Paddington Alcohol Test: From 1 Different Sources
a three-question tool designed to uncover any connection between an individual’s attendance at an A & E department and alcohol-related problems, thereby creating the potential for intervention and referral.
A colourless liquid, also called ethanol or ethyl-alcohol, produced by the fermentation of carbohydrates by yeast. Medically, alcohol is used as a solvent and an antiseptic; recreationally it is a widely used drug, taken in alcoholic drinks to give a pleasant taste as well as to relax, reduce inhibitions, and increase sociability. Taken to excess, alcohol causes much mental and physical harm – not just to the individual imbibing it, but often to their family, friends, community and work colleagues.
Alcohol depresses the central nervous system and disturbs both mental and physical functioning. Even small doses of alcohol will slow a person’s re?exes and concentration; potentially dangerous effects when, for example, driving or operating machinery. Drunkenness causes slurred speech, muddled thinking, amnesia (memory loss), drowsiness, erectile IMPOTENCE, poor coordination and dulled reactions – thereby making driving or operating machinery especially dangerous. Disinhibition may lead to extreme euphoria, irritability, misery or aggression, depending on the underlying mood at the start of drinking. Severe intoxication may lead to COMA and respiratory failure.
Persistent alcohol misuse leads to physical, mental, social and occupational problems, as well as to a risk of DEPENDENCE (see also ALCOHOL DEPENDENCE). Misuse may follow several patterns: regular but controlled heavy intake, ‘binge’ drinking, and dependence (alcoholism). The ?rst pattern usually leads to mainly physical problems such as gastritis, peptic ulcer, liver disease, heart disease and impotence. The second is most common among young men and usually leads to mainly social and occupational problems – getting into ?ghts, jeopardising personal relationships, overspending on alcohol at weekends, and missing days o? work because of hangovers. The third pattern – alcohol dependence – is the most serious, and can severely disrupt health and social stability.
Many researchers consider alcohol dependence to be an illness that runs in families, with a genetic component which is probably passed on as a vulnerable personality. But it is hard to disentangle genetic, environmental and social factors in such families. In the UK there are estimated to be around a million people suffering from alcohol dependence and a similar number who have di?culty controlling their consumption (together about 1:30 of the population).
Alcohol causes tolerance and both physical and psychological dependence (see DEPENDENCE for de?nitions). Dependent drinkers classically drink early in the morning to relieve overnight withdrawal symptoms. These symptoms include anxiety, restlessness, nausea and vomiting, and tremor. Sudden withdrawal from regular heavy drinking can lead to life-threatening delirium tremens (DTs), with severe tremor, hallucinations (often visual – seeing spiders and monsters, rather than the pink elephants of romantic myth), and CONVULSIONS. This must be treated urgently with sedative drugs, preferably by intravenous drip. Similar symptoms, plus severe INCOORDINATION and double-vision, can occur in WERNICKE’S ENCEPHALOPATHY, a serious neurological condition due to lack of the B vitamin thiamine (whose absorption from the stomach is markedly reduced by alcohol). If not treated urgently with injections of thiamine and other vitamins, this can lead to an irreversible form of brain damage called Korsako?’s psychosis, with severe amnesia. Finally, prolonged alcohol misuse can cause a form of dementia.
In addition to these severe neurological disorders, the wide range of life-threatening problems caused by heavy drinking includes HEPATITIS, liver CIRRHOSIS, pancreatitis (see PANCREAS, DISEASES OF), gastrointestinal haemorrhage, suicide and FETAL ALCOHOL SYNDROME; pregnant women should not drink alcohol as this syndrome may occur with more than a glass of wine or half-pint of beer a day. The social effects of alcohol misuse – such as marital breakdown, family violence and severe debt – can be equally devastating.
Treatment of alcohol-related problems is only moderately successful. First, many of the physical problems are treated in the short term by doctors who fail to spot, or never ask about, heavy drinking. Second, attempts at treating alcohol dependence by detoxi?cation or ‘drying out’ (substituting a tranquillising drug for alcohol and withdrawing it gradually over about a week) are not always followed-up by adequate support at home, so that drinking starts again. Home support by community alcohol teams comprising doctors, nurses, social workers and, when appropriate, probation o?cers is a recent development that may have better results. Many drinkers ?nd the voluntary organisation Alcoholics Anonymous (AA) and its related groups for relatives (Al-Anon) and teenagers (Alateen) helpful because total abstinence from alcohol is encouraged by intensive psychological and social support from fellow ex-drinkers.
Useful contacts are: Alcoholics Anonymous; Al-Anon Family Groups UK and Eire (including Alateen); Alcohol Concern; Alcohol Focus Scotland; and Alcohol and Substance Misuse.
