Blood test
A blood test is defined as the extraction of a small amount – approximately 2 to 50 milliliters – of venous or arterial blood, which provides an in depth look into the blood’s contents and solid particles by utilizing different laboratory methods. The results include a diagnostically relevant blood count, which indicates the state of one’s medical condition and hints at any diseases or risks of disease, amongst other revealing information (e.g. iron deficiency = anemia, etc.).
When is it advisable to have a blood test done?
There are several manners in which one can have a blood test done. A single blood sample can provide up to 40 different pieces of information on the medical condition of a patient. Therefore, blood tests are standard for almost all preventive medical check-ups in which blood counts specifically are a fixed component of the general clinical examination for preoperative preparations, inflammations, tumors, infections, coagulation disorders, anemia, and blood diseases.
What occurs during a blood test?
Blood samples can be arterial or venous. Venous blood is used for the majority of blood tests. However, arterial or capillary blood samples may be necessary for individual examinations.
Venous blood samples are normally taken from the inside of the patient’s elbow. The patient should be sitting down or lying down at the time. In order to ensure the vein is fully visible, the blood flow is constricted for a short period of time at the upper arm by means of a tourniquet or a cuff. The puncture site is cleansed with a disinfectant, following which the vein is punctured with a needle and the amount of blood required is extracted with a syringe or a vacuum blood collection tube. A gauze pad or plaster is then applied onto the puncture site for around a minute so that the bleeding stops. During that minute, the elbow should not be bent, so that the vein is not reopened and a bruise is not caused.
Blood test – are there alternatives?
Blood tests are painless and there are no accompanied risks. As such, there is no better alternative. If minuscule amounts of blood are required, e.g. for blood glucose level, then the fingertip or the earlobe can be pierced with a small lancet and a few drops of blood can then be squeezed out.
Computed tomography
Computed tomography (CT) should actually be called X-ray computed tomography, as CT is a computer-aided X-ray examination. In contrast to the “classic” X-ray, which only captures a two-dimensional image on the X-ray film, computed tomography provides cross-sectional images of the body from which three-dimensional images are generated. The three-dimensional images not only serve to detect various diseases, but also determine the position and extent of abnormal changes.
Today, computed tomography is a standard piece of equipment to have at clinics and doctor’s offices. It is used in the diagnosis process for various diseases and for monitoring the progress of treatments. For instance, a CT can track the status of a suspected tumor, stroke, slipped disc, bone fracture, examinations of the coronary vessels, and early detection of bowel cancer amongst others. X-ray images of the chest are frequently supplemented by a thorax computed tomography (Thorax CT).
What occurs during a CT?
The patient is pushed through the device, whilst the X-ray tube continually rotates around the patient. The examination is normally carried out in the supine position on the CT table. It typically takes anywhere between a few seconds and 15 minutes at most. Cross-sectional images in any desired region of the X-rayed body can be generated from the recorded data. For example, an image of the chest is taken with a Thorax CT. During or after the Thorax CT, the computer can convert the single cuts into a three-dimensional image.
For certain procedures, contrast agents may be used. Contrast agents are either administered to the patient via the vein or the mouth. Moreover, employing contrast agents can enhance the resolution or quality of the computed tomography.
Computed tomography – are there alternatives?
In comparison to a CT, ultrasounds (sonography) and magnetic resonance imaging (MRI) have the advantage that they do not expose the patient to X-rays. Today, some examinations, which have long been the domain of computed tomography, are carried out by way of an MRI instead. Each patient must make a decision as to which imaging method is best suited to their needs. It’s important to remember that the CT, MRI, classic X-ray, and ultrasound are not interchangeable. Computed tomography is often used when “more gentle” methods have come back empty.
Colonoscopy
Colonoscopy – how?
The tool used in a colonoscopy is the endoscope (coloscope), a flexible tube which adapts to the bends in the colon. There is a video chip at the tip, which transmits the recorded images to a monitor (video endoscopy). There are additional channels in the tube, such as cleaning and suction devices and channels for inserting surgical instruments. Smaller interventions can also be carried out as part of the endoscopy/rectoscopy, such as homeostasis, tissue sampling (biopsy) or polyp removal. In order to show the entire colon, the coloscope has a length of approximately 1.3 meters.
The examination is not very unpleasant and risk-free to a large extent. For those with sensitive natures, the colonoscopy can be carried out after administering sedatives or light anesthesia.
Colonoscopy – are there alternatives?
