Knowing Your Tests « Preventive Healthcare

KNOWING YOUR TESTS

ELECTROCARDIOGRAM (ECG)
STRESS TEST
PULMONARY LUNG FUNCTION TEST
CHEST X-RAY
BONE MINERAL DENSITOMETRY
ABDOMINAL ULTRASOUND
MAMMOGRAM
ULTRASOUND OF BREAST
PAP SMEAR
MRI
64-SLICE MSCT
HIGH-SENSITIVITY CRP
RHEUMATOID
BONE PROFILE
TUMOUR MARKERS
LIPID PROFILE
RENAL FUNCTION PROFILE
DIABETES
GOUT SCREENING
INFECTIOUS DISEASES
THYROID
AUDIOMETRY
DIETICIAN COUNSELLING
URINE
FULL BLOOD COUNT
LIVER FUNCTION PROFILE
CARDIAC SCREENING

KNOWING YOUR TESTS

ELECTROCARDIOGRAM (ECG)

An electrocardiogram (ECG) is a recording of the electrical activity of the heart over time produced by an electrocardiograph, usually in a noninvasive recording via skin electrodes. This display indicates the overall rhythm of the heart and weaknesses in different parts of the heart muscle. It is the best way to measure and diagnose abnormal rhythms of the heart, particularly abnormal rhythms caused by damage to the conductive tissue that carries electrical signals, or abnormal rhythms caused by levels of dissolved salts (electrolytes), such as potassium, that are too high or low and can identify damaged heart muscle.

STRESS TEST

A cardiac stress test is a medical test that indirectly reflects arterial blood flow to the heart during physical exercise. When compared to blood flow during rest, the test reflects imbalances of blood flow to the heart’s left ventricular muscle tissue – the part of the heart that performs the greatest amount of work pumping blood. The results may also be interpreted as a reflection on a person’s overall physical fitness.

PULMONARY LUNG FUNCTION TEST

This involves the measuring of breath which is, most common of the Pulmonary Function Tests (PFTs), measuring lung function, specifically the measurement of the amount (volume) and/or speed (flow) of air that can be inhaled and exhaled. The test is an important tool used for generating pneumotachographs which are helpful in assessing conditions such as asthma, pulmonary fibrosis, cystic fibrosis, and chronic obstructive pulmonary diseases.

CHEST X-RAY

A chest X-ray, commonly abbreviated CXR, is a projection radiograph (X-ray), taken by a radiographer, of the thorax which is used to diagnose problems in the lung, heart and spine.

BONE MINERAL DENSITOMETRY

This test works by measuring a specific bone or bones, usually the spine, hip, and wrist. The density of these bones is then compared with an average index based on age, sex, and size. The resulting comparison is used to determine risk for fractures and the stage of osteoporosis in an individual. The measurement is painless and non-invasive and is used to access bone health, monitor the rate of bone loss, detect osteoporosis and help monitor response to treatment.

ABDOMINAL ULTRASOUND

Abdominal ultrasound is a form of medical ultrasonography (medical application of ultrasound technology) to visualise abdominal anatomical structures. It uses transmission and reflection of ultrasound waves to visualise internal organs through the abdominal wall (with the help of gel which helps transmission of the sound waves). This test can provide information about the liver, gallbladder, spleen, pancreas, kidneys, ovaries, fallopian tubes, uterus, and urinary bladder, to detect abdominal masses and also to view blood flow to the abdominal organs.

MAMMOGRAM

Mammography is the process of using low-dose X-rays to examine the human breast. The goal of mammography is the early detection of breast cancer, typically through detection of characteristic masses and/or microcalcifications. Mammography reduces mortality from breast cancer. No other imaging technique has been shown to reduce risk, but breast self-examination (BSE) and physician examination are considered essential parts of regular breast care. Recommended for women aged 40 and above.

ULTRASOUND OF BREAST

A test that uses high-frequency sound waves to form images of tissues and other structures inside the breast to detect abnormalities. Recommended for women ages 40 and below.

