Diagnostic Procedures PDF

11/14/2024 DIAGNOSTIC Procedures Nancy Ali Mahfouz, PharmD Head of Clinical Pharmacy - Department of Neuropsychiatry, Alexandria University Hospitals. Lecturer Practitioner - Department of Clinical Pharmacy and...

11/14/2024 DIAGNOSTIC Procedures Nancy Ali Mahfouz, PharmD Head of Clinical Pharmacy - Department of Neuropsychiatry, Alexandria University Hospitals. Lecturer Practitioner - Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy Alexandria University. 1 Definition Methods and techniques performed to diagnose diseases, disorders, or conditions. Rationale Diagnostic procedures that are accurate and reliable leads to more efficient treatment and recovery, enhancing the quality of patient care, and reducing health care costs. Diagnostic workforce A wide range of health professionals are involved, from radiologists to nuclear medicine specialists, histopathologists to endoscopists. 2 1  11/14/2024 DIAGNOSTIC Procedures Nancy Ali Mahfouz, PharmD Head of Clinical Pharmacy - Department of Neuropsychiatry, Alexandria University Hospitals. Lecturer Practitioner - Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy Alexandria University. 1 Definition Methods and techniques performed to diagnose diseases, disorders, or conditions. Rationale Diagnostic procedures that are accurate and reliable leads to more efficient treatment and recovery, enhancing the quality of patient care, and reducing health care costs. Diagnostic workforce A wide range of health professionals are involved, from radiologists to nuclear medicine specialists, histopathologists to endoscopists. 2 1  11/14/2024 Ultrasound (US) An ultrasound is an imaging test that uses sound waves to make pictures of organs, tissues, and other structures inside the body without surgery. Ultrasound is also called ultrasonography, sonography or sonograms. Doppler ultrasound (Arterial Blood Flow Studies) is a non- invasive test that can be used to measure the blood flow through blood vessels and detect blood clots. Abdominal Doppler ultrasound Carotid Doppler ultrasonography For DVT carotid arteries large arteries in the neck that deliver blood to the brain 3 X-ray X-rays are a type of radiation called electromagnetic waves. X-ray imaging creates pictures of the inside of the body. The images show the body parts in different shades of black and white. This is because different tissues absorb different amounts of radiation. Calcium in bones absorbs x-rays the most, so bones look white. Fat and other soft tissues absorb less and look grey. Air absorbs the least, so lungs look black. The most familiar use of x-rays is checking for fractures (broken bones), but x-rays are also used in other ways. For example, chest x-rays can spot pneumonia. Mammograms use x-rays to look for breast cancer. 4 2  11/14/2024 Ultrasound (US) An ultrasound is an imaging test that uses sound waves to make pictures of organs, tissues, and other structures inside the body without surgery. Ultrasound is also called ultrasonography, sonography or sonograms. Doppler ultrasound (Arterial Blood Flow Studies) is a non- invasive test that can be used to measure the blood flow through blood vessels and detect blood clots. Abdominal Doppler ultrasound Carotid Doppler ultrasonography For DVT carotid arteries large arteries in the neck that deliver blood to the brain 3 X-ray X-rays are a type of radiation called electromagnetic waves. X-ray imaging creates pictures of the inside of the body. The images show the body parts in different shades of black and white. This is because different tissues absorb different amounts of radiation. Calcium in bones absorbs x-rays the most, so bones look white. Fat and other soft tissues absorb less and look grey. Air absorbs the least, so lungs look black. The most familiar use of x-rays is checking for fractures (broken bones), but x-rays are also used in other ways. For example, chest x-rays can spot pneumonia. Mammograms use x-rays to look for breast cancer. 4 2  11/14/2024 Computed Tomography (CT scan) Tomography is a method of producing a three-dimensional image of the internal structures of a solid object (as the human body) Computed tomography is commonly referred to as a CT scan. It is a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce detailed images of any part of the body, including the bones, muscles, fat, organs and blood vessels. In CT, the X-ray beam moves in a circle around the body. This allows many different views of the same organ or structure and provides much greater detail. CT scans may be done with or without contrast. Contrast refers to a substance taken by mouth or injected into an IV line that causes the particular organ or tissue under study to be seen more clearly. Contrast examinations may require fasting for a certain period of time before the procedure and informing the physician if the patient have ever had a reaction to any contrast media or any kidney problems. 