A
Abortion, threatened
serum B–human chorionic gonadothropin (hCG), serum progesterone levels, urine, hCG, pregnanediol, sonogram
Achalasia
barium swallow, mecholyl test, esophagoscopy, and esophageal manometry
Acoustic neuroma
skull x-ray, computed tomography (CT) scan, posterior fossa myelogram, magnetic resonance imaging (MRI)
Acquired Immunodeficiency Syndrome (AIDS)
human immunodeficiency virus (HIV) antibody titer, enzyme-linked immunosorbent assay (ELISA), western blot
Acromegaly
skull x-ray, CT scan, serum growth hormone, MRI
Actinomycosis
smear for sulfur granules, culture skin lesions
Addison disease
serum cortisol before and after corticotrophin, CT scan of abdomen, metapyrapone test
Adrenogenital syndrome
serum cortisol, hydroxyprogesterone, 11-deoxycortisol, urine 17-ketosteroids and pregnanetriol, dexamethasone suppression test, CT scan of the abdomen
Adult respiratory distress syndrome
chest x-ray, sputum culture, blood culture, Swan–Ganz catheterization, arterial blood gases (ABGs)
Agammaglobulinemia
serum electrophoresis and immunoelectrophoresis, blood type, lymph node biopsy, B-lymphocyte and T-lymphocyte counts
Agranulocytosis, idiopathic
complete blood count (CBC), bone marrow examination, spleen scan
AIDS
see Acquired Immunodeficiency Syndrome
Albright syndrome
x-ray of long bones, bone biopsy
Alcaptonuria
urinary homogentisic acid, x-ray of spine
Alcoholism
blood alcohol level, liver function tests, liver biopsy
Aldosteronism, primary
electrolytes before and after spironolactone, plasma renin, 24-hour urine aldosterone, CT scan, exploratory laparotomy
Allergic rhinitis
nasal smear for eosinophils, serum immunoglobulin E (IgE) antibody, radioallergosorbent test (RAST), skin test
Alveolar proteinosis
luteinizing hormone (LH), sputum for periodic acid-Schiff-positive material (PSP), lung biopsy
Alzheimer disease
CT scan or MRI
Amebiasis
stool for ova and parasites, rectal biopsy, hemagglutinin inhibition test
Amyloidosis
Congo red test, rectal biopsy, liver biopsy, gingival biopsy, subcutaneous fat aspiration and stain
Angina pectoris
graded exercise tolerance test (GXT), thallium 201 scintigraphy, coronary angiogram, trial of nitroglycerin
Angineurotic edema
C'1 esterase inhibitor
Ankylosing spondylitis
human leukocyte antigen (HLA) B-27 tissue antigen
Anthrax
smear and culture of lesion, skin biopsy, serologic test
Antitrypsin deficiency
serum protein electrophorosis
Aortic aneurysm
sonogram, CT scan, aortogram
Aortic valvular disease
echocardiogram, CT scan, MRI, cardiac catheterization
Appendicitis
CBC, flat plate of abdomen, CT scan
Aplastic anemia
bone marrow, lymph node biopsy, immunoelectrophoresis
Ascaris lumbricoides
cathartic stool for ova and parasites, eosinophil count
Asthma
spirometry, sputum for eosinophils, serum IgE antibodies, RAST, skin test
Attention deficit disorder
clinical diagnosis
Atrial arrhythmias
free thyroxine (FT4) index, electrocardiogram (ECG), Holter monitoring, His bundle study
Atypical pneumonia, primary
see Mycoplasma pneumoniae
B
Bacillary dysentery
stool smear (for leukocytes) and culture, febrile agglutinins
Balantidiasis
stool for ova and parasites
Banti syndrome
liver function tests, liver–spleen scan, bone marrow examination, hepatic vein catheterization
Barbiturate poisoning
blood or urine for barbiturates, electroencephalogram (EEG)
Basilar artery insufficiency
four-vessel cerebral angiogram, magnetic resonance angiogram
Bell palsy
CT scan of mastoids and petrous bones, electromyogram (EMG)
Beriberi
transketolase activity coefficient, urine thiamine afterload, therapeutic trial
Bilharziasis
stool or urine sediment for eggs, rectal biopsy
Biliary cirrhosis
liver function tests, mitochondrial antibodies, serum bile acids, endoscopic retrograde cholangiopancreatography (ERCP), liver biopsy
Blastomycosis
potassium hydroxide (KOH) prep, culture, chest x-ray, skin test, serologic test
Boeck sarcoid
chest x-ray, transbronchial lung biopsy, lymph node biopsy, Kveim test, liver biopsy, angiotensin-converting enzyme liver, gallium scan
Botulism
culture of food and stool, mouse assay of toxin
Brain tumor
CT scan, MRI
Brill–Symmer disease
lymph node biopsy
Bromide poisoning
blood bromide level
Broncheictasis
bronchogram, bronchoscopy, CT scan of lung
Bronchitis
sputum culture, chest x-ray
Bronchopneumonia
sputum smear and culture, chest x-ray, CBC, cold agglutinins
Brucellosis
blood cultures, serologic tests, skin test
Bubonic plague
culture of bubo, blood, or sputum; animal inoculation; serologic test
Buerger disease
phlebogram, arteriogram, biopsy of affected vessels, ultrasonography
C
Carbon monoxide poisoning
carboxyhemoglobin determination
Carbon tetrachloride poisoning
liver function tests, infrared spectrometry, liver biopsy, blood carbon tetrachloride
Carcinoid syndrome
serum serotonin, urine 5-hydroxyindoleacetic acid (5-HIAA), exploratory laparotomy, bronchoscopy
Carcinoma of the breast
mammogram, sonogram, fine-needle aspiration, biopsy
Carcinoma of the cervix
Papanicolaou (Pap) smears, cervical biopsy, colposcopy
Carcinoma of the colon
stool for occult blood, sigmoidoscopy, barium enema, colonoscopy, carcinoembyonic antigen (CEA), CT scan
Carcinoma of endometrium
Pap smear, dilatation and curettage (D & C)
Carcinoma of the esophagus
barium swallow, esophagoscopy, biopsy
Carcinoma of the lung
chest x-ray, CT scan, sputum Pap smears, brochoscopy and biopsy, needle biopsy, open lung biopsy, scalene node biopsy
