MEDICAL

INVESTIGATIONS
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MEDICAL INVESTIGATIONS

Contents
INVESTIGATION................................................................................................................................................................................................................................................. 2
BEST TIME FOR INVESTIGATION IN OBSTETRICS AND GYNECOLOGY ...................................................................................................................................... 3
INVESTIGATION OF CHOICE ......................................................................................................................................................................................................................... 4

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 INVESTIGATION 2
MEDICAL INVESTIGATIONS

INVESTIGATION
Non Invasive Method to Evaluate biliary tree MRCP
Accurate Modality for Diagnosis of Gall stones USG
Diagnosis of Temporal bone Fracture CT scan
Ideal Imaging for Blunt Abdominal Trauma FAST
(Hemodynamically stable)
Important Investigation for High risk fetus Colour Doppler
Best method for diagnosis of Unruptured Ectopic Combination of Transvaginal Ultrasound & Quantitaive
Pregnancy HCG Values
Diagnosis of Hydrocephalus in Infants USG
Inhaled Foreign body in Infant Bronchoscopy
First Indication in Ocular Trauma IOP measurement
Initial Investigation in Obstructive Jaundice USG
Initial Investigation Esophageal Dysphagia Barium swallow
Non Invasive test for altered bowel mucosa function Urinary D-Xylose Test
Best Initial imaging for Pulmonary Embolism Pulmonary Angiography
Best method for detecting HCG Radioimmunoassay
Chorionicity is best diagnosed by USG (6-9 weeks)
CPD best assessed by CT scan
Uterine Delineation best assessed by Saline Infusion USG
Best Investigation for Rapid Onset Hirsutism Testosterone
Best Investigation for Uterus Didelphys USG
Salpingitis best Confirmed by Laparoscopy/Hysteroscopy
First Investigation for Postmenopausal Bleeding Endometrial Biopsy
Best Investigation for Postmenopausal Bleeding Fractional Currettage
Luteal Phase Defect Endometrial Biopsy
Ovulation USG
Cystinuria Cyanide Nitroprusside Test
Gold Standard test for Diagnosis of Streptococcal Throat Culture
Pharyngitis
Streptococcal Glomerulonephritis Anti DNAase
Anti Hyaluronidase
Q Fever Indirect Immunofluorescence
Mycoplasma Enzyme Immuno Assay
Genital Herpes Tzank Smear
Human Immunodeficiency Virus Reverse Transcriptase PCR
Cruetzfeldt Jacob Disease PRPsc
Acute Primary Amoebic Meningoencephalitis Trophozoite in CSF
Invasive Amoebiasis ELISA
Amoebic Liver Abscess Trophozoite in Pus
Angiostrongulosis Peripheral CNS Eosinophilia
Tracing of Typhoid Carriers in City Sewer Swab Technique
Congenital Syphilis IgM FTA-ABS
Confirmation of Rheumatic fever ASLO Titre
Cytomegalovirus Culture of Virus
PCR Amplification
Ruling out Chronic Diarrhoea Small Intestinal Biopsy
Thalassemia Hemoglobin Electrophoresis
Ducchne Muscular Dystrophy CPK
Gold Standard test for Fat Malabsorption Quantitative estimation of Fecal Fat

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 BEST TIME FOR INVESTIGATION IN OBSTETRICS AND GYNECOLOGY 3
MEDICAL INVESTIGATIONS

First Investigation of Breast Lump FNAC

Best Investigation for Breast Lump Open Biopsy
Next Investigation after TFT Thyroid Scan
Early Diagnosis of Gastric cancer Staining with Endoscopic Biopsy
Serological test for Hydatid Cyst Immunoblast Test
First Investigation for CBD Stone USG
Initial Investigation for Post Cholecystectomy Biliary MRCP
Stricture
Insulinoma 72 hour Fasting Test
Next Investigation after visualizing filling defect in IVP USG
Assessment of Substances in Stones X-ray Crystallography
Differentiate between Stress Incontinence & Detrusor Urodynamic Study
Instability
Gross Painless Hematuria in Elderly Urine Microscopy
Syrinx MRI
Initial screening for Primary hyperparathyroidism Serum PTH
Initial Investigation for Hyperpituitarism Serum IGF-1
Detecting small Paraaortic Nodes CT Scan
Lung Sequestration CT scan
MC investigation for evaluation of cancer patient for Bone Scan
bone metastasis
MC Investigation for Hypothyroidism Serum TSH
Investigation done in downs syndrome before surgery Echocardiogram
Most Useful Investigation for Vesicovaginal Fistula Cystoscopy

BEST TIME FOR INVESTIGATION IN OBSTETRICS AND GYNECOLOGY

nd rd
FSH / LH Assay 2 /3 day
th th
Tubal Patency 6 8 day
th
Unsafe Period 8-18 day
Post Coital test 11-13 days (1-2 days before ovulation)
st
Serum Progesterone 21 day
st rd
Endometrial Biopsy 21 23 day

