In-House Testing Services
Internal Medicine and Primary Care Specialists performs various tests in our office. The following list comprises the tests that are performed on site and the necessary preparations when needed.
Allergy Testing | Blood and Urine Analysis | Bone Density | EKG | EMG | Glaucoma Screening | Hearing Test | Holter and Event Monitor | Pulmonary Function | Retinal Screening | School, Sport, and Work Physicals | Stress Test | Ultrasound | Xray | Nutritional Counseling | Suboxone (Substance Abuse) | Vaccinations and Immunizations
Allergy tests are used to determine the specific substances that cause an allergic reaction in an individual. They may also be used to determine if a group of symptoms is a true allergic reaction, which involves antibodies and histamine release.
Before any allergy testing, the health care provider will ask for a very detailed medical history. This may include questions about such things as illnesses, emotional and social conditions, work, entertainment, lifestyle, foods, and eating habits.
If skin testing will be performed, it is essential that you not take antihistamines and decongestants including over-the-counter products prior to the test. This may lead to a false-negative result, falsely reassuring you that a substance is unlikely to cause a severe allergic reaction. The antihistamines and decongestants will need to be stopped 48 hours prior to skin testing. Your doctor will tell you which other medicines to avoid and when to stop taking them before the testing.
Blood and Urine Analysis
Blood tests and urine test are performed to act as an aid in diagnosing a suspected disease or condition. They are also used to monitor existing conditions such as diabetes, hypertension and other illnesses.
We also do Coumadin monitoring using the latest techniques via finger stick in our office.
For some blood tests it is necessary for the patient to fast for a minimum of ten hours prior to the venipuncture or blood draw. These include full lipid analysis and cholesterol testing.
A bone density test, or scan, is designed to check for osteoporosis, a disease that occurs when the bones become thin and weak. A bone density test measures the strength and density of bones at various sites in the body. It can detect osteoporosis before a fracture occurs, predict your chances of fractures and determine the rate of bone loss. This test also can monitor the effects of treatment if the test is conducted at intervals of a year or more. Osteoporosis happens when the bones lose calcium and other minerals that keep them strong. Osteoporosis begins after menopause in many women, and worsens after age 65, often resulting in serious fractures. These fractures may not only bring disability, but may affect longevity. As many as one-fourth of women who fracture their hip after age 50 die within one year. Other conditions should be screened for osteoporosis including steroid use, thyroid disease and others.
No preparation is necessary prior to taking this test.
Electromyography is a test that assesses the health of the muscles and the nerves controlling the muscles.
An electrocardiogram (ECG) is a test that records the electrical activity of the heart. ECG is used to measure the rate and regularity of heartbeats as well as the size and position of the chambers, the presence of any damage to the heart, and the effects of drugs or devices used to regulate the heart (such as a pacemaker).
There are no restrictions for food or fluids. However, ingestion of cold water immediately before an ECG may produce changes in one of the waveforms recorded (the T wave). Exercise (such as climbing stairs) immediately before an ECG may significantly increase your heart rate. We do request that you use no body lotions, oil or powder on the day of the test.
EMG (Nerve Testing)
Electromyography (EMG) is an electrical recording of muscle activity that aids in the diagnosis of neuromuscular disease, which affects muscle and peripheral nerves. EMG results can help determine whether symptoms are due to a muscle disease or a neurological disorder, and, when combined with clinical findings, usually allow a confident diagnosis. Symptoms for which EMG may be useful include atrophy, stiffness, weakness, numbness, cramping and pain and diabetic neuropathy screening.
No special preparation is necessary prior to having this test.
Glaucoma is a disease of the eye in which damage is caused by elevated pressure within the eye. The incidence in persons over the age of 40 is about 0.5%, making glaucoma one of the most common and serious eye disorders.
A screening test is used to determine if pressure within the eye has begun to develop in order to be able to treat the condition at an early stage.
There is no special preparation needed for this test.
An audiology exam tests your ability to hear sounds. Sounds vary according to the intensity (volume or loudness) and the tone (the speed of sound wave vibrations).
Hearing occurs when sound waves are conducted to the nerves of the inner ear and from there to the brain. Sound waves can travel to the inner ear by air conduction (through the ear canal, eardrum, and bones of the middle ear) or bone conduction (through the bones around and behind the ear). Hearing tests are indicated after hear injury, noise trauma, ringing or tinnitus, dizziness or hearing loss.
There is no special preparation needed for this test.
Holter and Event Monitor
A Holter monitor is a small piece of equipment worn by the patient that continuously records the heart’s rhythms. The monitor is usually worn for 24 hours during normal activity. An Event Monitor records the same information but is worn for a period of three weeks to a month. In both tests, the patient should note when there are periods of increased stress or activity and will be asked to keep a diary. Indications include dizziness, palpitations, chest pain or blackouts.
There is no special preparation for the test. Your doctor will start the monitor. You’ll be told how to replace the electrodes, should they fall off or become loose.
A Pulmonary Function Test is the measurement of lung function, specifically the measurement of the amount (volume) and speed (flow) of air that can be inhaled and exhaled. This test is an important tool used for assessing lung diseases such as asthma, cystic fibrosis, emphysema, and COPD.
There is no special preparation necessary for this test to be performed.
Diabetic retinopathy is the leading cause of blindness among working-age adults. With early detection, 95% of vision loss cases can be prevented. The Retinavue camera is a simple, affordable and effective screening for diabetic retinopathy. Images are evaluated by a board-certified retinal specialist and a diagnostic report and referral/screening plan is returned the same day.
