Part 3 board review (pt.3)

Urinalysis: protein

nephron disease (multiple myeloma too!)

Urinalysis: glucose

DM, Shock

Urinalysis: ketones

DM, starvation

Urinalysis: blood

trauma, infection, stone, prostate and cancer

Urinalysis: casts

nephron disease

green urine

bilirubin

Yellow urine

concentrated

Orange urine

B vitamins

Black urine

ochronosis (alkaptonuria) → white disc and black piss (problem turning phenylalanine into tyrosine)

Red urine

lower GI tract RBC

Smoky urine

upper tract RBCs

Clay colored stool =

biliary obstruction

tarry stool

iron/blood

Fatty stool

steatorrhea → GB, pancreas, malabsorption

stool culture

ID agent

frank blood in stool

lower GI

occult blood in stool

Upper GI (GUAIAC)

IgG

Second to fight (bacterial / fungi / toxins) MM

IgA

mucosal lining (GI and lungs)

IgM

first to fight (“marines”)

IgE

small amount → hypersensitivity defense

IgD

trace

Acid phosphatase

prostate disease

A/G ratio

reversal = multiple myeloma

Alkaline Phosphatase

blastic bone disease/liver disease

Amylase/lipase

acute pancreatitis

ANA (sero +)

collagen disease → SLE, Scleroderma, polyarteritis nodosa, Sjogren’s, RA

ASO Titre

strep infection

Bilirubin

direct: liver, GB, pancreas

Indirect: liver, spleen, drugs, fever

BUN

increase = kidney disease

Decrease = liver disease

Calcium (9-11 mg%)

increase = hypercalcemia → hyperparathyroidism (benign), bone cancer

Decrease = hypocalcemia

CA and CEA

cancer

CPK (creatine)

tissue destruction

MI = CPK (CK-MB) / SGOT (AST) / LDH

creatinine

best kidney test

Downey cell

atypical lymphocyte → mono

ESR

inflammation (0-20 normal)

highest in temporal arteritis / MM

Blood glucose

DM

GGT

liver cirrhosis

GTT

Diabetes mellitus, hypoglycemia

HCG

increase = choriocarcinoma or twins

decreased = ectopic pregnancy

HLA-B27

Ulcerative Colitis, Crohns, Reiter’s, AS, Psoriatic, Enteropathic, arthropathy

LDH

tissue destruction

LE prep

SLE

Mono test

Paul Bunnell, heterophile agglutination

Potassium

increase = addison’s, renal failure

decrease = diuretics, vomit, diarrhea

Protein (CSF)

viral meningitis, sclerosis

Protein (Blood)

increase = hyperproteinemia (MM), proteinuria

decrease = hypoproteinemia (kidney), proteinuria

PSA

prostate

RA latex

RA

SGOT (AST)

heart destruction / liver disease

SGPT (ALT)

liver disease

TIBC

increase = Anemia, oral contraceptives, Hg

Decrease = chronic disease

T3/T4/ TSH

thyroid disease

Triglycerides

liver disease, alcoholism, MI, pancreatitis, renal disease (females 40-60, males 35-135)

Uric acid

gout, kidney

ELISA/western blot

AIDS (T cell count)

Lab profiles: bone (tumors, cancer, osteonecrosis)

calcium, phosphorus, alkaline phosphatase, acid phos (only with adult male)

Lab profile: Arthritis

RA latex, uric acid, HLA-B27, ANA, ESR

Lab profiles: Kidney

BUN, creatinine, albumin, globulin, UA, uric acid

Lab profiles: cardiac ischemia

CPK-MB, SGOT (AST), LDH)

Lab profiles: cardiac risk

(CRP), cholesterol, triglycerides, glucose

Lab profiles: hepatic

SGPT, SGOT, LDH, Bilirubin, GGT, Albumin / globulin

Lab profiles: rigid abdomen

pancreatitis, appendicitis, peritonitis → CBC with diff, amylase, lipase

Enteropathic and AS look alike →

bilateral fragile marginal syndesmophytes → spine only

Psoriatic and reactive look alike →

thick and flowing syndesmophytes

Psoriatic likes the hands while reactive likes the heel

NCV

tests the speed of nerve transmission

Condition = PNE

EMG (no dye)

muscle reaction → PNE, CNS, radiculopathy

SSEP (somatosensory evoked potential)

sensory → new eval

CNS and PNS

Dynamometer

Muscle strength → PNE, CNS, radiculopathy

MRI

soft tissue (spine) and vascular patterns → disc, nerve, brain, stroke, joint and healing

Discogram

visualize disc lesion (BEST) → discopathy

CAT scan (SPECT)

hard tissue (Spine) → stenosis, fracture, bleeding and lung

Absorptiometry / DEXA

bone density → osteopenia

Tomogram (tomography / CT)

Blur to center → nidus, teratoma, fractures

PET scan

metabolic activity in soft tissue → lymph and breast cancer

Bone scan (Scintigraphy)

metabolic activity of bone → lytic and blastic mets

Arteriography

outline arterial supply → brain, vessels, stroke

MRA

arterial and neurological tissue → CVA (apoplexy)

Diagnostic ultrasound

water densities → aorta, pregnancy, bladder and vessels

Biopsy

tissue evaluation → hodgkin’s, breast cancer

Aspiration

fluid evaluation → gout

Myelography

subarachnoid space, provocation → lateral recess

Arthroscopy

joint → meniscus, cruciate injury

Culdoscopy

female pelvis → ovarian tumor

Laparoscopy

internal abdomen → exploratory surgery

endoscopy

small intestine → esophagus

bronchoscopy

lung → cancer

Barium swallow (GI series)

view lumen of GI tract → ulcer

Sputum culture

identify agent from lungs → productive cough, strep (blood culture)

Blood culture

identify agent in blood → TB, septicemia, osteomyelitis

Spirometer and pulse ox

lung function and pressure → COPD

Tomometer

pressure in eye → glaucoma

Stress test

treadmill evaluation CV system → claudication, heart pain

EKG/ECG

electrical impulses of the heart → MI

Echocardiogram

size of heart chambers → valve competencies, CHF, AAA (arch)

EEG

electrical impulses in the brain → seizures

IVP (intravenous pyelogram)

dye to outline KUB system → kidney stones (helical CT)

Electronystagmography

electrical monitor during caloric test → Meniere’s, vertigo and dizziness

Oncologist

cancer

Rheumatologist

Arthritides, collagen disease

NOT OA, DISH or OCI