Top
20
Doctor insights on: Rest Excluded Clinical

Share
6

6
Would normal CBC, metabolic panel, ESR, CRP, PT, aPTT, d-dimer make multiple myeloma or waldenstrom macroglobulinemia unlikely? Given a presumptive diagnosis of von Willebrand at age 31 with no known family history. Concerned it may be acquired form.

Would normal CBC, metabolic panel, ESR, CRP, PT, aPTT, d-dimer make multiple myeloma or waldenstrom macroglobulinemia unlikely? Given a presumptive diagnosis of von Willebrand at age 31 with no known family history. Concerned it may be acquired form.

Not right tests: If you wish to be tested for multiple myeloma or Waldenstrom, you should have serum protein electrophoresis and immunofixation electrophoresis and if needed similar studies on urine. It is not a do it yourself diagnosis and your doctor should order the tests, if warranted. ...Read more

7

7
Can lupus be diagnosed on clinical symptoms alone?

Can lupus be diagnosed on clinical symptoms alone?

Yes: There's a list of 11 criteria to help diagnose sle. A person needs to satisfy at least 4 out of the 11 criteria before the diagnosis can be pinpointed. Of the 11 criteria, 7 relate to symptoms, and 4 have to do with lab tests. So it is possible to make a diagnosis of sle with just clinical symptoms as long as you have at least 4 from the list. ...Read more

9

9
Clinical Correlation: No Epileptiform abnormalities noted on this recording. Please note this does not exclude clinical diagnosis of epilepsy. Could the person be epileptic?

Clinical Correlation: No Epileptiform abnormalities noted on this recording. Please note this does not exclude clinical diagnosis of epilepsy. Could the person be epileptic?

Maybe: This report shows that there does not appear to be anything suggestive of epilepsy however, an eeg is not 100%. It is impossible to know if something is a seizure unless the event in question is captured on the eeg. ...Read more

See 2 more doctor answers
11

11
Feel great - incidental finding ANA 1:160 after acute sinusitis. Then had Anti-DNA, Ant-Smith, SSA/SSB, RNP, SCL-70, Centromere, and Thyroid labs all normal. Does this exclude autoimmune disorder?

Feel great - incidental finding ANA 1:160 after acute sinusitis. Then had Anti-DNA, Ant-Smith, SSA/SSB, RNP, SCL-70, Centromere, and Thyroid labs all normal. Does this exclude autoimmune disorder?

False positive ANA: ANA positivity very common in general population. You had the correct assessment showing no common autoimmune diseases. A repeat ANA can be 1:80 as you rid infection. It is a non specific test till titers of 1:640. ...Read more

See 3 more doctor answers
12

12
Doc investigating possible bleeding/coagulation disorders w/blood work. Ordered cardiac/hs CRP instead of normal CRP. Is that right?

Doc investigating possible bleeding/coagulation disorders w/blood work. Ordered cardiac/hs CRP instead of normal CRP. Is that right?

Crp : CRP is a test for inflammation, not aware of it for a bleeding disorder. HS CRP is more specific to inflammation of the blood vessels and the plaque that may be present and if it is inflamed. More a marker for heart disease. ...Read more

See 1 more doctor answer
13

13
Lab results led to subclinical hypothyroidism diagnosis. Treated for mdd, anxiety, ptsd. Should it be further examined? Chances of infertility?

Lab results led to subclinical hypothyroidism diagnosis. Treated for mdd, anxiety, ptsd. Should it be further examined?  Chances of infertility?

Labs alone =Dx???: History which includes symptoms over time family history and physical exam almost always trump lab results alone. Once a good history and physical are done then testing. Other endocrine disorders should be considered. However all alcohol/substances? Need to be stopped first and current meds reassessed after a new baseline mental status achieved. If appropriate, adrenal gland function may need test. ...Read more

See 1 more doctor answer
14

14
Experienced few flutters with exercise. Would a clear ecg read by a cardiologist be enough to exclude life threatening conditions. (E.g, arvd, hcm)?