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 INVESTIGATION OF CHOICE 4
MEDICAL INVESTIGATIONS

INVESTIGATION OF CHOICE
Atticoantral CSOM CT Scan
Extradural Abscess MRI
Bezold Abscess
Cerebral Abscess
Coalescent Mastoiditis CT scan
Imaging Modality for Nasopharyngeal Carcinoma MRI with Gadolinium and Fat Suppression
Acoustic Neuroma MRI with Gadolinium
Glomus tumour CT Scan
Malignant Hyperthermia Biopsy of Muscle
Contracture Study
Atopic Dermatitis Clinical Examination
Contact Dermatitis Patch Test
Donovanosis Microscopy
Chancroid Gram Staining
Dermatophytosis(Tinea) KOH Smear
Lupus Vulgaris Biopsy
Retinal Detachment Indirect Ophthalmoscopy
Traumatic Optic Neuropathy High Resolution CT Scan
Subarachnoid Hemorrhage Non Contrast CT scan
Post menopausal Bleeding Fractional Curettage
Rapid Onset Hirsutism S.Testosterone
Uterus Didelphys USG
Ectopic Pregancy Diagnostic Laparoscopy
Hydatidiform Mole USG
Endometriosis Laparoscopy
Streptococcal Pharyngitis Throat Culture
Diphtheria Carrier Throat Swab
Rapid Diagnosis of Syphilis RPR
Evaluation of therapy of Syphilis VDRL
Congenital Syphilis IgM FTA-ABS
st
Typhoid 1 week Blood Culture
rd
Typhoid 3 week(after 25 days of onset of fever) Widal Test
Narcolepsy Polysomnography
Multiple Sleep Latency Test
Urinary Bladder Neoplasm Cystoscopy & Biopsy
Bronchiectasis High Resolution CT Scan
Carcinoma Esophagus Endoscopy & Biopsy
Zenkers Diverticulum Barium Swallow
Achalasia Cardia Barium Swallow
Primary and Metastatic Neuroendocrine Tumour Somatostatin Receptor Scintigraphy
(except Insulinoma)
Pseudomyxoma Peritonei CT Scan
Hirschprungs Disease Rectal Biopsy
Angiomyolipoma CT Scan
Axillary Subclavian Vein Thrombosis Doppler
Abdominal Aortic Aneurysm Contrast Enhanced CT Scan
Soft Tissue Sarcoma Extremity MRI
Soft Tissue Sarcoma Retroperitoneum CT Scan
Solitary Thyroid Nodule FNAC

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 INVESTIGATION OF CHOICE 5
MEDICAL INVESTIGATIONS

GERD 24 Hours pH Study

CBD Stone Non Invasive MRCP
CBD Stone ERCP
Extrahepatic Biliary Atresia Peroperative Cholangiography
Insulinoma 72 hours Fasting Test
Diverticulosis Barium Enema
Diverticulitis CT Scan
Renal Cell Carcinoma CT Scan
Testicular Torsion Colour Doppler
Early Phase of Renal Transplant USG
Small para aortic Lymph Nodes CT Scan
Deep Vein Thrombosis Duplex USG
Blunt injury Abdomen(Stable&Unstable) USG
Parotid Swelling FNAC
GIST PET CT
Delayed Passage of Meconium Contrast Enema
Hip Fracture T1W MRI
Perthes Disease MRI
Ligamental Injury of Knee Arthroscopy followed by MRI
Altered Intestinal Mucosa Endoscopic Mucosal Biopsy
Altered Intestinal Mucosa(Non invasive) Urinary D-Xylose Test
Pyloric Stenosis USG
Wilsons Disease Liver Biopsy
Quantitative Copper Assay
Thalassemia Hemoglobin Electrophoresis
Ducchne Muscular Hypertrophy CPK
Tracheoesophageal Fistula Chest X ray
Primary Bone Tumour MRI
Bone Metastasis Whole body MRI
Parathyroid Location MIBI + CT Scan
Pulmonary Embolism CT Pulmonary angiography
Cavernous Angioma T2 Gradient ECHO MRI
Meningeal Carcinomatosis Gadolinium enhanced MRI
Temporal Bone Lesions Non Contrast CT Scan
Acute Renal Stone Non Contrast Helical CT Scan
Early Renal TB IVP
Late Renal TB CT Scan
UTI Children IVP
UTI Adults USG
Posterior Urethral Valve Micturating Cystourethrogram
Vesicoureteric Reflex Micturating Cystourethrogram
Vascular Rings MRI
Irreversibly Damaged Myocardium Delayed Contrast Enhanced MRI using Gadolinium
Upper GI Bleed Endoscopy
Acute Pancreatitis CT Scan
Spinal Stenosis MRI
Adrenal Phaeochromocytoma CT Scan
Extraadrenal Phaeochromocytoma MIBG
Cause of Sub arachnoid Hemorrhage Digital Subtraction Angiography
Abdominal Trauma CT scan

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 INVESTIGATION OF CHOICE 6
MEDICAL INVESTIGATIONS

Splenic Injury Contrast enhanced CT Scan

Displaced IUD USG
Osteoporosis DEXA
Gall Stones USG
Acute Cholecystitis USG
CT/RT induced Cardiotoxicity Endomyocardial Biopsy
Dental Biopsy Pantomography
Interstitial Lung Disease HRCT Scan
Aortic Dissection(Stable) MRI
Aortic Dissection(Unstable) Transesophageal ECHO followed by CT
Recurrent/Chronic Sinusitis Non Contrast CT
Hydrocephalus in Infants USG
Juvenile Nasopharyngeal Angiosarcoma Contrast enhanced CT Scan
AV Fistula Arteriography
Ca Larynx Diagnostic Laryngoscopy
Lumbar disc Herniation MRI
Diffuse Esophageal Spasm Manometry
Acute Mesentric Ischemia Laparotomy
Chronic Mesentric Ischemia Angiography
Ca Pancreas Contrast Enhanced CT Scan
Pancreatic Injury HRCT
Pseudomyxoma Peritonei CT Scan
Dysphagia for Solid food Endoscopy
Epitheloid Mesothelioma Electron Microscopy
Ca Colon (Radiological IOC) Double Contrast Barium enema
Meyer Rokitansky Kustner Syndrome USG
Detect Abnormal fetus in Diabetic Mother USG
Predict Chances of Abnormality in Diabetic Mother Glycosylated Hb

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