|
DISEASE
|
SPECIMEN
|
TEST
|
RESULTS & INTERPRETATION
|
|
Acute abdomen
|
Urine
|
Glucose
|
+ consider diabetic acidosis
|
|
|
Urine
|
Ketones
|
+ confirmative, consider diabetic ketoacidosis
|
|
|
Urine
|
Urobilinogen
|
+ consider malaria, thallasemia, sickle cell disease, other liver disease, drug intoxication
|
|
|
Urine
|
Nitrite
|
+ consider urinary tract infection
|
|
|
Urine
|
Bilirubin
|
+ consider hepatitis, leptospirosis, other liver disease
|
|
|
Stool
|
Blood
|
+ consider enteric (typhoid) fever
|
|
|
Blood smear
|
Blood smear: Schizonts Trophozoites Gametocytes
|
Patients can present with acute abdominal pain, guarding and rigidity, mimicking bowel perforation, acute appendicitis, acute cholecystitis, ureteric colic, etc. (Malaria can mimick almost anything!)
|
|
|
|
|
|
|
African sleeping sickness
|
Blood
|
Sedimentation rate
|
Very high (above 60), confirmative; Intermediate (30-60), doubtful; Normal (below 30), eliminates
|
|
Human African Trypanosomias
|
Blood
|
Blood smear
|
A wet smear of unstained blood or Giemsa-stained thick smear (more sensitive) is used to observe the mobile trypanosomes It requires immediate search for parasites because they are mobile for only 15-20 minutes.
|
|
|
Blood
|
Hemoglobin
|
Low, confirmative
|
|
|
Lymph
|
Lymph node aspiration
|
A rapid test for trypanosomes at a high dry magnification (X 400). It requires immediate search for parasites because they are mobile for only 15-20 minutes.
|
|
|
Cerebrospinal fluid
|
Lumbar puncture
|
Lumbar puncture should always be performed in patients with parasitemia or lymphadenopathy. The double centrifugation technique is the most sensitive method to detect the trypanosomes
|
|
AIDS
|
Urine
|
Ketones
|
+ confirmative
|
|
|
Blood
|
Formol gel
|
+ confirmative
|
|
|
Blood
|
Hemoglobin
|
Low, confirmative
|
|
|
Blood
|
Dry Mount
|
Significant puddling and dyscrasia in active and late stages
|
|
|
Saliva
|
OraQuick dipstick
|
Orasure Technologies, Medford, N.Y.
|
|
|
Blood
|
Whole blood dipstick
|
+HIV-1, Hema Diagnostic Systems, U.S.
|
|
Allergy
|
Urine
|
Nitrite
|
+ consider urinary infection
|
|
|
Urine
|
Bilirubin
|
+ consider liver disease
|
|
|
Stool
|
Hematest
|
+ consider schistosomes, other worms
|
|
|
Blood
|
Dry Blood Mount
|
Pock marks to puddling indicates the amount of free radical damage from the dietary due to silent (humoral) inflammation
|
|
|
Skin
|
Patch or Scratch test
|
+ if skin reddens as a reaction to the antigen
|
|
Ameobic liver disease (abscess)
|
Urine
|
Bilirubin
ErlichÕs diazo reagent
|
+ confirmative
+ confirmative Pink or Red
|
|
|
Blood
|
White Cell Count
|
There is usually a moderate leucocytosis accompanied by an absolute or relative increase in neutrophils.
|
|
|
Blood
|
Hemoglobin
|
Anemia is common in ALA.
|
|
|
Stool
|
Microscopic
|
If it reveals cysts or vegetative forms of E. Histolytica, it becomes a valuable aid in the diagnosis. However, in endemic areas, where the incidence of carriers is high, presence of cysts of E. Histolytica should not be given too much importance.
|
|
Ameobic dysentery
|
Stool
|
Microscopic
|
If it reveals cysts or vegetative forms of E. Histolytica, it becomes a valuable aid in the diagnosis. However, in endemic areas, where the incidence of carriers is high, presence of cysts of E. Histolytica should not be given too much importance.
|
|
|
Blood
|
White Cell Count
|
+ Leucocytosis, confirmative
|
|
Anemia
|
Blood
|
Hemoglobin
|
+Low; Normal, eliminates
|
|
|
Blood
|
Microscopic
|
Differential of microscopic and macroscopic forms
|
|
|
Stool
|
Hematest
|
+ confirmative, helps to find cause
|
|
Arterio/Athero-sclerosis
|
Blood
|
Cholesterol
|
+ > 200 mg.%
|
|
|
Blood
|
Microscopic Live Blood
|
+ Cholesterol chards
|
|
|
Nails
|
Capillary refill time
|
+ > 2 seconds
|
|
|
Skin
|
Head to toe temperatures
|
+ If the head temperature is 3¼C > than temp. at the bottom of the feet.