Experienced few flutters with exercise. Would a clear ecg read by a cardiologist be enough to exclude life threatening conditions. (E.g, arvd, hcm)?

Cardiology Consult: 21 year old gentleman experiencing possible arrhythmia with exercise. An EKG is a good start in this case but referral to a specialist in Cardiology is a good idea. A stress test and hotter monitor are more accurate in detecting arrhythmia that may be brought on by exertion. Echocardiography and or imaging usually employed to diagnose other disorders but they do have EKG signs experts recognize. ...Read more

15

15
For 55+ female, does early/mid stage GI issues (e.g. ulcer, tumor) get revealed by physical examination of doctor ?

For 55+ female, does early/mid stage GI issues (e.g. ulcer, tumor) get revealed by physical examination of doctor ?

Try elimination diet: Must start with your PRIMARY care doctor & if you do not have one find a good internist. Detail history will reveal many differential diagnosis. Exam alone may not reveal much but helps to rule out many options. go dairy free for 1 month except yogurt & see how your symptoms improve.If no change go grain free & see. Visit drhoffman.com for holistic & practical answers. ...Read more

16

16
Pr3 elevated at 3.9 u/ml labcorp, with no anca titre. anemia, kidney issue and shortness of breath: should vasculitid be worked up? diabetic patient.

Pr3 elevated at 3.9 u/ml labcorp, with no anca titre. anemia, kidney issue and shortness of breath: should vasculitid be worked up? diabetic patient.

Mgt: I would suggest chest imaging, and discussing a renal workup to include an ultrasound, renal function, and possibly a biopsy. Vasculitis is one possible cause of shortness of breath, but others include fluid retention due to decreased renal function. Is there a family history of renal disease? ...Read more

17

17
I know ARD diagnosis depends on the whole clinical picture. Probability-wise, which ARDs are associated with a nuclear coarse speckled ANA pattern?

I know ARD diagnosis depends on the whole clinical picture. Probability-wise, which ARDs are associated with a nuclear coarse speckled ANA pattern?

Depends on other lab: There are a number of rheumatologic diseases that could have that ANA pattern, and it's also possible to have a positive ANA without having a disease. Diagnosis depends on more than just the ANA -- your doctor will probably do other tests, and with all the lab results plus your physical exam, be able to give you a diagnosis. ...Read more

18

18
With repeated ECG, holter monitors, ECHO, cardiac MRI and stress tests would long QT syndrome be obvious to diagnose?

With repeated ECG, holter monitors, ECHO, cardiac MRI and stress tests would long QT syndrome be obvious to diagnose?

Ecg finding: long qt is an ECG finding, would see it on an ECG, or holter; sometimes situational such as exercise, and a treadmill ecg would pick it up. i don't know of any particular echo or MRI findings per se. ...Read more

See 1 more doctor answer
19

19
Bloodwork, xray, ekg, echo, stress test, 24hr holter. Had all these tests done and only benign arrhythmia. Does anxiety sound right? Or possible chd?

Bloodwork, xray, ekg, echo, stress test, 24hr holter. Had all these tests done and only benign arrhythmia. Does anxiety sound right? Or possible chd?

Not CHD: Missing information is what symptom prompted this extensive work-up in the first place. Assuming palpitations was the reason, the first thing to do is to better define this. Keep a log. Take your pulse every time. Record how fast, how often, how long it lasts and what happens when it stops (sudden or slows down). The answers to these questions will provide more information to start than the tests. ...Read more

See 1 more doctor answer
20

20
Would there be a narrow range of diagnoses for an ED patient who had 14 diagnostic lab tests, 1 unk diagnostic test at cost of $3k? Food poisoning?

Would there be a narrow range of diagnoses for an ED patient who had 14 diagnostic lab tests, 1 unk diagnostic test at cost of $3k? Food poisoning?

What is the question: You went to an emergency room for some illness and expected to be diagnosed without testing? You are lucky you were only charged $3, 000. It could have been a great deal more. Ers are abused, overused and populated by large numbers of people who never pay and cannot be turned away by law. Those who can pay foot the bill for those who cannot . This is why we need major revision to med care. ...Read more