Clinical Investigations at a Glance

Preface ix Acknowledgements x Abbreviations xi Overview of tests 1 1 Investigations and interpreting tests 2 2 Screening tests 4 3 Consent for investigations 6 4 Risks of tests 8 5 Genetic tests 10 6 Principles of radiological investigations 12 7 Cytology and histopathology tests 14 8 Presenting at radiology and histopathology meetings 16 9 Requesting tests 18 10 Therapeutic drug monitoring 20 11 Investigations in resource-limited settings 22 12 Tests for outpatient, inpatient and patients in intensive care 24 Common Presentations 27 13 Chest pain 28 14 Acute abdominal pain 31 15 Headache 34 16 Nausea and vomiting 36 17 Diarrhoea 38 18 Constipation 40 19 Haematemesis and melaena 42 20 Rectal bleeding 44 21 Dyspepsia 46 22 Dysphagia 50 23 Weight loss 52 24 Obesity 54 25 Fatigue 56 26 Coma and impaired consciousness 58 27 Preoperative investigations for elective surgery 60 28 Syncope 62 29 Back pain 64 30 Peripheral oedema 66 31 Jaundice 68 32 Meningitis 70 33 Anaemia 72 34 Lymphadenopathy 74 35 Cough 76 36 Haemoptysis 78 37 Palpitations and cardiac arrhythmias 80 38 Red eye 82 39 Vertigo 84 40 Urinary tract infection 86 41 Haematuria 88 42 Attempted suicide and self-poisoning 90 43 Immunosuppressed patients 92 44 Diagnosing death 94 45 Shock 96 46 Trauma 98 47 Alcohol-use disorder 104 48 Eating disorders 106 49 Seizure 108 50 Muscle weakness 110 51 Visual loss 112 52 Hearing loss 114 Conditions 117 Cardiovascular disease 53 Heart failure 118 54 Peripheral arterial disease 120 55 Infective endocarditis 122 56 Aortic disease 124 57 Hypertension 126 58 Hyperlipidaemia 128 Respiratory disease and sleep disorders 59 Pneumonia 130 60 Asthma 132 61 Chronic obstructive pulmonary disease 134 62 Pleural effusion 136 63 Pneumothorax 138 64 Pulmonary embolism 140 65 Pulmonary hypertension 144 66 Pulmonary nodules 146 67 Interstitial lung disease 148 68 Sleep disorders 150 Gastroenterology and hepatology 69 Ascites 152 70 Intestinal obstruction 154 71 Malabsorption 156 72 Inflammatory bowel disease 158 73 Irritable bowel syndrome 160 74 Colorectal cancer 162 75 Liver mass 164 76 Cirrhosis 166 77 Liver function tests 168 78 Acute pancreatitis 170 Nephrology and urology 79 Acute kidney injury 172 80 Chronic kidney disease 174 81 Metabolic acid–base disorders 176 82 Potassium disorders 178 83 Sodium disorders 180 84 Calcium disorders 182 85 Proteinuria 184 86 Renal mass 186 87 Kidney stones 188 88 Renal artery stenosis 190 Endocrinology 89 Diabetes mellitus: diagnosis 192 90 Diabetes mellitus: complications 194 91 Diabetes insipidus 196 92 Thyroid disorders 198 93 Thyroid function tests 202 Pituitary disorders 94 Hypopituitarism 204 95 Acromegaly 206 96 Hyperprolactinaemia 208 Adrenal disorders 97 Adrenal insufficiency 210 98 Adrenal incidentaloma 212 99 Cushing’s syndrome 214 100 Phaeochromocytoma 216 101 Primary hyperaldosteronism 218 Reproductive and obstetric medicine 102 Male hypogonadism 220 103 Infertility 222 104 Erectile dysfunction 224 105 Amenorrhoea 226 106 Hirsutism 228 107 Polycystic ovary syndrome 230 108 Pre-eclampsia and hypertensive disorders in pregnancy 232 109 Pregnancy 234 Infectious diseases 110 Pyrexia of unknown origin 236 111 Leucopenia and febrile neutropenia 238 112 Illness in returned travellers 240 113 Sepsis 242 114 Sepsis: testing for infectious diseases 244 115 Osteomyelitis 246 116 Sexually transmitted diseases 248 117 Tuberculosis 250 118 HIV 252 Haematology 119 Leucocytosis 254 120 Myelodysplastic syndromes 256 121 Erythrocytosis 258 122 Haemolytic anaemia 259 123 Leukaemia 262 124 Lymphoma 264 125 Multiple myeloma 266 126 Platelet disorders 268 127 Bleeding disorders 270 128 Thrombophilia 272 Oncology 129 Breast cancer 274 130 Spinal cord compression 276 131 Cancer of unknown primary 278 132 Tumour markers 280 133 Ovarian cancer 282 134 Prostate cancer 284 Neurology 135 Stroke 286 136 Haemorrhagic stroke 288 137 Brain abscess 291 138 Encephalitis 292 139 Brain tumours 294 140 Multiple sclerosis 296 141 Spinal cord disorders 298 142 Peripheral neuropathy 300 143 Movement disorders 304 Rheumatology 144 Septic and crystal arthropathies 306 145 Osteoarthritis 309 146 Spondyloarthropathies 310 147 Scleroderma and Raynaud’s phenomenon 313 148 Rheumatoid arthritis 316 149 Systemic lupus erythematosus 318 150 Sjögren’s syndrome 322 151 Vasculitis 324 152 Polymyalgia rheumatica and giant cell arteritis 326 153 Osteoporosis 328 Geriatric and general medicine 154 Dementia 330 155 Delirium 332 156 Falls 334 157 Urinary incontinence 336 Clinical immunology and allergy 158 Allergy and anaphylaxis 338 159 Primary immunodeficiency disorders 340 Dermatology 160 Skin cancers 342 161 Skin rashes 344 162 Urticaria and angioedema 346 Further reading 348 Index 352