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  • Rational test ordering in family medicine

    Author(s)
    Morgan, Simon
    van Driel, Mieke
    Coleman, Justin
    Magin, Parker
    Griffith University Author(s)
    Coleman, Justin
    Year published
    2015
    Metadata
    Show full item record
    Abstract
    A 54-year-old man, P.H., presented to his GP for a “health check.” He was well, with no relevant past medical history or family history. The GP examined him and requested “routine screening bloods” from the computer software program: full blood count; electrolyte, urea, and creatinine levels; liver function tests (LFTs); blood glucose level; lipid levels; thyroid-stimulating hormone level; iron studies; prostate-specific antigen level; and vitamin B12, folate, and vitamin D levels. The test results were all normal apart from mildly elevated transaminase levels. The GP telephoned P.H. and suggested repeating the LFTs in 1 ...
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    A 54-year-old man, P.H., presented to his GP for a “health check.” He was well, with no relevant past medical history or family history. The GP examined him and requested “routine screening bloods” from the computer software program: full blood count; electrolyte, urea, and creatinine levels; liver function tests (LFTs); blood glucose level; lipid levels; thyroid-stimulating hormone level; iron studies; prostate-specific antigen level; and vitamin B12, folate, and vitamin D levels. The test results were all normal apart from mildly elevated transaminase levels. The GP telephoned P.H. and suggested repeating the LFTs in 1 month. The repeat test results were abnormal and P.H. was referred for hepatitis serology and an antinuclear antibody test (the results of both were normal), and for an upper abdominal ultrasound scan. The ultrasound results were normal apart from an incidental 3.5-cm lesion in the right kidney suggestive of an angiomyolipoma (AML), with a recommendation for further investigation. The patient was recalled, causing him great anxiety about a possible malignant cause. A computed tomography (CT) scan confirmed the AML, although it led to a further recommendation for follow-up in 12 months to monitor size. Repeat LFT results were normal.
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    Journal Title
    Canadian Family Physician
    Volume
    61
    Issue
    6
    Publisher URI
    http://www.cfp.ca/content/61/6/535
    Subject
    Public Health and Health Services not elsewhere classified
    Public Health and Health Services
    Publication URI
    http://hdl.handle.net/10072/101318
    Collection
    • Journal articles

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