Carcinoma of the pancreas
sonogram, CT scan of abdomen, liver function tests, ERCP, exploratory laparotomy, cancer antigen (CA) 19-9
Carcinoma of the stomach
gastrointestinal (GI) series, gastroscopy and biopsy, gastric cytology
Cardiac arrhythmias
ECG, Holter monitoring, echocardiogram, electrophysiologic study
Cardiomyopathy
see Mycarditis/Myocardiopathy
Carpal tunnel syndrome
nerve conduction velocity (NCV) study, MRI
Cat-scratch disease
skin test, lymph node biopsy
Celiac disease
D-xylose absorption, mucosal biopsy, urine 5-HIAA, small bowel series
Cellulitis
smear and culture of wound exudates, antistreptolysin O (ASO) titer
Cerebellar ataxia
CT scan, MRI
Cerebral abscess
CT scan, MRI
Cerebral aneurysm
CT scan, MRI, arteriogram
Cerebral embolism
CT scan, blood culture, echocardiogram, carotid scan, four-vessel cerebral angiogram, ECG
Cerebral hemorrhage
CT scan, MRI
Cerebral thrombosis
CT scan, MRI, carotid scan, digital subtraction angiogram, four-vessel cerebral angiogram
Cerebral spondylosis
x-ray of cervical spine, EMG, MRI of myelogram with simultaneous CT scan
Chagas disease
blood smear and culture, cerebrospinal fluid (CSF) smear and culture, bone marrow or tissue biopsy, animal inoculation, serologic tests
Chancroid
smear and culture of lesion, skin biopsy, serology tests
Child abuse
skeletal survey, chest x-ray, vaginal smear and culture
Chlamydia pneumonia
chest x-ray, serologic tests
Cholangioma
liver function tests, transhepatic cholangiogram, ERCP, CT scan of abdomen, exploratory laparotomy
Cholangitis
liver function tests, transhepatic cholangiogram, ERCP, exploratory laparotomy
Cholecystitis
sonogram, cholecystogram, liver function tests, hepatobiliary iminodiacetic acid scan (HIDA) test
Choledocholithiasis
liver function tests, duodenal drainage, ERCP, transhepatic cholangiogram, sonogram
Cholelithiasis
sonogram, cholecystogram, liver function tests, ERCP
Cholera
stool smear and culture, dark field microscopy
Choriocarcinoma
plasma B-subunit hCG, urine chorionic gonadotropin, D & C
Cirrhosis
liver function tests, liver scan, CT scan, liver biopsy
Coarctation of the aorta
chest x-ray, clinical evaluation, aortograms rarely required
Coccidioidomycosis
smear, animal inoculation, serology, skin test, chest x-ray
Concussion
CT scan, MRI, EEG, evoked potentials, psychometric tests
Congestive heart failure
ECG, test x-rays, spirometry, circulation time, arterial blood gases (ABG), echocardiogram, B-type naturetic peptide (BNP)
Coronary insufficiency
see Angina pectoris
Costochondritis (Tietze syndrome)
lidocaine infiltration
Craniopharyngioma
skull x-ray, CT scan, MRI
Cretinism
FT4 index, thyrotropin, radioactive iodine (RAI) uptake and scan, x-ray for bone age
Crigler–Najjar syndrome
see Gilbert disease
Cryoglobulinemia
serum protein electrophoresis and immunoelectrophoresis, (SIA) water test, cold agglutinins, rheumatoid arthritis (RA) test, hepatitis C antibody titer
Cryptococcosis
spinal fluid smear and culture, sputum or blood cultures, CSF cryptococcal antigen
Cushing syndrome
24-hour urine free cortisol, plasma cortisol, single-dose overnight dexamethasone suppression test, CT scan of brain or abdomen
Cystic fibrosis
quantitative pilocarpine iontophoresis, sweat test
Cysticercosis
serologic test, CT scan of brain, MRI, biopsy of subcutaneous cysticerci
Cystinosis
slit-lamp examination, liver biopsy
Cystinuria
serum and urine cystine and arginine, cyanide–nitroprusside test, thin-layer chromatography
Cytomegalic inclusion disease
blood smear for atypical lymphs, cytomegalovirus (CMV), IgM antibody titer, human fibroblastic cell culture innnoculation, immunofluorescence technique for viral demonstration
D
Dehydration
intake and output of fluid, electrolytes, blood urea nitrogen (BUN) to creatinine ratio, serum/urine osmolality
Dengue
viral isolation from blood, serology test
Dermatomyositis
Antinuclear antibody (ANA), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatine phospho-kinase (CPK), aldolase, EMG, muscle biopsy
Diabetes insipidus
Hickey–Hare test, serum/urine osmolality intake and output before and after pitressin, CT scan, serum antidiuretic hormone (ADH)
Diabetes mellitus
glucose tolerance test, cortisone glucose tolerance test
Digitalis intoxication
serum digoxin level, ECG
Di Guglielmo disease
bone marrow, peripheral blood study
Diphtheria
Nose and throat culture
Diphyllobothrium latum
stool for ova and parasites, serum B12 level
Dissecting aneurysm
chest x-ray, CT scan or MRI of aorta, aortogram
Disseminated intravascular coagulation (DIC)
decreased fibrinogen, increased fibrin degradation products, D-Dimer assay
Diverticulosis
sigmoidoscopy, barium enema, colonoscopy, CT scan of abdomen, gallium scan, sonogram, exploratory laparotomy
Down syndrome
chromosome study, urinary B-aminoisobutyric acid
Dracunculiasis
noting presence of worms in subcutaneous tissues, serum IgE, antifilarial antibody titer
Dubin–Johnson syndrome
liver function tests, liver biopsy
Ductus arteriosus, patent
cardiac catheterization, angiocardiogram, echocardiogram
Duodenal ulcer
see Peptic ulcer
Dwarfism
x-ray of bones; endocrine, renal and GI function tests
Dysfunctional uterine bleeding
D & C, endometrial biopsy, progesterone challenge
E
Eaton–Lambert syndrome
EMG, Tensilon test, muscle biopsy, chest x-ray
Echinococcosis
CT scan, x-ray of long bones, Casoni skin test, serologic tests, liver biopsy