The virtual or CT coloscopy is a possible alternative to the endoscopic examination. Two and three-dimensional images of the colon are generated by means of high-resolution multi slice CT devices and special computer programs and examined for changes, such polyps or tumors. The colonoscopy and CT coloscopy are able to detect polyps with the same degree of precision. However, the conventional coloscopy offers the major advantage that such polyps can be removed in the same examination step. Patients whose polyps are detected during a CT coloscopy often require an additional colonoscopy for polyp removal. The radiation exposure from a CT examination can be seen as a disadvantage, even though it is low. The CT coloscopy is mainly used in case of severe constrictions of the colon, which cannot be passed by an endoscope. It can also be considered as an alternative in case of other contraindications for a colonoscopy.
ECG – Echocardiography
During the electrocardiography (ECG), the electrical activity of the heart is recorded in the form of a curve on an electrocardiogram. In the heart, there is a weak current with a voltage of around one thousandth of a Volt per beat. These electrical pulses are deduced using electrodes (metal platelets). For this purpose, the electrodes are applied to the arms, legs and chest. An ECG device amplifies these pulses and presents them as a curve on a screen or prints them on a strip of paper.
Thus, electrocardiography is the recording of the course of cardiac excitation.
ECG – when?
With the electrocardiogram, the doctor examines
- Cardiac rhythm and heart rate
- Disorders of the ectopic rhythm, propagation and regression in the impulse conduction system and in the cardiac muscles
- The position of the heart in the chest
The following can be detected by curve changes in the ECG:
- Cardiac infarction
- Coronary vessel diseases
- Overdosage of certain medications
- Lack or abundance of certain minerals and their influence on impulse conduction.
- Atrial fibrillation or atrial flutter and ventricular fibrillation or ventricular flutter
- heart beat that is too slow (bradycardia) in diseases of the sinus node or AV node
- Inflammation of the myocardium (myocarditis)
- Inflammation of the pericardium (pericarditis)
The treatment and progress of different heart diseases are often monitored by means of ECG.
ECG – how?
During a resting ECG, the patient lies down in a relaxed physical state. The measuring points are on the arms, legs and the chest. They are connected to the ECG device which then measures the electrical activity of the heart. After the examination, the doctor removes the measuring electrodes and evaluates the ECG.
During an exercise ECG, the patient must be active on either a treadmill or a room bicycle. This is useful:
- if there is a suspicion of coronary vessel diseases
- if there is a suspicion of exercise hypertension (abnormal increase in blood pressure during exercise)
- for the clarification of physical fitness after cardiac infarction or following cardiac surgery
- for the assessment of heart rhythm disorders during exercise
- for the assessment of medicinal treatment of coronary vessel diseases or increased blood pressure
A long-term ECG records the electrical activity of the heart over a period of at least 24 hours. In this case, the ECG device is particularly small so that, for example, it can be carried on the belt.
During exercise tests, cardiorespiratory fitness and changes in cardiovascular function are examined and assessed for different diseases, e.g. high blood pressure, bradycardia, chronotropic incompetence, heart failure, valvular heart disease, cardiac arrhythmia, coronary heart disease (CHD) and following heart surgery.
Ergometry
Ergometry – how?
You should wear comfortable sportswear and trainers for the exercise test on the bicycle ergometer or the treadmill. At the start of the examination, a resting ECG is recorded and the resting blood pressure is measured. For this purpose, several electrodes are attached to the skin on the chest and back and a blood pressure cuff is applied to the left upper arm. The ECG recordings during physical exercise are then repeated at regular intervals.
The physical exercise is either on a bicycle or a treadmill. The resistance of the bicycle ergometer or the speed of the treadmill is increased every two minutes to increase the level of exercise in a controlled manner. The examination is carried out until the exercise limit, unless certain measurement values (such as blood pressure or heart rate) exceed the determined limit values or if heart complaints or breathing difficulties occur. Once the exercise limit is reached, you should keep peddling or walking without effort for a few more minutes, so that complaints which occur a short period of time after exercise can be detected.
Ergometry – are there alternatives?
Ergometry is just one examination in a whole arsenal of cardiovascular examinations.
The worst side-effect for healthy patients is a slight muscular ache. With regard to patients with severe cardiac disease, the examining doctor must carefully consider whether there are any contraindications for the implementation of ergometry (e.g. acute coronary syndrome, myocarditis, serious
– if they are bleeding – they can also be treated immediately.
Further applications are the removal of polyps (benign mucosal proliferation), the removal of swallowed foreign bodies and the widening of constrictions in the oesophagus or the area of the pyloric orifice. For the latter, an inflatable balloon is pushed through the working channel of the endoscope.
Gastroscopy
Gastroscopy – how?
A special endoscope, the so-called gastroscope, is used for the gastric examination; a flexible tube which can be controlled and moved by the doctor. Inside, in addition to a working channel and an air/cleaning channel, there is a video lens which transmits images to a monitor.