5 Angiography Angiography is a type of X-ray used to check blood vessels. Blood vessels do not show clearly on a normal X-ray, so a special dye called a contrast agent needs to be injected into blood first. Types of angiography: - Coronary angiography - Cerebral angiography - Pulmonary angiography - Renal angiography Occasionally, angiography may be done using scans instead of X-rays. These are called CT angiography or MRI angiography. 6 3  11/14/2024 Computed Tomography (CT scan) Tomography is a method of producing a three-dimensional image of the internal structures of a solid object (as the human body) Computed tomography is commonly referred to as a CT scan. It is a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce detailed images of any part of the body, including the bones, muscles, fat, organs and blood vessels. In CT, the X-ray beam moves in a circle around the body. This allows many different views of the same organ or structure and provides much greater detail. CT scans may be done with or without contrast. Contrast refers to a substance taken by mouth or injected into an IV line that causes the particular organ or tissue under study to be seen more clearly. Contrast examinations may require fasting for a certain period of time before the procedure and informing the physician if the patient have ever had a reaction to any contrast media or any kidney problems. 5 Angiography Angiography is a type of X-ray used to check blood vessels. Blood vessels do not show clearly on a normal X-ray, so a special dye called a contrast agent needs to be injected into blood first. Types of angiography: - Coronary angiography - Cerebral angiography - Pulmonary angiography - Renal angiography Occasionally, angiography may be done using scans instead of X-rays. These are called CT angiography or MRI angiography. 6 3  11/14/2024 Magnetic Resonance Imaging (MRI) MRI is a non-invasive medical imaging test that produces detailed images of almost every internal structure in the human body, including the organs, bones, muscles and blood vessels. The MRI machine is a large, cylindrical (tube-shaped) machine that creates a strong magnetic field around the patient and sends pulses of radio waves from a scanner to create images of the part of the body being examined. Some MRI machines look like closed narrow tunnels, while others are more open. MRI may be used instead of computed tomography (CT) when organs or soft tissue are being studied? MRI is better at telling the difference between types of soft tissues and between normal and abnormal soft tissues. Because ionizing radiation is not used (unlike X-rays), there is no risk of exposure to radiation during an MRI procedure. 7 8 4  11/14/2024 Magnetic Resonance Imaging (MRI) MRI is a non-invasive medical imaging test that produces detailed images of almost every internal structure in the human body, including the organs, bones, muscles and blood vessels. The MRI machine is a large, cylindrical (tube-shaped) machine that creates a strong magnetic field around the patient and sends pulses of radio waves from a scanner to create images of the part of the body being examined. Some MRI machines look like closed narrow tunnels, while others are more open. MRI may be used instead of computed tomography (CT) when organs or soft tissue are being studied? MRI is better at telling the difference between types of soft tissues and between normal and abnormal soft tissues. Because ionizing radiation is not used (unlike X-rays), there is no risk of exposure to radiation during an MRI procedure. 7 8 4  11/14/2024 Newer uses for MRI have contributed to the development of additional magnetic resonance technology Magnetic Resonance Angiography (MRA) is a procedure used to evaluate blood flow through arteries. MRA can also be used to detect aneurysms in the brain and any vascular abnormalities in the brain, spinal cord or other parts of the body. Functional Magnetic Resonance Imaging (f MRI) Enables the detection of functional abnormalities of the brain, as well as the assessment of the normal functional anatomy of the brain, such as speech or memory, which cannot be accomplished with other imaging technique. Areas of the brain lights up while patients think or perform certain activities, so the patient will be asked to perform a specific task. By pinpointing the exact location of the functional centre in the brain, doctors can plan surgery or other treatments for a brain disorder. 