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
2
Q
_______ is the term for the liquid portion of blood that makes approximately 55% of blood.
A
plasma
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
4
Q
______ refers to the substrate remaining when the fibrinogen has been removed from the plasma (after coagulation).
A
serum
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
6
Q
- What is the primary reason to take arterial blood?
- Which artery is most commonly used?
A
- To measure blood gases
- radial artery
7
Q
______ testing means that if an initial test is positive, then the lab will automatically run commonly needed follow-up tests.
A
reflex
8
Q
For the following table, answer sensitivity or specificity: A/(A+C) = ______; D/ (B+D) = _________
A
Sensitivity; specificity
9
Q
For the table above, answer PPV = ____ /____ and NPV = ____ / ______
A
PPV= A/ (A+B); NPV = D / (C+D)
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.
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
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
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
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.
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.
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
17
Q
A lavender-topped tube that contains EDTA is used to obtain which lab test?
A
CBC
18
Q
Most chemistries run on plasma in a _____ (color) top tube with the anticoagulant heparin.
A
green
19
Q
_____ is a measure of the total blood volume that is made up by the RBCs.
A
hematocrit
20
Q
RBC Distribution _____ is an indication of the variation in RBC size.
A
width (RDW)
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
22
Q
What are the 8 levels obtained in a Basic Metabolic Panel?
A
- Sodium
- potassium
- bicarbonate
- chloride
- BUN
- Creatinine
- glucose
- calcium
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
24
Q
Sodium/potassium is the major cation in the intracellular space.
A
Sodium/potassium is the major cation in the intracellular space.
25
Hemolysis of a blood specimen can cause pseudo\_\_\_\_\_\_.
Pseudohyperkalemia
26
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 is Hgb
* B is platelet count
* C is lymphocytes
* D is WBC count
* E is granulocytes
* F is HCT
27
The reference range for sodium is \_\_\_\_mEq/L. The reference range for potassium is ____ mEq/L.
* 136-146
* 3.5-4.5
28
X-rays fall within the non-ionizing/ionizing radiation range of the electromagnetic radiation spectrum. Gamma rays are non-ionizing/ionizing radiation.
X-rays fall within the non-ionizing/**ionizing** radiation range of the electromagnetic radiation spectrum. Gamma rays are non-ionizing/**ionizing** radiation.
29
X-rays are very high frequency with shorter/longer wavelengths than visible light.
X-rays are very high frequency with **shorter**/longer wavelengths than visible light.
30
Computed tomography scans use X-rays/gamma rays
Computed tomography scans use **X-rays**/gamma rays
31
Medical imaging procedures are currently the greatest manmade source of ionizing radiation exposure to the general population, mostly related to the marked growth in ____ \_\_\_\_\_\_.
CT scanning
32
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
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
33
Transmitted/absorbed/scatter radiation is the radiation that passes through the patient and interacts with the detector to create the image
**Transmitted**/absorbed/scatter radiation is the radiation that passes through the patient and interacts with the detector to create the image
34
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 \_\_\_\_\_\_
* gray (Gy)
* Sievert (Sv)
35
True or false: absorbed dose measurements do not take into account the biological effect of that radiation
True
36
1 Sievert = __ Gray
1
37
A standard PA and lateral chest x-ray delivers an average effective dose of ___ mSv
0.1
38
True or false: CT scanning is responsible for over 50% of patient radiation exposure
false
39
Deterministic/stochastic effects are nonrandom
**Deterministic**/stochastic effects are nonrandom
40
Deterministic/stochastic effects may occur at any level of exposure without a threshold dose
Deterministic/**stochastic** effects may occur at any level of exposure without a threshold dose
41
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
* Stochastic
* ionizing
42
Justification/optimization/limitation refers to protocols designed to obtain diagnostic images at the lowest possible dose to the patient
Justification/**optimization**/limitation refers to protocols designed to obtain diagnostic images at the lowest possible dose to the patient
43
The growing fetus is most sensitive to radiation between \_\_-\_\_ weeks. Large radiation doses during this time increase risk of birth defects and brain damage
3-18 weeks
44
\_\_\_\_\_ medicine studies use radiopharmaceuticals that go to a target site and become imaged with a gamma camera
nuclear
45
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
46
The denser an object is, the less/more x-rays it absorbs and the whiter/blacker it appears on radiographic images
The denser an object is, the less/**more** x-rays it absorbs and the **whiter**/blacker it appears on radiographic images
47
The term “\_\_\_\_\_ read” refers to a STAT interpretation of an image
wet
48
The term view/projection refers to the path of the x-ray beam as it enters and exits the patient
The term view/**projection** refers to the path of the x-ray beam as it enters and exits the patient
49
A view/projection is an image created with the patient in a particular position and the x-ray beam in a particular projection
A **view**/projection is an image created with the patient in a particular position and the x-ray beam in a particular projection
50
In a lateral chest X-ray, typically the patient’s left/right side is against the film
In a lateral chest X-ray, typically the patient’s **left**/right side is against the film
51
In a right lateral decubitus X-ray, the patient will be lying on their left/right side
In a right lateral decubitus X-ray, the patient will be lying on their left/**right** side
52
What are the three planes of a standard CT
Axial or transverse; coronal; sagittal
53
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.
