diagnostic testing. a diagnostic test is any kind of medical test performed to aid in the diagnosis...
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Diagnostic Testing
Diagnostic Testing
A diagnostic test is any kind of medical test performed to aid in the diagnosis or detection of disease.
to diagnose diseases to measure the progress or recovery from disease to confirm that a person is free from disease
Types Invasive Minimally-invasive Non-invasive
Diagnostic Testing
Other characteristics of tests include: sensitivity specificity positive predictive value negative predictive value false positive false negative
Test options
Consulting room tests auscultation height and girth blood pressure pulse breath tests reflex tests eye examination ophthalmoscopy hearing test digital rectal examination vaginal exam
Testing options
Requiring laboratory analysis Urine tests Stool tests Hair tests Saliva tests Blood tests Erythrocyte sedimentation
rate (ESR) Complete blood count (CBC) Comprehensive metabolic
panel (CMP) Arterial blood gas (ABG) DNA tests
invasive examinations biopsies lumbar puncture
Requiring microscopy Pap smears
Testing options
Requiring elaborate medical equipment X-rays
barium enema intravenous pyelogram (IVP test)
ultrasound scans electrocardiogram (ECG or EKG) electroencephalogram (EEG) computer aided tomography (CAT) scans positron emission tomography (PET) magnetic resonance imaging (MRI) endoscopy
colonoscopy cystoscopy sigmoidoscopy colposcopy
blood test
X-Ray
“plain films” Bone abnormalities – Fx, dislocation, joint spaces Ectopic bone formation in soft tissue Bone tumors
Arthrogram
X-ray after an injection of a dye Shows the disruption of soft tissue
or loose bodies in the joint Uses a Fluoroscope
Fluoroscopy
Provides immediate projection of X-ray image on screen for viewing
Common for GI tract testing, cardiac catheterization, hip/shoulder injections
Portable x-ray in pros & D-I
Computed Tomography
Thin , fan shaped x-ray beam Cross section view if tissue Many angles Visual image on a computer
Positron Emission Tomography (PET)
Nuclear medicine imaging technique which produces a three-dimensional image of functional processes in the body.
Detects pairs of gamma rays emitted indirectly by a positron-emitting radionuclide (tracer)
Bone Scan
IV – radioactive tracer Bony lesions with inflammation will “take-up”
more dye (Bone stress sites)
Magnetic Resonance Imaging
Electromagnets circle the body Field up to 600,000x as strong as earth Magnet aligns hydrogen atom in water molecules. When
turned off, atoms continue to spin, emitting an energy that is detected by the computer.
Hydrogen atoms in different tissues spin at different rates
Ultrasonography
Used to view the location of, alignment of and measure the size of organs/tissue
Measures the reflection or transmission of high-frequency ultrasound waves
Computer calculates the distance from the
sound-reflecting/absorbing surface and creates
a two-dimensional image
Echocardiography
Uses ultrasound to produce image of cardiac structure/function
Can see the valves & dimensions of the 4 chamber
Electroencephalography
EEG Records electrical potentials produced in the brain Changes in brain wave patterns
Electromyography
Graphic recording of muscle contractions & the amt of electrical activity generated in a muscle
EMG Surface or needle electrodes Motor unit potentials can be observed on
a oscilloscope screen or from a graphic
recording (electromyogram)
Arteriography
Catheter is inserted into specific vessel Contrast is injected & radiographs are taken Blockage/Aneurysm
Electrocardiography
ECG/EKG Electrical activity of the heart Impulse formation, conduction, depolarization &
repolarization of the atria & ventricles follows a normal pattern
Nerve Conduction Velocity
Conduction velocity of nerves Apply stimulus to a peripheral nerve and measure
the speed at which the muscle action occurs Nerve compression/nerve fx
Synovial Fluid Analysis
Used to detect the reason for an joint effusion, increase ROM, by decreasing joint effusion
Not commonly used anymore Looked for blood & infections
Serum Testing
CBC Screen for numerous condtions
Anemia, diabetes, infection, monitor kidney function RBC count, hemoglobin levels, hematocrit, WBC count,
platelet count, cholesterol, etc
Urinalysis
UA Specific gravity, pH, ketones, hemoglobin, protein, nitrates,
WBC, drugs, hormones, electrolytes, glucose, RBC Color, odor, volume
Urinalysis - Procedure
Specimen collection Clear, clean container Fresh urine……if longer than 1 hr, put in frig Mid stream urine
Testing procedures Briefly (< 1 sec) dip test strip into urine Draw the edge of the strip along the rim to remove
excess urine Turn strip on its side and tab on a paper towel After appropriate time (1 min), compare strip to side of
container….if Leukocytes (+), reread @ 2 mins
Urinalysis – Testing for
Specific Gravity: Ability of kidneys to concentrate and dilute fluids; hydration levels
pH: Refers to how acidic or alkaline the urine is. Acidic urine is found in cases of diabetes & dehydration. Alkaline urine is a sign of a urinary tract infection or kidney disease
Glucose: Diabetes Hemoglobin: Kidney disease or after intense exercise Protein: Kidney disease Nitrates: Infection Ketones: Eating disorder, fasting Leukocytes: Infection
Urinalysis - Normal
Specific Gravity: 1.016 – 1.022 pH: 5-9…..morning urine Glucosuria……none Proteinuria……up to 30mg/dL Hematuria…….up to 5Ery/uL is okay Leukocytes…...none Ketones……….none Nitrates……….none
Urinalysis
Color: Normal – pale yellow Dark –dehydrated Red/brownish – blood, hemoglobin, myoglobin,
bilirubin Cloudy/milky – infection
Odor: Foul/strong - infection