9 Positron Emission Tomography (PET Scan) ** a positron an electron having positive electrical charge. Positron emission tomography (PET) is a type of nuclear medicine procedure that measures metabolic activity and visualize the biochemical changes of the cells of body tissues. PET is a combination of nuclear medicine and biochemical analysis. Used mostly in patients with brain or heart conditions and cancer. A tiny amount of a radioactive substance, called a radiopharmaceutical (radioactive tracer), is used during the procedure to assist in the examination of the tissue under study. It is attached to chemical substances that are used naturally by the particular organ or tissue during its metabolic process. For example, in PET scans of the brain, a radioactive atom is attached to glucose. PET studies evaluate the metabolism of a particular organ or tissue. Thus, PET may detect biochemical changes in an organ or tissue that can identify the onset of a disease process before anatomical changes related to the disease can be seen with other imaging processes such as CT or MRI. 10 5  11/14/2024 Newer uses for MRI have contributed to the development of additional magnetic resonance technology Magnetic Resonance Angiography (MRA) is a procedure used to evaluate blood flow through arteries. MRA can also be used to detect aneurysms in the brain and any vascular abnormalities in the brain, spinal cord or other parts of the body. Functional Magnetic Resonance Imaging (f MRI) Enables the detection of functional abnormalities of the brain, as well as the assessment of the normal functional anatomy of the brain, such as speech or memory, which cannot be accomplished with other imaging technique. Areas of the brain lights up while patients think or perform certain activities, so the patient will be asked to perform a specific task. By pinpointing the exact location of the functional centre in the brain, doctors can plan surgery or other treatments for a brain disorder. 9 Positron Emission Tomography (PET Scan) ** a positron an electron having positive electrical charge. Positron emission tomography (PET) is a type of nuclear medicine procedure that measures metabolic activity and visualize the biochemical changes of the cells of body tissues. PET is a combination of nuclear medicine and biochemical analysis. Used mostly in patients with brain or heart conditions and cancer. A tiny amount of a radioactive substance, called a radiopharmaceutical (radioactive tracer), is used during the procedure to assist in the examination of the tissue under study. It is attached to chemical substances that are used naturally by the particular organ or tissue during its metabolic process. For example, in PET scans of the brain, a radioactive atom is attached to glucose. PET studies evaluate the metabolism of a particular organ or tissue. Thus, PET may detect biochemical changes in an organ or tissue that can identify the onset of a disease process before anatomical changes related to the disease can be seen with other imaging processes such as CT or MRI. 10 5  11/14/2024 Echocardiogram (echo) An echocardiogram is an ultrasound test that checks the structure and function of the heart. It can diagnose a range of conditions including cardiomyopathy and valve disease. During an echo test, the healthcare provider uses ultrasound (high-frequency sound waves) from a hand-held wand placed on the patient’s chest to take pictures of heart’s valves and chambers. This helps the provider evaluate the pumping action of the heart. Echocardiogram is the most common test used to measure the Ejection fraction (EF) which is the percentage of blood the left ventricle pumps out with each contraction. An ejection fraction of 60 % means that 60 % of the total amount of blood in the left ventricle is pushed out with each heartbeat. A normal heart’s ejection fraction is between 55 and 70 %. It indicates how well the heart is pumping out blood can help to diagnose heart failure. 11 Cardiac Catheterization It is a medical procedure used to diagnose and treat some heart conditions by allowing cardiologists to take a close look at the heart. A long, thin, flexible tube called a catheter is put into certain blood vessels in the arm, groin, upper thigh, or neck. The catheter is then threaded through the blood vessels to the heart. A dye might be injected into coronary arteries to see whether they are narrowed or blocked. Cardiac catheterization may also be used instead of some heart surgeries to repair heart defects and install stents or balloons. 