Sunday, 27 October 2013

Significance of Laboratory Test in Medical Practice on 28-10-13

Subject -- Significance of  Important Pathology Investigations in Medical Practice 

Expert -- Dr.Ratnakar Pathologist  ,
Editor -- Prof .Dr.R.R.Deshpande

This post is very useful for 3rd BAMS Students & Medical General Practitioners

Dear Friends ,please write me back on -- mailme.drrrdeshpande@rediffmail.com or call me on 9226810630 

SR NO
NAME OF THE TEST
INDICATION OF THE TEST
CLINICAL PRESENTATION
HAEMATOLOGY
1
PTTK / APTT
To detect Coagulation abnormalities.
Liver disease / DIC / HAEMOPHILIA / HEPARIN Rx.
2
Sickling Test
To detect Sickle Cell Anemia
Anemia - weakness / pallor/ koilonychias etc
3
Reticulocyte Count
To assess Bone Marrow activity and monitor response.
In response to anaemia therapy
4
Coomb’s Test ( Direct)
To detect auto antibodies against RBCs , that may result from various diseases.
AIHA - Autoimmune Haemolytic anaemia ,
Chronic Lymphoproliferative Disorders - CLL
Drug Induced Haemolysis
HDN - Haemolytic Disease of New Born.
5
Coomb’s Test ( Indirect)
To detect antibodies in unbound state in serum.
6
G6 PD Estimation
To detect G6PD deficiency.
Haemolytic Anemia and the presentation.
7
D-Dimer
Elevated in Thromboembolism and active venous thrombosis.
DVT / DIC / PE
8
HB Electrophoresis
Haemoglobinopathies.
Sickle cell Anemia / Thallassemia
Anemia - weakness / pallor/ koilonychias etc
9
Sr.Ferritin
To study Iron Metabolism disorders.
10
Sr.Iron & TIBC
BIOCHEMISTRY
1
Urine Micro Albumin
done in cases of DM to rule out Diabetic Nephropathy.
Known case of Diabetes.
2
APO A / APO B
To evaluate risk of Atherosclerosis
RECOMMENDED FOR EVERY INDIVIDUAL ABOVE 30 YEARS OF AGE - Blame it on lifestyle.
3
LP ( A)
To evaluate risk of Atherosclerosis
4
Homocysteine
Risk factor for CHD , Vitamin B deficiency , disorders of metheonine metabolism
ELEVATED LEVELS ARE SEEN IN - VIT B12 def. , CRF / CHD / Hypothyroidism
Low levels are seen in Down's / Pregnancy.
5
Blood Urea Nitrogen / Creatinine
done in cases of Kidney diseases , GI bleed , cancer patients
Signs and symptoms of Renal insufficiency / differentiation of prerenal / renal / post renal azotemia.
6
Acid Phosphatase with Prostatic Fraction
Prostatic Diseases , Storage disorders - Gaucher's / Niemann Pick's , Vaginal swabs of rape victims.
Known cases of Ca Prostate
7
GGTP
ELEVATED in liver disease
Screening test for Alcoholism , Various Liver patholgies , Pancreatitis , DM , RA , COPD , Tumours
8
CPK (Total)
Necrosis , Muscular disorders
Muscular dystrophies
9
CK--MB
Marker for MI , recent MI , rhabdomyolysis , muscular dystrophy
Cardiac markers - Chest pain , Myocarditis
10
Phosphorus
Renal diseases
Acute / Chronic renal failure
11
Ammonia
Renal diseases
Acute / Chronic renal failure
12
Magnesium
Renal diseases
Acute / Chronic renal failure




1
IgE
ALLERGY
Important marker of allergy
SEROLOGY
Sr,No.
Test
Indication

1
CRP
Marker of inflammation
Ischemia , Tissue injury or necrosis , Malignancy or post surgery
2
Hs - CRP
More sensitive marker for Inflammation
3
LE cell Phenomenon
To detect SLE.
Crude test - Obsolete nowadays
4
ANA
Connective Tissue Disorders , SLE , RA …
Rheumatic Diseases
5
Anti DS DNA
Specific test for SLE.
Advanced stages of SLE clinically
6
P – ANCA/C- ANCA
Vasculitis , WG , CSS , Connective Tissue Disorders
Vasculitis , Ulcerative Colitis , Crohn's Disease
7
HLA B - 27
Ankylosing spondylitis , Reiter's syndrome
HLA - CROSS MATCH - DONE IN EXCEPTIONAL CASES
8
Protein Electrophoresis


9
Anti CCP Antibody
Rheumatoid Arthritis
Differentiation of RA with other arthritis
10
ANA Blot
Connective Tissue Disorders , SLE , RA …
symptoms related to systems involved .
11
HIV PCR (Qualitative)