Eclampsia
uric acid, renal function tests, renal biopsy
Ectopic pregnancy
serum B-hCG by immunoassay, sonogram, laparoscopy, culdocentesis, exploratory laparotomy, serum progesterone levels
Eczema
serum IgE levels
Ehlers–Danlos syndrome
capillary fragility test, bleeding time, skin biopsy
Emphysema
pulmonary function tests, ABGs, α-antitrypsin level, single breath diffusing capacity for carbon monoxide
Empyema
chest x-ray, sputum cultures, gallium scan, thoracentesis
Encephalitis
viral isolation from brain tissue and spinal fluid, MRI, serologic tests
Encephalomyelitis
viral isolation from brain tissue and spinal fluid, MRI, serologic tests
Endocardial fibroelastosis
ECG, chest x-ray, echocardiogram, angiocardiogram
Endocarditis
see Subacute bacterial endocarditis
Epilepsy
wake-and-sleep EEG, CT scan or MRI, positron emission tomography (PET) scan, ambulatory EEG monitoring
Erectile dysfunction
penile blood pressure nocturnal tumescence testing, sonogram
Erythema multiforme
skin biopsy, patch test
Erythroblastosis fetalis
bilirubin, direct Coombs test, amniocentesis
Esophageal varices
esophagoscopy, sphlenovenogram, ultrasonography
Esophagitis
Bernstein test, esophagoscopy and biopsy, esophageal manometry, ambulatory pH monitoring
Extradural hematoma
skull x-ray, CT scan, MRI
Endometriosis
sonogram, CA125 levels
Epididymitis
sonogram, radionuclide scan
F
Fanconi syndrome
x-ray (pelvis, scapula, femor, ribs), urinary amino acids, glucose, electrolytes, serum uric acid, alkaline phosphatase, renal biopsy
Filariasis
blood smear for microfilariae, skin test, complement-fixation test
Folic acid deficiency
serum folic acid, therapeutic trial
Friedlander pneumonia
sputum smear and culture, blood cultures, lung puncture, serial chest x-rays
Friedreich ataxia
clinical diagnosis
G
Galactosemia
Paigon assay of blood galactose, red blood cell (RBC) assay of (GAL-1-PUT) transferase
Gallstone
see Cholelithiasis
Gargoylism
urinary chondroitin sulfuric acid, serum assay of α-L-iduronidase, tissue culture, enzyme assay
Gastritis
serology for Helicobacter pylori, gastroscopy, biopsy
Gastroenteritis
stool for culture, smear, and ova and parasites
Gaucher disease
assay of leukocytes for B-glucosidase, bone marrow examination, x-ray of long bones
General paresis
blood and spinal fluid fluorescent treponemal antibody absorption (FTA–ABS) test
Giardia lambia
cathartic stool for ova and parasites, duodenal analysis, Giardia antigen, string test
Gigantism
CT scan or MRI of brain, serum growth hormone
Gilbert disease
liver function tests, liver biopsy
Gilles de la Tourette syndrome
urinary catecholamines
Glanders
culture of skin lesion, skin test, serologic tests, animal inoculation
Glanzmann disease
platelet counts, clot retraction, prothrombin time, bleeding time, capillary fragility test, see also Thrombocythemia
Glaucoma
tonometry, gonioscopy, visual fields
Glomerulonephritis
serum complement, streptozyme test, ANA, renal biopsy
Glossitis
culture, biopsy, therapeutic trial of vitamins and iron
Glycogen storage disease
glucose tolerance test, epinephrine test, liver biopsy and analysis for glucose-6-phosphatase
Goiter
FT4 index, RAI uptake and scan, thyrotropin, serum antibodies
Gonorrhea
urethral, rectal, vaginal, or throat smear and cultures; DNA probes and polymerase chain reaction (PCR).
Gout
serum uric acid, synovial fluid analysis, x-ray of bones and joints
Granuloma inguinale
Wright stain of scrapings from lesion and biopsy
Graves disease
see Hyperthyroidism
Guillain–Barré syndrome
EMG, spinal fluid analysis
Gumma
FTA–ABS
H
Haemophilus influenzae
nose, throat, and sputum culture or spinal fluid smear and culture
Hamman–Rich syndrome
chest x-ray, pulmonary function tests, lung biopsy
Hand–Schuller–Christian disease
x-ray of skull, bone biopsy, bone marrow examination
Hansen disease
see Leprosy
Hartnup disease
urinary amino acid, indican, and indoleacetic acid; FT4 index; thyrotropin
Hashimoto disease
FT4 index, thyrotropin, serum thyroglobulin antibodies
Haverhill fever
agglutination titer, aspiration of affected joint or abscess for streptobacillus moniliformis
Hay fever
see Allergic rhinitis
Heart failure
see Congestive heart failure
Helminth infections
stool for ova and parasites, serologic tests, skin tests, liver function tests
Hemangioblastoma
CT scan or MRI
Hemochromatosis
serum ferritin, serum iron and iron binding capacity, liver or skin biopsy
Hemoglobin C disease
blood smear for target cells, hemoglobin electrophoresis
Hemoglobinuria, paroxysmal cold
CBC, Coombs test, Donath–Landsteiner test, FTA-ABS, serum haptoglobins
Hemoglobinuria, paroxysmal nocturnal
CBC, Ham test, sucrose hemolysis test
Hemolytic anemia
serum haptoglobins, radioactive chromium–tagged red cell survival, urine and fecal urobilinogen, Coombs test, blood smear
Hemophilia
coagulation profile, thromboplastin generation test, assay of factors VIII, IX, XI
Hepatitis
liver function test, hepatitis profile, IgM, anti–hepatitis A virus (HAV), hepatitis B surface antigen (HBsAG), liver biopsy, anti–hepatitis C virus (HCV)
Hepatitis, chronic active
HBsAG, liver function tests, ANA, liver biopsy
Hepatolenticular degeneration
see Wilson disease
Hepatoma
ultrasonography, CT scan, α-fetoprotein, liver biopsy, arteriogram, MRI
Hernia, diaphragmatic
see Hiatal hernia
Herniated disc
EMG, MRI, CT scan, myelogram, discogram
Herpangina
serologic tests, viral isolation
Herpes genitalis
