Labs and Imaging Q&A

Laboratory and Imaging Questions:

1)  Name the appropriate laboratory test to confirm a suspected case of cystic fibrosis.

2)  Which common condition is related to obesity and insulin resistance and usually presents as mildly elevated liver enzymes with ALT elevated more that AST?

3)  Describe the MCV, MCHC, and Ret. count in iron deficiency anemia.

4)  Parvovirus B-19 IgM antibody is observed in 90% of patients with which acute illness?

5)  How is Blastomycosis diagnosed?

6)  In the case of DIC (disseminated intravascular coagulation) are fibrin and thrombin levels increased or decreased?

7)  High levels of Mg ammonium phosphate can lead to which type of renal calculi?

8)  Compare ferritin levels in anemia of chronic disease and iron deficiency anemia.

9)  For a suspected case of testicular cancer, what are the three most important tumor markers to aid in Dx?

10)  A biopsy reveals an osteosarcoma in a 15 year old.  What further imaging is required and why?



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Answers:

1) Chloride sweat test
2) Nonalcoholic steatohepatitis (NASH)
3) Low MCV (microcytic), low MCHC (hypochromic) with low reticulocytes.
4) Erythema Infectiosum (5th Disease)
5) Dx is confirmed by characteristic broad based budding organisms in sputum or tissues by KOH prep, cytology or histology.  (Chest X-ray or CT, skin or tissue biopsy and urine culture also used)
6) One or both may be increased in up to 75% of all patients with DIC.
7) Struvite
8) Ferritin is normal or high in ACD and low in IDA.
9) Serum HCG (human chorionic gonadotrphin), AFP (alpha-fetoprotein), and LDH (lactate dehydrogenase)
10) Chest x-ray and CT to detect lung mets and bone scan to detect bone mets.