12 6  11/14/2024 Echocardiogram (echo) An echocardiogram is an ultrasound test that checks the structure and function of the heart. It can diagnose a range of conditions including cardiomyopathy and valve disease. During an echo test, the healthcare provider uses ultrasound (high-frequency sound waves) from a hand-held wand placed on the patient’s chest to take pictures of heart’s valves and chambers. This helps the provider evaluate the pumping action of the heart. Echocardiogram is the most common test used to measure the Ejection fraction (EF) which is the percentage of blood the left ventricle pumps out with each contraction. An ejection fraction of 60 % means that 60 % of the total amount of blood in the left ventricle is pushed out with each heartbeat. A normal heart’s ejection fraction is between 55 and 70 %. It indicates how well the heart is pumping out blood can help to diagnose heart failure. 11 Cardiac Catheterization It is a medical procedure used to diagnose and treat some heart conditions by allowing cardiologists to take a close look at the heart. A long, thin, flexible tube called a catheter is put into certain blood vessels in the arm, groin, upper thigh, or neck. The catheter is then threaded through the blood vessels to the heart. A dye might be injected into coronary arteries to see whether they are narrowed or blocked. Cardiac catheterization may also be used instead of some heart surgeries to repair heart defects and install stents or balloons. 12 6  11/14/2024 Electrocardiogram (ECG) An electrocardiogram (ECG or EKG) is a quick test to check the heartbeat. It records the electrical signals of the heart. Test results can help diagnose heart attacks and irregular heartbeats, called arrhythmias. Another type of ECG machines is the Holter monitor which is a small, wearable device that records the heart's rhythm, usually for 1 to 2 days. A Holter monitor test may be done if a traditional electrocardiogram (ECG or EKG) doesn't provide enough details about the heart's condition. 13 Electroencephalogram (EEG) An electroencephalogram (EEG) is a test that measures electrical activity of the brain. The test uses small, metal discs called electrodes that attach to the scalp. Brain cells communicate via electrical impulses, and this activity shows up as wavy lines on an EEG recording. Brain cells are active all the time, even during sleep. Abnormalities in an EEG can play a role in diagnosing certain brain conditions. 14 7  11/14/2024 Electrocardiogram (ECG) An electrocardiogram (ECG or EKG) is a quick test to check the heartbeat. It records the electrical signals of the heart. Test results can help diagnose heart attacks and irregular heartbeats, called arrhythmias. Another type of ECG machines is the Holter monitor which is a small, wearable device that records the heart's rhythm, usually for 1 to 2 days. A Holter monitor test may be done if a traditional electrocardiogram (ECG or EKG) doesn't provide enough details about the heart's condition. 13 Electroencephalogram (EEG) An electroencephalogram (EEG) is a test that measures electrical activity of the brain. The test uses small, metal discs called electrodes that attach to the scalp. Brain cells communicate via electrical impulses, and this activity shows up as wavy lines on an EEG recording. Brain cells are active all the time, even during sleep. Abnormalities in an EEG can play a role in diagnosing certain brain conditions. 14 7  11/14/2024 Types of EEG Routine EEG A routine EEG recording lasts for about 20 to 40 minutes. patients will usually be asked to open or close their eyes from time to time, breathe in and out deeply (called hyperventilation) for a few minutes and flashing light may also be used to see if this affects your brain activity. Sleep EEG or sleep-deprived EEG A sleep EEG is carried out during sleep. It may be used if a routine EEG does not give enough information, or to test for sleep disorders. In some cases, patients may be asked to stay awake the night before the test to help ensure they can sleep while it's carried out. This is called a sleep-deprived EEG. Ambulatory EEG An ambulatory EEG is where brain activity is recorded throughout the day and night over a period of one or more days. The electrodes will be attached to a small portable EEG recorder that can be clipped onto clothing. patients can continue with most of your normal daily activities while the recording is being taken. Video EEG Video EEG, is a special type of EEG where you're filmed while an EEG recording is taken. This can help provide more information about your brain activity. The test is usually carried out over a few days while staying in a purpose-built hospital suite. The EEG signals are transmitted to a computer and a video is also recorded by the computer and kept under regular surveillance by trained staff. 