Labs/Imaging Flashcards
acne vulgaris
none
rosacea
none
depression
PHQ-9, CBC
Dementia
CBC. CMP, B12, folate, syphilis testing, arterial blood gasses, UA, ECG, EEG, toxicology, CT, MRI, lumbar puncture, chest x-ray
impetigo
bacterial culture
folliculitis
bacterial culture
furuncle
incision + drainage for bacterial culture
carbuncle
same as furuncle (incision + drainage for bacterial culture)
erythema infectiosum
IgM, IgG can be measured
measles
IgM and IgG titers
rubella
IgG and IgM titers
pityriasis rosacea
If present on palms and/or soles - check RPR (to rule out secondary syphilis)
scarlet fever
culture for group A strep
roseola
none
hand, foot, and mouth disease
none
insect bites
biopsy (occasionally needed)
bed bugs
none (observe environment for bugs, stains)
herpes simplex virus
- viral culture
- Tzanck smear
- screen for STIs + HIV (if hx warrants)
herpes zoster
- viral culture
- Tzanck smear
varicella zoster
ELISA titers (can confirm acute infection)
candidiasis
- KOH
- culture
tinea
- KOH
- culture
pityriasis (tinea) versicolor
- KOH
eczema/atopic dermatitis
- serum IgE
- culture for bacteria or HSV if indicated
contact/allergic dermatitis
patch testing
psoriasis
- ASO titer or strep culture (if indicated)
- HIV testing (if indicated)
- biopsy
seborrheic dermatitis
HIV testing (if indicated)
erythema multiforme
- skin biopsy
- chest x-ray (for Mycoplasma)
urticaria
- biopsy
- general workup to rule out systemic disease (for chronic urticaria)
malignant melanoma
- skin biopsy
- excisional biopsy
BCC
skin biopsy
SCC
- skin biopsy
- excisional biopsy
Delirium
CBC. CMP, B12, folate, syphilis testing, arterial blood gasses, UA, ECG, EEG, toxicology, CT, MRI, lumbar puncture, chest x-ray
Prostate cancer
CBC. CMP, B12, folate, syphilis testing, arterial blood gasses, UA, ECG, EEG, toxicology, CT, MRI, lumbar puncture, chest x-ray
DM
UA, serum glucose, hgA1C, insulin
Menopause
sleep diary, FSH/LH, TSH
Medication induced insomnia
none
Delayed sleep phase syndrome
sleep specialist
Narcolepsy
sleep specialist
Obstructive sleep apnea
sleep study, polysomnography, home testing
Periodic limb movement
sleep study
Restless leg
sleep study, serum ferritin
Multiple Myeloma
Monoclonal proteins, UA, peripheral smear, bone marrow, CT,
Thoracic outlet syndrome
electrodiagnostic testing, scalene muscle test injection, x-ray, US, CT, MRI
Lead
blood lead levels, X-ray fluorescence,
Tarsal tunnel
US, electrodiagnostic testing, MRI
Carpal tunnel
US, electrodiagnostic testing, MRI
Amyotrophic lateral sclerosis (ALS)
electrodiagnostic studies, MRI,
Guillain-Barré syndrome
CBC, lumbar puncture, Electrodiagnostic studies, CBC, CMP, ESR, serum glucose,
Diabetic neuropathy
Electrodiagnostic testing, insulin, hgA1c, CMP, fasting glucose
HIV
HIV RNA, HIV antigen, CBC
Lyme
western blot, ELISA
Rhabdomyolysis
creatine kinase, UA, BC, BUN, creatinine, CMP, liver function test, PT, aPTT, d-dimer, fibrinogen
Hyponatremia
CMP, CBC, serum osmolality
Hypernatremia (diabetes insipidus)
urine osmolality, UA specific gravity, CMP
Adrenal insufficiency/Addisons disease
ACTH stimulation test, serum cortisol, salivary cortisol, urinary cortisol,
Chronic Kidney disease
CMP, US, UA, creatinine, eGFR
Hypoparathyroidism
CMP, serum PTH, Mg, Phosphate, Vit D metabolites
Hypophosphatemia
24-hour urine collection, CMP, electrolytes
Hypokalemia
ECG, CMP
Cushing’s syndrome
salivary cortisol, 24-hour urinary free cortisol, dexamethasone suppression test, fasting blood glucose
