An iconic language for the Visualization of Concepts in Medicine

Lesson 6 : Icons for lab-tests and follow-up procedures

VCM represents lab-tests and follow-up procedures with the icon of the risk that is followed-up, with a small blue top-right pictogram indicating the type of lab-test or follow-up procedure (clinical, functional, biological or imaging). For example:

Examination and follow-up procedure, including diagnostics
Genetic disorder diagnostic
Clinical examination
Blood pressure monitoring
Functional examination
Lab test
Renal lab test (ex: clearance)
Hepatic lab test (ex: transaminases)
Glycemia monitoring
Spleen biopsy
Bone X-ray


In some situations, e.g. when taking particular drugs, lab test results might be modified. This can be represented as follows:

Risk of erroneous glycemia results


Similarly to contraindications, cautions for use can be represented on a “Mister VCM” (see example in exercise 2 below).

Exercise 1

What do the following icons mean?

(1) Answer: Submit


(2) Answer: Submit


(3) Answer: Submit


Exercise 2

The following text contains the warnings for use of a beta-blocking agent. It is enriched by icons, those in the left margin indicate the patient conditions referred to in the various paragraphs (e.g. "For diabetic patients..."), and those in the right margin show the actions recommended for, or the risks incurred by, these patients (e.g. "dose reduction" or "risk of gastrointestinal bleeding").

The attention of athletes is drawn to the fact that this medicine contains an active ingredient that can cause a positive reaction in tests performed during doping controls.

Diabetic patients: Warn the patient and reinforce glycemic monitoring at the beginning of the treatment. The signs of hypoglycemia may be masked, particularly tachycardia, palpitations and sweating.

In case of renal failure, the dose should be adapted to the renal function: in practice, it is sufficient to monitor the heart rate, and to lower doses if excessive bradycardia develops (50 - 55 beats / min at rest).

Asthma and chronic obstructive pulmonary disease: Lung functional examinations are recommended before the initiation of treatment.

For patients suffering from peripheral arterial disorders (Raynaud's disease or syndrome, arthritis or chronic occlusive arterial disease of the lower limbs), beta-blocking agents can cause aggravation of these disorders. In these situations, cardioselective beta-blocking agents and partial agonists should be favored, and should be administered with caution.

For patients with heart failure controlled by treatment and when necessary, this drug (acebutolol) should be administered at only very low doses.

If the frequency drops below 50-55 beats per minute at rest and the patient experiences symptoms related to bradycardia, the dose should be reduced.

Given their negative dromotropic effect, beta-blocking agents should be administered with caution to patients with first degree atrioventricular blockage.

Beta-blockers may increase the number and duration of seizures in patients with variant angina. The use of beta-1 cardioselective beta-blocking agents is possible in minor forms, provided that a vasodilator is administered simultaneously.

Psoriasis: Worsening of the disease has been reported to be associated with beta-blocking agents, so such agents may not be appropriate in these cases.


Answer the following question about the clinical cases described:

Case #1: Mrs. X is 49 years old; she is treated with omeprazole for gastric ulcer, and also suffers from COPD as a result of tobacco use. She suffers from mild depression due to professional problems. She also has hypertension. Can the beta-blocking agent presented in the text above be prescribed to this patient?

(4-a) Yes Wrong answer!

(4-b) Yes with a dose reduction Wrong answer!

(4-c) Yes with adapted monitoring Right answer!

(4-d) Yes with both a dose reduction and adapted monitoring Wrong answer!

(4-e) No Wrong answer!


Case #2: Mr. Y is 55 years old, he has a history of myocardial infarction, and suffers from heart failure, treated with digitalis. Can you prescribe him the beta-blocking agent presented in the text above?

(5-a) Yes Wrong answer!

(5-b) Yes with a dose reduction Right answer!

(5-c) Yes with adapted monitoring Wrong answer!

(5-d) Yes with both a dose reduction and adapted monitoring Wrong answer!

(5-e) No Wrong answer!