|
|
Arthritis
|
Blood
|
Sedimentation rate
|
Normal, implies arthritis due to previous injury or old age; High, implies other kinds of arthritis
|
|
|
Blood
|
Dry Blood Mount
|
Pock marks to puddling indicates the amount of free radical damage from the dietary due to silent (humoral) inflammation
|
|
|
|
|
|
|
Ascariasis
|
Urine
|
Ketones
|
+ indicates severe case
|
|
|
Stool
|
Microscopic
|
+ characteristic ova
|
|
|
Blood
|
White Cell Count
|
+ Eosinophilia
|
|
Asthma
|
Urine
|
Nitrite
|
+ consider urinary infection
|
|
|
Urine
|
Bilirubin
|
+ consider liver disease
|
|
|
Stool
|
Hematest
|
+ consider schistosomes, other worms (until proven otherwise)
|
|
|
Stool
|
Clinitest (4)
|
+ confirmative or milk intolerance
|
|
|
Blood
|
White Cell Count
|
+ Eosinophilia indicates allergy and/or parasitosis
|
|
|
Blood
|
Dry Blood Mount
|
Pock marks to puddling indicates the amount of free radical damage from the dietary due to silent (humoral) inflammation
|
|
Cancer
|
Blood mount
|
Lagoons with broken fields
|
+ confirmative
|
|
|
Blood
|
Sedimentation rate
|
High, severe disease, spreading malignancy
Normal or low, early disease or none
|
|
|
Blood
|
Hemoglobin
|
Low, confirmative
|
|
|
Urine
|
Carcinochrome reaction
|
+ Confirms, or raises suspicion levels when albuminuria is present
|
|
|
Blood
|
HartmanÕs & Koch Crenation Test
|
+ When 5 or more RBCÕs fail to crenate in 1% saline, in a microscopic field
|
|
|
Blood
|
Blood smear
|
+ characteristic presence of increased platelets (thrombocytosis)
|
|
Cancer, Cervical
|
Epithelial scraping
|
Pap test cytology
|
+ characteristic change in nuclei
|
|
|
Epithelia
|
SchillerÕs test
|
+ if cervix fails to retain tincture of iodine stain
|
|
Cancer, Bladder
|
Urine
|
Pap test cytology
|
+ characteristic change in nuclei
|
|
Cancer, Bronchopulmonary
|
Bronchial aspirate (sputum)
|
Pap test cytology
|
+ characteristic change in nuclei. Morning collection of sputum in smokerÕs can be preserved in vodka.
|
|
Cancer, Gastric
|
Gastric contents
|
Glycyltrophan test
|
+ Reddish color on addition of glucose & bromine
|
|
Cancer, Melanoma
|
Urine
|
ThormahlenÕs test
|
+ Deep blue color
|
|
|
Urine
|
Ferric chloride
|
+ Deep black color
|
|
Chaga's disease
|
Urine
|
Bilirubin
|
+ confirmative
|
|
American Trypanosomiasis
|
Urine
|
Urobilinogen
|
+ confirmative
|
|
Chlamydia
|
Whole Blood
|
Dipstick
|
+ confirmative; Hema Diagnostic Systems, U.S.
|
|
Cholera
|
Urine
|
Urobilinogen
|
+ consider malaria
|
|
|
Stool
|
Clinitest
|
- for cholera; confirmative for osmotic diarrhea or milk intolerance (a sensitive differential diagnosis)
|
|
Chronic Obstruc-tive Pulmonary Disease
|
Breath
|
Breath holding <20 sec.
Pitting edema
Capillary refill > 2 sec.
Tachycardia, dyspnea
|
+ confirmative
|
|
|
Breath
|
Match Test
|
+ Failure to blow out a match held 6 inches out, exhalation through pursed lips
|
|
Cirrhosis, hepatic
|
Urine
|
Urobilinogen
|
+ confirmative
|
|
|
Urine
|
Bilirubin
|
+ confirmative; - eliminates
|
|
|
|
|
|
|
|
Blood
|
Dry Blood Mount
|
Pock marks to puddling indicates the amount of free radical damage from the dietary due to silent (humoral) inflammation
|
|
|
|
|
|
|
Colic (simple)
|
Stool
|
Blood
|
+ consider some other cause
|
|
(see also acute abdomen, gall bladder disease, dysentery)
|
|
|
- confirms simple colic
|
|
|
Stool
|
Clinitest
|
+ consider milk intolerance
|
|
|
Enteric
|
Epsom salt challenge
|
+ of diagnostic and therapeutic value in Gallstone colic and severe constipation. From 2 to 4 teaspoonfuls in glass hot water taken at onset of a colicky attack may abort or stop the colic. The ordinary dose as a mild laxative is a heaping teaspoonful; as a cathartic, two to four teaspoonfuls. The taste may be improved, if necessary, by the addition of a little lemon juice and sugar.
