tolito
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for wilson disease,
liver biopsy ( not ser cerulosplasmin)
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| tolito
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for pry scl cholangitis
is ERCP or Transhepatic cholangiogram ( not liver biopsy)
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| tolito
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for hep B and C
is liver biopsy.
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| tolito
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the best screening test for SLE is ANA. if negative then SLE can be ruled out.
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| tolito
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joint fluid analysis is used in making diagnosis of acute gout. uric acid levels are not useful. some people may have high level and no gout. uric acid level may be normal or low level during a gout episode
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| tolito
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ser cr kinase and aldolase (raised up to 50x) in suspected cases of inflammatory myopathy
confirm with muscle biopsy
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CT Scan for head injury.
no need for contrast cos blood does not enhance
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| tolito
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in the first hrs following subarachnoid bleeding when ct is normal, the single most important test is lumbar puncture ( if RBC is absent then r/o SAH)
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| tolito
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for iron def anemia is bone marrow aspirate for fe staining..... this is rarely done.
beware of ser ferritin levels. a low level is specific for fe def but a high level may be seen in malig or inflammation
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| study_ing
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initial test for MG = anti Ach receptor antibodies ( yes, its not tensilon..the serology is supposed to be better)
best/ most accurate test= EMG
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| tolito
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the best test for determining renal artery stenosis is renal angiography
the best NON-INVASIVE test is captopril renogram.
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for sarcoidosis is biopsy
ACE levels are elevated ( non-sp...may be used for ff up)
uveitis and conjustivitis seen in 25%
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for PULM EMB,
gold standard test for diagnosis is pulm angiog ( this is invasive so it is not the first test to be performed)
V/Q ratio is second best but the one we are more likely to perform first. if it dx PE, no need for angio. in the post op pt, do spiral CT cos v/q are usu abN in these pts.
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| tolito
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nil for parkinson's dis
dx is clinical
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| tolito
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MRI for MS.
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for pemphigus and pemphigoid is skin biopsy and immunofluorescence
pemphigus.....intercellular deposits of IgG and C 3 in epidermis
pemphigoid.....ab at dermo-epidermal junction
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for primary syphilis is dark field microscopy.
VDRL and RPR have 25% false negative.
for secondary sypilis, VDRL and RPR have 100% accuracy
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for achalasia
best screening is barium swallow
best diagnostic is manometry
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in osteomyelitis, when the X ray film is normal, the best test is MRI.
it is same sensitivity with technitium scan but better specificity than it.
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single most important evaluation tool for growth evaluation = growth chart.
single most important diagnostic study is xray of left wrist and hand for bone age
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