Investigations Flashcards
what bloods should be done for haematology
FBC & Coags
what bloods check biochemistry
U&Es, LFTs, Ca, Glucose, amylase/lipase, CRP & Lactate
what amylase result is diagnostic?
> 3 times upper limit of normal
what are 2 serum transaminases?
ALT & AST
what do serum transaminases show
hepatocyte injury
where does alkaline phosphate show damage to?
bone and liver
what is the main marker for liver and cholestatic disease?
gamma glutamyl transferase (Gamma GT)
what does gamma GT aid the diagnosis of?
whether raised ALP indicates liver or bone damage
what are the 3 indices of synthetic functionality of liver?
albumin, prothrombin time and bilirubin
why does a raised prothrombin time suggest issues with liver synthetic functionality?
liver synthesises most clotting factors so long prothrombin time = damage to liver
what is endoscopy used for?
diagnosis, tx, screening and surveillance
what can endoscopy help diagnose?
ulcers, tumours, vascular pathology, stones, worms etc
what are 2 endoscopic diagnosis sub-techniques?
dye staining
microscopy
biopsy=
histology (cell structure)
brushing=
cytology (cell function)
what therapeutic techniques can endoscopy be used for?
GI bleeding, foreign body, resection of cancer, strictures
what can endoscopy do if a GI bleed occurs?
banding, glue, clips, injection therapy
what can endoscopy do for strictures?
balloon insertion, stenting
what can endoscopy do for tumours?
polypectomy, endoscopic mucosal removal
what does endoscopy screen for?
cancer
what object is used to survey UC, colonic polyps, Barrett’s O?
endoscope
what is MRCP commonly used to investigate?
common bile duct pathology
what is ERCP commonly used to investigate?
pancreatic and bile duct pathology
what radiological technique is used for cholecystitis?
USS then MRCP or ERCP
what radiological technique is used for pancreatitis?
bloods (high amylase), US (gallstones?), CT
what radiological technique is used to identify perforation?
erect CXR then CT
appendicitis is radiologically investigated by…
doing a USS
diverticulitis is radiologically investigated by…
doing a CT
what imaging should be done for a distended abdomen…?
AXR, then CT
for haematemesis what imaging should be done?
endoscopy + CT w IV contrast angiography
TIPSS is done for…
ascites and PHT
what imaging would you do for someone presenting with dysphagia?
endoscopy & fluoroscopic studies (barium swallow)
what go to imaging would you do for someone who has a change in bowel habit?
PR exam & Ba enema/ CT virtual colonography
when would you do a radio-labelled white cell scan?
active IBD
what investigations to do if small bowel disease e.g. stricture suspected?
fluoroscopic contrast, angiography
what imaging for jaundice/ liver disease?
USS then MRCP/ERCP, HIDA
what is the go to imaging for tumour confirmation?
CT
urease breath test and faecal Ag test are used to determine what infection?
H.Pylori