examination of skin scrapings, Tzanck test, culture, serologic tests
Herpes simplex
serologic tests, viral isolation, Tzanck test
Herpes zoster
Tzanck test, serologic tests
Hiatal hernia
Bernstein test, esophogram, esophagoscopy and biopsy, esophageal manometry, therapeutic trial
Hirschsprung disease
rectal or colonic biopsy
Histamine cephalgia
test trial of histamine subcutaneously, response to sumatriptin
Histoplasmosis
sputum culture, bone marrow culture, animal inoculation, skin test, serologic tests, chest x-ray
HIV infections
see Acquired Immunodeficiency Syndrome
Hodgkin lymphoma
lymph node biopsy, bone marrow lymphangiogram, CT scan, liver–spleen scan, exploratory laparotomy
Huntington chorea
clinical diagnosis, genetic markers, CT scan
Hurler syndrome
see Gargoylism
Hydronephrosis
intravenous pyelogram (IVP), sonogram
Hyperaldosteronism
see Aldosteronism, primary
Hypercholesterolemia, familial
lipoprotein electrophoresis, lipid profile
Hyperlipemia, idiopathic
lipoprotein electrophoresis, ultracentrifugation
Hypernephroma
IVP or retrograde pyelogram, CT scan, angiogram
Hyperparathyroidism
serum calcium, phosphorus, and alkaline phosphatase; urine calcium; serum parathyroid hormone (PTH); 1,25-(OH)2D; phosphate reabsorption test; exploratory surgery
Hyperprolactinemia
CT scan, MRI of brain
Hypersplenism
CBC, blood smear, red cell survival, spleen/liver ratio, bone marrow, epinephrine test, exploratory laparotomy
Hyperthyroidism
thyroid-stimulating hormone (TSH), free T3, FT4 index, free T4
Hypoparathyroidism
serum calcium and phosphorus, 24-hour urine calcium, skull x-ray, phosphate reabsorption, therapeutic trial, PTH assay, urine cyclic adenosine monophosphate (AMP)
Hypopituitarism
serum cortisol, serum thyroxine, serum growth hormone, serum corticotrophin, thyrotropin, follicle-stimulating hormone (FSH), LH, CT scan, MRI
Hypotension, idiopathic postural
clinical observation, response to vasopressin injection (Pitressin), tests to rule out causes of secondary hypotension
Hypothyroidism
FT4 index, thyrotropin-sensitive assay, thyroid microsomal antibodies, therapeutic trial
I
Idiopathic hypertrophic subaortic stenosis
EKG, echocardiography
Ileitis
see Regional enteritis
Inappropriate ADH secretion
plasma and urine osmolality, spot urinary sodium, serum ADH
Infectious mononucleosis
monospot test, heterophil antibody titer, smear for atypical lymphocytes, liver function tests, repeat tests, Epstein–Barr virus (EBV) antibody titer
Influenza, viral
culture of nasopharyngeal washing, complement-fixation tests
Insulinoma
see Islet cell tumor
Interstitial cystitis
cystoscopy and biopsy
Intestinal obstruction
flat plate of the abdomen with lateral decubitus films, double enema, sonogram, CT scan, GI series with diatrizoate maglumine and diatrizoate sodium (Hypague), exploratory laparotomy
Iron deficiency anemia
serum ferritin, serum iron and iron binding capacity, free erythrocyte protoporphyrins (FEP), bone marrow, therapeutic trial
Irritable bowel syndrome
clinical diagnosis
Islet cell tumor
glucose tolerance test 72-hour fast, plasma insulin, C-peptide, tolbutamide tolerance test, pancreatic arteriogram, exploratory laparotomy
K
Kala-azar
blood smear, bone marrow or splenic aspirate for parasites, culture, serologic tests (ELISA)
Kaposi sarcoma
Human Herpes Virus 8 (HHV8) antibody titer, biopsy
Klinefelter syndrome
sex chromatin pattern, testicular biopsy, serum FSH and LH
Kwashiorkor
serum albumin, CBC
L
Lactase deficiency
lactose tolerance test, mucosal biopsy, hydrogen breath test
Laennec cirrhosis
see Cirrhosis
Larva migrans, visceral
eosinophil count, serum globulin, skin testing, serologic tests, liver biopsy
Laryngeal carcinoma
laryngoscopy
Laryngitis
nose and throat culture, washings for viral studies, laryngoscopy
Lead intoxication
serum and urine lead content, urine for γ-aminolivulinic acid (ALA), coproporphyrin, FEP, test dose of diaminoethanetetraacetic acid (EDTA), x-ray of long bones
Legionnaire disease
sputum culture, serology, urinary Ag assay
Leishmaniasis
CBC, blood spleen and bone marrow smears for parasites, biopsy, serologic tests
Leprosy
Wade scraped incision procedure, culture of lesion, biopsy of skin nerves, x-ray of hands and feet, histamine tests, lepromin skin test
Leptospirosis
see Weil disease
Lettere–Siwe disease
x-ray of bones, bone marrow, lymph node biopsy
Leukemia
blood smear, bone marrow, uric acid, serum B12 concentration, iron binding capacity
Listeriosis
blood or spinal fluid smear and spinal fluid agglutination titer, bone marrow biopsy
Liver abscess
liver scan with technetium or gallium, liver aspiration and biopsy, CT scan, amebic hemagglutinin inhibition titer, cathartic stool for ova and parasites
Loeffler syndrome
eosinophil count, sputum for eosinophils, stool for ova and parasites
Lung abscess
chest x-ray, tomogram, CT scan, sputum culture, bronchoscopy, sputum cytology, needle aspiration, biopsy, and culture
Lupoid hepatitis
see Hepatitis, chronic active
Lupus erythematosus
ANA, anti–double-stranded DNA antibody titer, Coombs test, lupus erythematosus prep, coagulation profile, biopsy of skin, muscle, lymph node, or kidney
Lyme disease
serologic tests
Lymphangitis
CBC, sedimentation rate
Lymphogranuloma inguinale
lygranum test, Giemsa-stained smear, serologic tests, tissue or lymph node biopsy
Lymphogranuloma venereum
serologic tests, lymph node biopsy, aspiration of bubo for culture