15 COMMON MALPRACTICES AND MISCONCEPTIONS a) ROUTINE EEG DOES NOT exclude nor confirm epilepsy because the sensitivity of an EEG to identify epilepsy is less than 50% (i.e. an EEG taken during a seizure-free interval is normal in about 50% of patients); so ICTAL EEG [VIDEO EEG] is more accurate in diagnosis of epilepsy and seizure type but is more expensive and time consuming (at least 24 hrs). b) Epileptiform normal variants are EEG patterns that resemble epileptogenic VIDEO EEG abnormalities. Most of these patterns initially were thought to be associated with epilepsy or other neurologic conditions but subsequently were demonstrated to have no such significance. They now are considered normal variants of no clinical significance; however, their recognition is important to avoid overinterpretation or misinterpretation of their significance. Epileptiform normal variants c) A common malpractice and misconception is that ADHD is associated with increased electrical activity of the brain and antiepileptic drugs are prescribed which worsens the cognitive impairment. However, the most robust EEG feature associated with ADHD is elevated power of slow waves (theta waves) in the frontal region. 16 8  11/14/2024 Types of EEG Routine EEG A routine EEG recording lasts for about 20 to 40 minutes. patients will usually be asked to open or close their eyes from time to time, breathe in and out deeply (called hyperventilation) for a few minutes and flashing light may also be used to see if this affects your brain activity. Sleep EEG or sleep-deprived EEG A sleep EEG is carried out during sleep. It may be used if a routine EEG does not give enough information, or to test for sleep disorders. In some cases, patients may be asked to stay awake the night before the test to help ensure they can sleep while it's carried out. This is called a sleep-deprived EEG. Ambulatory EEG An ambulatory EEG is where brain activity is recorded throughout the day and night over a period of one or more days. The electrodes will be attached to a small portable EEG recorder that can be clipped onto clothing. patients can continue with most of your normal daily activities while the recording is being taken. Video EEG Video EEG, is a special type of EEG where you're filmed while an EEG recording is taken. This can help provide more information about your brain activity. The test is usually carried out over a few days while staying in a purpose-built hospital suite. The EEG signals are transmitted to a computer and a video is also recorded by the computer and kept under regular surveillance by trained staff. 15 COMMON MALPRACTICES AND MISCONCEPTIONS a) ROUTINE EEG DOES NOT exclude nor confirm epilepsy because the sensitivity of an EEG to identify epilepsy is less than 50% (i.e. an EEG taken during a seizure-free interval is normal in about 50% of patients); so ICTAL EEG [VIDEO EEG] is more accurate in diagnosis of epilepsy and seizure type but is more expensive and time consuming (at least 24 hrs). b) Epileptiform normal variants are EEG patterns that resemble epileptogenic VIDEO EEG abnormalities. Most of these patterns initially were thought to be associated with epilepsy or other neurologic conditions but subsequently were demonstrated to have no such significance. They now are considered normal variants of no clinical significance; however, their recognition is important to avoid overinterpretation or misinterpretation of their significance. Epileptiform normal variants c) A common malpractice and misconception is that ADHD is associated with increased electrical activity of the brain and antiepileptic drugs are prescribed which worsens the cognitive impairment. However, the most robust EEG feature associated with ADHD is elevated power of slow waves (theta waves) in the frontal region. 