1 standard drink =1 unit
=••• pint of beer
=1 measure of spirits
=1 glass of sherry or vermouth
=1 glass of wine
Limits within which alcohol is believed not to cause long-term health risks:... alcohol
The principal reproductive androgen of males, largely responsible for sexual maturation, some libido, and a range of metabolic reactions that, while supplying short-term strengths, creates a long-term fragility and brittleness if not in balance with less garish but more sustainable metabolic buffers. It is secreted by the Leydig cells of the testes, as well as smaller amounts in the adrenal cortices of both sexes. It is made under the direction of LH from the pituitary, and, if oversecreted, can be inhibited by sperm-producing cells, diminished pituitary support, and a rise in blood levels of its waste-product, stored in adipose tissues...estradiol... testosterone
A skin test to ?nd out if a person is immune to TUBERCULOSIS. TUBERCULIN (a preparation derived from the TUBERCLE bacillus) is injected via punctures in the skin of the forearm, using a spring-loaded gunlike instrument with six very short needles set in circular form. A positive test is indicated by a red raised reaction of the skin: this means that the subject is immune. If the result is negative, the subject can be given BCG VACCINE.... heaf test
A test for TUBERCULOSIS. It consists in injecting into the super?cial layers of the skin (i.e. intradermally) a very small quantity of old TUBERCULIN which contains a protein ANTIGEN to TB. A positive reaction of the skin – swelling and redness – shows that the person so reacting has been infected at some time in the past with Mycobacterium tuberculosis. However, it does not mean that such a person is suffering from active tuberculosis.... mantoux test
This is used to identify possible substances that may be causing a patient’s ALLERGY. Small amounts of di?erent substances are placed on the skin – usually of the back or arm. If the patient is allergic then a red ?are and swelling will appear, usually within about 15 minutes. Sometimes the reaction may take longer – up to three days – to develop.... patch test
A psychological test (see PSYCHOLOGY) for investigating personality and disorders of personality. Also called the ‘ink blot test’, it is now rarely used. It was devised by a Swiss psychiatrist, Hermann Rorschach (1884–1922), who determined individuals’ reactions to a series of symmetrical ink-blots, ten in number and standardised by him.... rorschach test
Every man has two testicles or testes which are the sexual glands. In the fetus, they develop in the abdomen, but before birth they descend into a fold or pouch of skin known as the SCROTUM. Each testicle consists of up to 1,000 minute tubes lined by cells from which the spermatozoa (see SPERMATOZOON) are formed. Around 4·5 million spermatozoa are produced per gram of testicle per day. These tubes communicate with one another near the centre of the testicle, and are connected by a much coiled tube, the EPIDIDYMIS, with the ductus, or VAS DEFERENS, which enters the abdomen and passes on to the base of the bladder. This duct, after joining a reservoir known as the seminal vesicle, opens, close to the duct from the other side of the body, into the URETHRA where it passes through the PROSTATE GLAND. Owing to the convolutions of these ducts leading from the testicles to the urethra, and their indirect route, the passage from testicle to urethra is over 6 metres (20 feet) in length. In addition to producing spermotozoa, the testicle also forms the hormone TESTOSTERONE which is responsible for the development of male characteristics.... testicle
Alcohol dependence, or alcoholism, is described under ALCOHOL but a summary of the symptoms may be helpful in spotting the disorder. Behavioural symptoms vary but include furtiveness; aggression; inappropriately generous gestures; personality changes (sel?shness, jealousy, irritability and outbursts of anger); empty promises to stop drinking; poor appetite; scru?y appearance; and long periods of drunkenness.... alcohol dependence
Removal of venous, capillary or arterial blood for haematological, microbiological or biochemical laboratory investigations.... blood test
A test for vestibular function (see EAR). It is performed by irrigating the external auditory meatus of the ear with alternate cold and hot water. This usually stimulates the vestibular apparatus, causing nystagmus (see DIABETES MELLITUS – Diabetic eye disease). If the vestibular apparatus is affected by disease, the response may be absent or reduced.... caloric test
A sensitive test that detects ANTIBODIES to the body’s red cells (see ERYTHROCYTE). There are two methods: one – the direct method – identi?es those antibodies that are bound to the cells; the other, indirect, method identi?es those circulating unattached in the serum.... coomb’s test
Skin test used to determine the immune s tatus to scarlet fever.... dick test
A way of assessing the body’s e?ciency at metabolising GLUCOSE. The test is used in the diagnosis of DIABETES MELLITUS. The patient is starved for up to 16 hours, after which he or she is fed glucose by mouth. The concentrations of glucose in the blood and urine are then measured at half-hour intervals over a period of two hours.... glucose-tolerance test
A standardised procedure of mental assessment to determine an individual’s intellectual ability. The result is produced as a score termed the INTELLIGENCE QUOTIENT (IQ). The Wechsler Adult Intelligence Scale (WAIS) and one for children, the Wechsler Intelligence Scale for Children (WICS), are commonly used, as is the Stanford-Binet Scale. Assessments are made for educational purposes and to help in the diagnoses of people with possible mental retardation or intellectual deterioration.... intelligence test
The characteristic histological test used for the diagnosis of SARCOIDOSIS. The test involves an intradermal injection of sarcoid SPLEEN tissue. If positive, non-caseating granulomata (see GRANULOMA) are seen at the injection site in 4– 6 weeks. A positive test is highly speci?c for sarcoid, but if negative, this would not be excluded.... kveim test
See CERVICAL SMEAR.... papanicolaou test
