Ultrasound and Sonography

What is an ultrasound?

An ultrasound is an imaging test that uses sound waves to create a picture (also known as a sonogram) of organs, tissues, and other structures inside the body. Unlike x-rays, ultrasounds don’t use any radiation. An ultrasound can also show parts of the body in motion, such as a heart beating or blood flowing through blood vessels.

There are two main categories of ultrasounds: pregnancy ultrasound and diagnostic ultrasound.

Pregnancy ultrasound is used to look at an unborn baby. The test can provide information about a baby’s growth, development, and overall health.

Diagnostic ultrasound is used to view and provide information about other internal parts of the body. These include the heart, blood vessels, liver, bladder, kidneys, and female reproductive organs.

Other names: sonogram, ultrasonography, pregnancy sonography, fetal ultrasound, obstetric ultrasound, diagnostic medical sonography, diagnostic medical ultrasound

What is it used for?

An ultrasound can be used in different ways, depending on the type of ultrasound and which part of the body is being checked.

A pregnancy ultrasound is done to get information about the health of an unborn baby. It may be used to:

Confirm that you are pregnant.

Check the size and position of the unborn baby.

Check to see you are pregnant with more than one baby.

Estimate how long you have been pregnant. This is known as gestational age.

Check for signs of Down syndrome, which include thickening in the back of the baby’s neck.

Check for birth defects in the brain, spinal cord, heart, or other parts of the body.

Check the amount of amniotic fluid. Amniotic fluid is a clear liquid that surrounds an unborn baby during pregnancy. It protects the baby from outside injury and cold. It also helps promote lung development and bone growth.

Diagnostic ultrasound may be used to:

Find out if blood is flowing at a normal rate and level.

See if there is a problem with the structure of your heart.

Look for blockages in the gallbladder.

Check the thyroid gland for cancer or non-cancerous growths.

Check for abnormalities in the abdomen and kidneys.

Help guide a biopsy procedure. A biopsy is a procedure that removes a small sample of tissue for testing.

In women, diagnostic ultrasound may be used to:

Look at a breast lump to see if it might be cancer. (The test may also be used to check for breast cancer in men, though this type of cancer is far more common in women.)

Help find the cause of pelvic pain.

Help find the cause of abnormal menstrual bleeding.

Help diagnose infertility or monitor infertility treatments.

In men, diagnostic ultrasound may be used to help diagnose disorders of the prostate gland.

Why do I need an ultrasound?

You may need a ultrasound if you are pregnant. There is no radiation used in the test. It offers a safe way of checking the health of your unborn baby.

You may need diagnostic ultrasound if you have symptoms in certain organs or tissues. These include the heart, kidneys, thyroid, gallbladder, and female reproductive system. You may also need ultrasound if you are getting a biopsy. The ultrasound helps your health care provider get a clear image of the area that is being tested.

What happens during an ultrasound?

A ultrasound usually includes the following steps:

You will lie on a table, exposing the area that’s being viewed.

A health care provider will spread a special gel on the skin over that area.

The provider will move a wand-like device, called a transducer, over the area.

The device sends sound waves into your body. The waves are so high pitched that you can’t hear them.

The waves are recorded and turned into images on a monitor.

You may be able to view the images as they are being made. This often happens during a pregnancy ultrasound, allowing you to look at your unborn baby.

After the test is over, the provider will wipe the gel off your body.

The test takes about 30 to 60 minutes to complete.

In some cases, a pregnancy ultrasound may be done by inserting the transducer into the vagina. This is most often done early in pregnancy.

Will I need to do anything to prepare for the test?

The preparations will depend on which type of ultrasound you are having. For ultrasounds of the abdominal area, including pregnancy ultrasounds and ultrasounds of the female reproductive system, you may need to fill up your bladder before the test. This involves drinking two to three glasses of water about an hour before the test, and not going to the bathroom. For other ultrasounds, you may need to adjust your diet or to fast (not eat or drink) for several hours before your test. Some types of ultrasounds require no preparation at all.

Your health care provider will let you know if you need to do anything to prepare for your ultrasound.

Are there any risks to the test?

There are no known risks to having an ultrasound. It is considered safe during pregnancy.

What do the results mean?

If your pregnancy ultrasound results were normal, it doesn’t guarantee you’ll have a healthy baby. No test can do that. But normal results may mean:

Your baby is growing at a normal rate. You have the right amount of amniotic fluid. No birth defects were found, though not all birth defects will show up on an ultrasound.

If your pregnancy ultrasound results were not normal, it may mean:

The baby is not growing at a normal rate.

You have too much or too little amniotic fluid.

The baby is growing outside the uterus. This is called an ectopic pregnancy. A baby can’t survive an ectopic pregnancy, and the condition can be life threatening for the mother.

There is a problem with the baby’s position in the uterus. This could make delivery more difficult.

Your baby has a birth defect.

If your pregnancy ultrasound results were not normal, it doesn’t always mean your baby has a serious health problem. Your provider may suggest more tests to help confirm a diagnosis.

