Overview of Medical Investigations.pdf

Overview of Medical Investigations.pdf

1. Overview of Medical Laboratory
Investigations And other
Investigations
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Dr. C V Karunarathna, MBBS (Kelaniya), MSc in Community Medicine(Colombo)
Medical Officer –Training
Provincial Health Training Centre North Central Province.

2. Objectives
´To understand what medical laboratory investigations/Medical
investigations are
´To know the types of medical laboratory investigations/other investigations
´To understand the importance of knowing about investigations as a
caregiver
´Getting familiar with some selected , basic and common investigations.
´Get to know the importance of preparation for some specific
investigations

3. Medical Investigations
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´Amedicalprocedurethatinvolvestestingasampleofblood,urine,
otherbodyfluids,cells,tissueorotherprocedurescarriedoutona
personwhichhelpsindiagnosisandmanagementofadisease
condition.
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4. Types of Medical Investigations
´Biochemical Ix (ෛජව ෛවද% ප'(ෂණ )
´Blood Ix (LFT/RFT/LIPID Profile/FBS/PPBS/HbA1C/Trop I/ Na/K)
´Urine Ix (UFR)
´Body fluids( Peritoneal fluid/CSF/Plural fluid/Sputum/Saliva)
´Hematological Ix (ර(තෙ.ද ප'(ෂණ )
´FBC/ Blood Picture/PT/INR
´Cytological/Histological Ix (ෛසල හා පටකප'(ෂණ )
´Immunological Ix (ප6ශ(6කරණය ස9බ;ධ ප'(ෂණ)
´Microbiological Ix ((=ද?වප'(ෂණ )
´Gram stain/Culture ABST/Viral/Fungal studies/Serology
´Radiological Ix (@Aරණෙ.ද ප'(ෂා )
´USS/MRI/CT/Angiogram
´Other procedures
´Endoscopy, ECG, Hearing tests, Vision tests

6. Types of
Investigations
Bed
side/Chair
side
Laboratory
Investigations
Other
medical
procedures

7. Types of Investigations
´Chair side/Bed side investigations
´RAT
´Urine HCG,
´Urine dipstick tests for Protein, Sugar
´CBS
´ECG

8. Types of investigations ctd….
´Laboratory Investigations
Urine
Blood
Other body fluids
Tissue

9. Types of investigations ctd….
´Other Medical Procedures
´Radiological investigations
´Endoscopy

10. Types ctd…..
Types of
Investigations
Screening TestsDiagnostic testsRoutine
investigations
Special
Investigations

11. Why you need to know
about investigations as a
Caregiver ?

13. Investigations alone can not help in the
management of the patient.
In a hospital/Clinical setting-
Doctors/Nurses
´History
´Examination
´Investigations
´Diagnosis
´Management
´Follow up
At Home/Care Institution
Caregiver
´Patient Assessment(Physical, Mental, Medical conditions)
´Preparing a Care plan
´Maintain Nutrition of the client
´Administering drugs
´Appointments for tests
´Preparation for investigations
´Identify emergency situations
´When to seek help for the client

15. When you read an Lab investigation
´Check for
´Name
´Age
´Date
´Compare with previous
investigations.
´Look who has referred
´Check from where the
investigation has done.
´Reference range (There can be
slight difference from lab to lab)
´Units (May differ)

16. Common Laboratory Investigationsa
caregiver should know
´Some of bed side/Lab
investigations
´Content
´Uses
´Preparation
´Values

17. Full Blood Count (FBC)
´White blood cells
´Red blood cells
´Hb(Haemoglobin)
´Platelets
´No need of special preparation

18. ESR
´Detection of inflammation in
body.
´Increase in
Inflammation(Artherites)
´Long-term illnesses/infections
´Cancer
No need of special preparation

19. C reactive protein (CRP)
´High in acute infections/injury
´Or in chronic infections
´No Special Preperation

20. Blood Sugar evaluation
´Capillary Blood Sugar (CBS)
´Random Blood Sugar (RBS)
´Fasting Blood Sugar (FBS)
´Post Prandial Blood Sugar (PPBS)
´HbA1C
´Oral Glucose Tolerance Test(OGTT)

21. Capillary Blood Sugar (CBS)
´Bed side test
´Glucometer
´Need to know how to check (Skills)
´Range
´Low Level –70 mg/dl
´High level ->126 mg/dl (Fasting)
´> 180/200 mg /dl (symptomatic)
´HI
´Look for the symptoms of hypoglycemia/Hyperglycemia
´No need of special preparation