Sjogrens
CBC with differential, ESR, total globulins, immunoglobulin, UA, CMP, urine protein/creatinine
RA
ESR, rheumatoid factor, CBC, x-ray
Systemic sclerosis
CBC with differential, serum creatinine levels, creatine kinase, UA with urine sediment, ANA, serologic testing
SLE
CMP, kidney function tests, antinuclear antibodies, ESR
Dermatomyosisits
CK, aldolase, CBC with differential, CMP, ESR, CRP, TSH, serologic tests
Polymyositis
CK, aldolase, CBC with differential, CMP, ESR, CRP, TSH, serologic tests
Inclusion body myositis
creatinine kinase, CMP, lactate dehydrogenase, serum aminotransferases, TSH, autoantibodies
MS
MRI, CSF analysis, autoantibody testing, optical coherence tomography
Fibromyalgia
CBC, ESR, CRP
Cancer
CBC, leukocyte count, CMP, UA, glucose, hgA1c, TSH, HIV, ESR, CRP, x-ray
Anemia
CBC with differential, ferritin, serum iron, transferrin, TIBC
Hypothyroid
TSH, antibodies, T3, T4
Myasthenia gravis
ice pack test, edrophonium test, failure of neuromuscular blockade reversal, serologic testing
Intracerebral hemorrhage
CT, MRI
Brain abscess
MRI, serologic evaluation for a parasitic pathogen, cryptococcal antigen
Pseudotumor cerebri
CT
Subdural hematoma
CT
Hydrocephalus
CT
Intracranial tumor
CT
Dietary ingestion (tyramines, MSG, and nitrates)
blood chemistry
Drug withdrawal
blood chemistry
Severe hypoglycemia
blood glucose or continuous glucose monitoring
Carbon monoxide poisoning
blood gasses and carboxyhemoglobin levels
Temporal arteritis
elevated ESR
Cervical spine disorders
x-ray
Optic neuritis
ophthalmology
Trigeminal neuralgia
MRI
Meningitis
lumbar puncture, CBC with differential, CMP, BUN, creatinine, PT, thrombin time, blood culture
Otitis media
pneumatic otoscopy, tympangram
Pharyngitis
throat culture, CBC, monospot, rapid strep test
Dental disorders
dental referral
Sinusitis
x-ray
Benign exertional headache
MRI, CT
Cluster headache
MRI
Mixed headache
MRI
Migraine w/o aura
none
Migraine w/ aura
none
Tension-type headache
none
Head Trauma
MRI or CT
Ototoxic and salt-retaining drugs
audiometry
Neurosyphilis
serology for syphilis
Arrhythmia
EKG, Holter monitor
Orthostatic
tilt table
Anxiety
hyperventilation, GAD7, AUDIT, CBC, CMP, TSH, T3/T4, salivary cortisol, urine drug screen
Reflex syncope
ECG, tilt table
Cholesteatoma
audiometry
Perilymph fistula
CT, audiometry
Acoustic neuroma
MRI, audiometry
Labyrinthitis
audiometry,
Vestibular neuronitis
MRI, CT
Meniere disease
audiometry, electronystagmography
Benign Paroxysmal Positional Vertigo
electronystagmography
Stroke
CT or MRI, ECG
Vascular insufficiency
US, venography
TIA
MRI
Balanitis
none
Gonococcal urethritis
urine NAAT test, gram stain culture
Nongonococcal Fitis
gram stain, culture, NAAT testing for chlamydia
Acute bacterial prostatitis
segmental urine specimens, culture and sensitivity or urine and discharge
Epididymitis or Orchitis
doppler flow studies, urethral gram stain, urinalysis, culture, molecular testing for chlamydia and gonorrhea
Kidney stones (calcium or uric acid)
CMP, UA, CT or US
Renal abscess
UA, CT or US, CMP, CBC
Renal cell carcinoma
CT or US, MRI, biopsy
Transitional cell carcinoma (kidney)
CT, retrograde pyelography, CT urography, Ureteropyeloscopy with cystoscopy
IgA nephropathy
kidney biopsy, UA, creatinine
Polycystic kidney disease
CT, genetic testing, MRI
Pyelonephritis
UA and culture, urine dipstick,
Hydronephrosis
creatinine, UA, CMP, US
Sickle cell disease