If you had diagnostic ultrasound, the meaning of your results will depend on which part of the body was being looked at.

Blood Sugar Test

What is a Blood Glucose Test?
A blood glucose test measures the glucose levels in your blood. Glucose is a type of sugar. It is your body’s main source of energy. A hormone called insulin helps move glucose from your bloodstream into your cells.

Too much or too little glucose in the blood can be a sign of a serious medical condition. High blood glucose levels (hyperglycemia) may be a sign of diabetes, a disorder that can cause serious, long-term health conditions.

High blood sugar may also be caused by other conditions that can affect insulin or glucose levels in your blood, such as problems with your pancreas or adrenal glands.

Low blood glucose levels (hypoglycemia) are common among people with type 1 diabetes and people with type 2 diabetes who take certain diabetes medicines. Certain conditions, such as liver disease, may cause low levels of blood glucose in people without diabetes, but this is uncommon. Without treatment, severe low blood sugar can lead to major health problems, including seizures and brain damage.

Other names: blood sugar, self-monitoring of blood glucose (SMBG), fasting plasma glucose (FPG), fasting blood sugar (FBS), fasting blood glucose (FBG), random blood sugar, glucose challenge test, oral glucose tolerance test (OGTT)

What is it used for?
A blood glucose test is used to find out if your blood sugar levels are in a healthy range. It is often used to help diagnose and monitor diabetes.

Why do I need a blood glucose test?
Your health care provider may order a blood glucose test if you have symptoms of high glucose levels or low glucose levels.

Symptoms of high blood glucose levels include:

Increased thirst and urination (peeing)
Blurred vision
Fatigue
Sores that don’t heal
Weight loss when you’re not trying to lose weight
Numbness or tingling in your feet or hands

Symptoms of low blood glucose levels include:

Feeling shaky or jittery
Hunger
Fatigue
Feeling dizzy, confused, or irritable
Headache
A fast heartbeat or arrhythmia (a problem with the rate or rhythm of your heartbeat)
Having trouble seeing or speaking clearly
Fainting or seizures

You may also need a blood glucose test if you have a high risk for developing type 2 diabetes. You’re more likely to develop diabetes .

What happens during a blood glucose test?
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out.

For some types of glucose blood tests, you will drink a sugary liquid and wait for an hour before your blood sample is taken:

A glucose challenge test is used to test for gestational diabetes in pregnancy. If your blood glucose level is higher than normal, you may have gestational diabetes. You’ll need an oral glucose tolerance test (OGTT) to get a diagnosis.
An oral glucose tolerance test (OGTT) is used to diagnose gestational diabetes, and type 2 diabetes and prediabetes in people who aren’t pregnant. A blood sample will be taken before you have a sugary drink and then again, every hour for the next 2 or 3 hours.
Will I need to do anything to prepare for the test?
If your provider orders a fasting blood glucose test or an oral glucose tolerance test, you will need to fast (not eat or drink) for at least eight hours before the test. Other blood glucose tests don’t require any special preparations. Ask your provider whether you need to fast before your glucose test.

Are there any risks to the test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly. After an oral glucose tolerance test, you may feel light-headed. Your provider may suggest that you plan to have someone take you home.

What do the results mean?
If your results show higher than normal glucose levels, it may mean you have or are at risk for getting diabetes. High glucose levels may also be a sign of:

Hyperthyroidism
Pancreas disorders
Stress from surgery, very serious illness, or trauma

If you have diabetes, lower than normal glucose levels may be caused by:

Side effects from certain diabetes medicines
Not eating enough, especially after taking diabetes medicine
Being more physically active than usual

If you don’t have diabetes, low blood glucose levels may be a sign of:

Liver disease
Kidney disease
Underactive adrenal, pituitary, or thyroid gland (hypothyroidism)
Alcohol use disorder (AUD)
If your glucose results are not normal, it doesn’t always mean you have a medical condition that needs treatment. Certain medicines and stress can affect glucose levels. To learn what your test results mean, talk with your health care provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I should know about a blood glucose test?
If you have diabetes, you may need to do blood sugar testing at home every day to help manage your blood glucose levels. There are two ways to do this:

Blood glucose meters require you to prick your finger with a small device called a lancet. You apply a drop of blood to a test strip and insert it into a small, electronic glucose meter, which measures the glucose is in your blood.
Continuous glucose monitors (CGM) use a tiny sensor that you insert under your skin. Every few minutes, the sensor measures glucose levels in fluids between your cells. If your glucose is too high or too low, you use a blood glucose meter to check your blood levels before making changes to raise or lower your glucose level.

HIV Viral Load

What is an HIV Viral Load?

An HIV viral load is a blood test that measures the amount of HIV in a sample of your blood. HIV stands for human immunodeficiency virus. The test looks for genetic material from the virus in your blood. These tests are called molecular tests or nucleic acid amplification tests (NAAT or NAT). There are several types of NAAT tests. A PCR test is one type of NAAT that may be used to find HIV.

HIV is a virus that destroys certain cells in your immune system. These cells protect your body against diseases from germs, such as viruses, bacteria, and fungi. If you lose too many immune cells, your body will have trouble fighting off infections and other diseases.

