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Basic Diagnostic Tests: What Do They Tell Us? image (CSF Testing (CSF…

- - - - Example- Dyspnea can be caused by asthma, heart problems, stress, anxiety, smoking, inhalation of other toxic substances, or tumors (to name a few)
  - - - Normal values for specific tests vary slightly from lab to lab
      - Even perfectly healthy people will sometimes have abnormalities on diagnostic tests; test results must be interpreted in context of patient’s overall medical history and physical exam; not every abnormal test is significant
      - A diagnosis is based on the patient, not solely on the test numbers
- - - - Causes excessive bleeding
- - - - Normal values: 4.5-5.4 mEq/L
      - Increased calcium
        
        May be caused by hyperthyroidism, malignant tumors, diuretic therapy, excessive calcium consumption (milk or antacids), or Vitamin D intoxication
        
        Signs and symptoms: anorexia, constipation, lethargy, weakness, hyporeflexia, mental deterioration, and kidney stones
      - Decreased calcium
        
        May be caused by hypoparathyroidism, Vitamin D deficiency, diuretic therapy, or pregnancy
        
        Signs and symptoms: muscle cramping, parenthesia, mental disturbances, and convulsion
    - - Normal values: 95-103 meg IL
      - Decreased chloride
        
        May be caused by excessive vomiting
        
        Signs and Symptoms: breathing depressed, muscle hypertension/ tetanus
      - Increased Chloride
        
        May be caused by renal tubular acidosis
        
        Signs and symptoms: breathing rapid and deep, disorientation, weakness
    - - Decreased potassium
        
        May be caused by diuretic therapy, diarrhea, endocrine disorder, chronic stress
      - Increased Potassium
        
        May be caused by muscle tissue damage, renal failure
        
        Signs and symptoms: diarrhea/nausea, ventricular fibrillation (heart arrhythmia), irritability, weakness
    - - Normal Values: 136-142 meg IL
      - Increased sodium
        
        May be caused by dehydration
        
        Signs and symptoms: dry mucous membranes and tongue, intense thirst, flushed skin
      - Decreased Sodium
        
        May be caused by excessive water intake, loss of GI secretions, excessive sweating, burns
        
        Signs and symptoms: abdominal cramps, muscle twitching, confusion, seizures, vasomotor collapse
    - - Complex proteins that facilitate chemicals charges
      - Normally found inside body cells
      - may be released into bloodstream following cell injury or death
        
        example: cardiac enzymes are released into bloodstream when cardiac tissue dies during heart.
    - - commonly used types of endoscopes otoscope simple lighted magnifying lens used to examine ear canal and eardrum otoscope is quick and painless procedure if done correctly.
- - - - Consistency, color, odor, pH, shape, size, and the presence/absence of blood, bacteria, food residue, mucus, parasites and eggs, pus and tissue particles
        
        Normal stool
        
        Consistency: plastic and soft with definite shape
        
        Volume: 100-200 g/day
        
        Stool abnormalities
        
        A pasty stool is often associated with a high fat diet
        
        Greasy, tar-like, or buttery-textured: cystic fibrosis
        
        Bulky, frothy stool: celiac disease (sprue)
        
        Diarrhea: overly rapid passage of stool through intestine (before water can be absorbed)
        
        Shape:
        
        Narrow, ribbon-like: spastic bowel or partial obstruction
        
        Small, ball-like: chronic moderate constipation
        
        Excessively hard: slow movement through colon resulting in excessive water absorption
        
        Stool pH
        
        Normal value: neutral or slightly alkaline
        
        Depends on diet and bacterial fermentation
        
        Acidic pH related to ingestion of carbohydrates
        
        Alkaline pH related to ingestion of proteins
        
        Stool color
        
        Normally brown (food/dye can cause variations)
        
        Color abnormalities
        
        Yellow/yellow-green: breast fed infant, bowel sterilization due to antibiotics, severe diarrhea
        
