tests Flashcards
anti-mitochondrial antibodies
increased IgM
primary biliary cirrhosis
anti smooth muscle
pANCA
ANA
primary sclerosing cholangitis
type 1 (both adults and children):
anti smooth muscle
ANA
type 2 (children only): anti liver kidney microsomal (LKMA)
type 3 (middle-aged adults): Soluble liver-kidney antigen
all IgG
autoimune hepatitis
fecal calprotectin
IBD
Wilson’s disease
reduces caeroplasmin
reduced total serum copper
increased 24hr urinary copper
alpha-fetoprotein
raised AFP in HCC
testicular Ca
fetal screening: raised in Downs, decreased in neural defects/ abdominal wall defects/ multiple pregnancies
increased ALP alone
boney mets
vit D def
recent bone fracture
renal osteodystrophy (constellation of musculoskeletal abnormalities that occur in patients with chronic renal failure)
auto-double stranded DNA antibodies
specific for SLE
antinuclear antibodies
seen in a range of conditions, including SLE and AI hepatitis
fetal fibronectin
rule out preterm labour. if positive, increased risk of premature labour
fecal elastase
pancreatic function. i.e Ix exocrine pancreatic insufficiency (EPI)
testicular Ca
AFP - alpha fetalprotein
HCG - human chorionic gonadotrophin
PLAP - placental alkaline phosphate
LDH - lactate dehydrogenase
CEA
carcinoembryonic antigen - used to check how well Rx is working in bowel Ca
CA19-9
tumour marker for pancreatic Ca
cholangiocarcinoma
anti-GAD
anti-IA2
anti-ZnT8
T1DM
short synactin test
addison’s
anti-TPS
anti-Tg
hashimotos
anti-TSH
Graves disease
CA15-3
breast
reverse warfarin
vit K
+ prothrombin complex concentrate to reverse anticoag effect of warfarin
hep B viral markers
Surface antigen (HBsAg) – active infection
E antigen (HBeAg) – marker of viral replication and implies high infectivity
Core antibodies (HBcAb) – implies past or current infection
Surface antibody (HBsAb) – implies vaccination or past or current infection
Hepatitis B virus DNA (HBV DNA) – this is a direct count of the viral load
(IgM is acute infection and IgG is previous infection, remains for life)
HBsAg >6months
defines chronic hep B infection. occurs in <10% of cases
thiopurine methyltransferase (TPMT)
activity to be checked before staring azithioprine for Crohns disease. enzyme involved in the breakdown
haematochromatosis
transferrin saturation > 55% in men or > 50% in women
raised ferritin (e.g. > 500 ug/l) and iron
low TIBC
2month baby with pyloric stenosis. what is the ABG?
hypochloraemic, hypokalaemic alkalosis
voltage gated calcium channel antibodies
lambert-eaton syndrome (weakness improves after exercise unlike MG)
treatment of prostatitis?
fluroquinalone (ciprofloxacin) for 14days . consider testing for STI
PEFR in obstructive and restrictive lung disease
reduced in obstructive and normal in restrictive
paraneoplastic syndromes of common lung ca’s
sclc:
ADH –> hyponataemia
ACTH –> cushings. hypokalaemic alkalosis (bilateral adrenal hyperplasia)
Lamber-eaton syndrome
adenocardcinoma:
gynocamastia
hypertrophic pulmonary osteoarthropathy (HPOA)
squamous cell PTH --> hypercalcaemia HPOA clubbing TSH --> hyperthyroid
large cell:
may secrete B-hcg
centor score
presence of tonsillar exudate
tender anterior cervical lymphadenopathy or lymphadenitis
history of fever
absence of cough
score of 3 or 4 present there is a 40-60% chance the sore throat is caused by Group A beta-haemolytic Streptococcus
diagnosis for idiopathic pulmonary fibrosis
high resolution CT
CRP and d-dimer post-op
would be raised post-operatively
sarcoidosis
serum ACE is raised
serum calcium raised
soluble IL-2 raised
CRP and immunoglobulins also raised
CXR (hilar lymphadenopathy)
high resolution CT (pulmonary nodules)
MRI (CNS involvement)
PET (active areas of inflammation)
GOLD STANDARD is histology!! will show non-caseating granulomas with epithelioid cells’
mesothelioma
gold standard is histology, followed by thoracoscopic biopsy
occupational asthma
serial peak flows at home and at work
Kussmaul sign
JVP increases with inspiration. feature of constrictive pericarditis (calcification of pericardium). The JVP should fall with inspiration due to reducing pressure in the thoracic cavity
investigation for necrotising zing enterocolitis in baby
abdo XR
test for seratonin syndrome (think with facial flushing/diarrhoea in carcinoid tumour)
24 hr urine 5-HIAA
T1DM
fasting plasma glucose
diagnose hirshsprungs
rectal biopsy
blood work indicating upper GI bleed
raised urea
normal creatine
normocytic anaemia
(look for clues i.e taking nsaid)
anti-centromere antibodies
limited cutaneous scleroisis
scl-70
associated with diffuse cutaneous systemic sclerosis
anti-cardiolipin antibodies
anti-phospholipid syndrome
anti-ro and la
sjogrens syndrome
cotton wool spots on skull
pagets disease
isolated ALP
paget’s disease
vasculitis that can be hep b positive
polyarteritis nodosa
SLE
most specific test (good for ruling IN) is anti-dsDNA. if asking for most sensitive (good for ruling OUT) then the answer is ANA!!!
99% are ANA positive: this high sensitivity makes it a useful rule out test, but it has low specificity
20% are rheumatoid factor positive
anti-dsDNA: highly specific (> 99%), but less sensitive (70%)
anti-Smith: highly specific (> 99%), sensitivity (30%)
also: anti-U1 RNP, SS-A (anti-Ro) and SS-B (anti-La)
someone on an immunosuppresant for i.e. UC develops sore throat, rigors and fever
FBC!! medications (Aminosalicylates e.g. sulphasalazine or mesalazine) can cause agranulocytosis