16 8  11/14/2024 Endoscopy The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are inserted directly into the organ using a thin, flexible tube with a light and a small video camera on the end. There are many types of endoscopies: - Bronchoscopy (lungs) - Colonoscopy (colon and rectum) - Cystoscopy (bladder and urethra) - Laparoscopy (the abdomen and pelvis) - Laryngoscopy (the larynx, including the vocal cords) - Endoscopy (the inner lining of the oesophagus, stomach, and duodenum) - Arthroscopy (joints) 17 Fine-needle aspiration / biopsy Fine-needle aspiration (FNA) is a procedure where healthcare providers use to get a cell sample from a suspicious lump or an abnormal area of the body using a thin needle and a syringe to pull out cells, tissue and fluids. Healthcare providers then sends the sample to a cytology lab where a pathologist examines cells for analysis. The main advantage of FNA is that it is fairly quick, often doesn't require anaesthesia, non-invasive, so no stitches are needed and there is usually no scar. However, an FNA can sometimes miss cancer cells if the needle does not go directly into them or might not remove enough cancer cells to do other lab tests needed. If the results of the FNA biopsy do not give a clear diagnosis, or if physicians still has concerns, patients might need a more extensive type of biopsy, such as a core needle biopsy or a surgical (open) biopsy. 18 9  11/14/2024 Endoscopy The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are inserted directly into the organ using a thin, flexible tube with a light and a small video camera on the end. There are many types of endoscopies: - Bronchoscopy (lungs) - Colonoscopy (colon and rectum) - Cystoscopy (bladder and urethra) - Laparoscopy (the abdomen and pelvis) - Laryngoscopy (the larynx, including the vocal cords) - Endoscopy (the inner lining of the oesophagus, stomach, and duodenum) - Arthroscopy (joints) 17 Fine-needle aspiration / biopsy Fine-needle aspiration (FNA) is a procedure where healthcare providers use to get a cell sample from a suspicious lump or an abnormal area of the body using a thin needle and a syringe to pull out cells, tissue and fluids. Healthcare providers then sends the sample to a cytology lab where a pathologist examines cells for analysis. The main advantage of FNA is that it is fairly quick, often doesn't require anaesthesia, non-invasive, so no stitches are needed and there is usually no scar. However, an FNA can sometimes miss cancer cells if the needle does not go directly into them or might not remove enough cancer cells to do other lab tests needed. If the results of the FNA biopsy do not give a clear diagnosis, or if physicians still has concerns, patients might need a more extensive type of biopsy, such as a core needle biopsy or a surgical (open) biopsy. 18 9  11/14/2024 Biopsy A biopsy is a procedure to remove a piece of tissue or a sample of cells from the body so that it can be tested in a laboratory. It can determine whether the patient has cancer or another condition. The procedure has many types as demonstrated in the image attached. Imaging tests, such as CT scans or MRIs, are helpful in detecting masses or irregular tissue, but they alone can't tell the difference between cancerous cells and cells that aren't cancerous. For most cancers, the only way to make a diagnosis is to perform a biopsy to collect cells for closer examination. Biopsy analysis and results, tissue sample is sent to a laboratory for analysis. The sample may be chemically treated or frozen and sliced into very thin sections. The sections are placed on glass slides, stained to enhance contrast and studied under a microscope. A biopsy also helps care providers to determine the cancer's grade. 19 - Centesis a puncture into a body cavity, usually to remove fluid for diagnostic or therapeutic purposes Thoracentesis involves inserting a thin needle into the pleural space to withdraw a small amount of fluid. When the procedure is done for pleural fluid testing, it is called diagnostic thoracentesis. If it is done to reduce fluid buildup and relieve symptoms, it is called therapeutic thoracentesis. Paracentesis is performed in patients with ascites, a needle is inserted into the peritoneal cavity to obtain ascitic fluid. Amniocentesis extraction of amniotic fluid from a pregnant woman to aid in the diagnosis of fetal abnormalities Arthrocentesis removal of fluid from a joint. Pericardiocentesis removal of pericardial fluid from the pericardial sac. lumbar puncture, spinal puncture, spinal tap removal of fluid from the subarachnoid space of the lumbar region of the spinal cord for diagnostic or therapeutic purposes 20 10  11/14/2024 Biopsy A biopsy is a procedure to remove a piece of tissue or a sample of cells from the body so that it can be tested in a laboratory. It can determine whether the patient has cancer or another condition. The procedure has many types as demonstrated in the image attached. Imaging tests, such as CT scans or MRIs, are helpful in detecting masses or irregular tissue, but they alone can't tell the difference between cancerous cells and cells that aren't cancerous. For most cancers, the only way to make a diagnosis is to perform a biopsy to collect cells for closer examination. Biopsy analysis and results, tissue sample is sent to a laboratory for analysis. The sample may be chemically treated or frozen and sliced into very thin sections. The sections are placed on glass slides, stained to enhance contrast and studied under a microscope. A biopsy also helps care providers to determine the cancer's grade. 