Acute inflammation |
FBC, ESR, C-reactive protein |
Urine mcs, U&E, LFT |
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Alopecia |
TFT, iron studies, antinuclear factor, ESR |
Fungal microscopy and culture |
Skin biopsy |
Amenorrhoea |
Quantitative HCG, Follicle Stimulating Hormone, Luteinsing Hormone |
TFT, oestradiol, prolactin |
|
Ante-natal screen (before 20 weeks) |
FBC, blood group & antibodies, Rubella, Syphilis, HIV, Hepatitis B & C serology, urine mcs, cervical cytology |
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Maternal serum antenatal screening programme (triple test) |
Ante-natal screen (for 26 - 28 Weeks) |
Blood group & antibodies, glucose tolerance test |
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Ante-natal screen (for 30 - 36 Weeks) |
FBC, group B Streptococcus screen |
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Anti-coagulant therapy (initial monitoring of warfarin therapy) |
INR |
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Arthritis |
Serum uric acid, rheumatoid factor, antinuclear factor, extractable nuclear antigen, ESR, C-reactive protein |
HLA B27, complement, faeces mcs, Ross River virus serology, Barmah Forest virus serology, Hepatitis C serology |
PCR/serology for Bordetella pertussis, PCR/serology for influenza A & B & parainfluenza & respiratory syncytial virus, adenovirus PCR, Q Fever serology, Mycobacterium tuberculosis culture, iron studies |
Atypical pneumonia / chronic cough |
Sputum mcs, Mycobacterium tuberculosis culture, Legionella serology and culture, serology for Mycoplasma & Chlamydophila |
PCR/Serology for Bortetella pertussis, respiratory viral serology, Q Fever serology |
|
Bleeding tendency |
FBC, INR, APTT, fibrinogen, LFT |
Platelet function analysis, coagulation factor studies, platelet aggregation |
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Chest pain |
Troponin, Creatine Kinase |
Repeat first stage tests |
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Dementia |
FBC, ESR, U&E, TFT |
Vitamin B12, red cell folate, Syphilis serology, blood lead |
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Depression |
FBC, fasting blood glucose, TFT |
Serum cortisol, urine drug screen |
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Diabetes monitoring |
HBA1c, urine albumin, lipids, U&E |
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Diarrhoea |
Faeces mcs x2 (Due to HIC requirements only one culture and two microscopies can be performed in 7 days) |
Reducing substances, Clostridium difficile toxin, rotavirus, adenovirus |
Vasoactive intestinal polypeptide, urine hydroxy indole acetic acid, bowel biopsy |
Erectile dysfunction |
Testosterone, luteinsing hormone, LFT |
Fasting blood glucose, iron studies, lipids |
|
Fatigue / weakness |
FBC, TFT, U&E, LFT |
Serum calcium, iron studies, EBV serology, Ross River virus serology, Barmah Forest virus serology |
Creatine kinase, antinuclear factor, acetylcholine receptor antibody, short synacthen stimulation test |
Gynaecomastia |
LFT, U&E, TFT |
Testosterone, luteinsing hormone, follicle stimulating hormone |
Urine drug screen (especially THC), prolactin, fine needle aspiration |
Hepatomegaly +/- Liver Dysfunction |
FBC, LFT, Hepatitis A, B & C screen |
Iron studies, CMV serology, EBV serology |
Fasting blood glucose, lipids, antinuclear factor, serum alpha-foetoprotein, carcinoembryonic antigen, Malarial parasites, Hydatid serology, Q Fever serology |
Hirsutism |
Testosterone, free testosterone, follicle stimulating hormone, luteinsing hormone |
Urine cortisol, 17 hydroxy progesterone |
|
Hyperlipidaemia |
Lipids, HDL cholesterol, fasting blood glucose |
LFT, TFT, U&E |
|
Hypertension |
Urine mcs, fasting blood glucose, U&E |
TFT, urine catecholamines, urine cortisol |
Aldosterone/renin |
Infertility – female |
Oestradiol, progesterone, follicle stimulating hormone, luteinsing hormone |
Prolactin, TFT, serum cortisol |
Testosterone, free testosterone, 17 hydroxy progesterone, chromosome studies (blood) |
Infertility – male |
Semen analysis |
Testosterone, follicle stimulating hormone, luteinsing hormone, fasting blood glucose, prolactin |
Chromosome studies (blood), iron studies, sperm antibodies, testicular biopsy |
Lymphadenopathy |
FBC, ESR, EBV serology, CMV serology, Toxoplasma serology |
Angiotensin converting enzyme, Syphilis serology, HIV serology |
Fine needle aspiration +/- flow cytometry, tissue culture |
Malabsorption, failure to thrive |
FBC, urine mcs, reducing substances, faeces mcs (including fat globules) |
Vitamin B12, LFT, HIV serology, iron studies |
Immunoglobulin A & G & M, serum carotene, GAD antibodies, endomysial antibody, small bowel biopsy |
Obesity |
Fasting blood glucose, TFT, urine cortisol |
Lipids |
Dexamethasone suppression test |
Peripheral neuropathy |
Vitamin B12, fasting blood glucose, U&E |
LFT, porphyrin screen (urine or faeces) |
Heavy metals (lead, arsenic, thallium) |
Pharyngitis |
Throat swab, FBC, monospot |
EBV serology |
Streptococcal serology |
Polyuria |
Fasting blood glucose, U&E, urine mcs |
Osmolality (serum and urine) |
Water deprivation test |
Pyrexia of Unknown Origin |
FBC, ESR, C-reactive protein, LFT, urine mcs |
Blood cultures, angiotensin converting enzyme, Malarial parasites, faeces mcs |
CMV serology, EBV serology, Brucella serology, Q Fever serology, Toxoplasma serology, Syphilis serology, Dengue Fever serology, HIV serology, Leprospirosis serology, Beta 2 microglobulin |
Recurrent / persistent infections (immune deficiency) |
FBC, ESR, immunoglobulin A & G & M, protein EPG, HIV serology |
Fasting blood glucose, complement, lymphocyte surface markers (blood) |
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Renal impairment / failure |
Urine mcs, urine albumin, U&E, LFT, fasting blood glucose, prostatic specific antigen, serum uric acid |
Creatinine clearance, urine protein |
Antinuclear factor |
Splenomegaly |
FBC, ESR, LFT, rhematoid factor |
Hepatitis B & C serology, INR, APTT, fibrinogen, angiotensin converting enzyme, antinuclear factor, EBV serology, CMV serology, HIV serology |
Malarial parasites, Mantoux test, flow cytometry (blood), osmotic fragility |
Suspected illicit drug usage |
Urine drug screen, LFT |
Hepatitis B & C serology, HIV serology |
|
Thrombotic tendency / investigation of DVT |
FBC, INR, APTT, fibrinogen, lupus anti-coagulant, anti-cardiolipin antibodies, prothrombin gene mutation, protein C and S, anti-thrombin III |
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Tumour markers |
Carcinoembryonic antigen, CA 125, CA 19-9 |
Serum alpha-foetoprotein, HCG (tumour marker), CA 15.3 |
BRCA2 (breast cancer gene) |
Urethritis |
Urethral swab, PCR for Chamydia and gonorrhoea |
Syphilis serology, HIV serology, Herpes simplex PCR |
|
Weight Loss |
FBC, TFT, U&E |
LFT, fasting blood glucose |
Short synacthen stimulation test, carcinoembryonic antigen, CA 125, CA 19-9 |