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Diagnostic Interpretation PA 545: Cardiac > DI EXAM 1 REVIEW > Flashcards

DI EXAM 1 REVIEW Flashcards

1
Q
  • BMP and CMPs are chemistry/hematology lab tests.
  • CBC is a chemistry/hematology lab test
A
  • BMP and CMPs are chemistry/hematology lab tests.
  • CBC is a chemistry/hematology lab test
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2
Q

_______ is the term for the liquid portion of blood that makes approximately 55% of blood.

A

plasma

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3
Q

A _____ coat is a thin gray-white layer between plasma and hematocrit, about 1% of the blood volume. Which two cells does it consist of?

A
  • buffy coat
  • leukocytes and platelets
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4
Q

______ refers to the substrate remaining when the fibrinogen has been removed from the plasma (after coagulation).

A

serum

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5
Q

Venous blood generally has a lower/higher pH, lower/higher PO2 and lower/higher PCO2 than arterial blood

A

Venous blood generally has a lower/higher pH, lower/higher PO2 and lower/higher PCO2 than arterial blood

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6
Q
  • What is the primary reason to take arterial blood?
  • Which artery is most commonly used?
A
  • To measure blood gases
  • radial artery
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7
Q

______ testing means that if an initial test is positive, then the lab will automatically run commonly needed follow-up tests.

A

reflex

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8
Q

For the following table, answer sensitivity or specificity: A/(A+C) = ______; D/ (B+D) = _________

A

Sensitivity; specificity

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9
Q

For the table above, answer PPV = ____ /____ and NPV = ____ / ______

A

PPV= A/ (A+B); NPV = D / (C+D)

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10
Q

As the prevalence of a disease decreases/increases, the PPV decreases/increases and the NPV decreases/increases.

A

As the prevalence of a disease decreases/increases, the PPV decreases/increases and the NPV decreases/increases.

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11
Q

When the sensitivity of a test is high, a negative/positive response rules out the target disorder

A

When the sensitivity of a test is high, a negative/positive response rules out the target disorder

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12
Q

Incidence/prevalence represents the number of new cases that have occurred in a specific time interval divided by the population at risk over that time period

A

Incidence/prevalence represents the number of new cases that have occurred in a specific time interval divided by the population at risk over that time period

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13
Q

A test with high sensitivity/specificity has very few false positives. A test with high sensitivity/specificity has very few false negatives

A

A test with high sensitivity/specificity has very few false positives. A test with high sensitivity/specificity has very few false negatives

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14
Q

Because the prevalence of disease is higher in risk-based groups, selective screening will decrease/increase the positive predictive value of a test.

A

Because the prevalence of disease is higher in risk-based groups, selective screening will decrease/increase the positive predictive value of a test.

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15
Q

Accuracy/sensitivity is the ability to detect a disease when it is present.

A

Accuracy/sensitivity is the ability to detect a disease when it is present.

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16
Q

A normal reference range is usually defined as those test values that fall within __ standard deviations of the mean, which includes 95% of all results.

A

2

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17
Q

A lavender-topped tube that contains EDTA is used to obtain which lab test?

A

CBC

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18
Q

Most chemistries run on plasma in a _____ (color) top tube with the anticoagulant heparin.

A

green

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19
Q

_____ is a measure of the total blood volume that is made up by the RBCs.

A

hematocrit

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20
Q

RBC Distribution _____ is an indication of the variation in RBC size.

A

width (RDW)

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21
Q

“CBC with differential” will break down the total WBC count into its different types. Name the 5 WBCs.

A

Neutrophils, eosinophils, basophils, lymphocytes, monocytes

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22
Q

What are the 8 levels obtained in a Basic Metabolic Panel?

A
  • Sodium
  • potassium
  • bicarbonate
  • chloride
  • BUN
  • Creatinine
  • glucose
  • calcium
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23
Q

What are the 6 extra levels that a CMP will provide along with the 8 BMP levels?

A
  • Albumin
  • total protein
  • alkaline phosphatase
  • alanine aminotransferase
  • aspartate aminotransferase
  • total bilirubin
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24
Q

Sodium/potassium is the major cation in the intracellular space.

