Diagnostic Tests

   Diabetes

•       What is Diabetes?
•       Causes of Diabetes
•       Types
•       Treatment (Dos & Don’ts)  

 Digestive Diseases

The various ailments of the gastrointestinal (GI) tract affect food digestion and absorption. Diagnosing them is critical to effective treatment and prevention of complications. Different diagnostic tests that help in efficient treatment of digestive diseases are:

• Clinical examination
  The symptoms present and a physical examination may help diagnose a few GI disorders like diarrhoea, constipation, acidity, etc. For diseases like haemorrhoids, physical rectal examination may be done wherein the doctor inserts a gloved finger into the rectum to feel for abnormalities.
• Blood test
  Blood tests like blood count, liver function test, lactose tolerance test, antibodies to H. pylori, pancreatic enzyme test, etc. can help diagnose certain GI conditions like bacterial or parasitic infection, celiac disease, lactose intolerance, exact cause of diarrhoea, etc. They may also be recommended to rule out other serious diseases. The laboratory tests to determine liver efficiency include CBC (complete blood count), liver function tests (SGOT, bilirubin, alkaline phosphatise, etc.), blood albumin and prothrombin time.
• Stool analysis
  Stool analysis can help assess the overall health of GIT. It helps analyse digestion, absorption, microbial balance, etc. This gastrointestinal test profile may be advised in conditions like indigestion, constipation, diarrhoea, IBS, malabsorption, infection, etc. For the analysis, a stool sample collected in a clean container is sent to the laboratory for microscopic examination and other tests.Changes in colour, consistency and pH, and the presence of mucus, blood, white blood cells, bile, fat, sugars, etc. help diagnose GI conditions. A stool culture can help diagnose bacterial infection. Increased fat levels in the stool may be seen in celiac disease, pancreatitis, etc. High pH of the stool could indicate inflammation, cancer, etc. Some enzyme immunoassays are used to detect viral and bacterial antigen in stool sample.
• Renal function test
  Gadolinium containing contrast agents, most commonly used in MRI and CT scans, are avoided in patients with reduced kidney function or kidney failure. Hence, kidney function tests are done prior to MRI or CT scans of GIT.
• Endoscopy
  Long-standing acidity, heartburn, unexplained weight loss and changes in bowel pattern may need a detailed investigation of the intestine. Endoscopy is a non-surgical procedure that involves examination of the stomach or digestive tract with the help of an instrument called endoscope. Biopsies (small tissue sample) may also be taken during endoscopy to be examined under microscope. They can help detect presence of cancerous cells.
• Abdominal ultrasound, CT scan and MRI
  • An ultrasound is a diagnostic medical procedure that uses high frequency sound waves to produce dynamic (or real-time) images of internal organs, tissue and blood vessels. Abdominal ultrasound is used to examine organs and their blood vessels in the abdomen like liver, pancreas, gallbladder, etc.
  • Computerized topography (CT) scan is a computerised X-ray technique that combines a large number of X-ray images taken in succession. These images then result in a cross sectional view of the internal organs which helps analyse the internal structures of the body. It can be used to examine the GIT for diagnosing traumatic injuries, tumours or an infection.
  • In magnetic resonance imaging (MRI), a beam of radio waves and magnetic fields is sent through the body to detect a defect in the organ of interest. It gives an accurate image of the organ and structures within, thus helping in getting a clear idea of cancerous cells and the extent of the growth.

Endocrine Diseases (Thyroid Tests)

• What is a TSH test?
  TSH stands for thyroid stimulating hormone. A TSH test is a blood test that measures this hormone. The thyroid is a small, butterfly-shaped gland located near your throat. Your thyroid makes hormones that regulate the way your body uses energy. It also plays an important role in regulating your weight, body temperature, muscle strength, and even your mood. TSH is made in a gland in the brain called the pituitary. When thyroid levels in your body are low, the pituitary gland makes more TSH. When thyroid levels are high, the pituitary gland makes less TSH. TSH levels that are too high or too low can indicate your thyroid isn’t working correctly.
  Other names: thyrotropin test
• What is it used for?
  A TSH test is used to find out how well the thyroid is working.
• Why do I need a TSH test?
  You may need a TSH test if you have symptoms of too much thyroid hormone in your blood (hyperthyroidism), or too little thyroid hormone (hypothyroidism).
• Symptoms of hyperthyroidism, also known as overactive thyroid, include:
  • Anxiety
  • Weight loss
  • Tremors in the hands
  • Increased heart rate
  • Puffiness
  • Bulging of the eyes
  • Difficulty sleeping
    • Symptoms of hypothyroidism, also known as underactive thyroid, include:
  • Weight gain
  • Tiredness
  • Hair loss
  • Low tolerance for cold temperatures
  • Irregular menstrual periods
  • Constipation
• What happens during a TSH test?
  A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
• Will I need to do anything to prepare for the test?
  You don’t need any special preparations for a TSH blood test. If your health care provider has ordered other blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.
• Are there any risks to the test?
  There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
• What do the results mean?
  High TSH levels can mean your thyroid is not making enough thyroid hormones, a condition called hypothyroidism. Low TSH levels can mean your thyroid is making too much of the hormones, a condition called hyperthyroidism. A TSH test does not explain why TSH levels are too high or too low. If your test results are abnormal, your health care provider will probably order additional tests to determine the cause of your thyroid problem. These tests may include:
  •         T4 thyroid hormone tests
  •         T3 thyroid hormone tests
  •         Tests to diagnose Graves’ disease, an autoimmune disease that causes hyperthyroidism
  •         Tests to diagnose Hashimoto’s thyroiditis, an autoimmune disease that causes hypothyroidism
• More information on TSH Test
  Thyroid changes can happen during pregnancy. These changes are usually not significant, but some women can develop thyroid disease during pregnancy. Hyperthyroidism occurs in about one in every 500 pregnancies, while hypothyroidism occurs in approximately one in every 250 pregnancies. Hyperthyroidism, and less often, hypothyroidism, may remain after pregnancy. If you develop a thyroid condition during pregnancy, your health care provider will monitor your condition after your baby is born. If you have a history of thyroid disease, be sure to talk with your health care provider if you are pregnant or are thinking of becoming pregnant.