PAP SMEAR

This is a screening test used in gynecology to detect premalignant and malignant processes in the ectocervix. Significant changes can be treated, thus preventing cervical cancer. In taking a Pap smear, a tool is used to gather cells from the outer opening of the cervix of the uterus and the endocervix. The cells are examined under a microscope to look for abnormalities. The test aims to detect potentially pre-cancerous changes which are usually caused by sexually transmitted human papillomaviruses (HPVs). The test remains an effective, widely used method for early detection of pre-cancer and cervical cancer. The test may also detect infections and abnormalities in the endocervix and endometrium.

MRI

Magnetic resonance imaging (MRI), is primarily a medical imaging technique most commonly used in radiology to visualize the structure and function of the body. It provides detailed images of the body in any plane. MRI provides much greater contrast between the different soft tissues, making it especially useful in neurological (brain), musculoskeletal, cardiovascular, and oncological (cancer) imaging.

64-SLICE MSCT

Computed tomography (CT) is a medical imaging method employing tomography. Digital geometry processing is used to generate a three-dimensional image of the inside of an object from a large series of two-dimensional X-ray images taken around a single axis of rotation to detect abnormality in various organs such as liver, gall, kidney, uterus and ovaries etc.

HIGH-SENSITIVITY CRP

To measure the CRP level, a “high-sensitivity” CRP or hs-CRP test needs to be performed and analyzed by a laboratory. This is an automated blood test designed for greater accuracy in measuring low levels of CRP, which allows the physician to assess cardiovascular risk. If a result in the low-risk range is found ( < 1 mg/L), it does not need repeating. Higher levels need repeating, and clinical evaluation as necessary.

RHEUMATOID

Rheumatism or Rheumatic disorder is a non-specific term for medical problems affecting the heart, bones, joints, kidney, skin and lung. Your blood may be tested for a marker called rheumatoid factor.

BONE PROFILE

Calcium- This test measures the levels of free calcium in the blood and helps to diagnose disorders of the bones, parathyroid gland, and some forms of cancer. It can also help diagnose nutritional deficiencies.

Phosphorus-High phosphorus levels can interfere with calcium absorption. This can eventually lead to poor bone maintenance and osteoporosis, or brittle bones. Excess phosphorus can also interfere with the absorption of iron.

TUMOUR MARKERS

Alpha-FetoProtein- AFP is the main tumor marker (sometimes with HCG) used to monitor testicular cancer, ovarian cancer, and malignant teratoma in any location: values of AFP over time can have significant effect on the treatment plan.

Carcinoembryonic antigen-(CEA) is a glycoprotein involved in cell adhesion. It is normally produced during fetal development, but the production of CEA stops before birth. Therefore, it is not usually present in the blood of healthy adults, thus is a possible marker of cancer, although levels are raised in heavy smokers.

LIPID PROFILE

Triglyceridesare the chemical form in which most fat exists in food as well as in the body. They’re also present in blood plasma and, in association with cholesterol, form the plasma lipids. High levels of it may be associated with a higher risk for heart disease and stroke.
Total Cholesterolis a lipidic, waxy alcohol found in the cell membranes and transported in the blood plasma. A desirable level of total cholesterol is less than 200.
High density lipoproteinA small amount of cholesterol is transported as HDL, which is mostly made up of protein and a small amount of fat.HDL actually helps prevent cholesterol deposits building up in the arteries. Having low levels of HDL (compared with LDL) in the blood is associated with an increased risk of CVD. So HDL is sometimes referred to as “good cholesterol”. Women tend to have a higher levels of HDL cholesterol than men.
Low Density LipoproteinMost of the body’s cholesterol is transported as LDL. This is made up of mostly fat and a small amount of protein. Too much LDL in the blood can cause cholesterol deposits to build up in the arteries, making it harder for the blood to flow through these blood vessels. High levels of LDL in the blood are associated with an increased risk of CVD. So LDL is sometimes referred to as ” bad cholesterol”.
Cholesterol/High Density LipoproteinCholesterol Ratio- If the total cholesterol (TC) level is too high, this is one risk factor for health problems. However, it’s important to consider the relative amounts of HDL and LDL. This is often referred to as the TC:HDL ratio. A high level of HDL and a low level of LDL (so a low TC:HDL ratio) is desirable.