19 - Centesis a puncture into a body cavity, usually to remove fluid for diagnostic or therapeutic purposes Thoracentesis involves inserting a thin needle into the pleural space to withdraw a small amount of fluid. When the procedure is done for pleural fluid testing, it is called diagnostic thoracentesis. If it is done to reduce fluid buildup and relieve symptoms, it is called therapeutic thoracentesis. Paracentesis is performed in patients with ascites, a needle is inserted into the peritoneal cavity to obtain ascitic fluid. Amniocentesis extraction of amniotic fluid from a pregnant woman to aid in the diagnosis of fetal abnormalities Arthrocentesis removal of fluid from a joint. Pericardiocentesis removal of pericardial fluid from the pericardial sac. lumbar puncture, spinal puncture, spinal tap removal of fluid from the subarachnoid space of the lumbar region of the spinal cord for diagnostic or therapeutic purposes 20 10  11/14/2024 Serum Protein Electrophoresis Protein electrophoresis is a test that measures specific proteins in the blood. The test separates proteins in the blood based on their electrical charge. The test is often used to find abnormal substances called M proteins. The presence of M proteins can be a sign of a type of cancer called multiple myeloma. Myeloma affects white blood cells called plasma cells in the bone marrow. Protein electrophoresis also tests for other proteins and antibodies (immunoglobulins). 21 Electromyography (EMG) & Nerve Conduction Studies Electromyography (EMG) and nerve conduction studies are tests that check how well muscles and nerves that control them are functioning. Nerves control muscles by sending out electrical signals to make muscles move. Muscles react by contracting, they give off electrical activity, which can then be measured. An EMG test looks at the electrical signals muscles make when they are at rest and when used. A healthy muscle should not give off any electrical signals when an individual is not moving it. If the muscle is damaged, it may show electrical activity while at rest or activity that is not normal while using it. A nerve conduction study measures how fast and how well the body's electrical signals move along nerves. A damaged nerve has a slower and weaker signal. 22 11  11/14/2024 Serum Protein Electrophoresis Protein electrophoresis is a test that measures specific proteins in the blood. The test separates proteins in the blood based on their electrical charge. The test is often used to find abnormal substances called M proteins. The presence of M proteins can be a sign of a type of cancer called multiple myeloma. Myeloma affects white blood cells called plasma cells in the bone marrow. Protein electrophoresis also tests for other proteins and antibodies (immunoglobulins). 21 Electromyography (EMG) & Nerve Conduction Studies Electromyography (EMG) and nerve conduction studies are tests that check how well muscles and nerves that control them are functioning. Nerves control muscles by sending out electrical signals to make muscles move. Muscles react by contracting, they give off electrical activity, which can then be measured. An EMG test looks at the electrical signals muscles make when they are at rest and when used. A healthy muscle should not give off any electrical signals when an individual is not moving it. If the muscle is damaged, it may show electrical activity while at rest or activity that is not normal while using it. A nerve conduction study measures how fast and how well the body's electrical signals move along nerves. A damaged nerve has a slower and weaker signal. 22 11  11/14/2024 Bone Density Test (Bone Densitometry) A bone density test is used to measure bone mineral content and density. It may be done using X-rays, dual-energy X-ray absorptiometry (DEXA or DXA), or a special CT scan that uses computer software to determine bone density of the hip or spine. For various reasons, the DEXA scan is considered the "gold standard" or most accurate test. A bone density test is used mainly to diagnose osteopenia and osteoporosis. It is also used to determine future fracture risk. Bone densitometry testing can find decreasing bone density and strength at a much earlier stage than X-ray when treatment can be beneficial. 