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History Taking > Investigations > Flashcards

Investigations Flashcards

1
Q

How would you investigate dysphagia?

A
  • Bloods: haematinics, FBC, U+E’s, LFTs
  • CXR
  • OGD
  • Barium swallow
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2
Q

What are the investigations for pancreatitis?

A

Amylase (lipase more sensitive) - levels 3x normal amylase

Examination - Cullen’s sign around umbilicus

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3
Q

What are the investigations for gallstones?

A
  • LFTs - obstructive
    Raise in ALP first, then bilirubin.
    Bilirubin rise when CBD stone.
  • WCC + CRP - cholecystitis, cholangitis
  • USS - confirmation of gallstones
  • MRCP - to identify CBD stone (obstructive LFTs)
  • ERCP - camera to remove stones and stent
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4
Q

What are the investigations for pancreatic cancer?

A
  • Courvoisier’s law - palpate gallbladder
  • Markers: Ca19-9
  • Imaging CT, CT/PET if still unclear/looking for mets
  • ERCP to remove biliary obstruction
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5
Q

What are the investigations for asthma?

A
  • PEFR
  • Spirometry + BDR (bronchodilator reversibility)
  • FeNO
  • Sputum culture
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6
Q

What are the investigations for COPD?

A
  • ECG
  • Spirometry
  • Sputum culture
  • AATD
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7
Q

What are investigations for HF?

A
  • Cardio exam
  • NTproBNP/BNP
  • Lipid profile
  • Echo
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8
Q

What are the investigations for pneumonia?

A
  • Blood cultures
  • Sputum culture
  • Urine antigen
  • CRP/FBC
  • CURB-65
  • ABG
  • ECG
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9
Q

What are the investigations for PE?

A
  • D-dimer
  • CTPA
  • US
  • V/Q scan
  • Wells score (if <4 do d-dimer)
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10
Q

What investigations for a pneumothorax?

A
  • ABG

- CXR

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11
Q

What are the exudative results for pleural effusion?

A
  • Causes: pancreatitis, infection, neoplasia, PE
  • Pleural protein >35g/L
  • Pleural fluid : serum protein - >0.5
  • Pleural fluid : serum LDH - >0.6
  • Pleural fluid LDH more than 2/3 upper limits of normal serum LDH
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12
Q

What are obstructive spirometry results?

A

FEV1 very low
FVC normal/low
Ratio <70%
Causes: COPD, asthma, bronchiectasis, CF

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13
Q

What are restrictive spirometry results?

A

Low FEV1/FVC
Ratio >70%
Causes: pulmonary fibrosis, sarcoidosis, lobectomy, scoliosis

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14
Q

What are investigations for lung cancer?

A
  • 2WW
  • Bloods - rule out infective causes, potentially hyponatremia (SIADH - SCLC)
  • CXR
  • EBUS
  • CT TAP
  • PET-CT
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15
Q

What are investigations for bowel cancer?

A
  • Faecal occult blood
  • Sigmoidoscopy/colonoscopy
  • Biopsy
  • Staging CT CAP
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16
Q

What would indicate hepatocellular jaundice?

A

ALT&raquo_space; ALP

  • Hepatitis (all types)
  • Cancer
  • Cirrhosis
  • Liver failure
17
Q

What would indicate obstructive jaundice?

A

ALP&raquo_space; ALT

  • Gallstones
  • Cholangitis
  • PSC (primary sclerosing cholangitis)
  • Pancreatic tumour
18
Q

What are the investigations for ACS?

A
  • ECG - NSTEMI, STEMI
  • Troponins T + I
  • FBC, U+E, glu, lipids
  • CXR
  • Echo
19
Q

What are investigations for HF?

A
  • History is key
  • BNP
  • ECG (indicate cause)
  • Echo
20
Q

What investigations for Arrhythmias?

A
  • FBC
  • U&E
  • Glucose
  • Ca + Mg
  • TFTs
  • ECG
21
Q

What investigations for a SAH?

A
  • Urgent CT
  • LP
  • CT angiography
  • Cerebral angiogram
22
Q

What are the investigations for renal stones?

A
  • Bloods - FBC, U+E, CRP, LFT
  • Urine dip and MSU
  • AXR
  • CT urogram
  • Renal US (pyelonephritis or hydronephrosis)
23
Q

What investigations for BPH?

A
  • PSA
  • Urine dip + MSU
  • DRE
  • Bloods - U+E, LFT, CRP, FBC
  • US
24
Q

What are the investigations for prostate cancer?

A
  • PSA
  • Urinalysis
  • Bloods
  • TRUSS + prostate biopsy
  • MRI
  • Isotope bone scan
25
Q

What investigations for a UTI?

A
  • Urine dip - nitrate/leucocytes +ve and RBCs

- MSU

26
Q

What tests are done for thyroid disease?

A
  • TFTs
  • Thyroid antibodies: antithyroid peroxidase (TPO) antibodies may be increased in autoimmune thyroid disease > leading to increased risk of problems
  • TSH receptor antibody: may be increased in Graves disease
  • Serum thyroglobulin
  • Ultrasound
  • Isotope scan
27
Q

What are the investigations for Addison’s disease?

A
  • Decreased Na, increased K, urea and Ca
  • Decreased glucose
  • Eosinophilia
  • Anaemia
  • Short ACTH stimulation test (synacthen)

History Taking (8 decks)

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