RENAL FUNCTION PROFILE

Blood Urea Nitrogen This test determines the level of urea nitrogen in the blood. Urea nitrogen is produced when proteins are metabolized or broken down. Elevated levels of blood urea can be a sign of kidney disease, liver disease or dehydration.
Creatinine This test measures the amount of creatinine in the urine. Creatinine is produced in the muscles and filtered by the kidneys. The amount of creatinine in the urine is a measure of how well the kidneys are functioning.
Sodium Sodium is one of the main minerals called electrolytes that are found in the body. This test measures the amount of sodium that is in the blood to detect hyponatremia(low sodium) or hypernatremia(high sodium) associated with dehydration, edema, and a variety of diseases.
Potassium is one of the electrolyte minerals. It is important in maintaining the body’s acid-base and fluid balance. Potassium works very closely with sodium and chloride, which are electrolyte minerals. These three minerals are all in fluids of the body. Potassium is found in fluids within cells. The other two are found in fluids outside cells.
Chloride This test measures the amount of chloride in the blood. Changes in the chloride levels in the blood are often similar to changes in sodium levels.
Calcium Calcium metabolism or calcium homeostasis is the mechanism by which the body maintains adequate calcium levels. Derangements of this mechanism lead to hypercalcemia or hypocalcemia, which both can have important consequences for health.
Phosphate High plasma phosphate as a risk factor for decline in renal function and mortality in pre-dialysis patients.

DIABETES

Fasting Blood Sugar- The blood glucose test is ordered to measure the amount of glucose in the blood right at the time of sample collection. It is used to detect both hyperglycemia and hypoglycemia, to help diagnose diabetes, and to monitor glucose levels in persons with diabetes. A fasting glucose is collected; then the patient drinks a standard amount of a glucose solution to “challenge” their system. This is followed by one or more additional glucose tests performed at specific intervals to track glucose levels over time. The OGTT may be ordered to help diagnose diabetes and as a follow-up test to an elevated blood glucose.

GOUT SCREENING

Uric Acid- The uric acid test is used to learn whether the body might be breaking down cells too quickly or not getting rid of uric acid quickly enough. Some patients with high levels of uric acid have a disease called gout, which is an inherited disorder that affects purine breakdown. Patients with gout suffer from joint pain, most often in their toes but in other joints as well. The test also is ordered as a monitoring test when a patient has undergone chemotherapy or radiation, to learn whether uric acid levels are getting dangerously high.

INFECTIOUS DISEASES

Venereal Disease Research Laboratory(VDRL) is a screening test for syphilis that measures antibodies called regains that can be produced by Treponema palladium, the bacteria which causes syphilis.
Titre (if VDRL is reactive) A titer (or titre) is a measure of concentration. Titer testing employs serial dilution to obtain approximate quantitative information from an analytical procedure that inherently only evaluates as positive or negative. The titer corresponds to the highest dilution factor that still yields a positive reading; for example, positive readings in the first 8 serial twofold dilutions translate into a titer of 1:256. A specific example is viral titer.
Assay (TPHA) The Syphilis TPHA test is a classic, indirect hemagglutination test used for the detection and titration of antibodies against the causative agent of syphilis, Treponema pallidum. In the test red blood cells (erythrocytes) are sensitized with antigens from T. pallidum. The erythrocytes will then aggregate together to form distinctive patterns on the surface of a microplate wells when exposed to syphilitic serum.
Hepatitis B Surface Antigen The presence of Hepatitis B Surface Antigen indicates that the person is infectious. The body normally produces antibodies to Hepatitis B Surface Antigen as part of the normal immune response to infection.
Hepatitis B Surface Antibody The presence of Hepatitis B Surface Antibody is generally interpreted as indicating recovery and immunity from Hepatitis B Virus infection. The antibody develops in a person who has been successfully vaccinated against hepatitis B.
HIV I & II Two species of HIV infect humans: HIV-1 and HIV-2. HIV-1 is more virulent and more easily transmitted. HIV-1 is the source of the majority of HIV infections throughout the world, while HIV-2 is less easily transmitted.
Hepatitis (HAV) Antibody (Ig G) (men only) Hepatitis A antibody is produced in response to an infection with the hepatitis A virus or to the hepatitis A vaccine. The test detects the presence of this antibody. IgG (immunoglobulin G) antibodies develop later and remain present for many years, protecting the person against further infection by the same virus.