Lymphoma
see Hodgkin disease
Lymphosarcoma
CT scan, x-rays of chest and abdomen, lymphangiogram
M
Macroglobulinemia
serum electrophoresis and immunoelectrophoresis, ultracentrifugation, Sia water test, bone marrow
Malabsorption syndrome
D-xylose absorption test, urine 5-HIAA, mucosal biopsy, small-bowel series
Malaria
blood smear for parasites, bone marrow, serologic tests
Mallory–Weiss syndrome
esophagoscopy
Marfan syndrome
x-ray of long bones and ribs, slit-lamp examination of eyes, IVP, urinary hydroxyproline, CT scan of aorta
Marie–Strumpell spondylitis
x-ray of lumbosacral spine, bone scan, HLA typing
Mastocytosis
skin biopsy, Darier sign, long bone x-ray, bone marrow biopsy
Mastoiditis
x-ray of mastoid, CT scan
McArdle syndrome
liver biopsy, enzyme assay of muscle phosphorylase, muscle biopsy, urine myoglobin
Measles
smear of nasal secretions for giant cells, serologic tests
Meckel diverticulum
technetium scan, exploratory laparotomy
Mediastinitis
CT scan or MRI of chest, mediastinoscopy, exploratory surgery
Medullary sponge kidney
IVP, CT scan
Medulloblastoma
CT scan, MRI
Megaloblastic anemia
see Pernicious anemia
Meig syndrome
thoracentesis, culdoscopy, laparoscopy, exploratory laparotomy, sonogram
Melanoma
serum or urinary melanin, biopsy
Ménière disease
CT scan, audiogram, caloric tests, electronystagmography (ENG)
Meningioma
CT scan, MRI, x-ray of skull or spine, myelogram
Meningitis
spinal fluid examination, smear and culture, serum for viral serologic studies, blood culture
Meningococcemia
blood culture spinal fluid examination, smear and culture, Gram stain of punctured petechiae
Menopause syndrome
serum LH, FSH, serum estradiol, vaginal smear for estrogen effects, therapeutic trial
Mental retardation
CT scan or MRI, EEG, psychometric testing, skull x-ray, phenylketonuria (PKU), FT4 index, thyrotropin, urinary amino acids, chromosomal analysis
Methemoglobinemia
erythrocyte methemoglobin, ABG, blood diaphorase 1, spectrophotometry
Migraine
nitroglycerin test, histamine test, sedimentation rate to rule out temporal arteritis
Mikulicz disease
CBC, bone marrow, tuberculin test, biopsy of lesion, ANA, lymph node biopsy
Milk–alkali syndrome
serum calcium, phosphorus, alkaline phosphatase, urinary calcium and phosphates
Milroy disease
clinical diagnosis
Mitral insufficiency or stenosis
ECG, chest x-ray, echocardiogram, phonocardiogram, cardiac catheterization
Moniliasis
vaginal smear or culture, skin scrapings with KOH prep, biopsy
Mononucleosis, infectious
see Infectious mononucleosis
Mucormycosis
nose and throat culture, biopsy
Mucoviscoidosis
see Cystic fibrosis
Multiple myeloma
serum protein, electrophoresis, 24-hour urine electrophoresis, bone marrow, x-ray of skull and spine, MRI
Multiple sclerosis
somatosensory evoked potentials, (SSEP), visual evoked potential (VEP), spinal fluid globulin and myelin basic protein, MRI
Mumps
skin test, serologic tests, viral isolation from throat washings
Muscular dystrophy
EMG, muscle biopsy, urine creatine, chromosome analysis, serum enzyme (creatine kinase, and so forth)
Myasthenia gravis
EMG, Tensilon test, acetylcholine receptor antibody titer, CT scan of chest to rule out thymoma
Mycoplasma pneumoniae
cold agglutinins, (MG) streptococcal agglutinins, culture
Mycosis fungoides
skin biopsy
Myeloid metaplasia, agnogenic
red cell morphology, CBC, bone marrow, leukocyte alkaline phosphatase, urine and serum erythropoietin
Myelophthisic anemia
CBC, bone marrow, bone scan, lymph node biopsy
Myocardial infarction
serial enzymes ([MB], creatine phosphokinase [CPK]), and so forth), serial ECGs serum troponin-1, thallium 201 scintigraphy, pyrophosphate imaging, echocardiogram
Myocarditis/Myocardiopathy
echocardiogram, endomyocardial biopsy, cardiac catheterization
Myotonia atrophica
EMG, urine creatinine and creatine, muscle biopsy
Myxoma, cardiac
echocardiogram, angiocardiogram
N
Narcolepsy
sleep study, EEG, HLA-DR2
Nematodes
gastric analysis, muscle biopsy, eosinophil count, skin test, serologic tests, stools for ova and parasites, duodenal aspiration for ova and parasites, GI series, rectal swabs with Scotch tape
Nephritis
see Glomerulonephritis
Nephrocalcinosis
serum PTH, serum calcium, phosphorus and alkaline phosphatase, IVP, renal biopsy
Nephrotic syndrome
urinalysis serum complement, sedimentation rate, serum protein electrophoresis, renal function tests, ANA, renal biopsy
Neurinoma, acoustic
see Acoustic neuroma
Neuritis, peripheral
see Neuropathy
Neuroblastoma
urinary vanillylmandelic acid (VMA) and homovanillic acid acid (HVA), CT scan, bone marrow, exploratory laparotomy
Neurofibromatosis
biopsy, skeletal survey, CT scan, spinal fluid analysis, myelogram
Neuropathy
glucose tolerance test, blood lead level, urine porphobilinogen, blood and urine arsenic levels, urine N-methylnicotinamide, ANA, serum B12 and folic acid, spinal fluid examination, NCV, EMG, serum transketolase activity coefficient, nerve biopsy
Neurosyphilis
blood and spinal fluid FTA–ABS
Niacin deficiency
see Pellagra
Niemann–Pick disease
demonstration of sphingomyelin in reticuloendothelial cells, bone marrow biopsy, tissue biopsy, skeletal survey, culture of skin fibroblasts
Nocardiosis
sputum smear and culture, spinal fluid examination, smear and culture
Nonketotic hyperosmolar coma
blood sugar, plasma osmolality
Normal pressure hydrocephalus
CT scan, nuclear flow study (radioactive iodinated albumin [RISA])
