A

24 hour urinary catecholamines

VANILLYLMANDELIC ACID

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24
Q

What test for Addison’s?

A

Short SynActhen

FAILURE for cortisol to rise

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25
Q

What test for Cushing’s?

A

FIRST!!! = Free urinary cortisol +++++

Dexamethasone suppression test

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26
Q

What test for congenital adrenal hyperplasia?

A

17-hydroxyprogesterone

There is an AD deficieny of 21-hydroxylase

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27
Q

What test for carcinoid tumour?

A

24 hour urinary 5-hydroxyindole acetic acid

breakdown product of 5-HT

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28
Q

Cystitis

A

MSU for MC&S

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29
Q

Renal colic (calculi)

A

xray KUB

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30
Q

Kidney transplant problems

A

Renal biopsy

31
Q

Renal TB

A

Three early morning MSU for MC&S + Z-N stain

32
Q

Pulmonary embolism - initial investigation

A

CXR

33
Q

Pulmonary embolism - clear on CXR - next appropriate step?

A

V/Q perfusion scan

34
Q

Pulmonary embolism - patchy shadowing on CXR - next appropriate step?

A

CTPA

35
Q

Pneumonia shown on CXR

A

Sputum culture

36
Q

Tension PTX

A

No investigations –> cannula into 2nd ICS at MCL

37
Q

Dermatomyositis / polymyositis

A

Muscle biopsy

38
Q

Sjogrens syndrome

A

Schirmer’s test

39
Q

Takayasu’s arteritis

A

Angiography

40
Q

Gout

A

Joint aspiration + microscopy

Negatively birefringent, needle-shaped crystals

41
Q

Giant cell arteritis (+/- polymyalgia rheumatica)

A

Temporal artery biopsy

42
Q

Suspected gastric cancer

A

URGENT endoscopy

43
Q

Dyspepsia without red flag symptoms persisting despite lifestyle changes

A

H pylori stool antigen test

44
Q

Crohn’s disease

A

Barium swallow and follow through

45
Q

Oesophageal rupture

A

Gastrografin

46
Q

Coeliac

A

Anti-endomyseal antibodies

47
Q

Renal failure - initial best investigation?

A

Serum U+Es and creatinine

determine current level of renal function

48
Q

Abdominal bruits / renovascular disease

A

Renal arteriography

49
Q

Hydronephrosis

A

Abdominal USS

50
Q

Renal cyst

A

Abdominal USS

51
Q

Renal cell carcinoma

A

CT with biopsy

Renal USS

52
Q

Amyloidosis (renal involvement)

A

Biopsy of rectal mucosa –> stain with Congo Red

53
Q

Polycystic kidney disease

A

USS kidneys

CT KUB

54
Q

Renal stones

A

CT KUB

55
Q

High blood pressure

A

24hour ambulatory BP to eliminate essential hypertension

56
Q

Hypothyroidism

A

TFTs

BEST out of these is the TSH

57
Q

Rheumatoid arthritis

A

RHEUMATOID FACTOR

Antibody = anti-CCP

58
Q

Thalassaemia

A

Hb electrophoresis

59
Q

Pericarditis

A

ECG! (not ECHO)

60
Q

Acute cord compression

A

MRI spine

61
Q

PCOS

A

USS pelvis

62
Q

MEN syndromes

A

CT / MRI

63
Q

Diabetes insipidus

A

Water deprivation +/- desmopressin

64
Q

Colon cancer

A

Colonoscopy

Screen at 50yo (40yo if +ve FHx)

65
Q

Aortic dissection

A

****BEST = CT scan

66
Q

Nephrotic syndrome (diabetic)

A

24 hour urine protein

67
Q

Pericarditis

A

****FIRST = ECG

***next = ECHO

68
Q

Variant angina

A

Coronary angiography

69
Q

Pharyngeal pouch / Zenker’s diverticulum

A

Barium swallow

70
Q

Oesophageal stricture (absolutely no suggestion of malignancy)

A

Barium swallow

71
Q

Oesophageal cancer

A

OGD + biopsy

72
Q

Achalasia

A

****BEST = oesophageal manometry

***FIRST = Barium swallow - ‘bird’s beak’

73
Q

Diffuse oesophageal spasm

A

****BEST = oesophageal manometry

***Barium swallow –> “corkscrew” appearance

74
Q

Suspected hypercalcaemia

A

****PTH and serum calcium

Bone imaging (xray)

JG EMQ revision (14 decks)

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