Diagnosis of Fetal alcohol syndrome
Fetal alcohol syndrome Diagnosis: Book Excerpts
Diagnosis of Fetal alcohol syndrome: medical news summaries:
The following medical news items
are relevant to diagnosis and misdiagnosis issues for Fetal alcohol syndrome:
Diagnostic Tests for Fetal alcohol syndrome: Online Medical Books
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Alcohol-related disorder:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
For characteristic findings in patients with alcoholism, see Diagnosing substance dependence and related disorders, page 430.
Clinical findings may help support the diagnosis of alcohol-related disorder. For example, laboratory tests can confirm alcohol use and complications and document recent alcohol ingestion. A blood alcohol level ranging from 0.08% to 0.10% weight/volume (200 mg/dl) is accepted as the level of intoxication, depending on the state or country. The blood alcohol level in a physically dependent and tolerant drinker may exceed levels that would cause severe dysfunction or death in a nontolerant drinker. For example, a tolerant drinker might have a blood alcohol level of more than 0.5 mg (the usual lethal level) and still be alive, talking, and moving.
In severe hepatic disease, the blood urea nitrogen level is increased, and the serum glucose level is decreased. Further testing may reveal increased serum ammonia and amylase levels. Urine toxicology studies may help determine if the patient with alcohol withdrawal delirium or another acute complication abuses other drugs as well.
Liver function studies revealing increased levels of serum cholesterol, lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, and creatine phosphokinase may point to liver damage, and elevated serum amylase and lipase levels point to acute pancreatitis. A hematologic workup can identify anemia, thrombocytopenia, increased prothrombin time, and increased partial thromboplastin time.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Cesarean birth:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Special tests and monitoring procedures provide early indications of the need for cesarean birth:
❑ Magnetic resonance imaging or clinical pelvimetry reveals CPD and malpresentation.
❑ Ultrasonography shows pelvic masses that interfere with vaginal delivery and fetal position.
❑ Auscultation of fetal heart rate (by fetoscope, Doppler unit, or electronic fetal monitor) determines acute fetal intolerance of labor.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Cholelithiasis and related disorders:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Echography and X-rays detect gallstones. Other tests may include the following:
❑ Abdominal computed tomography scan or ultrasound reflects stones in the gallbladder.
❑ Percutaneous transhepatic cholangiography, done under fluoroscopic control, distinguishes between gallbladder or bile duct disease and cancer of the pancreatic head in patients with jaundice.
❑ Endoscopic retrograde cholangiopancreatography visualizes the biliary tree after insertion of an endoscope down the esophagus into the duodenum, cannulation of the common bile and pancreatic ducts, and injection of contrast medium.
❑ HIDA scan of the gallbladder detects obstruction of the cystic duct.
❑ Oral cholecystography shows stones in the gallbladder and biliary duct obstruction.
An elevated icteric index and total bilirubin, urine bilirubin, and alkaline phosphatase levels support the diagnosis. The white blood cell count is slightly elevated during a cholecystitis attack. Differential diagnosis is essential because gallbladder disease can mimic other diseases (myocardial infarction, angina, pancreatitis, pancreatic head cancer, pneumonia, peptic ulcer, hiatal hernia, esophagitis, and gastritis). Serum amylase levels distinguish gallbladder disease from pancreatitis. With suspected heart disease, serial cardiac enzyme tests and electrocardiography should precede gallbladder and upper GI diagnostic tests.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Alcoholism:
Diagnosis
(Handbook of Diseases)
For characteristic findings in patients with alcoholism, see Diagnosing substance dependence and related disorders, page 286.
Laboratory values may help support the diagnosis of alcoholism — for example, they can confirm alcohol use and complications and indicate recent alcohol ingestion:
Blood alcohol level of 0.10% weight/volume (200 mg/dl) is accepted as the level of intoxication.
Blood urea nitrogen level rises in severe hepatic disease.
Blood glucose level is decreased.
Serum ammonia and amylase levels are increased.
Urine toxicology studies may help detect other types of drug abuse in patients with alcohol withdrawal delirium or another acute complication.
Liver function studies reveal increased levels of serum cholesterol, lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, and creatine kinase (which indicate liver damage) and elevated serum amylase and lipase levels (which indicate acute pancreatitis).
Blood studies may identify anemia, thrombocytopenia, increased prothrombin time, and increased partial thromboplastin time.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Cholelithiasis, cholecystitis, and related disorders:
Diagnosis
(Handbook of Diseases)
Ultrasonography and X-rays detect gallstones. Specific procedures include the following:
❑ Ultrasonography reflects stones in the gallbladder with 96% accuracy.
❑ Percutaneous transhepatic cholangiography allows imaging under fluoroscopic control to help distinguish between gallbladder or bile duct disease and cancer of the pancreatic head in patients with jaundice.
❑ Endoscopic retrograde cholangiopancreatography visualizes the biliary tree after insertion of an endoscope down the esophagus into the duodenum, cannulation of the common bile and pancreatic ducts, and injection of contrast medium.
❑ Hepatobiliary iminodiacetic acid analogue scan of the gallbladder helps detect obstruction of the cystic duct.
❑ Computed tomography scan, although not routinely used, helps distinguish between obstructive and nonobstructive jaundice.
❑ Plain abdominal X-rays identify calcified but not cholesterol stones with 15% accuracy.
❑ Oral cholecystography shows stones in the gallbladder and biliary duct obstruction.
Elevated icteric index and elevated total bilirubin, urine bilirubin, and alkaline phosphatase levels support the diagnosis. White blood cell count is slightly elevated during a cholecystitis attack.
Differential diagnosis is essential because gallbladder disease can mimic other diseases (myocardial infarction, angina, pancreatitis, pancreatic head cancer, pneumonia, peptic ulcer, hiatal hernia, esophagitis, and gastritis). Serum amylase levels help distinguish gallbladder disease from pancreatitis. With suspected heart disease, cardiac enzyme testsand an electrocardiogram should precede gallbladder and upper GI diagnostic tests.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
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