Kidney Diseases

You have two kidneys. They are fist-sized organs on either side of your backbone above your waist. Your kidneys filter and clean your blood, taking out waste products and making urine. Kidney tests check to see how well your kidneys are working. They include blood, urine, and imaging tests.
Early kidney disease usually does not have signs or symptoms. Testing is the only way to know how your kidneys are doing. It is important for you to get checked for kidney disease if you have the key risk factors – diabetes, high blood pressure, heart disease, or a family history of kidney failure.

• Specific kidney tests include:
  • Glomerular filtration rate (GFR) – one of the most common blood tests to check for chronic kidney disease. It tells how well your kidneys are filtering.
  • Creatinine blood and urine tests – check the levels of creatinine, a waste product that your kidneys remove from your blood
    Albumin urine test – checks for albumin, a protein that can pass into the urine if the kidneys are damaged
  • Imaging tests, such as an ultrasound – provide pictures of the kidneys. The pictures help the health care provider see the size and shape of the kidneys, and check for anything unusual.
  • Kidney biopsy – a procedure that involves taking a small piece of kidney tissue for examination with a microscope. It checks for the cause of kidney disease and how damaged your kidneys are.

Liver Disease

• What are liver function tests?
  Liver function tests (also known as a liver panel) are blood tests that measure different enzymes, proteins, and other substances made by the liver. These tests check the overall health of your liver. The different substances are often tested at the same time on a single blood sample, and may include the following:
  • Albumin, a protein made in the liver
  • Total protein. This test measures the total amount of protein in the blood.
  • ALP (alkaline phosphatase), ALT (alanine transaminase), AST (aspartate aminotransferase), and gamma-glutamyl tansferase (GGT). These are different enzymes made by the liver.
  • Bilirubin, a waste product made by the liver.
  • Lactate dehydrogenase (LD), an enzyme found in most of the body’s cells. LD is released into the blood when cells have been damaged by disease or injury.
  • Prothrombin time (PT), a protein involved in blood clotting.

If levels of one or more of these substances are outside of the normal range, it may be a sign of liver disease.

Other names: liver panel, liver function panel, liver profile hepatic function panel, LFT

What are they used for?
Liver function tests are most often used to:

• Help diagnose liver diseases, such as hepatitis
• Monitor treatment of liver disease. These tests can show how well the treatment is working.
• Check how badly a liver has been damaged or scarred by disease, such as cirrhosis
• Monitor side effects of certain medicines

Why do I need liver function testing?
You may need liver function testing if you have symptoms of liver disease. These include:

• Jaundice, a condition that causes your skin and eyes to turn yellow
• Nausea and vomiting
• Diarrhea
• Abdominal pain
• Dark-colored urine
• Light-colored stool
• Fatigue

You may also need these tests if you have certain risk factors. You may be at higher risk for liver disease if you:

• Have a family history of liver disease
• Have alcohol use disorder, a condition in which you have difficulty controlling how much you drink
• Think you have been exposed to a hepatitis virus
• Take medicines that may cause liver damage

What happens during a liver function test?
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
Will I need to do anything to prepare for the test?
You may need to fast (not eat or drink) for 10-12 hours before the test.
Are there any risks to the test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
What do the results mean?
If one or more of your liver function test results were not normal, it may mean your liver is damaged or not working properly. Liver damage can be caused by a number of different conditions, including:

• Hepatitis A
• Hepatitis B
• Hepatitis C
• Alcohol use disorder, which includes alcoholism.
• Liver cancer
• Diabetes

Urology Diseases

Urology, at its core, is a surgical specialty that helps to deal with the diseases of both male and female urinary tracts1. Urinary tract problems are possible regardless of age, so if you feel like you’re having problems or things aren’t regular, it’s time to see your urologist. When you make an appointment to see your urologist, there are a number of commonly performed tests used in diagnosing the underlying problem. In this article, we’ll discuss some of the most commonly performed urology tests used in the office. Based on the results of the test, further monitoring, care, or surgery is recommended and you and your doctor will discuss the best plan of action for your circumstances.