UA, culture, hemoglobin electrophoresis, DNA testing, CBC, CMP, serum iron, ferritin, transferrin, sickly solubility test, ALT, AST, ALP
Urothelial carcinoma of the bladder
cystoscopy
Squamous cell carcinoma of bladder
UA, cystoscopy, urine cytology, CT,
Acute cystitis
UA and culture
Radiation cystitis
UA, culture, cystoscopy, CT
BPH
UA, culture, creatinine, PSA
Schistosomiasis infection
antigen tests, PCR, serology
Drugs induced hematuria
creatinine, UA,
Wegner’s granulomatosis
ANCA, creatinine, UA, CBC, ESR, CRP, CT
Hemolytic Uremic Syndrome
CBC, c. difficile toxin assay or stool culture, molecular testing
pregnancy
pregnancy test, US
drug induced hematuria
UA, blood chemistry
Cystocele
US, postvoid residual (PVR) urine volume, Defecography
Reactive arthritis
x-ray, arthrocentesis, NAAT testing (chlamydia), CBC, CMP, UA
Urethral stricture
UA, dipstick,
Cauda Equina
MRI, CT, Nerve conduction studies and electromyography
Urge incontinence
UA, culture, office cystometrography, BUN/Creatinine
Bladder outlet obstruction
UA, culture, BUN, Creatinine,
Detrusor underactivity
UA, culture, BUN, Creatinine,
Chronic urinary retention
UA, culture, BUN, Creatinine,
Stress incontinence
UA, culture,
Mixed incontinence
UA, culture, office cystometrography
Interstitial cystitis
UA, culture, postvoid residual volume, STI testing
Vaginitis
gram stain, KOH, culture, molecular testing
Genitourinary syndrome of menopause/vaginal atrophy
vaginal pH,
Sickle cell anemia
CBC, CMP, iron panel, peripheral smear, UA, hemoglobin electrophoresis, DNA testing
breast cancer
- diagnostic mammogram
- ultrasound
- tissue biopsy
breast cysts
- clinical exam
- FNA
- mammogram
- ultrasound
fibroadenoma (breast)
- diagnostic mammogram
- US
- biopsy
breast abcess
incision and drainage with culture
fat necrosis (breast)
biopsy
lipoma (breast)
biopsy
TB
biopsy, HIV testing, chest x-ray, purified protein derivative, QuantiFERON-TB gold test
ruptured implant
- diagnostic mammogram
- US
- MRI
mastitis/acute abcess
- bacterial culture
- CBC
fibrocystic breast changes
- mammogram
- if nipple d/c present: ductogram, maybe MRI
intraductal papilloma (breast)
- diagnostic mammogram
- US
- ductogram
- maybe MRI
duct ectasia
- diagnostic mammogram
- US
- ductogram
- maybe MRI
hyperprolactinemia
- serum prolactin
- TSH
- MRI (if indicated)
cyclic mastalgia
none (hx and clinical exam)
noncyclic mastalgia
- mammogram
- US
costochondritis
- none
- trial of NSAIDs
- ECG
- CXR, ultrasound, MRI/PET
Klinefelter syndrome
karyotyping
stable angina
- ECG
- CBC/CMP, urea, electrolytes
- fasting blood glucose, cholesterol, triglycerides
- ALP, ALT, AST (baseline for statin)
- troponin, cardiac enzymes
- echo
- exercise testing/ECG
muscle strain of the chest (intercostal muscle, pectoralis minor/major)
- diagnosis is clinical
- CXR
- MRI to rule out rib fracture
pneumonia
- CBC, CMP, differential WBC count
- CRP, ESR
- BUN, electrolytes
- ALP, ALT, AST
- blood culture, sputum culture
- CXR
- pulse ox, blood gases
- aspiration of pleural fluid
pneumothorax
- CXR
- lung ultrasound (traumatic pneumothorax)
- CT scanning
- pulse ox, arterial blood gases
ischemic heart disease
- CBC, CMP, ferritin
- BNP
- fasting glucose, HbA1c
- ECG
- Echo
COPD
- spirometry, peak flow
- CXR
- CBC, CMP
- ECG
- CT scan
- sputum culture
pulmonary embolism
- CBC, CMP, ferritin, clotting screen
- ECG
- CXR
- pulse ox, arterial blood gases
- echo
- troponins
- D-dimer
pericarditis
- diagnosis is clinical
- CXR
- ECG
- echo
- MRI, CT
- needle aspiration
