Exam 7

Question 1

What is a normal liver span in women? In men?

Answer 1

Women - 7 cm

Men - 10.5 cm

Question 2

What is Duputyren’s contracture associated with?

Answer 2

Alcohol use disorder

Question 3

What is palmar erythema associated with?

Answer 3

Portal HTN

Question 4

How sensitive/specific is bulging flanks for ascites?

Answer 4

Good sensitivity, mediocre specificity

Question 5

How sensitive/specific is flank dullness for ascites?

Answer 5

Good sensitivity, mediocre specificity

Question 6

What is shifting dullness?

Answer 6

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.

Question 7

What is the psoas sign and what does it indicate?

Answer 7

Increased abdominal pain on flexion of the leg at the hip - appendicitis

Question 8

What is McBurney’s point?

Answer 8

2” from the anterior superior spinus process of the ilium on a line drawn from there to the umbilicus

Question 9

What is the Rovsing’s sign and what does it indicate?

Answer 9

Pain the RLQ during left-sided pressure - appendicitis

Question 10

What is the obturator sign and what does it indicate?

Answer 10

Right hypogastric pain with internal rotation of the leg at the hip - appendicitis

Question 11

The normal gallbladder will have a ___ wall with a ___ lumen.

Answer 11

Hyperechoic; anechoic

Question 12

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.

Answer 12

Main lobar fissure

Question 13

The normal anterior wall thickness of the gallbladder is less than ___.

Answer 13

3 mm

Question 14

How can you differentiate between the common bile duct and the hepatic artery?

Answer 14

Flow will be seen within the hepatic artery on color doppler

Question 15

The normal lumen of the common bile duct is less than ___.

Answer 15

6 mm (add 1 mm/decade beyond 60 y/o)

Question 16

What are the 6 dimensions of health care quality?

Answer 16

1. Safe
2. Timely
3. Effective
4. Efficient
5. Equitable
6. Patient-centered

Question 17

What is based on the principle that an opportunity for improvement exists in every process on every occasion?

Answer 17

Continuous quality improvement

Question 18

What is the PDSA cycle?

Answer 18

Plan
Do
Study
Act

Question 19

What is a statistical unit reflecting the number of standard deviations a process is from perfection?

Answer 19

Sigma (6 sigma is virtually error free)

Question 20

Six sigma uses the DMAIC algorithm - what is this?

Answer 20

Define
Measure
Analyze
Improve
Control

Question 21

___ allows visualization of where waste can be removed.

Answer 21

Value stream mapping

Question 22

What are teams who have achieved high degrees of safety or reliability despite operating in hazardous conditions?

Answer 22

High Reliability Organizations (HROs)

Question 23

What are the 5 principles of HROs?

Answer 23

1. Preoccupation with failure
2. Sensitivity to operations
3. Reluctance to simplify
4. Commitment to resilience
5. Deference to expertise