The screening of apparently healthy people to identify those who may have treatable diseases. Cervical smears are done when screening women to detect if they have cancer or precancer of the neck of the womb (cervix). Newborn babies are screened for hip dislocation. Screening tests are not designed to diagnose individual persons, but rather to divide a population into a large number at low risk and a small number at high risk of a condition. This allows clinicians to concentrate on a sub-section of the population. All screening tests produce false negative and false positive results, a problem often misunderstood by those at the receiving end. Factors to be assessed when planning screening procedures include the severity, frequency and distribution of the disease, and the availability and e?ectiveness of treatment. Convenience, safety, sensitivity and cost should also be assessed. In the United Kingdom the government has supported the extension of screening procedures for breast cancer, cervical cancer, hypertension and diabetes. (See PREVENTIVE MEDICINE.)... screening test
See EMBRYO TRANSFER.... test-tube baby
Most vision tests examine a person’s sharpness of VISION (visual acuity) and often of the ?eld of vision (see VISION, FIELD OF). Refraction tests assess whether a person has an error that can be corrected with glasses such as ASTIGMATISM, HYPERMETROPIA or MYOPIA. Visual acuity is tested using a Snellen chart when the patient tries to read letters of di?ering standard sizes from 6 metres away. The optician will prescribe lenses to correct any defects detected by vision tests.... vision tests
An alternative name for methanol.... methyl alcohol
A testis that is drawn up.... testis, retractile
A test for gauging the e?ciency of the balancing mechanism (the vestibular apparatus) by applying hot or cold air or water to the external ear.... barany’s test
A medico-legal defence for a clinician accused of failing to provide an acceptable standard of care for one of his or her quali?cation and experience. The defence is that a responsible body of medical practitioners would have taken the same action, even though others would have acted di?erently. The precise size of a ‘responsible body’ has not been de?ned. The test has been modi?ed following a case referred to as Bolitho, in which it was held that the Bolam defence failed if it could be shown that the actions relied upon, although shown to be carried out by some responsible doctors, were nonetheless illogical.... bolam test
In surveys, studying the process of interpretation of questions and the formation and reporting of responses by respondents to learn how to make the questions more accurately obtain the data the questionnaire is seeking.... cognitive testing
A disorder of newborn infants that is caused by the toxic effects on the growing FETUS of excessive amounts of alcohol taken by the mother. Low birth-weight and retarded growth are the main consequences, but affected babies may have hand and facial deformities and are sometimes mentally retarded.... fetal alcohol syndrome
See GENETIC SCREENING.... gene testing
A test for colour vision, introduced by a Japanese doctor, comprising several plates with round dots of di?erent colours and sizes. It is also the name of a type of blood test for SYPHILIS.... ishihara’s test
See under TESTICLE, DISEASES OF.... maldescended testis
The determination of eligibility for a publicly financed programme on the basis of an applicant’s income and assets (means).... means test
A test for MONONUCLEOSIS which is based upon the fact that patients with this disease develop ANTIBODIES which agglutinate sheep red blood cells.... paul-bunnell test
A test for INFERTILITY. A specimen of cervical mucus, taken up to 24 hours after coitus (during the post-ovulatory phase of the menstrual cycle), is examined microscopically to assess the motility of the sperms. If motility is above a certain level, then sperms and mucus are not interacting abnormally – thus eliminating one cause of sterility.... post-coital test
A hearing test in which a vibrating tuning fork is placed on the mastoid process (see EAR). When the subject can no longer hear the ringing, it is placed beside the ear. Normal subjects can then hear the noise once more, but in people with conductive DEAFNESS, air conduction does not persist after bone conduction has ceased. It can help to distinguish between nerve (sensorineural) and conduction deafness.... rinnes test
A mathematical formula (or function) that is used to determine if the difference between outcomes of a treatment or intervention and a control group is great enough to conclude that the difference is statistically significant. Statistical tests generate a value that is associated with a particular P value. Among the variety of common statistical tests are: F, t, Z, and chi-square. The choice of a test depends upon the conditions of the study, e.g. what type of outcome variable is used, whether or not the subjects are randomly selected from a larger population, and whether it can be assumed that the outcome values of the population have a normal distribution or other type of distribution.... statistical test
A tube of thin glass closed at one end, which is used for observing chemical reactions or for bacterial culture.... test-tube
A positive tourniquet test with scattered fine petechiae is one of the earliest clinical signs in dengue haemorrhagic fever.... tourniquet test
See under TESTICLE, DISEASES OF.... undescended testis
The SCROTUM may be affected by various skin diseases, particularly eczema (see DERMATITIS) or fungal infection. A HERNIA may pass into the scrotum. Defective development of the testicles may lead to their retention within the abdomen, a condition called undescended testicle.
Hydrocoele is a collection of ?uid distending one or both sides of the scrotum with ?uid. Treatment is by withdrawal of the ?uid using a sterile syringe and aspiration needle.
Hypogonadism Reduced activity of the testes or ovaries (male and female gonads). The result is impaired development of the secondary sexual characteristics (growth of the genitals, breast and adult hair distribution). The cause may be hereditary or the result of a disorder of the PITUITARY GLAND which produces GONADOTROPHINS that stimulate development of the testes and ovaries.
Varicocoele is distension of the veins of the spermatic cord, especially on the left side, the causes being similar to varicose veins elsewhere (see VEINS, DISEASES OF). The chief symptom is a painful dragging sensation in the testicle, especially after exertion. Wearing a support provides relief; rarely, an operation may be advisable. Low sperm-count may accompany a varicocele, in which case surgical removal may be advisable.