There is no special preparation for this test. The patient sits in a darkened room for five minutes prior to the image being recorded for dilation and the test takes less than five minutes
School, Sport, and Work Physicals
Sports physicals, also called a pre-participation exam (PPE), are exams that help determine whether it’s safe for a child or adolescent to participate in physical activity.
They are used to:
- Maximize safe participation in physical activity by children and adolescents,
- Identify any life threatening medical conditions such as certain heart conditions
- Identify conditions that may limit participation
- Identify conditions that require a treatment plan before or during exercise such as uncontrolled blood pressure, eating disorders or certain lung conditions
An employer may require a prospective employee to have a physical examination prior to hiring. Passing a physical can be a condition of employment. Employment physical examinations may include physical examinations and health inquiries including drug and alcohol tests, psychological tests, and physical or mental health assessments. In addition, employees may be required to have physicals if health or fitness is a job requirement.
An exercise stress test is a screening tool to test the effect of exercise on your heart. The test gives a general sense of how healthy your heart is. .It is graded test to measure an individual’s heart rate and oxygen intake while undergoing strenuous physical exercise, as on a treadmill.
The patient walks on an exercise machine while the electrical activity of their heart is measured with an electrocardiogram (ECG), and blood pressure readings are taken. This will measure the heart’s reaction to your body’s increased need for oxygen. The test is often done in conjunction with a nuclear scan of the heart which requires an injection and time under the camera before and
after exercise. Occasionally a medication is injected for those who cannot adequately walk on the treadmill. This can give some patients a headache. Let the technician know if this occurs so that it can readily be treated.
On the day of the exam prior to the test, the patient may not drink anything that contains caffeine and they may not smoke. No bath oils, powder or lotion should be worn and the patient should wear comfortable clothes and walking shoes. It is also important to bring a list of all medications that are being taken.
An ultrasound uses high-frequency sound waves. Ultrasound waves can be bounced off of tissues using special devices. The echoes are then converted into a picture called a sonogram. Ultrasound imaging, referred to as ultrasonography, allows physicians and patients to get an inside view of soft tissues and body cavities, without using invasive techniques.
Preparation for kidney, thyroid, breast, extremities, aorta or carotid ultrasound is not necessary.
- Abdomen: Nothing to eat or drink 8 hours prior to exam. You can drink water and take your normal medications.
- Pelvic: Drink 32 ounces of liquid. Complete drinking the liquid 1 hour prior to exam. DO NOT URINATE UNTIL AFTER THE EXAM IS COMPLETE.
- Abdomen & Pelvic: Do not eat 8 hours prior to the exam and you MUST finish drinking 32 ounces of water prior to the exam.
An X-ray examination uses electromagnetic radiation to make images of your bones and internal organs. An X-ray machine sends individual x-ray particles, called photons. These particles pass through the body. A computer or special film is used to record the images that are created. Simply put, an X-ray allows your doctor to take pictures of the inside of your body.
One of the oldest forms of medical imaging, X-ray is a painless medical test that can help your doctor in diagnosis and treatment — even in emergency situations. It’s a fast, easy and safe way for your doctor to view and assess conditions ranging from broken bones to pneumonia to cancer. Many different types of X-rays, such as bone or chest X-rays, exist. The type your doctor uses depends on what part of your body is being examined and for what purpose.
There is no special preparation necessary for this test to be performed.
Nutritional deficiencies rob the body of its own natural resources and can manifest as symptoms such as fatigue, mood swings and insomnia. Many times, these symptoms are taken for granted as a natural sign of aging. When left unchecked, however, these same deficiencies can contribute to diseases such as arteriosclerosis, high blood pressure, diabetes and arthritis.
Nutrition-related conditions we address include diabetes, blood lipids (cholesterol and triglycerides), hypertension, kidney disease before dialysis, polycystic ovarian syndrome, hypoglycemia, gluten intolerance (celiac disease), irritable bowel syndrome, gastro esophageal reflux disease, and obesity.
Medical nutrition therapy is provided by appointment only.
Suboxone® (Substance Abuse)
Suboxone® is the first opioid medication approved under DATA 2000 for the treatment of opioid dependence in an office-based setting. Suboxone® also can be dispensed for take-home use, just as any other medicine for other medical conditions.
Suboxone® at the appropriate dose may be used to:
- Suppress symptoms of opioid withdrawal
- Decrease cravings for opioids
- Reduce illicit opioid use
- Block the effects of other opioids
- Help patients stay in treatment
Vaccinations and Immunizations
The Center for Communicable Diseases has strongly advised that all adults become aware of the various vaccinations that are available and when they should be considered. To help you with the information needed, we are providing you with the following list. All vaccinations are available in our office by appointment.
|Vaccine||For whom vaccination is recommended||Schedule for vaccine administration|
|Hepatitis B (Hep B)||
|Hepatitis A (Hep A)||
|Tetanus, diphtheria, pertussis||
|Polio||Not routinely recommended for persons age 18yrs and older.
Note: Adults living in the U.S. who never received or completed a primary series of polio vaccine need not be vaccinated unless they intend to travel to areas where exposure to wild-type virus is likely (i.e., India, Pakistan, Afghanistan, and certain countries in Africa). Previously vaccinated adults can receive one booster dose if traveling to polio endemic areas.
|Varicella (Chickenpox)||All adults without evidence of immunity. Immunity is defined as any one of the following:
|MMR (Measles, mumps, rubella)||
||One or two doses are needed.
|Human-papillomavirus (HPV)||All previously unvaccinated women through age 26yrs.||
|Zoster (shingles)||A herpes zoster (shingles) vaccine was licensed in May 2006 for use in persons age 60yrs and older. ACIP recommendations for its use are pending. Refer to the package insert for details on its use.|