A

Sodium/potassium is the major cation in the intracellular space.

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25
Q

Hemolysis of a blood specimen can cause pseudo______.

A

Pseudohyperkalemia

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26
Q
  1. Match the following with the correct range on CBC with Diff: HCT, Hgb, Platelet count, WBC count, granulocytes, lymphocytes
    1. Male: 13.5-17.5; females 12-16
    2. 150-450 x 10³
    3. About 30% of CBC with diff
    4. 4.5 – 11 x 10³
    5. About 60% of CBC with diff
    6. Male: 39-59%; females 35-45%
A
  • A is Hgb
  • B is platelet count
  • C is lymphocytes
  • D is WBC count
  • E is granulocytes
  • F is HCT
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27
Q

The reference range for sodium is ____mEq/L. The reference range for potassium is ____ mEq/L.

A
  • 136-146
  • 3.5-4.5
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28
Q

X-rays fall within the non-ionizing/ionizing radiation range of the electromagnetic radiation spectrum. Gamma rays are non-ionizing/ionizing radiation.

A

X-rays fall within the non-ionizing/ionizing radiation range of the electromagnetic radiation spectrum. Gamma rays are non-ionizing/ionizing radiation.

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29
Q

X-rays are very high frequency with shorter/longer wavelengths than visible light.

A

X-rays are very high frequency with shorter/longer wavelengths than visible light.

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30
Q

Computed tomography scans use X-rays/gamma rays

A

Computed tomography scans use X-rays/gamma rays

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31
Q

Medical imaging procedures are currently the greatest manmade source of ionizing radiation exposure to the general population, mostly related to the marked growth in ____ ______.

A

CT scanning

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32
Q

Transmitted/absorbed/scatter radiation interacts with the tissues of the patient, depositing its energy in the tissue; it is the source of the patient radiation exposure

A

Transmitted/absorbed/scatter radiation interacts with the tissues of the patient, depositing its energy in the tissue; it is the source of the patient radiation exposure

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33
Q

Transmitted/absorbed/scatter radiation is the radiation that passes through the patient and interacts with the detector to create the image

A

Transmitted/absorbed/scatter radiation is the radiation that passes through the patient and interacts with the detector to create the image

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34
Q

The current preferred unit for absorbed dose is the _____ which represents the radiation absorbed per unit mass (kilogram). The current preferred unit for effective dose used is the ______

A
  • gray (Gy)
  • Sievert (Sv)
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35
Q

True or false: absorbed dose measurements do not take into account the biological effect of that radiation

A

True

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36
Q

1 Sievert = __ Gray

A

1

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37
Q

A standard PA and lateral chest x-ray delivers an average effective dose of ___ mSv

A

0.1

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38
Q

True or false: CT scanning is responsible for over 50% of patient radiation exposure

A

false

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39
Q

Deterministic/stochastic effects are nonrandom

A

Deterministic/stochastic effects are nonrandom

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40
Q

Deterministic/stochastic effects may occur at any level of exposure without a threshold dose

A

Deterministic/stochastic effects may occur at any level of exposure without a threshold dose

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41
Q

The linear no-threshold model is the most conservative theoretical dose-response model and most widely used to understand deterministic/stochastic effects. It assumes that any exposure to ______ radiation, however small, can induce future cancer

A
  • Stochastic
  • ionizing
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42
Q

Justification/optimization/limitation refers to protocols designed to obtain diagnostic images at the lowest possible dose to the patient

A

Justification/optimization/limitation refers to protocols designed to obtain diagnostic images at the lowest possible dose to the patient

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43
Q

The growing fetus is most sensitive to radiation between __-__ weeks. Large radiation doses during this time increase risk of birth defects and brain damage

A

3-18 weeks

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44
Q

_____ medicine studies use radiopharmaceuticals that go to a target site and become imaged with a gamma camera

A

nuclear

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45
Q
  1. Put the following in order from least to most dense:
    1. Air
    2. Metal
    3. Calcium
    4. Fat
    5. Fluid or soft tissue
A