Physical Exam

The most common urology test begins with a simple physical exam. Physical exams start with a series of questions to give your urologist a better understanding of your lifestyle and history. Come prepared with any symptoms that are present, a strong knowledge about your current health, medical history, and any medications you’re using.

These questions help your urologist with their physical exam, as having the bigger picture is essential in making a proper diagnosis.

The physical exam will take place in the urologist’s office and include physical examination of your entire urinary tract system—including the kidneys, ureters, and bladder. If you’re having problems related to the penis or testicles, the examination will also include them2.

Digital Rectal Exam (DRE)

If you’re a male, the physical examination includes a digital rectal exam or DRE. This exam is performed to evaluate the prostate gland and look for enlargement or irregularities. Digital rectal exams are done by inserting a lubricated, gloved finger into the rectum and evaluating the prostate.

Blood Tests

To learn more about your urinary tract system and what is going awry, urologists rely a number of different blood tests. Using a standard procedure for drawing and examining blood, urologists are able to detect certain diseases or cancers. There are three common blood tests used.

1. Prostate-Specific Antigen (PSA) Blood Tests

This test focuses on detecting inflammation of the prostate, which is used to help determine the underlying cause. PSA tests do not detect cancer on their own. Even though many people think of them as the prostate cancer test, they are merely a way of indicating inflammation levels. If inflammation levels point to a risk of cancer, further tests need to be done for a proper diagnosis.

Specifically, the test measures the amount of protein currently being released from the prostate gland, which increases when there is inflammation2.

2. Creatinine and Blood Urea Nitrogen (BUN) Blood Tests

The next type of blood test is a creatinine and blood urea nitrogen test, which is used to assess how the kidneys are functioning through creatinine measurement. When you have high levels of creatinine in your blood, it’s oftentimes an indication that your kidneys aren’t functioning properly or efficiently. Depending on the ratio of creatinine to blood urea nitrogen, your urologist will be able to diagnose the problem.

When your kidneys aren’t functioning well, the blood flow is thrown off. Sometimes, the problem is as simple as dehydration. Other times, it’s more serious and helps diagnose congestive heart failure2.

3. Testosterone Blood Tests

When evaluating male erectile dysfunction, your urologist will administer a testosterone blood test2. This will give a clear indication of your testosterone levels, which is the cause of a number of erectile dysfunction cases.

After your blood work, your urologist will walk through the results with you and explain any abnormalities, diseases, or causes for dysfunction. If you have any questions about upcoming blood tests, or are looking to schedule one, contact your urologist today. If you don’t have a urologist, talk to your doctor about getting a recommendation.

Urine Tests

If a blood test isn’t needed, or if your urologist wants to gather more information before a diagnosis, urine tests are administered. Urine tests usually all involve urinating into a sterile cup for analysis, but differ based on what’s being tested for.

Urinalysis

The most common urine test performed is a urinalysis. In fact, in most yearly physical exams, urinalyses are done even if there is no cause for concern. They’re used to test for bacteria, blood cells, and foreign substances that aren’t supposed to be living in your kidneys2.

Urinalyses are used to determine whether or not a urinary tract infection is present, in the diagnoses of diabetes, and to keep an eye out for early indications of disease.

Each of these diagnoses will have specific symptoms such as higher white blood cell counts, high protein levels or glucose levels, and the presence of leukoesterase2. Your doctor will be able to better identify any problems that present themselves during a urinalysis.

Urine Cultures

Similarly, a urine culture is used to determine whether or not certain bacteria are present in a urine sample2. It’s more intensive, so this test needs to be performed in a laboratory. Once isolated, it’s possible to test antibiotics on the urine cultures to see which treatment will be the most effective.

24-Hour Urine Test

If instructed that you need a 24-hour urine test, you will need to collect all of the urine you expel over the course of a 24-hour time period. This allows urologists to determine if your body has normal levels of specific substances, which would indicate healthy kidneys. When things are abnormal, the test helps point urologists in the right direction of certain diseases.

Imaging Techniques

Other popular urology tests involve using imaging techniques to see problems that aren’t necessarily visible to the naked eye. The most frequently used imaging tool is a simple ultrasound. During an ultrasound, high-frequency sound waves are emitted that produce pictures of internal systems, organs, and foreign substances. Ultrasounds are able to detect problems such as those related to the kidneys, bladder, testicles, and prostate gland.

Depending on the results from using an ultrasound and/or an X-ray, other imaging tests may be needed. For a more detailed look inside the body, doctors and urologists use computerized tomography scans—commonly known as a CT scan.

Semen Analysis (Seminogram)

While this isn’t the only other test that urologists perform, it’s the last of the routine exams. Semen analyses are done for males who are struggling with fertility problems. During a seminogram, a sample is examined in a laboratory to check the strength of a male’s sperm. Motility and quality are measured along with the evaluation of the number of sperm actually present. Seminograms are also performed after every vasectomy to ensure that the procedure was successful.