Course 5: ED course Flashcards
1
Q
What is in a CBC, what is the significance of each test
A
- WBC(White Blood Cells)High=infection
- Hgb(Hemoglobin)—Low=Anemia
- Hct(Hematocrit)—low=Anemia
- Plt(Platelets)—Low(Thrombocytopenia)=Prone to bleeding
2
Q
Type of Lab studies
A
- Blood
- Urine
- Cultures
3
Q
What is CBC with Diff, what is the significance of each test?
A
CBC tests+ more detailed look at WBC
- Bands—high(bandemia)=serious infection
- Segs(segmented Neutrophils—High(left shift)= acute infection
- Lymphs(lymphocytes)—High=Viral infection
- Monos(monocytes)—High=Bacterial Infection
- Eos(Eosinophils)—High=parasitic infection
4
Q
Whats done in a CMP?
A
- BMP
- LFTs
5
Q
What are the LFTs (liver function Tests)?
A
wALT wALKs pAST
6
Q
Whats done in a BMP?
A
- Electrolytes
- Kidney Function
- BUN(Blood Urea Nitrogen)
- Creat(Creatinine)
- Blood Glucose
7
Q
What tests are done in a CEP(Cardiac enzyme panel), what is important?
A
Looks for heart Damage
- Troponin
- CK(Creatine Kinase)
- Other Creatine tests
- Myo(myoglobin)
8
Q
what are the 6 Cardiac Orders?
A
- CBC
- BMP
- CK, CK-MB
- Troponin
- EKG
- CXR
9
Q
Respiratory labs and significance?
A
- BNP(B-type Natriuretic Peptide)
- High=CHF
- ABG(Arterial Blood Gas)
- VBG(Venous Blood Gas)
10
Q
What Does a positive D-Dimer mean?
A
Possible PE, order a CTA Chest and VQ scan
11
Q
What does a Negative D-Dimer mean?
A
No PE
12
Q
What is important about D-Dimer?
A
- Signifies a PE
- SOB
- Pleuritic CP
- If Negative no blood clots, PE excluded
- Need CTA chest or VQ scan to diagnose PE
13
Q
What does Troponin Test tell about pt?
A
- If it is high signifies a non-STEMi
- can take 4-12 hours for Troponin levels to rise
14
Q
What test will show a Hemorrhagic CVA?
A
CSF RBC
15
Q
3 Coag studies and significance
A
- PTT
- PT
- PT and INR
- INR
- Normal INR=1.0
- >3.0 Supratheraputic—>Too Much Coumadin
- <2.0 Subtheraputic —>Not enough Coumadin
16
Q
What labs are used to test inflammation?
A
- CRP(C -Reactive Protein)
- ESR/Sed Rate( Erythrocyte Sedimentation Rate)
- if Either are high—>inflamation
17
Q
What are the 4 ENT( ears, nose and throat labs)?
A
- Strep- Rapid Strep Test
- Monospot-Mononucleosis
- Influenza A+B
- RSV-Respiratory Synctial Test
- if positive likely bronchitis
18
Q
CSF Analysis Tests
A
- DDx: Meningitis, hemorrhagic CVA(RBC)
- Tests
- CSF gluc
- CSF prot
- CSF RBC(hemorrhagic CVA)
- CSF WBC
- CSF Gram Stain
19
Q
What Labs would you use to Diagnose Pancreatitis?
A
- Lip (Lipase)
- specific to pancreatitis
- Amy (Amylase)
- possible pancreatitis
20
Q
What are the 3 Thyroid Labs?
A
- TSH(Thyroid stimulating hormone)
- Low- Hyperthyroidism
- High-Hypothyroidism
- T3
- T4
21
Q
What are the OB/GYN Labs and their significance?
A
- HCG
- Positive=Preg
- Serum HCG Quant
- Higher/Unchanged= Further along in preg
- Lower=failed pregnancy
- Serum HCG Qual
- Positive=Preg
- Negative=Not Preg
- T+S/ABORh
- Rh Negative= Needs RhoGAM shot if pregnant
22
Q
What are the Pelvic Exam Labs?
A
- Wet Prep(vaginal wet mount)
- GC (Gonococcus)
- CT (Chlamydia)
- Genital Cx (genital Culture)
23
Q
What are the Three labs that are key for efficiency?
A
- D-Dimer-must order CTA Chest or VQ scan
- Troponin- Acute MI
- Creatinine(From BMP)-Kidney Function
24
Q
What is the difference between the Urine Dip and Microscopic Urinalysis
A
- Urine dip can be done at bedside and is qualitative
- Microscopic Urinalysis is Quantitative
- Both can be used to determine if pt has a UTI or a Kidney Stone
25
What are the parts of the Urine Dip and their significance?
* Leuks-Likely UTI
* Nit(Nitrite)-UTI
* Glu(glucose)- Positive=Glycosuria/ High Blood Sugar(DM)
* Blo(Blood)- Kidney Stone or UTI
26
Parts of Microscopic Urinalysis
* WBC
* \>6 (pyuria) UTI
* RBC
* \>6 (hematuria) UTI or Kidney Stone
* Bact (bacteria)
* UTI
* Epi (epithelial cells)
* Contaminated sample
27
What tests are used to determine if a pt has sepsis?
* CBC- Possible Sepsis
* Lactate- Sepsis or cell death in the body
* Blood Cx- Definitive Sepsis
28
What Cultures( Cx) are used?
* BCx--Sepsis
* UCx--UTI
29
List the Toxicology Labs and their purpose.
* ASA- Toxic asprin level
* APAP- toxic tylenol level
* EtOH- Alcohol intoxication
* Utex(urine drug screen)- Drug abuse
30
What are the two diabetes labs?
* Ketones--Likely DKA
* Accu-Check---Low or high blood sugar
31
Will a Culture ever give results the same day?
No
32
Critical Care definition
care provided to any pt that is at serious risk for deterioration that may lead to permanent bodily harm or death
33
Ultrasounds and significance?
* US doppler LE
* DVT
* US RUQ
* Cholelithiasis
* Cholecystitis
* US OB/transvag/pelvic
* IUP
* ovarian cyst/torsion
* US scrotum
* Testicular torsion/mass
34
What are the 3 types of CT scans and what are they used for?
* CT w/o IV contrast "Dry CT"
* fractures and kidney stones and such
* CTA, CT w/ angiogram or IV contrast
* things that have to do with blood blockage like CVA PE
* CT A/P w/ PO
* Appendicitis
* diverticulitis
35
How do you determine what is a procedure and what is not?
Any time the physician performs something that fixes the pt is is a separate procedure
36
What are AAS/KUB X-rays used to detect?
* Free air(rupture)
* SBO
* Constipation
* Large Kidney Stones
37
what is a CXR used to detect?
* PNA
* PTX
* Widened Mediastinum(Dissection)
* Pleural Effusion
* CHF
38
What procedures qualify as CC?
* Procedural Sedation
* Intubation
* Central Line Placement
* Chest Tube
* Cardioversion
* CPR
* CPAP/BiPAP
39
What questions are important to ask regarding CCT?
1. Does the pt Qualify
2. How many minutes of CCT were provided?