Orchitis or acute in?ammation may arise from CYSTITIS, stone in the bladder, and in?ammation in the urinary organs, especially GONORRHOEA. It may also follow MUMPS. Intense pain, swelling and redness occur; treatment consists of rest, support of the scrotum, analgesics as appropriate, and the administration of antibiotics if a de?nitive microorganism can be identi?ed. In some patients the condition may develop and form an ABSCESS.
Torsion or twisting of the spermatic cord is relatively common in adolescents. About half the cases occur in the early hours of the morning during sleep. Typically felt as pain of varying severity in the lower abdomen or scrotum, the testis becomes hard and swollen. Treatment consists of immediate undoing of the torsion by manipulation. If done within a few hours, no harm should ensue; however, this should be followed within six hours by surgical operation to ensure that the torsion has been relieved and to ?x the testes. Late surgical attention may result in ATROPHY of the testis.
Tuberculosis may occur in the testicle, especially when the bladder is already affected. Causing little pain, the infection is often far advanced before attracting attention. The condition generally responds well to treatment with a combination of antituberculous drugs (see also main entry for TUBERCULOSIS).
Tumours of the testes occur in around 600 males annually in the United Kingdom, and are the second most common form of malignant growth in young males. There are two types: SEMINOMA and TERATOMA. When adequately treated the survival rate for the former is 95 per cent, while that for the latter is 50 per cent.
Injuries A severe blow may lead to SHOCK and symptoms of collapse, usually relieved by rest in bed; however, a HAEMATOMA may develop.... testicle, diseases of
Venereal Diseases Research Laboratory Test. One of the non-treponemal reaginic tests for syphilis.... vdrl test
A test with a tuning fork that is used to assess a person’s DEAFNESS.... weber’s test
An agglutination test used in the laboratory to diagnose rickettsial diseases. It depends on a nonspecific cross reaction between antibodies produced by the rickettsial infection with the OX-2, OX-19 and OXK antigens of the Gram negative rod, Proteus.... weil-felix test
A serological test used to detect antibodies in the diagnosis of typhoid. Antigens detected are the O (somatic), H (flagellar) and Vi (virulence) antigens.... widal test
The first intelligence test that attempted to measure higher mental functions, devised in 1905.... binet test
Tests to screen for and diagnose bleeding disorders, usually resulting from deficiencies or abnormalities of blood coagulation factors or of platelets (see blood clotting). Tests are also used to monitor treatment with anticoagulant drugs.... blood-clotting tests
Three to four daily drinks for several weeks result in increased fat in liver cells. Then comes alcoholic hepatitis, inflammation of the liver tissue and destruction of cells, degenerating into an irreversible state known as cirrhosis. Complications develop such as intestinal bleeding, fluid accumulation, kidney failure and death if not arrested in time. Alcoholism is compulsive drinking leading to dependence.
Alternatives: Teas. Hops, Angelica, German Chamomile, or Skullcap. 1 heaped teaspoon to each cup boiling water; infuse 5-15 minutes. 1 cup 3-4 times daily.
Tablets/capsules. Cramp bark, Black Cohosh, Valerian.
Formula. Equal parts: Cramp bark and Valerian. Dose – powders: 250mg, or one 00 capsule; liquid extracts: 15-30 drops; bark tinctures: 30-60 drops; in honey or water 3-4 times daily.
Cold infusion. 1 teaspoon Oak bark cut, in cup cold water. Infuse 1 hour. Dose: sips during the day. Tincture Cinchona, BPC (1949), 15-30 drops, 2-3 times daily.
Tincture Myrrh BPC (1973) 5-10 drops in half glass water 2-3 times daily.
Oil of Evening Primrose improves brain function in cases of withdrawal (Efamol Can Improve Alcohol Recovery, General Practitioner, p11, Sept 18, 1987).
Milk Thistle. Good responses observed. Dose: 80-200mg, thrice daily.
Chinese Medicine. Kudzu vine (Pueraria lobata) can effectively reduce the cravings of alcohol. The flowers are used in China for alcoholic poisoning. Used for reforming alcoholics. (Herbarium Dec 1993) Supplements. B-complex, A, C, E. Magnesium, Selenium, Zinc. For bone-loss of alcoholism: see: OSTEOPOROSIS.
Information. Alcoholics Anonymous, Stonebow House, Stonebow, York YO1 2NJ. ... alcohol abuse
One of a group of tests used to assess the function of the heart in people who experience chest pain, breathlessness, or palpitations during exercise. The test establishes whether the patient has coronary artery disease. An ECG machine records the patterns of the heart’s electrical activity while the heart is stressed. This is usually achieved by the patient exercising on a treadmill or cycling. Specific changes in the electrical pattern as exercise levels increase indicate angina. Cardiac stress testing may be used in conjunction with radionuclide scanning to identify damaged areas of heart muscle.... cardiac stress test
Analysis of a sample of blood to give information on its cells and proteins and any of the chemicals, antigens, antibodies, and gases that it carries. Such tests can be used to check on the health of major organs, as well as on respiratory function, hormonal balance, the immune system, and metabolism. Blood tests may look at numbers, shape, size, and appearance of blood cells and assess the function of clotting factors. The most important tests are blood count and blood group tests if transfusion is needed. Biochemical tests measure chemicals in the blood (see acid–base balance; kidney function tests; liver function tests). Microbiological tests (see immunoassay) look for microorganisms that are in the blood, as
in septicaemia. Microbiology also looks for antibodies in the blood, which may confirm immunity to an infection. blood transfusion The infusion of large volumes of blood or blood products directly into the bloodstream to remedy severe blood loss or to correct chronic anaemia. In an exchange transfusion, nearly all of the recipient’s blood is replaced by donor blood. Before a transfusion, a sample of the recipient’s blood is taken to identify the blood groups, and it is matched with suitable donor blood. The donor blood is transfused into an arm vein through a plastic cannula. Usually, each unit (about 500 ml) of blood is given over 1–4 hours; in an emergency, 500 ml may be given in a couple of minutes. The blood pressure, temperature, and pulse are monitored during the procedure.