23 Myelography (Myelogram) A myelogram is a diagnostic imaging which uses a contrast dye and X-rays or computed tomography (CT) to look for problems in the spinal canal. Problems can develop in the spinal cord, nerve roots, and other tissues. Pulse oximetry Pulse oximetry is a test used to measure the oxygen level (oxygen saturation) of the blood. It's an easy, painless measure of how well oxygen is being sent to parts of the body furthest from heart, such as the arms and legs. A clip-like device called a probe is placed on a body part, such as a finger. The probe uses light to measure how much oxygen is in the blood. This information helps the healthcare provider decide if a person needs extra oxygen. 24 12  11/14/2024 Bone Density Test (Bone Densitometry) A bone density test is used to measure bone mineral content and density. It may be done using X-rays, dual-energy X-ray absorptiometry (DEXA or DXA), or a special CT scan that uses computer software to determine bone density of the hip or spine. For various reasons, the DEXA scan is considered the "gold standard" or most accurate test. A bone density test is used mainly to diagnose osteopenia and osteoporosis. It is also used to determine future fracture risk. Bone densitometry testing can find decreasing bone density and strength at a much earlier stage than X-ray when treatment can be beneficial. 23 Myelography (Myelogram) A myelogram is a diagnostic imaging which uses a contrast dye and X-rays or computed tomography (CT) to look for problems in the spinal canal. Problems can develop in the spinal cord, nerve roots, and other tissues. Pulse oximetry Pulse oximetry is a test used to measure the oxygen level (oxygen saturation) of the blood. It's an easy, painless measure of how well oxygen is being sent to parts of the body furthest from heart, such as the arms and legs. A clip-like device called a probe is placed on a body part, such as a finger. The probe uses light to measure how much oxygen is in the blood. This information helps the healthcare provider decide if a person needs extra oxygen. 24 12  11/14/2024 Pulmonary function testing Pulmonary function tests (PFTs) are tests that show how well lungs are working. The tests measure lung volume, capacity, rates of flow, and gas exchange. This information can help healthcare providers diagnose and decide the treatment of certain lung disorders. 25 TB (Tuberculosis) Skin Test A TB test checks to see if a person have been infected with Mycobacterium tuberculosis complex, which is the bacteria that causes tuberculosis (TB). Tuberculosis is a serious bacterial infection that mainly affects lungs. There are two types of latent tuberculosis infection screen tests: a skin test and a blood test. A TB skin test is also called a Mantoux test or tuberculin skin test (TST). A TB blood test is called an Interferon-Gamma Release Assay (IGRA), also called “QuantiFERON” (the most commonly used commercial test). TB skin and blood tests can show if you’ve ever been infected with M. tuberculosis complex, but they can’t distinguish between a latent (dormant) or active TB infection. Additional tests are needed (like a sputum test) to detect active infection. 26 13  11/14/2024 Pulmonary function testing Pulmonary function tests (PFTs) are tests that show how well lungs are working. The tests measure lung volume, capacity, rates of flow, and gas exchange. This information can help healthcare providers diagnose and decide the treatment of certain lung disorders. 25 TB (Tuberculosis) Skin Test A TB test checks to see if a person have been infected with Mycobacterium tuberculosis complex, which is the bacteria that causes tuberculosis (TB). Tuberculosis is a serious bacterial infection that mainly affects lungs. There are two types of latent tuberculosis infection screen tests: a skin test and a blood test. A TB skin test is also called a Mantoux test or tuberculin skin test (TST). A TB blood test is called an Interferon-Gamma Release Assay (IGRA), also called “QuantiFERON” (the most commonly used commercial test). TB skin and blood tests can show if you’ve ever been infected with M. tuberculosis complex, but they can’t distinguish between a latent (dormant) or active TB infection. Additional tests are needed (like a sputum test) to detect active infection. 26 13  11/14/2024 Thank You 27 14  11/14/2024 Thank You 27 14