Haiguslugu gastroenteroloogias 4

5. Laboratory-instrumental Examination

The student shall provide the strategy for how to confirm the primary diagnosis as the clinical diagnosis and he/she will eliminate the alternative hypotheses by analyzing the appropriate laboratory and instrumental tests. The results of those tests shall be introduced under the laboratory-instrumental examination section. Different types of tests have to be divided into paragraphs [laboratory tests, radiology, functional tests, electrophysiology (incl. ECG), endoscopy, morphology (aspirations, biopsies etc.)]. If some tests have been ordered frequently, the student should include only the results of those days which are essential for confirming the clinical diagnosis or show a significant change in the patient´s condition (e. g not all of the daily blood test results are required but the student should only choose the most characteristic ones to the disease). If necessary, the data should be arranged in a table format. All of the patient´s laboratory and instrumental tests are to be included. Students must give their opinion on how the results confirm their primary hypothesis. The test results that do not support the primary diagnosis should also be analyzed. Students must offer their opinions on the relevance of tests ordered. It is important to take into account the diagnostic algorithms and the principle that non-invasive or less invasive procedures precede more invasive manipulations. When considering the succession of analyses, it is essential to follow the protocol of the subspeciality and/or take into account the protocols for establishing your primary diagnosis. If the particular clinical practice somehow differs from recognized guidelines, the student should provide an explanation for it (e. g patient refusal, possible contraindications, unavailability of procedure, high cost, technical or organizational difficulties etc.). Students must evaluate how the aforementioned influences the establishment of the clinical diagnosis.