22. Random Blood Sugar (RBS)
´Venous blood sample
´A blood sugar level less than 140
mg/dLis normal.
´A reading of more than 200
mg/dLafter two hours means
you have diabetes.
´A reading between 140 and 199
mg/dLprediabetes.
´> 200 mg/dl consider as high
´No need of special preparation

23. Fasting blood sugar (FBS)
´Venous Blood sample
´Diagnosis
´100-125mg/dl Pre-diabetic
´=/> 126 mg/dl with symptoms
diabetes +
´=/> 126 mg/dl without symptoms
repeat test
´Treatment
´126-200 mg/dl –one drug
´>200 mg/dl –start with two drugs
´>300 mg/dl /
complications/severe symptoms -
2/3 drugs with insulin.
´Maintenance
´Diabetic patient-Glycemic target
(FBS-80-130 mg/dl )

24. FBS ctd
´Preparation
´8-10 hour overnight fasting
´Avoid caloric food drink
´Can take water

25. Post Prandial Blood Sugar (PPBS)
´Venous Blood
´2 hours after meal
´Timing stats from the start of the
meal
´Usual antidiabetic drugs should
be taken in regular intervals
Range
< 140 mg/dl for normal person
< 180 mg/dl for a diabetic patient
(glycemic control)

26. HbA1C
´Venous blood
´No need preparation
´Long term control of blood sugar
´Over past 3 months
´=/> 6.5%
cut off for diagnosis
´Control –7%
´Individualized glycemic targets
´HbA1C level will high with advanced aging and other diseases

27. Lipid Profile
´Venous Blood
´Cholesterol levels
´Need 12 Hour Overnight fasting
´Can take small amount of water
´Total Cholesterol -<200 mg/dl
´Triglycerides -,150 mg/dl
´LDL -< 100 mg/dl
´HDL -> 60 mg/dl
´VLDL

28. TSH/T3/T4
´TSH -thyroid stimulating hormone
´Blood test that measures this
hormone.
´TSH levels that are too high or too
low may be a sign of a thyroid
problem.
´T3/T4 Thyroid hormone levels

29. B.Urea,S.Cr,eGFR
´Blood investigations
´Kidney function
´Venous Blood samples
´To test the renal (kidney)functions
´eGFR< 60 –Kidney damage
´No need fasting
´Hydrate well before test

30. Liver Function Tests (LFT)
´Liver function tests
´Liver function
´Liver profile
´Venous blood
´No need preparation
´AST
´ALT
´ALP
´GGT
´Bilirubin
´Protein(Albumin/Globulin)

31. ECG
´Check your heart's rhythm and
electrical activity.
´Heart rate
´Rhythm
´Wall function abnormalities(Heart
attacks/Heart failure)
´Abnormal electrical activity

32. Other Cardiac investigations
´Troponin I
´Echocardiogram
´Angiogram

33. Urine Full Report (UFR)
Done in a laboratory.
´Color, cloudiness and
concentration of the urine.
´Chemical composition
-Using a test strip.
´Examination of the urine
Under a microscope
to look for bacteria, cells and parts
of cells.
No need special preparation
Collect to UFR normal bottle

34. Urine Culture
´A urine culture is a lab test to
check for bacteria or other germs
in a urine sample.
´How to collects
´sterile urine bag,
´urethral catheterization (CATH),
suprapubic aspiration (SPA),
´Clean-catch (CC)

35. Urine culture
´Clean catch/Midstream urine sample
´Wash your hands
´Clean the surrounding area –tip of penis
(push back foreskin if needed) for men and in
between the labia for women
´Start to urinate, stop if possible or wait until
the first part of urine has passed, then using
your container capture a midstream urine
sample.
´Void the rest of urine
´close the container ,wipe the specimen
container and wash your hands.

36. Urine Culture
´Culture and ABST

37. USS Abdomen/Pelvis
´Full bladder
´Fasting
´Don't give /eat solid food for 6
hours before the ultrasound.
´Drink 4 to 6 cups of water 1 hour
before your ultrasound.
´Don't urinate (pee) before the
ultrasound.

38. Ctd..
´Chest X-ray
´Abdominal x-ray
´X-ray head, neck, limbs, Spine

39. X ray KUB
´Fasting
´Bowel preparation

40. Summery
´Always clarify your doubts. Ask from Doctor and Nurse
´Prepare for investigations(Fasting, Premedication, Bladder bowel
preparations, Pre-investigations, Pre-consultations, Need admission)
´Get the investigations timely and get the opinion.
´Always check the name, date, relaentdetails to confirm.
´Things to consider after the investigations
´Know the basics
´Maintain Confidentiality

41. Thank You!