THYROID

Thyroid Simulating Hormone – This test measures the amount of thyroid-stimulating hormone (TSH) in your blood. TSH is produced by the pituitary gland, a tiny organ located below the brain and behind the sinus cavities. It is part of the body’s feedback system to maintain stable amounts of the thyroid hormones thyroxine (T4) and triiodothyronine (T3) in the blood. Thyroid hormones help control the rate at which the body uses energy. When concentrations decrease in the blood, the hypothalamus (an organ in the brain) releases thyrotropin releasing hormone (TRH). This stimulates the release of TSH by the pituitary gland.

AUDIOMETRY

A hearing test to determine how well a person can hear different sounds.

DIETICIAN COUNSELLING

Counseling and advice on a suitable balanced diet.

URINE

A series of physical, microscopic, and chemical tests is done on a sample of urine. The tests can screen for kidney disease and infections of the urinary tract. It can also help diagnose diseases that produce abnormal breakdown products called metabolites that are passed from the body in the urine.

FULL BLOOD COUNT

The cells that circulate in the bloodstream are generally divided into three types: white blood cells (leukocytes), red blood cells (erythrocytes), and platelets or thrombocytes. Abnormally high or low counts may indicate the presence of many forms of disease, and hence blood counts are amongst the most commonly performed blood tests in medicine.

LIVER FUNCTION PROFILE

Liver (hepatic) function tests or LFT, is used to detect, evaluate, and monitor liver disease or damage. It usually consists of eight tests that are run at the same time on a blood sample. These include:

Bilirubin two different tests of bilirubin often used together (especially if a person has jaundice): total bilirubin measures all the bilirubin in the blood; direct bilirubin measures a form that is conjugated (combined with another compound) in the liver.
Total Protein Measures albumin and all other proteins in blood, including antibodies made to help fight off infections.
Albumin Measures the main protein made by the liver and tells whether or not the liver is making an adequate amount of this protein.
Globulin is one of the two types of serum proteins, the other being albumin. This generic term encompasses a heterogeneous series of families of proteins, with larger molecules and less soluble in pure water than albumin, which migrate less than albumin during serum electrophoresis. The normal range in blood is 2 to 3.5 g/dl.
Albumin/Globulin Ratio To determine your nutritional status or to screen for certain liver and kidney disorders as well as other diseases
Alkaline phosphatase (ALP) an enzyme related to the bile ducts; often increased when they are blocked
Aspartate Transaminase (SGOT) AST is an enzyme found mostly in the heart and liver, and to a lesser extent in other muscles. When liver or muscle cells are injured, they release AST into the blood.
Alanine Transaminase (SGPT) ALT is an enzyme found mostly in the liver; smaller amounts of it are also in the kidneys, heart, and muscles. Under normal conditions, ALT levels in the blood are low. When the liver is damaged, ALT is released into the blood stream, usually before more obvious symptoms of liver damage occur, such as jaundice (yellowing of the eyes and skin).

CARDIAC SCREENING

64-slice MSCT -Coronary Calcium Score A cardiac CT scan for coronary calcium is a non-invasive way of obtaining information about the presence, location and extent of calcified plaque in the coronary arteries—the vessels that supply oxygen-containing blood to the heart wall. Calcified plaque is a build-up of fat and other substances, including calcium, and is a sign of atherosclerosis a disease of the vessel wall, which is called coronary artery disease (CAD). People with this disease have an increased risk for heart attacks. In addition, over time, progression of plaque build up (CAD) can narrow the arteries or even close off blood flow to the heart. The result may be painful angina in the chest or a heart attack. Because calcium is a marker of CAD, the amount of calcium detected on a cardiac CT scan is a helpful prognostic tool. The findings on cardiac CT are expressed as a calcium score.
Homocysteine (men only) Homocysteine may be ordered as part of a cardiac risk assessment, depending on the patient’s age and other risk factors. It may also be ordered following a heart attack or stroke to help guide treatment.
C-Reative Protein (men only) Arterial damage is thought to result from inflammation due to chemical insults. CRP is a general marker for inflammation and infection, so it can be used as a proxy for heart disease risk.