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What is the free T
4
? If this is elevated, think of hyperthyroidism.
What is the plasma cortisol? If this is elevated, think of Cushing's syndrome.
What is the plasma growth hormone? If this is ... DIAGNOSTIC WORKUP
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What is the calcium level? If this is increased, one should look for primary hyperparathyroidism and bone metastasis. These two findings can be further differentiated with parathyroid hormone (PTH) assay. If calcium is decreased, the ... DIAGNOSTIC WORKUP
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Is the patient receiving heparin therapy? As many as 27% of patients taking heparin have an elevated aspartate aminotransferase [AST, or serum glutamine-oxaloacetic transaminase (SGOT)], and 60% have an elevated alanine ... DIAGNOSTIC WORKUP
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What is the level of
creatine phosphokinase isoenzyme containing M and B subunits (MB-CPK)
? An elevated MB-CPK combined with elevated LDH is most likely due to a myocardial infarction, although ... DIAGNOSTIC WORKUP
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Normal fasting glucose is <110 mg/dL, impaired fasting glucose is 111–125 mg/dL, and diabetes mellitus is defined as a fasting glucose >126 mg/dL. Several values above normal are indicated before making a diagnosis of impaired fasting glucose or diabetes.
Differential> ... Workup and Diagnosis ... Treatment
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Diabetes mellitus is the most common endocrine disorder of childhood, affecting about 2/1,000 school-age children in the U.S. The absolute or relative lack of insulin results in an abnormal metabolic state, including hyperglycemia. Children with diabetes are at risk for the acute... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... To form a list of diagnostic possibilities in a case of hyperglycemia, one needs only to think of the endocrine glands. Considering the pancreas should prompt the recall of diabetes mellitus and glucogonomas. Considering the adrenal gland would prompt the recall of Cushing disease and
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... When the chemistry profile shows an elevation of these enzymes, recall the tissues that produce a large amount of these enzymes: the liver, heart, and skeletal muscles. This translates into hepatitis, myocardial infarction, and dermatomyositis as the principal conditions to
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... Developing a list of diagnostic possibilities for an elevated alkaline phosphatase level involves the use of biochemistry and physiology. As with other laboratory values, we need to know where alkaline phosphatase is produced, how it is transported, and how
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... Inadequate dietary preparation for glucose tolerance test
Impaired glucose tolerance
Gestational diabetes
Type 1 diabetes (B-cell destruction, usually leading to absolute insulin deficiency)
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... Pseudoelevation
Subpulmonic effusion
Diaphragmatic neoplasm
True Elevation
Intrathoracic conditions
Lobar or segmental atelectasis
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... Elevated Total Thyroxine, but Normal Free Thyroxine
Increased affinity of serum binding proteins for thyroxine (T4)
Increased affinity of albumin for T4
... References
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... Judith A. Fisher and M. Gina Glazier
Alkaline phosphatase (ALP) is an enzyme expressed on the plasma membrane of many cells. It has two primary sources: the liver (specifically, the biliary tree) and bones (it marks new... Approach ... Pictures
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... Judith A. Fisher and Douglas J. Ivins
In the practice of cost-effective medicine, no value is seen to routine laboratory testing. An antinuclear antibody titer (ANA) should only be ordered in cases of a clinical suspicion of a rheumatologic disease (also known as... Approach ... Pictures
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To form a list of diagnostic possibilities in a case of hyperglycemia,
one needs only to think of the endocrine glands. Considering the pancreas
should prompt the recall of diabetes mellitus and glucagonomas. Considering
the adrenal gland would prompt the recall of... Pictures
... READ EXCERPTS »
...
Developing a list of diagnostic possibilities for an elevated alkaline
phosphatase level involves the use of biochemistry and physiology. As with
other laboratory values, we need to know where alkaline phosphatase is
produced,
... READ EXCERPTS »
... Author:
Heidi Herrera, MD and Nickie Niforatos, MD
What to Do - Gather Appropriate Data
Glucose is the major source of energy for tissue metabolism, particularly
in the brain, where lack of alternate energy stores makes glucose an essential... Management ... Suggested Reading ... Pictures
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... Author:
Caroline Rassbach, MD
What to Do - Interpret the Data
Seizures are one of the most common neurologic conditions affecting children. The majority are short, self-limited seizures that occur secondary to
disorders... Suggested Readings
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The statistics for heart disease in women are staggering. Yet many don't know they are at risk, nor do they know the signs and symptoms of...
Safe exercise will prevent most injuries. But if you happen to suffer an injury, what can you do to get back in action as quickly as possible? Join...
An ejection fraction is a measurement of the amount of blood pumped out of the heart with each beat. Find out what the experts say are normal and...