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
* 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?
* 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
True or false: seafood or shellfish allergy has no relationship to iodinated contrast reactions
true
56
The two main types of oral contrast used in CT scanning are dilute ____ sulfate-based and dilute \_\_\_\_-based contrast
* Dilute barium sulfate-based
* dilute iodine-based
57
CT-scanning/fluoroscopy is a common radiological technique that allows real time x-ray visualization
CT-scanning/**fluoroscopy** is a common radiological technique that allows real time x-ray visualization
58
\_\_\_\_\_\_\_ films are static images that detail areas of interest observed during fluoroscopy
spot
59
\_\_\_\_\_ scanning helps detect changes in metabolic activity
Positron Emission Tomography (PET)
60
On an ultrasound “echogenic” refers to whiter/blacker tissues, while “echolucent” refers to whiter/blacker tissue
On an ultrasound “echogenic” refers to **whiter**/blacker tissues, while “echolucent” refers to whiter/**blacker** tissue
61
Cysts are considered echogenic/echolucent. Tissue masses are considered echogenic/echolucent
Cysts are considered echogenic/**echolucent**. Tissue masses are considered **echogenic**/echolucent
62
True or false: ultrasound imaging uses ionizing radiation
false
63
The time it takes for tissue to regain equilibrium during an MRI is referred to as the reflex/relaxation time
The time it takes for tissue to regain equilibrium during an MRI is referred to as the reflex/**relaxation** time
64
\_\_\_\_\_\_ based contrast is the most common IV contrast agent used in MRIs
Gadolinium
65
In nuclear medicine, radiopharmaceuticals are injected, ingested, or inhaled and then emit ____ rays for a brief period of time
Gamma
66
SPECT stands for ____ \_\_\_\_\_ emission computed tomography
Single photon emission computed tomography
67
SPECT scans utilize X-rays/gamma rays
SPECT scans utilize X-rays/**gamma** rays
68
PET scanning uses radioisotopes that emit \_\_\_\_\_
Positrons
69
For neural tissue, muscles, tendons, and ligaments use a(n) MRI/ultrasound/CT
For neural tissue, muscles, tendons, and ligaments use a(n) **MRI**/ultrasound/CT
70
For imaging of the liver, gallbladder, biliary tree, and ovaries use a(n) MRI/ultrasound/PET
For imaging of the liver, gallbladder, biliary tree, and ovaries use a(n) MRI/**ultrasound**/PET
71
Which type of study is frequently used for non-traumatic abdominal pain cases, inflammatory bowel disease, or locating site of bowel perforation
CT scanning with oral contrast
72
Clinically, SPECT/PET/CTs are most frequently used for diagnosis and follow-up of cancer
Clinically, SPECT/**PET**/CTs are most frequently used for diagnosis and follow-up of cancer
73
Technetium-99m (Tc-99m) is the most widely used isotope in which type of study?
nuclear medicine
74
18-fluoro-2deoxyglucose (FDG) is the most commonly used agent in which type of study?