12
HBV PCR (Quantitative)


13
HBV PCR (Qualitative)


14
Alfa Feto Protein
Marker of various cancers - Hepatic / Germ cell
Used in cases of known cancers - to detect recurrence
15
B - hCG
Pregnancy / Ectopic / Gestational Tropho Disease
Imp is Threatened abortions
16
PSA
Prostate cancer screening and Follow ups
monitoring of patients
17
Torch IgG & IgM
TOXOPLASMA , RUBELLA , CYTOMEGALOVIRUS , HEPATITIS
IgM - RECENT INF / IgG - CHRONIC
TESTS TO BE ORDERED IN CASES OF BAD OBSTETRIC HISTORY
18
Torch IgM only
19
CMV – IgG & IgM
20
Anti Cardiolipin IgG,IgM.IgA
ANTIPHOSPHOLIPID SYNDROME
CLINICAL AND LAB CRITERIA ARE THERE FOR FINAL DIAGNOSIS
SEEN IN CASES OF SLE , CANCERS , ACUTE INFECTIONS DRUG EFFECTS
21
Anti Phospholipids Antibody
22
Lupus Anti coagulant




Sr,No.
Test
Indication

1
Free T3
THYROID DISORDERS
Hyper and Hypo thyroidism
2
Free T4
3
TSH (Ultrasensitive)
4
FSH
Hyper / Hypo gonadism , Precautious puberty
Cases of Infertility  , Amenorrhoea , Bad obstetric History , Ectopic Hormone production , CRF , Liver failure , Drug effects ,
5
LH
6
Prolactin
prolactine secreting tumours
7
B - HCG
Pregnancy / Ectopic / Gestational Tropho Disease
Imp is Threatened abortions
8
Progesterone
Detection of Ovulation , Pregnancy , tumours
Imp is Threatened abortions , Toxaemias , Gonadal agenesis
9
Testosterone
To evaluate Hormonal / Functional status
Virilising tumours / Hirutism / Hypo / Klinefelter's/ Estrogens therapy
10
Estradiol(E2)
Hyper / Hypo - Gynecomastia , Estrogens producing tumours
Feminization in children , Hepatic Cirrhosis
11
Growth Hormone
Hyper / Hypo pituitarism
Acromegaly / Chronic diseases
12
Cortisol AM/PM
Adrenal insufficiency
HYPER AND HYPO disorders
13
Dhea – SO4
Adrenal insufficiency , Cushing's syndrome
increased in Cushing's / Cancers / PCOD ,
decreased in Addison's
14
Estriol ( E3)
PREGNANCY ESTROGENS

15
C Peptide
Levels directly proportional to Insulin levels as both are coreleased in blood
Increased in Insulinoma / Type 2 DM.
Decreased in Type 1 and Exogenous Insulin Admin.
16
Insulin F/PP
done along with Glucose levels in cases of fasting Hypoglycaemia , Insulinomas
Have lot of limitations and is of limited use.
17
Pappa –(1st Trimester)
Pregnancy Associated Plasma Protein A
Low levels are associated with Aneuploidy
18
Triple Test (2nd Trimester)
DONE IN 2ND TRIMESTER PREG - ASSAY INCLUDE AFP, bHCG,Unconj. Estriol
assay gives three values that are determined to assess the risk of Down's Synd , Edward's Synd , Neural Tube defect




Sr,No.
Test
Indication

1
TB – IgG/IgM / IgA
Detection of Unknown Tuberculosis
Various presentations of Tuberculosis - Not diagnostic or suspicious but not confirmed by routine modalities.
2
TB PCR ( Qualitative)
Detection of Unknown Tuberculosis




Sr,No.
Test
Indication

1
VMA
Metabolite of catecholamines done in cases of Pheochromocytoma , Neuroblastoma , Paraganglioma
The test is replaced by fractionated plasma free metanephrines
2
Proteins
Done in cases of Major illnesses - Liver / Kidney / Debilitating disorders
Important marker of Nutritional state of the person.
3
Calcium
Monitoring of various disorders - Bone , Kidney , Parathyroid , GIT
Commonest deficiency in today's era , silent most of the time
4
Creatinine
Renal function assessment

5
Creatinine Clearance
Evaluation of Glomerular Function
Renal disorders , Anemia , Leukemias , Monitoring of renal diseases
6
Sodium
Together considered as electrolytes
Potassium derrangement happens in some cardiac cases too and plenty of other disorders
water electrolyte imbalance , Dehydreations , elevated in Hyperaldosteronism
7
Potassium
8
Uric Acid
Renal function assessment , Gout ,
Monitoring of Gout and Chemoterapeutic agents


1 comment:

  1. caregivers support groups
    The Caregiver Space is a free social network that supports those providing Respite Care for Elderly, Caregiver Services, Dementia Caregiving and Caregiver Support.

    ReplyDelete