        Green: severe diarrhea, antibiotic therapy, ingestion of chlorophyll-rich vegetables
        
        Tan/clay colored: common bile duct blockage, pancreatic insufficiency, excessive fat intake
        
        Black: upper GI bleeding, ingestion of iron, high meat diet, ingestion of charcoal or bismuth
        
        Red: bleeding from lower GI tract; if red streaking on outer surface of stool, consider hemorrhoids or anal pathology; if blood mixed through stool, consider problem higher up GI tract
        
        Blood in stool
        
        Normal value: <2.8ml / 24 hours
        
        Any amount greater than 2.8ml/24 hours is abnormal; can be occult (hidden in feces)
        
        Most common cause is hemorrhoids and anal fissures
        
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        Conditions that can cause false positive occult blood tests: ingestion of red meat, large amounts of inorganic iron, and large doses of vitamin C
        
        Mucus in stool
        
        Normally none
        
        Presence of translucent, gelatinous mucus in stool may be due to emotional excitation, excessive straining during bowel movements, spastic constipation, mucous colitis
        
        3-4 liters of mucus/24hr period
        
        Presence of mucus with blood may indicate inflammation of rectal canal, neoplasm
        
        Presence of mucus/blood/pus mixture may indicate cancer of colon (ulcerative); ulcerative colitis; bacterial dysentery; rarely, diverticulitis or intestinal tuberculosis
- - - - We can monitor how these electrical impulses travel through the heart through the use of an electrocardiogram
        
        EKG purpose: to monitor how electrical impulses travel through heart
        
        Procedure
        
        Electrical wires (leads) attached to torso; wires pick up any electrical activity in the heart
        
        Electrical activity is converted to visual image; image can be viewed on EKG monitor or strip of paper that records image (EKG tracing)
        
        Sometimes heart irregularities do not last all day long….you can’t catch them on an ECG machine at the doctor’s office.
        
        Holter monitor
        
        Purpose: to monitor electric activity in heart over long periods of time (24 hours or more)
        
        Procedure
        
        EKG leads attached to body, and Holter monitor is attached to belt or shoulder strap
        
        Holter monitor records EKG activity
        
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        Stress testing
        
        Purpose:
        
        To identify early heart disease by inducing physical exertion in controlled environment
        
        In early heart disease, patient may ONLY have symptoms (such as chest pain, shortness of breath or lightheadedness) during physical exertion
        
        Procedure
        
        Patient walks on treadmill at varying speeds and inclines over period of time; if unable to walk, drug injected causing rapid heart beat, mimicking exercise; EKG and blood pressure are monitored
        
        In some cases, radioactive dye also injected into bloodstream, and then images of heart are taken; EKG and dye images analyzed for evidence of deficient blood flow to heart, suggests clogged cardiac arteries in need of treatment
- - - - normal value: straw-amber color
      - abnormal colors and their significne
      - Brown, black, clear/hearly clear, orange, and red
    - - normal values: has district, but non-offensive aroma
      - unusual odors can suggest speific problems
      - ammoria scent, general sweet smell, and maple syrup scent
- - - - upper level, lighter in weight color is plasma or liquid of blood which numorous dissolved substances.
- - - - Measurement of kidney's ability to eliminate urea (waste product) from blood or how well your kidney's are functioning
        
        Normal values: 7-18 ml/dl or 2.5-6 mmol/L
        
        Decreased BUN
        
        May be caused by low protein diet/malnutrition, fluid overload, liver failure, nephrotic syndrome, overhydration, and drugs
        
        Signs and symptoms of decreased BUN: edema
        
        Increased BUN
        
        May be caused by renal function impairment, non-renal causes (acute MI, chronic gout, diabetes excessive protein consumption, etc.), pregnancy, GI hemorrhage, shock, tissue trauma (severe)
        
        Signs and symptoms of increased BUN: confusion, convulsion, etc.