GERD
endoscopy, upper GI barium swallow, CBC, CMP, ferritin, esophageal pH monitoring (catheter, pH capsule)
peptic ulcer
- CBC, CMP, ferritin
- H. pylori testing (urea breath test, stool antigen test, serology)
- endoscopy
cholecystitis
- CBC, CMP, differential WBC count
- abdominal ultrasound
- HIDA Cholescintigraphy (blocked cystic duct)
- ALT, AST, ALP, GGT
pancreatitis
- CBC, CMP
- CRP, creatinine, calcium, serum amylase, lipase
- glucose, Hba1c
- serum trypsinogen
- secretin stimulation test
- plain abdominal x-ray
CT scan, US, MRI - peritoneal aspiration, bacterial culture
- laparoscopy, pancreatic biopsy
myocarditis
- ECG
- CBC, CMP, creatine kinase, urea, electrolytes, ESR, CRP
- Troponin
- CXR
- Viral or Chagas’s serology
- Systemic autoantibodies
- Echo
- Cardiac MRI
- Endomyocardial biopsy
rib fracture
- pain radiograph
- CT
- Ultrasound
Frailty syndrome
CBC
Hyperthyroidism
TSH, T3/T4, autoantibodies, thyroid ultrasound, CRP, ESR
Malabsorption
colonoscopy, stool culture, fecal fat
Anorexia nervosa
TSH, T4, CMP,
Crohn disease
CBC, colonoscopy, barium enema, small bowel follow-through
Nonorganic failure to thrive
CBC, CMP
Cystic fibrosis
sweat test
URI
none
Gastroenteritis
none
PID
CBC, culture, molecular testing
Osteomyelitis
culture, CBC, radionuclide scan, CT, MRI
Kawasaki disease
CBC, CRP, ESR, serum IgM, IgE
Enterovirus
none
Drugs and alcohol
CAGE alcohol screening
Heart failure
ECG, chest x-ray, arterial blood gases
Mononucleosis
Monospot, CBC with differential,
Hepatitis
liver enzyme function, BUN
anorexia or bulimia
- TSH
- prolactin
- FSH/LH
- glucose
- ECG
exercise-induced amenorrhea
- TSH
- prolactin
Turner syndrome
karyotype
Cushing syndrome
- cortisol levels
PCOS
- FSH/LH
- DHEA-S
- pelvic exam
- US
Asherman syndrome
- hysteroscopy
- PCT
ovarian failure
- FSH/LH
- estradiol
Sheehan syndrome
- hemoglobin
- pituitary hormones
pituitary adenoma
- PRL
- MRI
spontaneous or threatened abortion
- beta-hCG levels
- US
placenta previa
US
ectopic pregnancy
- beta-hCG levels
- US
- laparoscopy
leiomyoma
- pelvic exam
- US
adenomyosis
- pelvic exam
- US
uterine or endometrial cancer
- endometrial biopsy
- D&C
- US
- CT or MRI
perimenopause
- FSH/LH
- estradiol
PID
- WBC
- ESR/CRP
- gram staining
- bacterial cultures
- molecular testing
- pregnancy test
- HIV and syphilis testing
genital warts
acetic acid test
vulvovaginitis
STI testing: G&C, syphilis, HIV
bacterial vaginosis
- KOH whiff test
- microscopy
candida vulvovaginitis
- KOH prep
trichomoniasis
microscopy
syphilis
syphilis and molecular testing
cholelithiasis
- CBC, CMP, differential WBC count
- abdominal ultrasound
- HIDA Cholescintigraphy (blocked cystic duct)
- ALT, AST, ALP, GGT
infectious endocarditis
- echo
- CT, PET, MRI
- CRP, ESR
- CXR
- ECG
- blood culture, serology testing
ACS/MI
- ECG
- CBC, CMP
- BUN, electrolytes
- troponins
- CK-MB
- CXR
- pulse ox, arterial gases
- CT coronary angiograph, echo
Rheumatic fever/RHD
- throat swab, culture
- ASO, anti-DNase B, anti-streptokinase, anti-NAD, anti-streptococcal esterase
- ECG
- CXR
- doppler echo
pericardial effusion
- CBC, CMP, ferritin, differential WBC count
- urea, GFR, electrolytes
- TSH, T3, T4
- troponin
- autoantibodies (RF)
- blood culture
- echo
- CXR
- ECG
- pericardial fluid aspiration
- MRI/CT scan
- pericardial biopsy
tuberculosis
- CXR
- rapid nucleic acid amplification testing
- sputum sample culture
- biopsy, needle aspiration
atrial fibrillation
- ECG
- 24-hour heart monitor
