Title Page

Guide to Diagnostic Tests, Seventh Edition Copyright © 2017 by McGraw-Hill Education. All rights reserved.

Authors
Associate Authors
Preface
Abbreviations and Acronyms
Notices and Disclaimers

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Authors

Diana Nicoll, MD, PhD, MPA
Clinical Professor and Vice Chair
Department of Laboratory Medicine
University of California, San Francisco
Associate Dean
University of California, San Francisco School of Medicine
Chief of Staff and Chief, Laboratory Medicine Service
Veterans Affairs Medical Center, San Francisco

Chuanyi Mark Lu, MD
Professor of Laboratory Medicine
University of California, San Francisco
Chief, Hematology and Hematopathology
Laboratory Medicine Service
Veterans Affairs Medical Center, San Francisco

Stephen J. McPhee, MD
Professor of Medicine, Emeritus
Division of General Internal Medicine
Department of Medicine
University of California, San Francisco

Associate Authors

Barbara L. Haller, MD, PhD
Clinical Professor of Laboratory Medicine
Chief of Microbiology
Department of Laboratory Medicine
University of California, San Francisco
Zuckerberg San Francisco General Hospital & Trauma Center, San Francisco
Microbiology: Test Selection

Fred M. Kusumoto, MD
Professor of Medicine
Department of Medicine
Division of Cardiovascular Diseases
Director of Electrophysiology and Pacing
Mayo Clinic Jacksonville, FL
Basic Electrocardiography & Echocardiography

Zhen Jane Wang, MD
Associate Professor of Radiology
Department of Radiology
University of California, San Francisco
Diagnostic Imaging: Test Selection & Interpretation

Benjamin M. Yeh, MD
Professor of Radiology
Department of Radiology
University of California, San Francisco
Diagnostic Imaging: Test Selection & Interpretation

Phil Tiso
UCSF Principal Editor
Division of General Internal Medicine
Department of Medicine
University of California, San Francisco

Preface

Purpose
The Guide to Diagnostic Tests, Seventh edition, is intended to serve as a reference manual for medical, nursing, and other health professional students, house officers, and practicing physicians, physician assistants, and nurses. It is a quick reference guide to the selection and interpretation of commonly used diagnostic tests, including laboratory procedures in the clinical setting, common laboratory tests (chemistry, hematology, coagulation, immunology, microbiology, drug monitoring, pharmacogenetic, and molecular and genetic testing), diagnostic imaging tests (plain radiography, CT, MRI, and ultrasonography), electrocardiography, echocardiography, and the use of tests in differential diagnosis, helpful diagnostic algorithms, and nomograms and reference material.

This book enables readers to understand frequently used diagnostic tests and diagnostic approaches to common disease states.

Outstanding Features

•   Over 350 tests presented in a concise, consistent, and readable format.

•   Full coverage of more than two dozen new laboratory tests and diagnostic algorithms.

•   Expanded content regarding molecular and genetic tests, including pharmacogenetic  tests.

•   Full section on diagnostic imaging.

•   Sections on basic electrocardiography and echocardiography.

•   Updated and additional microbiologic coverage of emerging (new) and reemerging pathogens and infectious agents.

•   Fields covered: internal medicine, pediatrics, surgery, neurology, and obstetrics and  gynecology.

•   Costs and risks of various procedures and tests.

•   Full literature citations with PubMed (PMID) numbers included for each reference.

•  An index for quick reference on the back cover.

Organization
This pocket reference manual is not intended to include all diagnostic tests or disease states. The authors have selected the tests and diseases that are most common and relevant to the general practice of medicine.

Guide to Diagnostic Tests is divided into 10 sections:

1. Diagnostic Testing & Medical Decision Making
2. Point-of-Care Testing & Provider-Performed Microscopy
3. Common Laboratory Tests: Selection & Interpretation
4. Therapeutic  Drug  Monitoring  &  Pharmacogenetic  Testing:  Principles  &  Test  Interpretation
5. Microbiology: Test Selection
6. Diagnostic Imaging: Test Selection & Interpretation
7. Basic Electrocardiography & Echocardiography
8. Diagnostic Tests in Differential Diagnosis
9. Diagnostic Algorithms
10. Nomograms & Reference Material

New to This Edition
1. More than two dozen new or substantially revised clinical laboratory test entries, including: beta-D-glucan, BRCA1/BRCA2 genotyping, calreticulin (CALR) mutation, cystatin C, D-dimer, heparin anti-Xa assay, hepatitis B e antigen/antibody (HBeAg/ Ab), hepatitis C virus genotyping, hepatitis C viral load, new HIV screening algorithm, HLA-B51 typing, IgG subclasses, kappa and lambda free light chains with ratio, lipoprotein(a), lipoprotein-associated phospholipase A2 (Lp-PLA2), procollagen type-1 intact N-terminal propeptide (PINP), ribosomal DNA (16S rDNA) sequencing, and syphilis tests (new algorithm).