If mismatched blood is accidentally introduced into the circulation, antibodies in the recipient’s blood may cause donor cells to burst, leading to shock or kidney failure. Less severe reactions can produce fever, chills, or a rash. Reactions can also occur as a result of an allergy to transfused blood components. All
blood used for transfusion is carefully screened for a number of infectious agents, including HIV (the AIDS virus) and hepatitis B and hepatitis C.
In elderly or severely anaemic patients, transfusion can overload the circulation, leading to heart failure.
In patients with chronic anaemia who need regular transfusion over many years, excess iron may accumulate (haemosiderosis) and damage organs such as the heart, liver, and pancreas.
Treatment with desferrioxamine to remove excess iron may be needed.... blood tests
Another name for ethanol, the alcohol in alcoholic drinks.... ethyl alcohol
A test for meningitis that involves pressing a clear glass against a rash. If the rash remains visible, it may be a form of purpura, which sometimes occurs in meningitis.... glass test
An outdated psychological test in which the subject was asked to interpret the appearance of a number of ink blots. The most widely used example was the Rorschach test.... ink-blot test
See pulmonary function tests.... lung function tests
Questionnaires designed to define various personality traits or types. Tests may be designed to detect psychiatric symptoms, underlying personality traits, how outgoing or reserved a person is, and predisposition to developing neurotic illness.... personality tests
See Guthrie test.... pku test
See pulmonary function tests.... respiratory function tests
A type of intelligence test.... stanford–binet test
A rare, cancerous tumour of the testis. Testicular cancer is most common in young to middle-aged men, and the risk increases in individuals with a history of undescended testis (see testis, undescended). The most common types of testicular cancer are seminomas, which are made up of only 1 type of cell, and teratomas. The cancer usually appears as a firm, painless swelling of 1 testis. There may also be pain and inflammation. Biopsy, followed by orchidectomy, is the usual treatment, and may be combined with chemotherapy. The tumours usually respond well to treatment.... testis, cancer of
A testis that is absent from the scrotum because it has descended into an abnormal position, usually in the groin or at the base of the penis. The condition is most often discovered soon after birth during a routine physical examination. It is treated by orchidopexy. (See also testis, undescended.) ... testis, ectopic
Pain in a testis may be caused by mild injury, a tear in the wall of the testis due to a direct blow, orchitis, epididymo-orchitis, and torsion of the testis (see testis, torsion of). Sometimes, no cause is found and the pain disappears without treatment. If the wall of the testis is torn, an operation to repair it may be needed. ... testis, pain in the
Swelling of the testis or the surrounding tissues in the scrotum. Harmless and painless swellings include epididymal cysts, hydroceles, varicoceles, and spermatoceles. Cancer of the testis (see testis, cancer of) is rare but may be a cause of painless swelling. Swelling that is painful may be caused by a direct blow, torsion of the testis (see testis, torsion of), orchitis, epididymoorchitis, or, in very rare cases, cancer of the testis. Any swelling of the testes should be assessed promptly by a doctor.... testis, swollen
A group of blood tests used to evaluate the function of the thyroid gland and to detect or confirm any thyroid disorder. The thyroid hormones T3 and T4 are measured, as well as thyroid-stimulating hormone (TSH), the pituitary gland hormone that stimulates the thyroid gland.... thyroid-function tests
Skin tests used to determine whether or not a person has been exposed to the bacterium that causes tuberculosis. Tuberculin tests are carried out for diagnosis of tuberculosis, and before BCG vaccination. A small amount of tuberculin (purified protein from the bacteria) is injected into the skin. A few days later, the skin reaction, if any, is noted. A reaction indicates previous exposure.... tuberculin tests
Hearing tests carried out to diagnose conductive deafness. In the Weber test, a vibrating tuning fork is held against the forehead. If there is conductive hearing loss, the sound seems louder in the affected ear. In the Rinne test, a vibrating tuning fork is held first near the ear, and then against the bone behind it. If it sounds louder when held against the bone, there is conductive hearing loss.... tuning fork tests
See urinalysis.... urine tests
a test for the presence of sugar in urine or other liquids. A few drops of the test solution are added to Benedict’s solution, prepared from sodium or potassium citrate, sodium carbonate, and copper sulphate. The mixture is boiled and shaken for about two minutes, then left to cool. The presence of up to 2% glucose is indicated by the formation of a reddish, yellowish, or greenish precipitate, the highest levels corresponding to the red coloration, the lowest (about 0.05%) to the green. [S. R. Benedict (1884–1936), US surgeon]... benedict’s test
where clinical *negligence is claimed, tests used to determine the standard of care owed by professionals to those whom they serve, e.g. the standards of care provided to patients by doctors. The 1957 case of Bolam v Friern Hospital Management Committee established that if a doctor acts in accordance with a responsible body of medical opinion, he or she will not be negligent. In 1997 this standard of care test was amended by the case of Bolitho v City and Hackney Health Authority, which requires the doctor’s behaviour to satisfy the judgment not only of responsible medical opinion but also of a court’s own independent logical analysis.... bolam and bolitho tests
