Test Meal: From 3 Different Sources
A procedure to measure the output of acid by the stomach. A nasogastric tube is passed into the stomach after an overnight fast, and a sample ofgastric fluid is sucked up through the tube. An injection of histamine or, more usually, pentagastrin (a synthetic preparation of the hormone gastrin) is given; further samples of stomach fluid are taken at intervals for up to 2 hours and analysed for hydrochloric acid content.
The test is used for people thought to be suffering from Zollinger–Ellison syndrome, and to confirm the absence of stomach acid in people with pernicious anaemia (see anaemia, pernicious).
(1) The name given to a gastric-function test, involving injection of HISTAMINE – a powerful stimulator of gastric juice, or pentagastin. After the stimulant has been injected, the digestive juices are withdrawn through a stomach tube (inserted through the nose and throat) and their volume and chemistry measured. A similar test is used to assess the working of the PANCREAS.
(2) The second meaning (also called test feed) applies to a diagnostic procedure for congenital PYLORIC STENOSIS, whereby a paediatrician feels over the baby’s abdomen while he or she is feeding. The pyloric mass can be felt as a ?rm swelling with the consistency of a squash ball, which comes and goes under the examiner’s ?ngers.
a standard meal given to stimulate secretion of digestive juices, which can then be withdrawn by tube and measured as a test of digestive function. A fractional test meal was a gruel preparation to stimulate gastric secretion, whose acid content was measured. This has been replaced by tests using secretory stimulants. The Lundh test meal is a meal of oil and protein to stimulate pancreatic secretion, which is withdrawn from the duodenum and its trypsin content measured as a test of pancreatic function.
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
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
A service which provides nutritious meals at a nominal fee to people in their homes who are homebound and/or disabled or would otherwise be unable to maintain their dietary needs.... meals on wheels
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
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
Delivery of meals and socialization activities to older adults in a designated location.... congregate meals programme
See “meals on wheels”.... delivered meals
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
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
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
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
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 Guthrie test.... pku test
A type of intelligence test.... stanford–binet test
a radiological technique used to assess the anatomy and function of the upper gastrointestinal tract. The patient swallows radiopaque contrast (barium sulphate), which coats the mucosal surfaces of the oesophagus, stomach, and duodenum. The descent of the barium is charted by a series of radiographs. Gas-forming agents (such as sodium bicarbonate) may be given to aid gastric distension and improve the quality of the images. This can be used to diagnose disorders of oesophageal motor function, tumours, peptic ulcers, hiatus *hernias, and *gastro-oesophageal reflux disease. Many indications for this examination have been replaced by the use of an endoscope.... barium swallow and meal
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
(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
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
(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
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
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.... paddington alcohol 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
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
(barium follow-through) a technique for examining the small bowel, often used when small-bowel enema is not tolerated. The patient swallows dilute *barium sulphate suspension and then a series of abdominal radiographs are taken. A complete examination occurs when contrast reaches the first part of the large bowel (caecum). This technique is particularly useful for investigating small-bowel *Crohn’s disease.... small-bowel meal
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
(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 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
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
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