BOOKS FOR DOCTORS

Pathinterp

        This book grew out of necessity. As a doctor I found myself confronted by a never ending barrage of pathology results from hospitals, specialists and laboratories. many of these tests, and the scores of others listed by the pathology services that were available to me, I found difficult to interpret. Heavy medical tomes were reached for in an effort to avoid missing some of the more subtle meanings of even relatively common tests. The indications for performing other more esoteric tests totally eluded me.

    I started making lists for myself to remind me of the information I had gathered (often with difficulty) from many diverse sources. Thus Pathinterp grew and took on its present form.

    Pathinterp now covers every conceivable pathology test with the expected normal range, indications for its use, the interpretation of abnormal results and a brief summary of physiology of the test.

    It is updated on a weekly basis as new information is gleaned from a wide range of medical journals and text books.

    It was first published in 1978 and since then has gone through 14 editions, been published in eleven different languages and distributed in more than 80 countries. It is still in print and its circulation now exceeds 250,000 copies.

    The data it contains is available to be used in print or electronically.

PATHINTERP

The Interpretation of Pathology Tests

FORMAT

Test Name, Test Substance  [Abbreviation]

(Alternate Name) [Abbreviation]

RI:    Reference interval (or value), and units. System Internationale (SI) units are used where possible. (Alternative units are in brackets). 90% of the population have results that lie within this range.

Ind:    Indications. The suspected diseases and conditions in which the test is indicated.

Int:    Interpretation of the results. The diseases, conditions, syndromes etc. that should be considered with results that vary from the reference interval (eg: HIGH, LOW, V.LOW). With a history, examination and possibly other tests (in some instances, other tests that should be considered are in brackets after the diagnosis followed by a ?), a definite diagnosis may be made from the differential diagnoses suggested.

Phys:    The basic physiology of the test, to enable the significance to be better understood.

See also Other Relevant Tests

SAMPLE ENTRIES:-

Platelet Count, Blood

RI:    150-450 x 109/L (150,000-450,000/mm3)

Ind:    Bleeding disorders

Int:    HIGH (thrombocytosis) - Myelofibrosis, chronic leukaemia, polycythaemia rubra vera, essential thrombocythaemia, infection, trauma, post-splenectomy, strenuous exercise, labour of childbirth, familial

    Low  number, normal type (thrombocytopenia) - Marrow suppression or infiltration, carcinoma, myeloma, cytotoxic drugs, infections, megaloblastic anaemia, SLE, acute leukaemia, disseminated intravascular coagulation, haemolytic-uraemic syn., massive  transfusion, autoimmune diseases, hypersplenism, rheumatoid arthritis, Fanconi syn., HELLP syn.,  sticky platelet syn., Wiskott-Aldrich syn., alcohol, viral or bacterial infections (eg. rubella, infectious mononucleosis), idiopathic, congenital, post-transfusion, drugs (eg. quinidine, quinine, heparin, aurothiomalate, NSAIDs)

    Normal number, abnormal type (thromboasthenia) - Glanzmann's disease

    Low number, abnormal type - May-Hegglin anomaly

Phys:    Platelets are essential for blood clotting  

See also Fibrinogen, Blood; Clotting Time

Platelet Function Analysis, Blood [PFA-100]

RI:    Collagen epinephrine aperture  -  82 to 150 secs.

    Collagen ADP aperture  -  42 to 110 secs.

Ind:    Suspected bleeding disorder

Int:    HIGH - Abnormal platelet function, aspirin or other anticoagulant use, von Willebrand disease, Bernard-Soulier syndrome, Glanzmann syndrome, other inherited platelet functioin disorders

Phys:    Whole blood sample passed under high shear stress through different apertures in a biochemically activated membrane and time to clot formation and aperture blockage measured. Test within 5 hours of collection

Platelet Survival, Blood

RI:    8-10 days

Ind:    Thrombocytopenia

Int:    LOW - Immune thrombocytopenia, hypersplenism, other causes of platelet destruction

Phys:    Radioactive platelets injected, and sampled after 30 minutes and 2 hours, then at daily intervals

Pleural Fluid

RI:    Protein > 25g/L : Exudate

    Protein <25g/L : Transudate

Ind:    Pleural effusion

Int:    EXUDATE - Infection (eg. TB, pneumonia), malignancy

    TRANSUDATE - Congestive cardiac failure, cirrhosis, nephrotic syndrome, Meigs syndrome, hypothyroidism