A <d>
</d>

46
Q

The denser an object is, the less/more x-rays it absorbs and the whiter/blacker it appears on radiographic images

A

The denser an object is, the less/more x-rays it absorbs and the whiter/blacker it appears on radiographic images

47
Q

The term “_____ read” refers to a STAT interpretation of an image

A

wet

48
Q

The term view/projection refers to the path of the x-ray beam as it enters and exits the patient

A

The term view/projection refers to the path of the x-ray beam as it enters and exits the patient

49
Q

A view/projection is an image created with the patient in a particular position and the x-ray beam in a particular projection

A

A view/projection is an image created with the patient in a particular position and the x-ray beam in a particular projection

50
Q

In a lateral chest X-ray, typically the patient’s left/right side is against the film

A

In a lateral chest X-ray, typically the patient’s left/right side is against the film

51
Q

In a right lateral decubitus X-ray, the patient will be lying on their left/right side

A

In a right lateral decubitus X-ray, the patient will be lying on their left/right side

52
Q

What are the three planes of a standard CT

A

Axial or transverse; coronal; sagittal

53
Q

In terms of Hounsfield units, denser substances have low/high CT numbers, are said to demonstrate decreased/increased attenuation, and are displayed as whiter densities on CT scans.

A

In terms of Hounsfield units, denser substances have low/high CT numbers, are said to demonstrate decreased/increased attenuation, and are displayed as whiter densities on CT scans.

54
Q
  • IV contrast has been associated with greater risk of worsening renal function and lactic acidosis in patients on which medication?
  • How long before and after the procedure should the patient stop the medication?
A
  • metformin
  • should be discontinued the day of (or one day prior) the procedure and withheld for 48 hrs after, resumed only after renal function is shown to be stable
55
Q

True or false: seafood or shellfish allergy has no relationship to iodinated contrast reactions

A

true

56
Q

The two main types of oral contrast used in CT scanning are dilute ____ sulfate-based and dilute ____-based contrast

A
  • Dilute barium sulfate-based
  • dilute iodine-based
57
Q

CT-scanning/fluoroscopy is a common radiological technique that allows real time x-ray visualization

A

CT-scanning/fluoroscopy is a common radiological technique that allows real time x-ray visualization

58
Q

_______ films are static images that detail areas of interest observed during fluoroscopy

A

spot

59
Q

_____ scanning helps detect changes in metabolic activity

A

Positron Emission Tomography (PET)

60
Q

On an ultrasound “echogenic” refers to whiter/blacker tissues, while “echolucent” refers to whiter/blacker tissue

A

On an ultrasound “echogenic” refers to whiter/blacker tissues, while “echolucent” refers to whiter/blacker tissue

61
Q

Cysts are considered echogenic/echolucent. Tissue masses are considered echogenic/echolucent

A

Cysts are considered echogenic/echolucent. Tissue masses are considered echogenic/echolucent

62
Q

True or false: ultrasound imaging uses ionizing radiation

A

false

63
Q

The time it takes for tissue to regain equilibrium during an MRI is referred to as the reflex/relaxation time

A

The time it takes for tissue to regain equilibrium during an MRI is referred to as the reflex/relaxation time

64
Q

______ based contrast is the most common IV contrast agent used in MRIs

A

Gadolinium

65
Q

In nuclear medicine, radiopharmaceuticals are injected, ingested, or inhaled and then emit ____ rays for a brief period of time

A

Gamma

66
Q

SPECT stands for ____ _____ emission computed tomography

A

Single photon emission computed tomography

67
Q

SPECT scans utilize X-rays/gamma rays

A

SPECT scans utilize X-rays/gamma rays

68
Q

PET scanning uses radioisotopes that emit _____

A

Positrons

69
Q

For neural tissue, muscles, tendons, and ligaments use a(n) MRI/ultrasound/CT

A

For neural tissue, muscles, tendons, and ligaments use a(n) MRI/ultrasound/CT

70
Q

For imaging of the liver, gallbladder, biliary tree, and ovaries use a(n) MRI/ultrasound/PET