Nutritional neuropathy
see Neuropathy
O
Ochronosis
urinalysis (Benedict solution, isolation of homogentisic acid), x-ray of spine
Oppenheim disease
EMG, muscle biopsy
Optic atrophy
CT scan of brain and orbits, visual fields, spinal tap, serum B12, x-ray of skull and optic foramina
Optic neuritis
FTA–ABS antibody titer, visual fields, MRI of the brain
Osteitis deformans
serum calcium, phosphorus, alkaline phosphatase, skeletal survey, bone scan, bone biopsy, urine hydroxyproline
Osteoarthritis
x-ray of spine and joints, exclusion of other forms of arthritis
Osteogenic sarcoma
alkaline and acid phosphatase, x-ray of bone, bone scan, bone biopsy
Osteomalacia
serum calcium phosphorus, alkaline phosphatase, x-ray of long bones, response to vitamin D and calcium, serum vitamin D levels
Osteomyelitis
sedimentation rate, blood culture, culture of bone biopsy, x-ray of bone, bone scan, teichoic acid antibody titer (TAAB)
Osteopetrosis
bone marrow, x-ray of bones, bone biopsy
Osteoporosis
serum, calcium, phosphorus, alkaline phosphatase, bone biopsy, x-ray of spine, quantitative computerized tomogram, bone mineral density (BMD)
Otitis media
nasopharyngeal or aural smear and culture, CBC, sedimentation rate, tympanometry, audiogram
Otosclerosis
audiometry
Ovarian cancer
serum CA125, pelvic sonogram, CT scan of abdomen and pelvis
P
Paget disease
see Osteitis deformans
Pancreatic carcinoma
see Carcinoma of the pancreas
Pancreatitis, acute
serum amylase and lipase, blood sugar, serum calcium, paracentesis, flat plate of abdomen, 2-hour urinary amylase
Pancreatitis, chronic
serum and urinary amylase and lipase before and after secretin, glucose tolerance test, duodenal analysis for bicarbonate and enzyme concentration, CT scan, ERCP, fecal fat, triolein iodine 131 (131I) uptake
Panniculitis
bone marrow, skin and subcutaneous tissue biopsy
Paralysis agitans
clinical diagnosis
Pediculosis
Woods lamp, microscopic examination of hair shafts
Pellagra
urine N-methylnicotinamide, urine niacin after loading dose
Pelvic inflammatory disease (PID)
laparoscopy, culture of cervical mucus, exploratory laparotomy
Pemphigus
skin biopsy, Tzanck test, immunofluorescence studies
Peptic ulcer
upper GI series, stool for occult blood, gastroscopy and duodenoscopy, gastric analysis, serology for H. pylori
Periarteritis nodosa
ANA; eosinophil count; CBC; urinalysis; muscle, skin, subcutaneous tissue, and testicular biopsy; nerve biopsy; angiography
Pericarditis
ECG, echocardiogram, chest x-ray, angiocardiogram, pericardial tap, CT scan or MRI
Periodic paralysis, familial
serum potassium, ECG, EMG, response to glucose
Peritonitis
CBC, flat plate of abdomen, CT scan, sonogram, peritoneal tap, exploratory laparotomy
Pernicious anemia
CBC, blood smear, serum B12 and folic acid, Schilling test, gastric analysis with histamine, bone marrow
Pertussis
CBC, nasopharyngeal smear and culture
Petit mal
sleep EEG, CT scan
Peutz–Jeghers syndrome
small bowel series, exploratory laparotomy
Pharyngitis
nose and throat culture, rapid agglutination test of throat swab (Abbott test pack strep A, Abbott Laboratries, Abbott Park, IL), streptozyme test
Phenylpyruvic oligophrenia
urine for PKU and phenylalanine, Guthrie test, serum phenylalanine
Pheochromocytoma
plasma and urine catecholamines, 24-hour urine VMA, CT scan, MRI
Phlebitis
see Thrombophlebitis
Phlebotomus fever
serologic tests
Pickwickian syndrome
pulmonary function tests, ABG, sleep study
Pinealoma
CT scan or MRI
Pinworms
Scotch tape swab of perianal area with microscopic examination for eggs
Pituitary adenoma
CT scan, MRI, serum thyrotropin, corticotrophin, LH and FSH, FT4 index, serum cortisol, growth hormone
Placenta previa
ultrasonography
Plague
see Bubonic plague
Platyhelminthes
stool for ova and parasites, serologic tests, skin test, urine sediment for eggs, eosinophil count
Pleurisy
chest x-ray, thoracentesis, pleural biopsy, bronchoscopy, CT scan, ultrasonography
Pleurodynia, epidemic
serologic tests, stool and throat cultures for Coxsackie B virus
Pneumococcal pneumonia
see Pneumonia
Pneumoconiosis
chest x-ray, pulmonary function tests, ABG, sputum smear, lung biopsy, lung scan, scalene node biopsy
Pneumonia
stat sputum smear, culture, blood cultures, chest x-ray
Pneumothorax
chest x-ray, ABG, CT scan
Poliomyelitis
viral isolation from stool, serologic tests, spinal fluid analysis
Polyarteritis
see Periarteritis nodosa
Polycystic kidney
sonogram, CT scan
Polycystic ovary
see Stein–Leventhal syndrome
Polycythemia vera
CBC, platelet count, uric acid, ABG, pulmonary function tests, serum erythropoietin, bone marrow
Polymyalgia rheumatica
sedimentation rate
Polyneuritis
see Neuropathy
Porphyria
urine porphyrins and porphobilinogen
Portal cirrhosis
see Cirrhosis
Pott disease
x-ray of the spine, aspiration and culture of synovial fluid, synovial or bone biopsy, purified protein derivative (PPD)
Pre-eclampsia
see Eclampsia
Pregnancy
blood or urine test for pregnancy
Prostate carcinoma
serum acid and alkaline phosphatase, prostate-specific antigen (PSA) skeletal survey, bone scan, biopsy of prostate
Prostatic hypertrophy
sonogram cystoscopy, IVP
Protein-losing enteropathy
I131 polyvinylpyrrolidone test, serum protein electrophoresis
Pseudogout
synovial analysis
Pseudomembranous colitis
Clostridium difficile toxin B
Pseudohypoparathyroidism
serum calcium, phosphorus, alkaline phosphatase, urine calcium, Ellsworth–Howard test, parathyroid tissue biopsy