PET scanning
75
This picture shows a left/right lateral decubitus X ray
This picture shows a left/**right lateral decubitus** X ray
76
\_\_\_\_\_\_\_ is the most widely used and helpful cardiac biomarker
Troponin
77
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
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
AMI/unstable angina is characterized by a rise and fall in biomarkers of myocyte injury
**AMI**/unstable angina is characterized by a rise and fall in biomarkers of myocyte injury
79
The two assays available for Troponin are Troponin __ and Troponin __ (answers are letters)
* Troponin I
* Troponin T
80
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
6-12 hours
81
True or false: elevated troponins are exclusive to an AMI
False
\*\*can indicate inflammatory cardiac disease, pulmonary HTN, PE, CHF
82
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)
* Ventricular
* Heart Failure
83
True or false: A BNP of \< 100 means that the diagnosis of heart failure is highly likely
False
\*\* \< 100 is normal; \> 400 is heart failure
84
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?
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
What is the number on cause of mortality in the US
ischemic Heart Disease/coronary atherosclerotic disease
86
\_\_\_\_\_\_\_\_ ________ 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
* Coronary angiography (cardiac cath)
87
The premise of cardiac stress testing is provocation of transient myocardial ______ which would be evidence of underlying CAD
Ischemia
88
True or false: screening for CAD in asymptomatic patients with stress testing is not recommended
True
89
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
* 85%
* 220
90
The Bruce/Modified Bruce protocol is generally used for older, more overweight, or more debilitated patients
The Bruce/**Modified Bruce** protocol is generally used for older, more overweight, or more debilitated patients
91
The ischemic response during a stress test generally consists of \> \_\_mm of ST segment depression/elevation in at least __ consecutive depolarizations
* 1mm
* depression
* 3
92
This diagnostic accuracy and cost-effectiveness of exercise treadmill testing is best in patients with high/intermediate/low risk of CAD
This diagnostic accuracy and cost-effectiveness of exercise treadmill testing is best in patients with high/**intermediate**/low risk of CAD
93
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
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
A “positive” test during myocardial perfusion imaging is one that demonstrates reversible \_\_\_\_\_\_.
ischemia
95
Of the exercise stress testing with imaging studies (myocardial perfusion imaging and stress echo), which is the most sensitive? Which is the most specific?
* Myocardial perfusion imaging
* stress echo
96
What are the 4 most common pharmacologic agents used for non-exercise stress testing?
* IV dobutamine
* dipyridamole
* adenosine
* adenosine receptor agonists
97
Which two arteries are usually used for cardiac catheterization?
Femoral and radial
98
The most commonly used imaging tests to assess cardiac structure and function are trans\_\_\_\_\_ (TTE) and trans\_\_\_\_\_ (TEE)
* Transthoracic
* transesophageal
99
TTE/TEE is especially useful in infective endocarditis, valve prosthesis evaluation, and left atrium thrombus
TTE/**TEE** is especially useful in infective endocarditis, valve prosthesis evaluation, and left atrium thrombus
100
All patients with suspected new diagnosis of ___ \_\_\_\_ need an echo
Heart Failure
101
The ejection fraction (EF) is determined by measuring left/right ventricular end diastolic volume and end systolic volume on echo
The ejection fraction (EF) is determined by measuring **left**/right ventricular end diastolic volume and end systolic volume on echo
102
What is the EF equation?
EF = (EDV-ESV)/ EDV x 100%
103
What is the normal EF range? What ranges are considered borderline and reduced?
* Greater than or equal to 50% (50-70 is normal range)
* borderline: 41-49%
* reduced \< or equal to 40 %
104
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
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
“Heart failure with preserved EF” is from systolic/diastolic dysfunction
“Heart failure with preserved EF” is from systolic/**diastolic** dysfunction
106
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
doppler
107
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
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
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
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
Short, quiet murmurs are generally benign/pathologic
Short, quiet murmurs are generally **benign**/pathologic
110
TEEs will offer a much clearer image of the heart, particularly the left/right atrium and mitral valve, as well as the aorta
TEEs will offer a much clearer image of the heart, particularly the **left**/right atrium and mitral valve, as well as the aorta
111
True or false: a holter monitor is an example of cardiac telemetry
False
112
A holter monitor/event recorder is used for less frequent symptoms and is typically used for 30 days
A holter monitor/**event** recorder is used for less frequent symptoms and is typically used for 30 days