A

For imaging of the liver, gallbladder, biliary tree, and ovaries use a(n) MRI/ultrasound/PET

71
Q

Which type of study is frequently used for non-traumatic abdominal pain cases, inflammatory bowel disease, or locating site of bowel perforation

A

CT scanning with oral contrast

72
Q

Clinically, SPECT/PET/CTs are most frequently used for diagnosis and follow-up of cancer

A

Clinically, SPECT/PET/CTs are most frequently used for diagnosis and follow-up of cancer

73
Q

Technetium-99m (Tc-99m) is the most widely used isotope in which type of study?

A

nuclear medicine

74
Q

18-fluoro-2deoxyglucose (FDG) is the most commonly used agent in which type of study?

A

PET scanning

75
Q

This picture shows a left/right lateral decubitus X ray

A

This picture shows a left/right lateral decubitus X ray

76
Q

_______ is the most widely used and helpful cardiac biomarker

A

Troponin

77
Q

CK-MM/MB/BB is mostly found in the heart muscle. CK-MM/MB/BB is mostly found in skeletal muscle and heart. CK-MM/MB/BB is mostly found in the brain

A

CK-MM/MB/BB is mostly found in the heart muscle. CK-MM/MB/BB is mostly found in skeletal muscle and heart. CK-MM/MB/BB is mostly found in the brain

78
Q

AMI/unstable angina is characterized by a rise and fall in biomarkers of myocyte injury

A

AMI/unstable angina is characterized by a rise and fall in biomarkers of myocyte injury

79
Q

The two assays available for Troponin are Troponin __ and Troponin __ (answers are letters)

A
  • Troponin I
  • Troponin T
80
Q

Troponin levels may begin to rise as early as 2-4 hours after an AMI, but are not reliably elevated in all patients until ___ to ___ hours

A

6-12 hours

81
Q

True or false: elevated troponins are exclusive to an AMI

A

False

**can indicate inflammatory cardiac disease, pulmonary HTN, PE, CHF

82
Q

BNP is a hormone released primarily from the heart, particularly the atrial/ventricular myocytes. Obtaining a BNP is indicated when ____ _____ is a diagnostic consideration (and a useful clue in the differential diagnosis of dyspnea)

A
  • Ventricular
  • Heart Failure
83
Q

True or false: A BNP of < 100 means that the diagnosis of heart failure is highly likely

A

False

** < 100 is normal; > 400 is heart failure

84
Q

BNP values tend to be higher in younger/older age, male/female sex, and acute and chronic renal failure. What type of people will BNP values tend to be lower?

A

BNP values tend to be higher in younger/older age, male/female sex, and acute and chronic renal failure. What type of people will BNP values tend to be lower?

  • Obese Pt
85
Q

What is the number on cause of mortality in the US

A

ischemic Heart Disease/coronary atherosclerotic disease

86
Q

________ ________ is considered the gold standard of diagnostic tests for CAD but its limitations make it inappropriate as an initial study for the majority of patients

A
  • Coronary angiography (cardiac cath)
87
Q

The premise of cardiac stress testing is provocation of transient myocardial ______ which would be evidence of underlying CAD

A

Ischemia

88
Q

True or false: screening for CAD in asymptomatic patients with stress testing is not recommended

A

True

89
Q

For a patient to undergo an exercise stress test, they must be able to exercise adequately, which means achieving at least ___% of the predicted maximal heart rate. Max heart rate = ___ - the patient’s age in years

A
  • 85%
  • 220
90
Q

The Bruce/Modified Bruce protocol is generally used for older, more overweight, or more debilitated patients

A

The Bruce/Modified Bruce protocol is generally used for older, more overweight, or more debilitated patients

91
Q

The ischemic response during a stress test generally consists of > __mm of ST segment depression/elevation in at least __ consecutive depolarizations

A
  • 1mm
  • depression
  • 3
92
Q

This diagnostic accuracy and cost-effectiveness of exercise treadmill testing is best in patients with high/intermediate/low risk of CAD

A

This diagnostic accuracy and cost-effectiveness of exercise treadmill testing is best in patients with high/intermediate/low risk of CAD

93
Q

During myocardial perfusion imaging, functionally significant CAD is suspected when an area of relative hypoperfusion/hyperperfusion is detected on peak stress images compared to resting images

A

During myocardial perfusion imaging, functionally significant CAD is suspected when an area of relative hypoperfusion/hyperperfusion is detected on peak stress images compared to resting images

94
Q

A “positive” test during myocardial perfusion imaging is one that demonstrates reversible ______.

