Diagnostic Tests for Hypoglycemic attack
Hypoglycemic attack Tests: Book Excerpts
Home Diagnostic Testing
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Hypoglycemic attack Diagnosis: Book Excerpts
Diagnostic Tests for Hypoglycemic attack: Online Medical Books
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HYPOGLYCEMIA:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
The finding of hypoglycemia on routine blood analysis requires nothing in an asymptomatic patient. If there is doubt, a repeat analysis should be done. If the patient is symptomatic, a 5-hr glucose tolerance test or hospitalization for repeated blood sugar during a 72-hr fast should be done. If these are negative, the patient most likely has functional hypoglycemia. Additional tests to order include a T
4
, plasma, cortisol, plasma growth hormone assay, plasma proinsulin, C-peptide, plasma insulin, CT scan of the abdomen, and a tolbutamide tolerance test. Obtain an endocrinology consult.
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Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
Hypo/Hyperpigmentation:
Diagnostic Approach
(Field Guide to Bedside Diagnosis)
ABCDE criteria and their histopathological counterparts are: Asymmetry—If the lesion bisected in half is not identical to the other half, consistent with asymmetrical architecture at scanning magnification. Border—Border is uneven or ragged as opposed to smooth and straight; consistent with poor lateral circumscription (single cell extension along junction). Color—More than one shade of pigment is present; consistent with atypical melanocytes at various levels of the epidermis (brown/black) and thickening and fibrosis of the papillary dermis with loss of melanin from the epidermis (white-regression). Diameter—.6 mm; consistent with broad extension of melanocytes along
the junction. Evolving—Changed with respect to size, shape, symptoms (e.g., itching or tenderness), surface (e.g., bleeding) or shades of color. This will pick up 78% of nodular melanomas, which present at a more advanced stage but do not have the other signs.
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Source: Field Guide to Bedside Diagnosis, 2007
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