Pseudotumor cerebri
CT scan, MRI, spinal tap
Psittacosis
chest x-ray, serologic test, virus isolation
Pulmonary embolism
see Pulmonary infarction
Pulmonary emphysema
see Emphysema
Pulmonary fibrosis
diffusion capacity, bronchoscopy, lung biopsy, CT scan
Pulmonary hypertension, idiopathic
ABG, pulmonary function test, cardiac catheterization, pulmonary angiogram
Pulmonary infarction
ABG, lung scan, pulmonary angiogram, impedance plethysmogram, helical CT scan, rapid D-dimer assay
Pyelonephritis
urine culture, colony count, IVP, cystoscopy, renal biopsy
Pyloric stenosis
GI series, gastroscopy, sonogram
Pyridoxine deficiency
serum iron and iron binding capacity, blood pyridoxine, urine pyridoxic acid
Q
Q fever
serologic tests
R
Rabies
autopsy of infected animals, isolation of virus from saliva, serum and CSF antibody titer, fluorescent antibody stain of corneal or skin cells
Rat-bite fever
dark field examination, culture of lesion, aspiration and culture of regional lymph node, animal inoculation, serologic tests
Raynaud disease
ANA, lupus erythematosus prep, immunoelectrophoresis, cold agglutinins, cryoglobulins, skin or muscle biopsy, cold challenge
Reflux esophagitis
see Esophagitis
Regional enteritis
sedimentation rate, small bowel series, sigmoidoscopy or colonoscopy and biopsy, surgical exploration
Reiter disease
HLA typing, bone scan, synovial analysis
Relapsing fever
peripheral blood smear for Borrelia organisms, animal inoculation, serologic tests, total leukocytes, spinal tap
Renal calculus
IVP, CT scan, cystoscopy, retrograde pyelogram, sonogram, stone analysis
Renal tubular acidosis
serum electrolytes, calcium, phosphorus, alkaline phosphatase, urine calcium, phosphatase and bicarbonate, urine pH after ammonium chloride load
Respiratory distress syndrome
Ratio PaO2 to FiO2, pulmonary artery catheterization
Reticuloendotheliosis
X-ray, CBC, tissue cholesterol content, biopsy of skeletal lesion, bone marrow, or lymph nodes
Reticulum cell sarcoma
alkaline phosphatase, lymph node biopsy, x-ray of chest, skeletal survey, GI series, IVP, cytologic examination of pleural or ascitic fluid
Rheumatic fever
throat culture, streptozyme test, C-reactive protein (CRP), sedimentation rate, ECG, echocardiogram, serial ASO titer
Rheumatoid arthritis
RA test, sedimentation rate, ANA, x-ray of joints, synovial fluid analysis
Riboflavin deficiency
activity coefficient of erythrocyte glutathione reductase
Rickets
serum calcium, phosphorus, alkaline phosphatase, urine calcium, x-ray of bones, serum PTH, serum 25-OHD, bone biopsy
Rickettsialpox
serologic tests
Rocky Mountain spotted fever
specific serologic tests, Weil–Felix test, fluorescent antibody staining of skin lesions
Rubella
viral isolation, latex agglutination card assay, other serologic tests
Rubeola
see Measles
S
Saddle embolus of aorta
oscillometry, Doppler flow study, aortogram
Salicylate intoxication
serum or urine salicylates, electrolytes
Salmonellosis
stool culture, febrile agglutinins
Salpingitis
vaginal smear and culture, sonogram, laparoscopy, exploratory surgery
Sarcoidosis
see Boeck sarcoid
Scabies
KOH prep
Scalenus anticus syndrome
x-ray of cervical spine, arteriogram
Scarlet fever
nose and throat culture, streptozyme test, Schultz–Charlton reaction
Schilder disease
EEG, CT scan, MRI, spinal tap, brain biopsy
Schistosomiasis
stool or urine for ova, rectal biopsy, liver biopsy, serologic tests
Schönlein–Henoch purpura
urinalysis, platelet count, coagulation profile, bleeding time, capillary fragility
Schuller–Christian disease
see Hand–Schuller–Christian disease
Scleroderma
ANA, RA test, anticentromere antibody titer, skin biopsy, esophagram, malabsorption workup
Scurvy
serum ascorbic acid, capillary fragility, x-ray of bones, therapeutic trial
Seminoma
urine hCG, sonogram, exploratory surgery, α fetoprotein
Septicemia
blood culture
Sexual precocity
skull x-ray, CT scan, urine 17-ketosteroids and 17-hydroxysteroids, plasma cortisol, metyrapone test, exploratory surgery
Shigellosis
stool examination for leukocytes, stool culture
Sickle cell anemia
CBC, blood smear, sickle cell preparation, hemoglobin electrophoresis
Silicosis
chest x-ray, pulmonary function tests, ABG, lung biopsy, CT scan
Silo-filter's disease
chest x-ray, clinical observations
Simmond disease
see Hypopituitarism
Sinusitis
x-ray of sinuses, CT scan of sinuses, nose and throat culture, erythrocyte sedimentation rate (ESR), CRP
Sjogren syndrome
Schirmer test for tear production, ANA, RA titer, HLA typing, thyroglobulin antibody titer, anti-Sjogren syndrome B (La) antibody titer
Smallpox
smear of vesicular fluid for virus particles, viral isolation, serologic test
Spherocytosis, hereditary
CBC, blood smear, red cell fragility test, reticulocyte count, serum haptoglobins, bilirubin
Spinal cord tumor
x-ray of spine, CT scan of spine, MRI
Spinal stenosis
CT scan, MRI, myelogram
Sporotrichosis
cultures of exudates from ulcer, serologic tests, skin tests, chest x-ray
Staphylococcal pneumonia
sputum smear and culture, chest x-ray
Steatorrhea
see Celiac disease
Stein–Leventhal syndrome
culdoscopy, laparoscopy, serum LH, urine 17-ketosteroids, sonogram, exploratory surgery, biopsy of ovaries
Stevens–Johnson syndrome
streptozyme test, nose and throat culture
Still disease
RA test, sedimentation rate, CRP, synovianalysis
Stokes–Adams syndrome
ECG, Holter monitoring, event monitoring, electrophysiologic testing
