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English to Spanish: Diagnostic Workup General field: Medical Detailed field: Medical: Health Care
Source text - English Routine diagnostic studies include a CBC, sedimentation rate, urinalysis, chemistry panel, thyroid panel, serum amylase and lipase, febrile agglutinins, tuberculin test, ANA titer, serum protein electrophoresis, serum B12 and folic acid, chest x-ray, EKG, and a flat plate of the abdomen. An HIV antibody titer needs to be done in selected clinical circumstances.
A stool for fat, trypsin, occult blood, and ovum and parasites should be done. Further tests for steatorrhea are listed on page 457. If these tests are within normal limits or are unrevealing, it is best to refer the patient to a gastroenterologist or oncologist for further evaluation. Sometimes, clinical clues suggest the need for an endocrinologist or psychiatrist as well. However, if the primary care physician wishes to proceed further, he may order an upper GI series and esophagogram, a small bowel series, barium enema, and a sigmoidoscopic examination. A CT scan of the abdomen and pelvis may be useful, but it is an expensive procedure.
Twenty-four-hour urine collection for free cortisol or rapid ACTH stimulation test will diagnose Addison’s disease. Quantitative stool fat and D-xylose absorption or a simple glucose tolerance test will diagnose some cases of malabsorption syndrome. Endoscopic procedures, including laparoscopy and even an exploratory laparotomy, have their place in the diagnostic workup. However, it is always best to enlist the help of specialists before considering these procedures, even if one is located in an isolated community. If a trial of a nutritional supplement halts the weight loss, depression is most likely the cause.
Translation - Spanish Los estudios de diagnóstico de rutina incluyen un hemograma completo (HC), velocidad de sedimentación, análisis de orina, panel químico, pruebas de tiroides, lipasa y amilasa sérica, aglutininas febriles, prueba de tuberculina, título de anticuerpos antinucleares (ANA), electroforesis de proteína sérica, vitamina B12 y ácido fólico, radiografía torácica, electrocardiograma, y radiografía del abdomen. Se debe de llevar a cabo un título de anticuerpos de VIH bajo circunstancias clínicas especiales.
Se recomienda realizar un examen de heces para buscar grasa, tripsina, sangre oculta, huevos y parásitos. Otros exámenes para detectar la esteatorrea aparecen en la lista de la página 457. Si estas pruebas están dentro de los límites normales o si no aportan resultados reveladores, es mejor derivar al paciente a un gastroenterólogo o a un oncólogo para una evaluación más exhaustiva. A veces, las claves clínicas indican que también es necesaria la intervención de un endocrinólogo o un psiquiatra. Sin embargo, si el médico de atención primaria desea seguir investigando, él puede ordenar un tránsito esofagogastroduodenal (TEGD) o un esofagograma, una serie del intestino delgado, un enema de bario, y una sigmoidoscopía. Una tomografía del abdomen y de la pelvis puede ser útil, pero es un procedimiento costoso.
Un análisis de la orina para la detección de cortisol libre o la prueba de estimulación rápida con la hormona adrenocorticotropa (ACTH) puede diagnosticar la enfermedad de Addison. Una absorción cuantitativa de grasa en las heces y D-xilosa o una simple prueba de tolerancia a la glucosa diagnosticará algunos casos de síndrome de malabsorción. Los procedimientos endoscópicos, incluyendo la laparoscopia e incluso la laparotomía exploratoria, tienen su lugar en el estudio diagnóstico. Sin embargo, lo más recomendable es recurrir a la ayuda de especialistas antes de considerar estos procedimientos, incluso si uno se encuentra en una comunidad aislada. Si el ensayo de un suplemento alimenticio detiene la pérdida de peso, la depresión es la causa más probable.
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