tests Flashcards by MED DUO

anti-mitochondrial antibodies

increased IgM

primary biliary cirrhosis

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anti smooth muscle
pANCA
ANA

primary sclerosing cholangitis

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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

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fecal calprotectin

IBD

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Wilson’s disease

reduces caeroplasmin
reduced total serum copper
increased 24hr urinary copper

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alpha-fetoprotein

raised AFP in HCC

testicular Ca

fetal screening: raised in Downs, decreased in neural defects/ abdominal wall defects/ multiple pregnancies

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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)

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auto-double stranded DNA antibodies

specific for SLE

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antinuclear antibodies

seen in a range of conditions, including SLE and AI hepatitis

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fetal fibronectin

rule out preterm labour. if positive, increased risk of premature labour

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fecal elastase

pancreatic function. i.e Ix exocrine pancreatic insufficiency (EPI)

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testicular Ca

AFP - alpha fetalprotein
HCG - human chorionic gonadotrophin
PLAP - placental alkaline phosphate
LDH - lactate dehydrogenase

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CEA

carcinoembryonic antigen - used to check how well Rx is working in bowel Ca

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CA19-9

tumour marker for pancreatic Ca

cholangiocarcinoma

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anti-GAD
anti-IA2
anti-ZnT8

T1DM

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short synactin test

addison’s

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anti-TPS

anti-Tg

hashimotos

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anti-TSH

Graves disease

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CA15-3

breast

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reverse warfarin

vit K

+ prothrombin complex concentrate to reverse anticoag effect of warfarin

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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