Sometimes medicine does throw you a real curveball - I did an autoimmune
screen as part of workup for a possible inflammatory arthritis, and got
antimitochondrial antibody levels of 1:320. LFT normal, and abdo exam
normal.
Asked on dnuk, but not very useful replies - if she now applies for
insurance her possible future primary biliary cirrhosis will be stacked
against her, but can't say for sure if will happen.
Tried to explain to her - real nightmare consult from hell. Neither of us
clearer at the end.
James
----Original Message Follows----
From: Declan Fox <[log in to unmask]>
Reply-To: GP-UK <[log in to unmask]>
To: [log in to unmask]
Subject: Re: Microscopic haematuria
Date: Mon, 27 Aug 2007 22:25:47 +0100
Only reason I can think of for doing lipids here is because various "expert"
bodies say we should be checking everyone over 40. Me, I think that is
extreme. I don't encourage it.
But if I did happen to see a chol >6.5 in this person, I would do what you
suggest as the next step.
Declan
<<> Take apparently normal person, BMI 22, swears they have one glass a wine
a day. Say 45 years old, would like lipids and BP done. On no meds.
> Should this person have LFTs done?
As a BTW Declan
Screening / case finding for hypertension is probably reasonable. Why would
you do the lipids?
We also wouldn't do LFTs for this person, but if we did their total
cholesterol and it came back at >6.5 we would do:
Renal, LFTs, TFTs, fasting glucose and repeat lipids. We would also meet
them again to discuss the results, causes and management.
Would anyone want to suggest that we should do less than this.
Julian>>
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