2. Microbiologic tests for emerging (new) and reemerging pathogens and infectious agents, including Chikungunya virus, Cryptococcus gattii, dengue virus, Ebola virus, Middle East respiratory syndrome (MERS) coronavirus, human granulocytic anaplasmosis, carbapenem-resistant Enterobacteriaceae (CRE), and Zika virus.

3. More than one dozen new or substantially revised tables or algorithms concerning diagnostic approaches to genetic diseases (molecular diagnostic testing), prenatal diagnostic testing, blood component therapy, adrenocortical insufficiency, inherited bleeding disorders, jaundice, lymphocytosis, monoarthritis, pulmonary embolism, syphilis testing, and thrombocytosis.

4. New reference materials displaying the complement system and steroidogenesis pathways.

Intended Audience
Medical students will find the concise summary of diagnostic laboratory, microbiologic, and imaging studies, and of electrocardiography and echocardiography in this convenient reference book of great help during clinical ward rotations. Busy house officers, physicians’ assistants, nurse practitioners, and physicians (internal medicine and family medicine, etc.) will find the clear organization and current literature references useful in devising proper patient management. Nurses and other health practitioners will find the format and scope of the Guide to Diagnostic Tests valuable for understanding the use of laboratory tests in patient management.

Acknowledgments
The editors acknowledge the invaluable editorial contributions of William M. Detmer, MD, and Tony M. Chou, MD, to the first through third editions, and Michael Pignone, MD, to the third through sixth editions of this book.

In addition, the late G. Thomas Evans, Jr., MD, contributed the electrocardiography section of Chapter 7 for the second and third editions. In the fourth, fifth, sixth, and this seventh edition, this section has been revised by Fred M. Kusumoto, MD.

We thank Jane Jang, BS, MT (ASCP) SM, for her revision of the microbiology chapter in the fifth edition. In the sixth and seventh editions, the chapter has been substantially revised by Barbara Haller, MD, PhD.

We thank our associate authors for their contributions to this book and are grateful to the many clinicians, residents, and students who have made useful suggestions.We welcome comments and recommendations from our readers for future editions.

Diana Nicoll, MD, PhD, MPA
Chuanyi Mark Lu, MD
Stephen J. McPhee, MD

Abbreviations and Acronyms

Ab

Antibody

Abn

Abnormal

AFB

Acid-fast bacillus

Ag

Antigen

AIDS

Acquired immunodeficiency syndrome

ALT

Alanine aminotransferase

ANA

Antinuclear antibody

AST

Aspartate aminotransferase

CBC

Complete blood count

CF

Complement fixation

CK

Creatine kinase

CNS

Central nervous system

CSF

Cerebrospinal fluid

CXR

Chest x-ray

CYP

Cytochrome P450

Diff

Differential cell count

EDTA

Ethylenediaminetetraacetic acid (edetate)

ELISA

Enzyme-linked immunosorbent assay

GI

Gastrointestinal

GNR

Gram-negative rod

GNCB

Gram-negative coccobacillus

GPC

Gram-positive coccus

GVCB

Gram-variable coccobacillus

HF

Heart failure

HLA

Human Leukocyte Antigen

Ig

Immunoglobulin

IM

Intramuscular(ly)

INR

International Normalized Ratio

IV

Intravenous(ly)

min

Minute

MN

Mononuclear cell

MRI

Magnetic resonance imaging

N

Normal

Neg

Negative

NPO

Nothing by mouth (nil per os)

PCR

Polymerase chain reaction

PO Orally

(per os)

Pos

Positive

PMN

Polymorphonuclear neutrophil (leukocyte)

POCT

Point-of-care testing

PTH

Parathyroid hormone

RBC

Red blood cell

SIADH

Syndrome of inappropriate antidiuretic hormone (secretion)

SLE

Systemic lupus erythematosus

SPEP/IFE

Serum protein electrophoresis/immunofixation electrophoresis

T3

Triiodothyronine

T4

Tetraiodothyronine (thyroxine)

TSH

Thyroid-stimulating hormone

V

Variable

VDRL

Venereal Disease Research Laboratory (syphilis test)

WBC

White blood cell

wk

Week

yr

Year

Increased

Decreased

No change

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