Streptococcal pharyngitis
see Pharyngitis
Strongyloidiasis
stool or duodenal aspirate for ova and parasites
Sturge–Weber syndrome
skull x-ray, CT scan, MRI
Subacute bacterial endocarditis
blood culture, bone marrow cultures, echocardiogram, RA test, FTA–ABS, transesophageal echocardiography
Subarachnoid hemorrhage
CT scan of brain, spinal tap, arteriogram
Subdiaphragmatic abscess
chest x-ray, gallium scan, indium scan, CT scan, needle aspiration, exploratory surgery
Subdural hematoma
CT scan, MRI, arteriogram
Subphrenic abscess
see Subdiaphragmatic abscess
Substance abuse
blood alcohol level, urine drug screen, CAGE questionnaire
Sulfhemoglobinemia
shaking of venous blood in test tube, spectroscopic examination of blood
Syphilis
blood and spinal fluid venereal disease research laboratory (VDRL) test or FTA–ABS, dark field microscopy
Syringomyelia
CT scan, myelogram, MRI
T
Tabes dorsalis
blood and spinal fluid, FTA–ABS
Takayasu disease
CT scan of aorta, aortogram, serum protein electrophoresis
Tapeworm infections
stool for ova and parasites, serology, sonogram, CT scan
Tay-Sachs disease
cortical biopsy
Temporal arteritis
sedimentation rate, biopsy of temporal artery
Tetanus
clinical diagnosis, positive culture does not establish diagnosis
Thalassemia
CBC, blood smear, reticulocyte count, serum haptoglobin, hemoglobin electrophoresis
Thromboangiitis obliterans
see Buerger disease
Thrombocythemia (thrombasthenia)
platelet count, bleeding time, clotting time, clot retraction, capillary fragility
Thrombocytopenic purpura, idiopathic
coagulation profile, platelet count, platelet antibody titer, bone marrow, liver–spleen scan, capillary fragility
Thrombophlebitis
impedance plethysmography, compression ultrasonography, fibrinogen I 125 scan, venogram, thermogram, ultrasonography
Thymoma
chest x-ray, CT scan of mediastinum, mediatinoscopy, exploratory thoracotomy
Thyroiditis, subacute
FT4 index, RAI uptake and scan, sedimentation rate, antithyroid autoantibodies
Thyroid nodule
RAI uptake and scan, fine-needle aspiration, biopsy, FT4 index, sonogram, trial of thyroid suppression therapy
Tonsilitis
see Pharyngitis
Torsion of testicle
ultrasonography, radionuclide scintigraphy
Tourette syndrome
clinical diagnosis
Torulosis
see Cryptococcosis
Toxemia of pregnancy
see Eclampsia
Toxoplasmosis
indirect fluorescent antibody (IFA) titer, passive hemogglutination test (PHA), skin test, animal inoculation
Trachoma
smear of conjunctival scrapings, culture for Chlamydia, tears for microimmunofluorescent antibodies
Transfusion reaction
serum hemoglobins and methemalbumin, Coombs test
Transient ischemic attack (TIA)
carotid scan, digital subtraction angiogram, CT scan, four-vessel cerebral angiogram, MRI
Trichinosis
eosinophil count, skin test, serologic tests, muscle biopsy
Trypanosomiasis
smears and culture of blood, CSF, lymph node aspirate for parasites, animal inoculation, serology
Tuberculosis
smear and culture of sputum and gastric washings, Guinea pig inoculation, skin test, chest x-ray, CT scan
Tuberosclerosis
skull x-ray, CT scan, skin biopsy, cortical biopsy, EEG
Tularemia
smear and culture of ulcer, lymph nodes, or nasopharynx; Foshay skin test; serologic tests
Turner syndrome
buccal smear for chromatins (Barr bodies), chromosome analysis
Typhoid fever
culture of stool, blood, or bone marrow; febrile agglutinins
Typhus, epidemic
serologic tests, Weil–Felix reaction
Typhus scrub
isolation from blood, serologic tests, Weil–Felix reaction
U
Ulcer
see Peptic ulcer
Ulcerative colitis
barium enema, sigmoidoscopy or colonoscopy, biopsy
Urethritis
urethral smear and culture, vaginal smear and culture, urine culture, Chlamydia culture, cystoscopy
Uterine fibroids
sonogram, CT scan, MRI
Urticaria
RAST, allergic skin testing, elimination diet, C'I esterase inhibitor
Uveitis
slit-lamp examination, ANA, HLA-B27 typing, VDRL, lyme serology
V
Varicella
serologic tests
Varicose veins
phlebogram, thermogram
Variola
see Smallpox
Ventricular septal defects
ECG, echocardiogram, cardiac catheterization
Visceral larva migrans
blood typing, serologic tests, biopsy
Vitamin A deficiency
serum vitamin A or carotene, skin biopsy
Vitamin B deficiency
see Beriberi
Vitamin C deficiency
see Scurvy
Vitamin D deficiency
see Rickets
Vitamin K deficiency
coagulation profile including prothrombin time
Von Gierke disease
see Glycogen storage disease
Von Willebrand disease
coagulation profile, thromboplastin-generation test, factor VIII assay
W
Waterhouse–Friderichsen syndrome
blood cultures, spinal fluid examination, nose and throat culture, plasma cortisol
Wegener granulomatosis
x-ray of nose, sinuses, and chest; urinalysis; renal biopsy; lung biopsy; nasal biopsy; antineutrophil cytoplasmic antigen (ANCA)
Weil disease
dark field examination of blood, Guinea pig inoculation, serologic tests, spinal tap
Wernicke encephalopathy
response to intravenous thiamine
Whipple disease
small-bowel series, lymph node biopsy, jejunal biopsy, malabsorption tests
Whooping cough
see Pertussis
Wilson disease
urine copper and amino acids, serum copper and ceruloplasmin, liver biopsy, slip-lamp examination of cornea, uric acid
Y
Yaws
dark field examination, serologic tests
Yellow fever
viral isolation, serologic tests, liver biopsy
Z
Zollinger–Ellison syndrome
12-hour quantitative and basal gastric acid output (BAO) gastric analysis, serum gastrin, GI series, gastroscopy, exploratory laparotomy