(in statistics) a test to determine if the difference between two groups of observations is statistically significant (see significance), used in controlled trials and other studies. It measures the differences between theoretical and observed values and identifies whether or not *variables are related.... chi-square test
a test used to detect a squint. The observer looks at a target object, one eye at a time being covered. If the uncovered eye deviates to focus on the target, then a squint is confirmed. The movement can be up, down, sideways, or a combination, depending on the type of squint (see strabismus).... cover test
a screening tool for young people under the age of 21 to identify alcohol and drug use. The first part consists of three questions about drug or alcohol use over the past year. Participants giving positive answers to two or more questions proceed to the second part (from which the name derives), which contains six questions with the key words car, relax, alone, family/friends, forget, trouble, used to assess the need for further input.... crafft screening test
a hearing test used for screening infants between the ages of six and ten months. The infant is placed on its carer’s knee, one examiner sits in front of the infant and gains its attention, and a second examiner is situated just behind the infant. At a given moment the first examiner becomes very still and the second examiner makes a sound at the level of the infant’s ear to one side or the other. If the infant can hear it turns in the direction of the sound. The sounds made should be of different pitches and a given loudness.... distraction test
(FOBT) a noninvasive test used to identify microscopic blood (see occult) in faeces. It is widely used as a screening test for colorectal cancer.... faecal occult blood test
a test for detecting the presence of sugar in urine, which has now been replaced by better and easier methods. [H. von Fehling (1812–85), German chemist]... fehling’s test
(DSTs) tests based on the principle that appropriate doses of *dexamethasone can suppress the output of cortisol from the adrenal glands in the normal state and that this ability is reduced or lost in *Cushing’s syndrome. In the overnight DST 1 mg of dexamethasone is administered at midnight and the serum cortisol level is measured at 9.00 am the next morning. Failure to suppress cortisol output may indicate Cushing’s syndrome but also occurs in patients with obesity and depressive illness. In the low-dose DST (0.5 mg dexamethasone every 6 hours for 48 hours), cortisol suppression occurs in patients with obesity and depression but not in those with Cushing’s syndrome. In the high-dose DST (2 mg dexamethasone every 6 hours for 48 hours), cortisol is suppressed in patients with Cushing’s disease (in which excess amounts of ACTH are secreted by the pituitary gland) but not in those with Cushing’s syndrome due to other causes. Although the low- and high-dose tests are unreliable, all three tests should be performed to aid the diagnosis of Cushing’s syndrome.... dexamethasone suppression tests
(Hallpike test) a test for *benign paroxysmal positional vertigo (BPPV), performed with the patient first sitting upright on an examination couch and then lying supine with the head and neck extended beyond the edge of the couch. The patient’s head is rotated to the left (or right) and supported by the examiner while the patient assumes the supine position and keeps his or her eyes focused on the examiner’s eyes. The test is then repeated with the other ear facing down. In patients with BPPV, after a short delay rotatory *nystagmus is seen, in association with severe vertigo and nausea, which gradually abates. The effect diminishes with repeated manoeuvres. In conditions affecting the cerebellum or brainstem, the nystagmus occurs immediately, in any direction, and does not diminish, and patients do not feel especially nauseated. [M. R. Dix and C. S. Hallpike (20th century), British otologists]... dix–hallpike test
(FASD, fetal alcohol syndrome, FAS) a condition of newborn babies that results from the toxic effects on the fetus of maternal alcohol abuse. Babies have a low birth weight and growth is retarded. They have a small head (*microcephaly), low-set ears, eye, nose, lip, and nail abnormalities, and disturbances of behaviour and intellect. The greater the alcohol abuse, the more severe the fetal manifestations.... fetal alcohol spectrum disorder
a test for folate or vitamin B12 deficiency. A dose of the amino acid histidine, which requires the presence of folate or vitamin B12 for its complete breakdown, is given by mouth. In the absence of these vitamins, formiminoglutamic acid (figlu) – an intermediate product in histidine metabolism – accumulates and can be detected in the urine.... figlu test
a test for *ataxia or cerebral lesions. Using the index finger, the patient alternately touches his or her nose and then the examiner’s finger, which is shifted to a new position for each of the patient’s movements. The test is positive if the patient misses a target or develops a tremor as the target is approached (intention tremor).... finger–nose test
(FPL test) a test used to evaluate the *visual acuity of infants and young children by observing whether the child looks at a blank screen or one with stripes, the spatial frequency of which can be changed.... forced preferential looking test
see forced preferential looking test.... fpl test
a rarely used diagnostic test for the sexually transmitted disease *lymphogranuloma venereum. A small quantity of the virus, inactivated by heat, is injected into the patient’s skin. If the disease is present a small red swelling appears at the site of injection within 48 hours. [W. S. Frei (1885–1943), German dermatologist]... frei test