- echo
supraventricular tachycardia
- ECG
- 24-hour heart monitor
- echo
mitral valve prolapse
- echo
- transthoracic echo
- ECG
- CXR
- 24-hour heart monitor
- stress test
mitral regurgitation
- CXR
- ECG
- echo
- cardiac MRI
- coronary angiograph
- BNP
heart valve disease
- CXR
- ECG
- Echo
- CT, MRI
bronchitis
- CBC, CMP
- CXR
- sputum culture
emphysema
- CBC, CMP
- spirometry
- CXR
- CT
cardiac tamponade
- creatinine kinase
- urea, GFR, electrolytes
- CBC, CMP, ferritin
- ESR, CRP, rhematic factor
- HIV testing, TB testing
- ECG
- CXR
- echo
- MRI, CT scan
- pericardiocentesis
- pericardial biopsy
cardiomyopathy
- CBC, CMP, ferritin
- electrolytes, ALT, AST, ALP
- ESR, CRP
- thyroid function: TSH, T3/T4
- CXR
- ECG
- transthoracic doppler
- BNP
- MRI
- endomyocardial biopsy
mitral valve stenosis
- CBC, CMP, ferritin
- CXR
- ECG
- Echo (transthoracic/transesophageal)
aortic coarctation
- urea, electrolytes, creatinine
- CBC, CMP, ferritin, blood glucose
- CXR
- echo
- MRI scan
- ECG
congestive heart failure
- BNP
- ECG
- echo
- urea, electrolytes
hypertension
- albumin, creatinine
- ECG
- HbA1c, electrolytes, GFR, cholesterol
- renal US
aortic stenosis
- ECG
- CXR
- Echo
- stress test
- BNP
aortic dissection
- ECG
- CXR
- CT, MRI
- color flow doppler
pulmonary stenosis
- echo
- ECG
- angiography
- CXR
aortic regurgitation
- ECG
- CXR
-Echo - Cardiac MRI
coronary artery disease
- CBC, CMP, ferritin, differential WBC count
- cardiac enzymes, troponins
- ECG
- coronary angiography
- stress echo
- MRI
congenital heart disease
- US, echo
- pulse ox, arterial blood gases
- CXR
- ECG
ventricular tachycardia
- ECG
- electrolytes, urea
- troponin
- CXR
vasovagal syncope
- ECG
- CBC, CMP, ferritin, differential WBC count
- fasting blood glucose
- echo, CT, MRI
- stress testing
- tilt test
asthma
- peak expiratory flow rate
- peak flow, spirometry, FeNO
- CXR
anaphylaxis
- serum mast-cell tryptase
- ESR, CRP
HIV/AIDS
- HIV antibody (ELISA, western blot)
- viral load. HIV RNA or bDNA assay
CBC, CMP, ferritin, differential WBC count - ESR, CRP
- screening for co-existing infections
- CXR
pulmonary hypertension
- electrolytes, ALT, AST, ALP
- TSH, T3, T4
- autoantibodies (SLE, scleroderma)
- CXR
- ECG
- spirometry, peak flow
- lung biopsy
- echo
- thorax CT
- MRI
pulmonary regurgitation
- ECG
- CXR
- echo
atherosclerosis
- Ultrasound
- MRI, CT
- cholesterol, triglycerides, blood glucose
- CRP/ESR
- stress test
- ECG
- Echo
- coronary calcium scan
- ankle-brachial index
- angiogram
iron deficiency anemia
- CBC, CMP, serum iron, ferritin, transferrin
- endoscopy/CT
- urinalysis
- celiac disease screening
hemolytic anemia
- CBC, CMP, serum iron, ferritin, transferrin
- LDH, bilirubin
- Coomb’s test
- CXR
- ECG
- abdominal US (spleen)
- autoantibodies
macrocytic anemia
- CBC, CMP, serum iron, ferritin, transferrin, reticulocyte count
- serum folate levels
- serum B12
- ALT, AST, ALP
- Coomb’s test
pernicious anemia/B12 deficiency
- serum B12
- plasma homocysteine, methylmalonic acid
- CBC, CMP, ferritin
- ALT, AST, ALP
- TSH, T3, T4
- autoantibody screen, intrinsic factor
- bone marrow aspiration
thalassemia
- CBC, CMP, serum iron, ferritin
- hemoglobin electrophoresis
- DNA testing
- plain film x-ray, CT, MRI
- ECG
- HLA typing (bone marrow transplant)
- liver biopsy
sideroblastic anemia
- CBC, CMP, serum iron, ferritin, transferrin
anemia of chronic disease
- CBC, CMP, ferritin, transferrin
- bone marrow aspiration
- ESR, CRP