The instruments are still smaller than a centimetre thin and they can be pushed into the stomach via the mouth and oesophagus without any problems.
During the examination, the patient lies on their left side. The gastroscope is then pushed through the mouth via the oesophagus into the stomach and also the duodenum if a diagnosis is also required there. In order to unfold the mucous membranes and thus for a better assessment, the stomach is inflated with air for a gastroscopy. The doctor then sees the inside of the upper digestive tract, piece by piece, via the integrated lens. If they detect changes, they can take mucous membrane samples with small forceps passed through the working channel, which are then examined in the laboratory.
The duration of a gastric examination is normally only a few minutes. Once it is complete, the doctor slowly pulls the device back and then straight out. The previously injected air is extracted to prevent or reduce excessive belching and bloating.
The method does not cause pain. However, the insertion of the gastroscope can cause an unpleasant gag reflex. Meanwhile, there are also devices which are pushed through the nose, which many patients perceive as more pleasant.
Gastroscopy – are there alternatives?
All in all, the gastroscopy is a very safe procedure, which has long become routine practice in hospitals and doctor’s offices. In many cases, there are no alternatives, as the Lipid profile
Lipid Profile
The lipid profile is part of the blood test in which the presence of HDL cholesterol, LDL cholesterol, total cholesterol, and triglycerides in the blood are determined with laboratory resources. This examination, which carried out regularly, plays a major role in the prevention of atherosclerosis and cardiovascular diseases.
Biochemistry has taught us a lot about the function of different blood lipids. Cholesterol, which is partly ingested with food and partly synthesised in the liver, is an essential component of cell membranes. Triglycerides primarily serve as sources of energy and storage substances. They also form the mostly undesired fat pads on the body and they represent a form of energy that can be continued during physical exercise. Lipoproteins, such as HDL and LDL, serve to transport the cholesterol in the blood. The basis for an assessment regarding the percentage of risk involved in terms of arteriosclerosis and thus, to ensure suitable recommendations ensue for a health-conscious lifestyle can come by way of investigating the distribution of cholesterol, HDL, LDL and triglycerides in the blood. This can be determined with a blood test.
When it is advisable to check on your lipid profile?
The lipid profile can be checked with simple blood test at the Wiener Privatklinik as part of preventive medical check-ups. It serves as a crucial decision-making factor regarding what nutritional and lifestyle recommendations the specialist will make for the sake of prevention of cardiovascular diseases.
Mammography
Mammography – are there alternatives?
The X-ray examination of the breast – the mammography – is the most important internationally recognised and standardised method for the early detection of breast cancer. Magnetic resonance imaging (MRI) is also used in exceptional cases.
The ultrasound examination (sonography) of the breast is another established method; however, it accuracy depends on the breast density. In contrast to the Mammography, it is not possible to detect so-called microcalcification, which can indicate a surface carcinoma in the mammary ducts in some cases.
MRI – Magnetic resonance imaging
MRI – Magnetic resonance imaging – Process, benefits and alternatives
MRI – what is involved?
Magnetic resonance imaging/MRI is an imaging method, with which organs and tissue can be shown in great detail and any changes can be assessed. The examination method also known as nuclear spin tomography uses magnetic fields and high-frequency electromagnetic waves instead of X-rays.
Cross-sectional images of the inner body can be produced using magnetic resonance imaging. Soft tissue, such as the brain and internal organs, show up high in contrast on an MRI image and differentiated so that even details less than a millimetre in size are discernible. In addition to this high resolution, another advantage of the method is that the images can be taken in any desired plane – i.e. not only crosswise through body, but also lengthwise or diagonally. The computer can then generate a three-dimensional image of the inner body from the cross-sectional images.
MRI – when?
Magnetic resonance imaging is an essential medical instrument both for the detection and exclusion of a disease and for the monitoring of therapies. With the exception of organs with a low water content, bones or the lungs, MRI provides highly precise images of almost
MRI – are there alternatives?
When bony structures or the lungs are examined, the classic X-ray and computed tomography (CT) are more suitable than MRI. In other respects, the procedure is often used as an alternative or supplement to other diagnostic methods when their limits are reached.
I.e. magnetic resonance imaging is usually only carried out if other techniques, such as ultrasound, X-ray and CT do not provide reliable results, or at least sufficiently reliable results. Accordingly, there are also no alternatives for many issues.
PSA test
“PSA” stands for “prostate-specific antigen.” PSA is a protein molecule, which is produced in the prostate. The concentration of PSA can be measured in the blood.