A

ischemia

95
Q

Of the exercise stress testing with imaging studies (myocardial perfusion imaging and stress echo), which is the most sensitive? Which is the most specific?

A
  • Myocardial perfusion imaging
  • stress echo
96
Q

What are the 4 most common pharmacologic agents used for non-exercise stress testing?

A
  • IV dobutamine
  • dipyridamole
  • adenosine
  • adenosine receptor agonists
97
Q

Which two arteries are usually used for cardiac catheterization?

A

Femoral and radial

98
Q

The most commonly used imaging tests to assess cardiac structure and function are trans_____ (TTE) and trans_____ (TEE)

A
  • Transthoracic
  • transesophageal
99
Q

TTE/TEE is especially useful in infective endocarditis, valve prosthesis evaluation, and left atrium thrombus

A

TTE/TEE is especially useful in infective endocarditis, valve prosthesis evaluation, and left atrium thrombus

100
Q

All patients with suspected new diagnosis of ___ ____ need an echo

A

Heart Failure

101
Q

The ejection fraction (EF) is determined by measuring left/right ventricular end diastolic volume and end systolic volume on echo

A

The ejection fraction (EF) is determined by measuring left/right ventricular end diastolic volume and end systolic volume on echo

102
Q

What is the EF equation?

A

EF = (EDV-ESV)/ EDV x 100%

103
Q

What is the normal EF range? What ranges are considered borderline and reduced?

A
  • Greater than or equal to 50% (50-70 is normal range)
  • borderline: 41-49%
  • reduced < or equal to 40 %
104
Q

Patients with lower than normal EF have heart failure due to systolic/diastolic dysfunction; patients with normal to high EF have HF due to systolic/diastolic dysfunction

A

Patients with lower than normal EF have heart failure due to systolic/diastolic dysfunction; patients with normal to high EF have HF due to systolic/diastolic dysfunction

105
Q

“Heart failure with preserved EF” is from systolic/diastolic dysfunction

A

“Heart failure with preserved EF” is from systolic/diastolic dysfunction

106
Q

If valvular disease is suspected, use echo with _____ which uses ultrasound reflecting off moving RBCs to measure the direction and velocity of blood flow across valves

A

doppler

107
Q

Holter/serial monitoring is a concept that involves performing echos more frequently as a patient’s valvular condition worsens to try to optimally time the need for surgical valve repair or replacement

A

Holter/serial monitoring is a concept that involves performing echos more frequently as a patient’s valvular condition worsens to try to optimally time the need for surgical valve repair or replacement

108
Q

An echo is always indicated for symptomatic patients, those with a greater than or equal to systolic/diastolic murmur, or those with a systolic/diastolic murmur

A

An echo is always indicated for symptomatic patients, those with a greater than or equal to systolic/diastolic murmur, or those with a systolic/diastolic murmur

109
Q

Short, quiet murmurs are generally benign/pathologic

A

Short, quiet murmurs are generally benign/pathologic

110
Q

TEEs will offer a much clearer image of the heart, particularly the left/right atrium and mitral valve, as well as the aorta

A

TEEs will offer a much clearer image of the heart, particularly the left/right atrium and mitral valve, as well as the aorta

111
Q

True or false: a holter monitor is an example of cardiac telemetry

A

False

112
Q

A holter monitor/event recorder is used for less frequent symptoms and is typically used for 30 days

A

A holter monitor/event recorder is used for less frequent symptoms and is typically used for 30 days

Diagnostic Interpretation PA 545: Cardiac (7 decks)

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