a test for *phaeochromocytomas not displaying typically high levels of plasma *catecholamines. An intravenous bolus of *glucagon is administered and the test is positive when there is a threefold increase in plasma catecholamine levels with a consequent rise in blood pressure. The test is now very rarely used due to safer and more sensitive screening tests, combined with modern tumour imaging techniques.... glucagon stimulation test
(heel-prick blood test) a blood test performed on all newborn babies at the end of the first week of life. The blood is obtained by pricking the heel of the baby. The test can detect several *inborn errors of metabolism (including *phenylketonuria) and *hypothyroidism; it can also be used for detecting *cystic fibrosis, although this is not routinely offered. [R. Guthrie (1916–95), US paediatrician]... guthrie test
see Dix–Hallpike test.... hallpike test
see Guthrie test.... heel-prick blood test
a test for the presence of protein (albumin) in the urine. A quantity of urine is carefully poured onto the same quantity of pure nitric acid in a test tube. A white ring forms at the junction of the liquids if albumin is present. However, a similar result may be obtained if the urine contains certain drugs or is very concentrated. A dark brown ring indicates the presence of an abnormally high level of potassium indoxyl sulphate in the urine (see indicanuria). [J. F. Heller (1813–71), Austrian pathologist]... heller’s test
an important but potentially dangerous test of anterior pituitary function involving the deliberate induction of a hypoglycaemic episode with injected insulin and the subsequent measurement of plasma cortisol and growth hormone at regular intervals over the next three hours. The stress of the hypoglycaemia should induce a rise in the levels of these hormones unless the anterior pituitary or the adrenal glands are diseased. The test can induce epileptic seizures or angina in those with a predisposition and should not be performed in susceptible individuals. It is often combined with the thyrotrophin-releasing hormone (TRH) test and the gonadotrophin-releasing hormone (GnRH) test in what is known as the triple test (or dynamic pituitary function test).... insulin stress test
a card with text printed in type of different sizes, used for testing acuity of near vision. [E. R. Jaeger von Jastthal (1818–84), Austrian ophthalmologist]... jaeger test types
a test to detect and measure fetal red blood cells in the maternal circulation of Rh-negative women who have *antepartum haemorrhage or have previously had a Rh-positive baby. It is used to calculate the correct dose of *anti-D immunoglobulin that will prevent *haemolytic disease of the newborn.... kleihauer–betke test
a test of the ability of the pituitary to secrete growth hormone, in which levodopa is administered by mouth and plasma levels of growth hormone are subsequently measured (they should peak within the following hour). It is a safer alternative to the *insulin stress test but does not give information on cortisol production, which is usually more clinically important to know.... levodopa test
see significance.... mann–whitney u test
a hearing test used in preschool children in which the child must discriminate between similar speech sounds. The test consists of 14 toys that are paired because their names sound similar; for example, tree and key, plane and plate. Having first identified all the objects, the child is then asked in a quiet voice to indicate a particular toy (e.g. Can you find the key?).... mccormick toy test
a simple noninvasive procedure that enables the detection of *carriers for single gene defects, e.g. *cystic fibrosis. Epithelial cells from the buccal cavity are obtained from a saline mouthwash: from these it is possible to isolate DNA, which is amplified by the *polymerase chain reaction to enable gene analysis.... mouthwash test
see significance.... parametric test
a test used in the investigation of infertility. A specimen of cervical mucus, taken 6–24 hours after coitus, is examined under a microscope. The appearance of 10 or more progressively motile spermatozoa per high-power field in the specimen indicates that there is no abnormal reaction between spermatozoa and mucus. The test should be undertaken in the postovulatory phase of the menstrual cycle.... postcoital test
any of several methods used to demonstrate whether or not a woman is pregnant. Most pregnancy tests are based on the detection of a hormone, *human chorionic gonadotrophin (hCG), in the urine. The sample of urine is mixed with serum containing antibodies to hCG and marker particles (sheep red cells or latex particles) coated with hCG. In the absence of pregnancy, the antibodies will cause *agglutination of the marker particles. If the urine is from a pregnant woman, the antibodies will be absorbed and no agglutination will occur. These tests may be positive for pregnancy as early as 30 days after the date of the last normal period and are 98% accurate. Newer tests using *monoclonal antibodies (beta hCG) are more easily interpreted. When carried out on serum rather than urine, these tests give even earlier positive results.... pregnancy test
(in psychology) a way of measuring aspects of personality, in which the subject is asked to talk freely about ambiguous objects. His responses are then analysed. Examples are the *Rorschach test and the Thematic Apperception Test (in which the subject invents stories about a set of pictures).... projective test
a part of the routine *lumbar puncture procedure. It is used to determine whether or not the flow of cerebrospinal fluid is blocked in the spinal canal. [H. H. G. Queckenstedt (1876–1918), German physician]... queckenstedt test
tests for assessing the function of the kidneys. These include measurements of the specific gravity of urine, creatinine *clearance time, and blood urea levels; intravenous urography; and renal angiography.... renal function tests