In general, malignant changes in the prostate gland can lead to an increased distribution of this protein molecule in the blood. Nowadays, attempts are made to use this in early detection. Today, more than 80 percent of all newly discovered prostate carcinomas are only detected by the PSA test. The difficulty here is that there is no clear lower limit from which prostate cancer can be excluded with certainty and that the increased PSA level has other, comparatively harmless causes in many cases, such as that of prostate inflammation.
When is it advisable to have a PSA test done?
A PSA test may be recommended as part of a prostate examination, particularly as part of cancer screening. However, the potential stress caused by a conspicuous PSA level should be openly discussed between doctor and patient.
How is a PSA test done?
The PSA test is included in the blood test and requires nothing more from the patient than a blood sample.
PSA test – are there alternatives?
The test is only part of a comprehensive preventive medical check-up. The fact that there still remains debate about its value among experts is due to it not being a standard facet of blood tests at clinics or hospitals worldwide. Therefore, people should obtain comprehensive information about the PSA test from their doctors in order to reach a joint decision on whether or not they wish to make use of the test. However, there is no doubt that the PSA level is essential for the diagnosis and monitoring of a previously detected prostate carcinoma.
X – ray examination
n many areas of medicine, X-ray is the fastest, most reliable and proven method of detecting injuries or diseases. During an X-ray examination, X-rays which are generated by an X-ray tube are sent through the body. These rays are then captured on the other side by means of X-ray film or digital storage media.
While bones and other tissue with a very high calcium content (such as gall or kidney stones) absorb a large part of the radiation and they become very visible in the X-ray images, soft tissue and hollow organs are very radiolucent and thus they are less visible. In order to improve clarity, a contrast-enhancing agent
(contrast agent) is used in certain cases.
X-ray examination – are there alternatives?
If you are pregnant or if a pregnancy cannot be excluded with certainty, the examining doctors will decide not to carry out an X-ray examination in most cases. In any case, a precise risk-benefit analysis will be carried out before you are exposed to radiation. Where appropriate, other potential examination methods will be used.
X-ray examination – when?
X-ray diagnostics are particularly well suited for representing the bony skeleton (i.e. detecting bone fractures or malpositions), but also showing lung diseases (such as also showing lung diseases (such as inflammations, tumours or fluid accumulations). To this day, mammography, the X-ray imaging of the mammary glands, is the method of first choice for the early detection of breast cancer. However, vessels (arteries, veins, lymphatic vessels), hollow organs (gastro-intestinal tract, kidneys, efferent urinary tract, gallbladder and biliary tract, tract systems), artificial cavities in the body (such as fistulas or abscesses) as well as organs and soft tissue can also be made visible and assessed in computed tomography using X-ray contrast agents.
X-ray examination – how?
During the X-ray examination, the body is exposed to a higher level of X-ray radiation than in everyday life, i.e. earth radiation or radiation from television sets, for a short period of time. Modern X-ray machines with short exposure times keep the radiation exposure extremely low. Particularly radiosensitive organs (such as the genitals) are shielded with lead aprons or screens to keep the radiation dose for the organs as low as possible. If a contrast agent is used for the examination, it is either injected into the bloodstream via a visible vein or artery by means of catheter or injection, or it enters the gastro-intestinal tract through drinking, depending on the case.
Two-dimensional images allow the doctor to gain a spatial view of the size, shape and structure of the investigated organs. Besides the normal structure of the liver, spleen, heart, kidneys and other organs, changes in blood vessels and soft tissue can also be shown.
Ultrasound examination
The ultrasound examination or sonography is the examination of organic tissue by means of ultrasound. Today, it is one of the most frequently used imaging processes in medicine, as many diseases can be examined and clarified faster, and thus with reduced costs and risks, through ultrasound examination. Furthermore, the treatment is completely harmless and free of side-effects.
During ultrasound examinations, sound waves with a frequency above the audible range of the human ear are sent through the body, reflected by structures and tissue and registered by a receiver. A computer creates an image from this information.
The flow rates of fluids in vessels and the heart can be converted into an image with special pulse forms.
Ultrasound examination – when?
Ultrasound examinations of the breast (mammasonography or breast ultrasound examination), the heart (cardiac ultrasound) and the important main arteries (carotid ultrasound) as well as examinations during pregnancy are just the most prominent examples for the wide range of applications of this examination method.
Ultrasound examination – how?
The ultrasound examination is painless and completely free of side-effects. The examining doctor touches the patient with a sensor and the image of the examined body region appears on a monitor.
Ultrasound examination – are there alternatives?
As no dangerous rays are released, the ultrasound examination is completely harmless. The real question is what are the alternatives to ultrasound when the method reaches its limits. Because not all organs are as well suited for ultrasound examination.
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