Exam 7 Flashcards
What is a normal liver span in women? In men?
Women - 7 cm
Men - 10.5 cm
What is Duputyren’s contracture associated with?
Alcohol use disorder
What is palmar erythema associated with?
Portal HTN
How sensitive/specific is bulging flanks for ascites?
Good sensitivity, mediocre specificity
How sensitive/specific is flank dullness for ascites?
Good sensitivity, mediocre specificity
What is shifting dullness?
Begin by percussing at the umbilicus and moving toward the flanks. The transition from air to fluid can be identified when the note becomes dull. Roll the patient on their side. The area of tympany will shift towards the top and the area of dullness towards the bottom.
What is the psoas sign and what does it indicate?
Increased abdominal pain on flexion of the leg at the hip - appendicitis
What is McBurney’s point?
2” from the anterior superior spinus process of the ilium on a line drawn from there to the umbilicus
What is the Rovsing’s sign and what does it indicate?
Pain the RLQ during left-sided pressure - appendicitis
What is the obturator sign and what does it indicate?
Right hypogastric pain with internal rotation of the leg at the hip - appendicitis
The normal gallbladder will have a ___ wall with a ___ lumen.
Hyperechoic; anechoic
The gallbladder is connected to the portal triad by the ___, which appears as a hyperechoic line connecting the neck of the gallbladder to the portal triad.
Main lobar fissure
The normal anterior wall thickness of the gallbladder is less than ___.
3 mm
How can you differentiate between the common bile duct and the hepatic artery?
Flow will be seen within the hepatic artery on color doppler
The normal lumen of the common bile duct is less than ___.
6 mm (add 1 mm/decade beyond 60 y/o)
What are the 6 dimensions of health care quality?
- Safe
- Timely
- Effective
- Efficient
- Equitable
- Patient-centered
What is based on the principle that an opportunity for improvement exists in every process on every occasion?
Continuous quality improvement
What is the PDSA cycle?
Plan
Do
Study
Act
What is a statistical unit reflecting the number of standard deviations a process is from perfection?
Sigma (6 sigma is virtually error free)
Six sigma uses the DMAIC algorithm - what is this?
Define Measure Analyze Improve Control
___ allows visualization of where waste can be removed.
Value stream mapping
What are teams who have achieved high degrees of safety or reliability despite operating in hazardous conditions?
High Reliability Organizations (HROs)
What are the 5 principles of HROs?
- Preoccupation with failure
- Sensitivity to operations
- Reluctance to simplify
- Commitment to resilience
- Deference to expertise