|
|
Dehydration
|
Urine
|
Specific gravity
|
High, confirmative
Normal or low, eliminates
|
|
|
Urine
|
Color
|
+ Dark yellow (moderate) to deep orange/brown (severe)
|
|
|
Skin
|
Skin Tenting
|
High, confirmative
|
|
|
|
|
|
|
Dengue fever
|
Urine
|
Ketones
|
+ consistent
|
|
|
Urine
|
Blood
|
+ may be hemorrhagic fever
|
|
|
Stool
|
Blood
|
+ may be hemorrhagic fever
|
|
Depression
|
Blood
|
Sedimentation rate
|
Normal, confirmative; High, indicates a physical cause
|
|
|
Blood Pressure
|
Elevated right sided systole & diastole
|
|
|
Diabetes
|
Urine
|
Glucose
|
+ confirmative
|
|
|
|
|
- mild, well-treated, or over-treated
|
|
|
Urine
|
Ketones
|
+ confirmative, severe, under-treated
|
|
|
Blood
|
Glucose
|
+ High, confirmative, needs treatment; Low, over-treated or eliminates; Normal, well-treated or eliminates
|
|
|
Blood
|
Dry Blood Mount
|
Pock marks to puddling indicates the amount of free radical damage from the dietary due to silent (humoral) inflammation
|
|
Diarrhea
|
Stool
|
BenedictÕs test
|
+ Yellow orange to greenish (some sugar) is specific for osmotic diarrhea vs. enteropathic
|
|
Dysentery
|
Stool
|
Hematest
|
+ confirmative; - consider ordinary diarrhea
|
|
|
Urine
|
Nitrite
|
+ confirmative
|
|
Enteric (typhoid) fever
|
Stool
|
Hematest
|
+ confirmative, severe case
|
|
|
Urine
|
ErhlichÕs diazo
|
+ Pink or red
|
|
|
Urine
|
GerhardtÕs acetoacetic acid test
|
+ deep red
|
|
|
Urine
|
Nitrite
|
+ confirmative
|
|
|
Urine
|
Russo typhoid reaction
|
+ Early stages urine change light green to addition of 4 drops methylene blue, emerald green at the height, blue during the decline
|
|
|
Blood
|
White Blood Cell Count
|
+ Leucopenia
|
|
Filariasis
|
Urine
|
Protein
|
+ confirmative
|
|
|
Blood
|
BrugiaRapid
|
+ specific IgG4 antibodies against Brugia filarial parasites; BioDiagnostic Research SDN BHD, Malaysia
|
|
Gallbladder disease; gallstones
|
Urine
|
Bilirubin
|
+ confirmative
|
|
|
Enteric
|
Epsom salt challenge
|
+ of diagnostic and therapeutic value in Gallstone colic. From 2 to 4 teaspoonfuls in glass hot water taken at onset of a colicky attack may abort or stop the colic.
|
|
Gastroenteritis
|
Urine
|
Ketones
|
+ confirmative; - mild disease
|
|
|
Urine
|
Glucose
|
+ consider diabetes
|
|
|
Stool
|
Clinitest
|
+ consider milk intolerance
|
|
Giardiasis
|
Urine
|
Ketones
|
negative ; if + confirmative
|
|
|
Stool
|
Clinitest
|
+ consider milk intolerance
|
|
Gonorrhea
|
Urine/pus
|
Microscopy
|
+ confirmative with gram negative diplococci (in pairs)
|
|
|
Whole Blood
|
Dipstick
|
+ confirmative; Hema Diagnostic Systems, U.S.
|
|
Heart failure
|
Urine
|
Protein
|
+ confirmative
|
|
|
|
Breath holding <20 sec.
Pitting edema
Capillary refill > 2 sec.
Tachycardia, dyspnea
|
+ confirmative
|
|
|
Blood
|
Leucocytosis
|
+ confirmative, severe
|
|
Heat stroke
|
Urine
|
Blood
|
+ confirmative, severe
|
|
|
Urine
|
Protein
|
+ confirmative, severe
|
|
Hemorrhagic fever, viral
|
Urine
|
Blood
|
+ confirmative
|
|
|
Stool
|
Hematest
|
+ confirmative
|
|
|
Blood
|
Hemoglobin
|
Low, confirmative
|
|
Hepatitis
|
Urine
|
|