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
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
|
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