a test to determine whether *deafness is conductive or sensorineural. A vibrating tuning fork is held first in the air, close to the ear, and then with its base placed on the bone (mastoid process) behind the ear. If the sound conducted by air is heard louder than the sound conducted by bone the test is positive and the deafness sensorineural; a negative result, when the sound conducted by bone is heard louder, indicates conductive deafness. [H. A. Rinne (1819–68), German otologist]... rinne’s test
a method of testing urine for the presence of acetone or acetoacetic acid: a sign of *diabetes mellitus. Strong ammonia is added to a sample of urine saturated with ammonium sulphate crystals and containing a small quantity of sodium nitroprusside. A purple colour confirms the presence of acetone or acetoacetic acid. [A. C. H. Rothera (1880–1915), Australian biochemist]... rothera’s test
a test to determine whether a person is susceptible to diphtheria. A small quantity of diphtheria toxin is injected under the skin; a patch of reddening and swelling shows that the person has no immunity and – if at particular risk – should be immunized. With safer *toxoids, this test is no longer necessary. [B. Schick (1877–1967), US paediatrician]... schick test
a test used to assess a patient’s capacity to absorb vitamin B12 from the bowel. Radioactive vitamin B12 is given by mouth and urine collected for 24 hours. A normal individual will excrete at least 10% of the original dose over this period; a patient with *pernicious anaemia will excrete less than 5%. [R. F. Schilling (1919), US physician]... schilling test
a test for detecting visual impairment in children who are too young to be able to read the *Snellen chart. A series of cards, each marked with a single letter of a specific size, are held up at a distance of 6 metres from the child being tested. The child is provided with an identification card containing a selection of letters and is asked to point to the letter that is the same as the one on the card in the distance. The test is suitable for children between the ages of two and seven.... sheridan–gardiner test
an investigation to seek evidence of cardiac *ischaemia. The heart is stressed by exercise or by the administration of an intravenous drug that increases heart rate (i.e. mimicked exercise). Ischaemia may then be detected by electrocardiography (stress ECG or exercise ECG), *echocardiography (showing the development of impaired function in areas of heart muscle that are ischaemic), *myocardial perfusion scan, or cardiac MRI.... stress test
see significance. [Pseudonym of W. S. Gosset (1876–1937), British statistician]... student’s t test
Standard Tests for Young Children and Retardates: tests to detect visual problems in children between the ages of six months and five years. They consist of a series of standardized balls, toys, or letters. The tests were developed by the paediatrician Mary Sheridan.... stycar tests
tests used to assess the ability of the adrenal cortex to produce cortisol. Serum cortisol is measured before and then 30 minutes (or 5 hours) after an intramuscular injection of 250 ?g (or 1 mg) tetracosactide (Synacthen), an analogue of *ACTH. The adrenal glands are considered to be inadequate if there is a low baseline concentration of cortisol or the rise is less than a certain predefined amount.... synacthen tests
(Trendelenburg’s sign) a test for detecting dysfunction of the hip joint. Normally when a leg is lifted off the ground, the pelvis on the same side is raised by the hip abductor muscles on the other side. If these muscles cannot raise the pelvis against body weight, the pelvis will tilt downwards and the test is positive, indicating arthritis, paralysis of the muscles due to superior gluteal nerve injury, or other hip pathology (e.g. congenital hip dislocation). [F. Trendelenburg]... trendelenburg’s test
1. (in *prenatal screening) a blood test that can be performed between the 15th and 20th weeks of pregnancy but has largely been replaced by combined first-trimester *PAPP-A screening and *nuchal translucency scanning. Levels of *alpha-fetoprotein (AFP), *unconjugated oestriol (uE3), and *human chorionic gonadotrophin (hCG) in the serum are computed with maternal age to determine the statistical likelihood of the fetus being affected by Down’s syndrome or spina bifida. The double test is similar but omits measurement of uE3. 2. see insulin stress test.... triple test
(VEMP) a test used to measure the response of the *saccule. It is used in the diagnosis of *superior canal dehiscence syndrome, *Ménière’s disease, and other disorders of the inner ear.... vestibular evoked myogenic potential test
a hearing test in which a vibrating tuning fork is placed at the midpoint of the forehead. A normal individual hears it equally in both ears, but if one ear is affected by conductive *deafness the sound appears louder in the affected ear. If one ear has a sensorineural deafness the sound appears louder in the unaffected ear. [F. E. Weber (1832–91), German otologist]... weber’s test
a direct percutaneous renal infusion test to investigate possible obstruction of the ureter or kidney. It detects subtle obstructions that cannot be detected by imaging. [R. Whitaker (20th century), British urologist]... whitaker’s test
a test for *diabetes insipidus in which fluid and food intake is withheld completely for up to 24 hours, with regular measurement of plasma and urinary *osmolality and body weight. Normally (and in a person with psychogenic *polydipsia) the output of *vasopressin will be increased in order to concentrate the urine as the plasma osmolality rises; correspondingly, the urine osmolality also rises and its volume diminishes. In a patient with diabetes insipidus, however, the urine osmolality will remain low and of high volume while the patient steadily dehydrates. The test must be abandoned if the patient loses 3% of body weight.... water-deprivation test
Health Encyclopedia