From the Guidelines
A diagnostic workup for Hodgkin's lymphoma should include a lymph node biopsy, medical history and physical examination, contrast-enhanced CT scan of neck, chest and abdomen, PET, full blood cell count and blood chemistry, HBV, HCV and HIV screening, pre-treatment examinations, ECG, echocardiography, pulmonary function test, and reproductive counselling in younger patients. When considering a diagnostic workup, it is essential to prioritize tests that provide the most relevant information for diagnosis and staging. According to the guidelines for Hodgkin's lymphoma diagnosis, treatment, and follow-up 1, a comprehensive diagnostic workup should include:
- Lymph node biopsy (or a biopsy from another organ with suspected affection)
- Medical history and physical examination for staging and risk stratification
- Imaging studies such as X-ray of the chest, contrast-enhanced CT scan of neck, chest and abdomen, and PET
- Laboratory tests including full blood cell count and blood chemistry
- Screening for HBV, HCV, and HIV
- Pre-treatment examinations such as ECG, echocardiography, and pulmonary function test
- Reproductive counselling in younger patients It is crucial to note that the diagnostic approach should be tailored to the patient's presentation, medical history, and risk factors. The guidelines for early and locally advanced non-small-cell lung cancer (NSCLC) diagnosis, treatment, and follow-up 1 also emphasize the importance of a comprehensive diagnostic workup, including medical history, physical examination, imaging studies, and laboratory tests. However, the specific components of the workup may vary depending on the clinical suspicion and patient's condition.
From the FDA Drug Label
§ Disc diffusion interpretive criteria for ceftriaxone discs against Streptococcus pneumoniae are not available, however, isolates of pneumococci with oxacillin zone diameters of >20 mm are susceptible (MIC ≤ 0. 06 mcg/mL) to penicillin and can be considered susceptible to ceftriaxone. Streptococcus pneumoniae isolates should not be reported as penicillin (ceftriaxone) resistant or intermediate based solely on an oxacillin zone diameter of ≤ 19 mm. The ceftriaxone MIC should be determined for those isolates with oxacillin zone diameters ≤ 19 mm
The diagnostic work up for Streptococcus pneumoniae involves:
- Determining the oxacillin zone diameter
- If the oxacillin zone diameter is ≤ 19 mm, then the ceftriaxone MIC should be determined 2
From the Research
Diagnostic Workup
The diagnostic workup for a patient typically involves a combination of history taking, physical assessments, and laboratory investigations.
- A thorough patient history is fundamental for accurate diagnosis and effective management of health conditions 3.
- The history should include characteristics of the patient's pain, mechanical symptoms, joint effusion, and mechanism of injury 4.
- A physical examination may provide clues to diagnosis, and should include careful inspection, palpation for point tenderness, assessment of joint effusion, range-of-motion testing, and evaluation of ligaments and menisci 4.
Laboratory Tests
Laboratory tests are an essential part of the diagnostic workup, and may include:
- Complete blood count (CBC) with platelet count, peripheral blood smear, prothrombin time, and partial thromboplastin time 5.
- More specialized tests, such as the Platelet Function Analyzer-100, mixing studies, and inhibitor assays, may also be helpful in diagnosing bleeding disorders 5.
- Radiographs should be obtained in patients with specific symptoms or risk factors, such as isolated patellar tenderness or inability to bear weight 4.
Importance of History and Physical
The importance of using the patient history and physical as a basis for selecting relevant diagnostic testing cannot be overstated, as it leads to a timely and accurate diagnosis, protects patients from unnecessary testing, and is cost-effective 6.
- A standardized bleeding score system can help physicians organize the patient's bleeding history and avoid overlooking common inherited bleeding disorders, such as von Willebrand's disease 5.