Plz help answer q's to Best initial test/most accurate...?

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NoWayOut

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So I made a list of what I could not find, or had some doubt in..for the following..
please help in answering whatever you can. Thx

Best Initial Test (BIT) for:
Aplastic Anemia?
Essential Thrombocytosis?
Paroxysmal Noctunal Hburia?
Herediatrary Spherocytosis?
Gout ?
Pseudogout?
psoriatic arthritis?
Gonoccocal arthritis?
hairy cell lekemia?
MGUS ?


Best Confirmatory/ Most Accurate Test (MAT) for:
Essential Thrombocytosis?
Cryoglobinemia ?
Rheumatoid arthritis ?
Myelodysplastic syndrome ?
Myelodysplastic syndrome?
CLL?
Waldenstrom Macroglobinemia?

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So I made a list of what I could not find, or had some doubt in..for the following..
please help in answering whatever you can. Thx

Best Initial Test (BIT) for:
Aplastic Anemia? CBC w/ diff
Essential Thrombocytosis? CBC w/ smear
Paroxysmal Noctunal Hburia? Urinalysis or dipstick, perhaps a CBC w/ bili
Herediatrary Spherocytosis? smear (spherocytes)
Gout ? joint aspirate
Pseudogout? joint aspirate (alternatively, can see calcification of joints on plain film)
psoriatic arthritis? clinical diagnosis imo, pretty characteristic appearance
Gonoccocal arthritis? high clinical suspicion, negative joint aspirate common, i believe serum culture more likely to yield oranism.
hairy cell lekemia? smear/CBC
MGUS ? Monoclonal protein in serum electrophoresis, id imagine this requires clinical suspicion, perhaps hypercalcemia first?


Best Confirmatory/ Most Accurate Test (MAT) for:
Essential Thrombocytosis? not sure, bone marrow biopsy?
Cryoglobinemia ? serum cryoblobulins
Rheumatoid arthritis ? no one best test, look at whole picture, i think anti-CCP is fairly specific
Myelodysplastic syndrome ? def marrow biopsy i'd think
Myelodysplastic syndrome?
CLL? there are several, way beyond scope of step 2 (all that immunoflourescent and cytogenetic stuff)
Waldenstrom Macroglobinemia? way too many to list, i think step 2 questions would give a clinical picture and just ask you to identify (jelly like blood for example)


giving it a shot for my own amusement
 
So I made a list of what I could not find, or had some doubt in..for the following..
please help in answering whatever you can. Thx

Best Initial Test (BIT) for:
Aplastic Anemia?
Essential Thrombocytosis?
Paroxysmal Noctunal Hburia?
Herediatrary Spherocytosis?
Gout ?
Pseudogout?
psoriatic arthritis?
Gonoccocal arthritis?
hairy cell lekemia?
MGUS ?


Best Confirmatory/ Most Accurate Test (MAT) for:
Essential Thrombocytosis?
Cryoglobinemia ?
Rheumatoid arthritis ?
Myelodysplastic syndrome ?
Myelodysplastic syndrome?
CLL?
Waldenstrom Macroglobinemia?

You aren't even trying to study... i like questions like this, and have worked on a resource just like this. But seriously dude, buy a book. FA and SU2Step have all these in them...
 
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You aren't even trying to study... i like questions like this, and have worked on a resource just like this. But seriously dude, buy a book. FA and SU2Step have all these in them...

As for your comments..."You aren't even trying to study"....just plain stupid ....and "buy a book"... well..DUDE..I have SUTS2 and although it does mention several tests, it doesn't emphasize on which is the "best" or "most appropriate" in many of the diseases I listed. I am following MTB 2 + 3 and I didn't find my answers there, so decided to confirm with others and see what they think.
 
As for your comments..."You aren't even trying to study"....just plain stupid ....and "buy a book"... well..DUDE..I have SUTS2 and although it does mention several tests, it doesn't emphasize on which is the "best" or "most appropriate" in many of the diseases I listed. I am following MTB 2 + 3 and I didn't find my answers there, so decided to confirm with others and see what they think.

Does your school offer you mobile epocrates for free? if not you can get on epocrates.com and make a free account and use it on the computer. It is really quite solid for these kinds of questions (i.e. what tests to order and first line treatments for everything).

However, for almost ALL the disorders you listed, there is no gold standard, hence why the book probably doesn't mention a single best test. It's one of those things where you have options depending on how you trained and what your hospital has available.
 
However, for almost ALL the disorders you listed, there is no gold standard, hence why the book probably doesn't mention a single best test. It's one of those things where you have options depending on how you trained and what your hospital has available.

Actually, that's what I was thinking...that it's most likely a combination of Physical findings and symptoms or not just one simple thing. But since this test is all about "what's the best/most appropriate.." I wanted to double check that I'm not missing something.
I'm gonna check out the website you mentioned. Thanks. As always..you've been really helpful, since step 1..thanks again.
 
Actually, that's what I was thinking...that it's most likely a combination of Physical findings and symptoms or not just one simple thing. But since this test is all about "what's the best/most appropriate.." I wanted to double check that I'm not missing something.
I'm gonna check out the website you mentioned. Thanks. As always..you've been really helpful, since step 1..thanks again.

np, I doubt youd get a best test question on those. they'd more likely give you one of the findings and ask you for the diagnosis.
 
giving it a shot for my own amusement

Just to add to MGUS.

To differentiate between MM and MGUS you have to see the following:
- MGUS has <10% plasma's in bone marrow (MM has >10% plasma)
- and NO SYMPTOMS of MM ie. hypercalcemia, bone lesions, anemia etc.

Waldenstrom's: IgM spike not IgG as seen in MM, MGUS. Here there are NO lytic lesions.
 
Just to add to MGUS.

To differentiate between MM and MGUS you have to see the following:
- MGUS has <10% plasma's in bone marrow (MM has >10% plasma)
- and NO SYMPTOMS of MM ie. hypercalcemia, bone lesions, anemia etc.

Waldenstrom's: IgM spike not IgG as seen in MM, MGUS. Here there are NO lytic lesions.

Thanks. Those are all good points to keep in mind.
 
Just to add to MGUS.

To differentiate between MM and MGUS you have to see the following:
- MGUS has <10% plasma's in bone marrow (MM has >10% plasma)
- and NO SYMPTOMS of MM ie. hypercalcemia, bone lesions, anemia etc.

Waldenstrom's: IgM spike not IgG as seen in MM, MGUS. Here there are NO lytic lesions.

Both MGUS and Waldenstrom do not have lytic lesions.
 
Both MGUS and Waldenstrom do not have lytic lesions.

Just to add to MGUS.

To differentiate between MM and MGUS you have to see the following:
- MGUS has <10% plasma's in bone marrow (MM has >10% plasma)
- and NO SYMPTOMS of MM ie. hypercalcemia, bone lesions, anemia etc.

Waldenstrom's: IgM spike not IgG as seen in MM, MGUS. Here there are NO lytic lesions.
 
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