You can get HIV from contact with the blood of a person who has an HIV infection. This usually happens through sex or sharing needles or other equipment used to inject drugs.

HIV is the virus that causes AIDS (acquired immunodeficiency syndrome). AIDS is the final, most serious stage of an HIV infection. Without treatment, the amount of HIV in your body can increase. It can gradually destroy your immune system and become AIDS. With AIDS, your body has trouble fighting off infections from germs that usually don’t cause problems in healthy people. These are called opportunistic infections, and they can become life-threatening. AIDS increases your risk of developing certain cancers, too.

Most people with HIV don’t have AIDS.
 If you have HIV, you can take HIV medicines that protect your immune system and help prevent you from getting AIDS. Medicines that treat HIV are called antiretroviral therapy (ART). ART can’t get rid of HIV completely, so you’ll need to take medicines for the rest of your life. But ART can control HIV and help you live a longer, healthier life.
Having regular HIV viral load tests is an important part of making sure your HIV medicines are keeping your viral load low, so you stay healthy.
Other names: nucleic acid testing, NAT, nucleic acid amplification test, NAAT, HIV PCR, RNA Test, HIV quantification

Necessity of Viral Load

An HIV viral load test is mainly used after you’re diagnosed with HIV to:

Guide decisions about your treatment

Check how well your HIV medicines are working

Watch for any changes in your HIV infection

HIV viral load testing is also used to test newborn babies when they are born to a person who has HIV. That’s because HIV can be passed to a baby during pregnancy, childbirth, and through breast milk.
In certain cases, an HIV viral load test may be used to diagnose HIV. Usually, HIV screening tests are used first. That’s because HIV viral load tests are expensive. But viral load tests can find HIV sooner after an infection than screening tests. So, your health care provider may order this test if your risk of having HIV is very high.

Why do I need an HIV viral load?

A viral load test is needed to guide treatment decisions. If you have HIV, you’ll probably start taking HIV medicines soon after your diagnosis. But first, you’ll need a viral load test to find out how much virus is in your blood. This information helps your provider choose the right medicines for you. Your first test result will be compared with later test results to see if the medicines are working.
A viral load test is needed to see how well treatment is working and to monitor your HIV infection. The goal of HIV treatment is to reduce the amount of virus in your blood until there’s too little to show up on a test. You’ll need to have regular viral load tests to see whether your viral load is dropping enough. HIV viral load tests are usually done:

Before you start taking medicine

About two to eight weeks after starting or changing HIV medicines

Every three to six months to monitor your infection when your treatment is working well

Your provider may order an HIV viral load test to diagnose HIV if:

You recently had a high-risk exposure to HIV. High-risk exposures include:

Having vaginal or anal sex with someone who has HIV or whose HIV status you don’t know

Sharing needles, syringes, or other items used to inject drugs with other people

Exchanging sex for money or drugs

Having a sexually transmitted disease (STD), such as syphilis

Having sex with anyone who has done anything listed above

You had a recent possible exposure to HIV, and you have early symptoms of HIV infection. The early stage of HIV doesn’t always cause symptoms. When it does, they may include:

Flu-like symptoms, such as fever, chills, aches

Extreme fatigue

Swollen lymph nodes (in your neck, groin, or armpit)

Rash

Sores in your mouth

If you think you were exposed to HIV, talk with your provider right away about getting tested. You may also be able to have emergency treatment to prevent HIV infection within the first 3 days after a possible exposure.

What happens during an HIV viral load?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?

You don’t need any special preparations for an HIV viral load. But if you are getting this test to find out if you are infected with HIV, you should talk with a counselor before or after your test so you can better understand the results and your treatment options.

What do the results mean?

If you have an HIV viral load test because you have HIV:

A negative or undetectable viral load means that you have so little HIV in your blood that the test can’t find it. This means that your HIV medicines are working well to protect your immune system, and you are unlikely to spread HIV through sex. It does not mean you’re cured. You must continue to take your medicines as prescribed to keep your HIV in control.

A low viral load means your medicine is stopping the virus from growing and your infection is unlikely to get worse.

A high viral load means the virus is growing and your treatment is not working well. The higher the viral load, the more risk you have for infections and diseases related to a weak immune system. It may also mean you have a higher risk for developing AIDS. If your results show a high viral load, your provider will probably change your medicines.

If you had an HIV viral load test to diagnose whether you have HIV:

A normal or negative result means that no HIV was found in your blood, and you are probably not infected with HIV.

A result that shows any amount of virus in your blood means you have an HIV infection. Your provider will likely order other tests, including a CD4 count, to see how much HIV has damaged your immune system.

If you have questions about your results, talk with your provider.
Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about an HIV viral load?

If you are living with HIV, you will have regular viral load tests to monitor your infection and treatment. It’s best to have the same type of test done at the same lab if possible. That’s because labs have different ways of measuring HIV viral load. Your provider needs to compare your test results over time to see if your viral load is going up or down, and different tests from different labs can be difficult to compare.

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