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Midwifery > Health Assessment & Diagnostic Tests > Flashcards

Health Assessment & Diagnostic Tests Flashcards

1
Q

OLDCARTS mnemonic

A

Onset, Location, Duration, Characteristics, Aggravating/Associated factors, Relieving factors, Temporal factors and Severity

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2
Q

BMI Catergories

A 
Underweight- <18.5
Normal weight- 18.5-24.9
Overweight- 25-29.9
Obesity- 30-39.9
Extreme obesity- >40
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3
Q

ABCDEs of malignant melanoma

A

Asymmetry, Borders irregular, Color blue/black/variegated, Diameter >6mm and Elevation

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4
Q

Head and Neck Lymph Nodes

A

Preauricular, postauricular, occipital, tonsillar, submandibular, submental, superficial cervical, posterior and deep cervical chains, supraclavicular
All should be <1cm in size, non-tender, mobile and soft

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5
Q

Assessment of extraocular movement (EOM) function

A

symmetrical movement through the six cardinal fields of gaze without lag or nystagmus

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6
Q

Adventitious lung sounds: crackles

A

caused by air flowing by fluid (pneumonia, bronchitis, early heart failure)

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7
Q

Adventitious lung sounds: rhonchi

A

air passing over solid or thick secretions in large airways (bronchitis, pneumonia)

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8
Q

Adventitious lung sounds: wheezes

A

air flowing through constricted passageways (asthma, chronic emphysema)

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9
Q

Adventitious lung sounds: pleural friction rub

A

inflammation of pleural tissue (pleuritis, pericarditis)

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10
Q

Extra heart sounds: physiologic murmur

A

mid-systole, 2nd-4th left ICS, grades 1-3, disappears/decreases when sitting, normal finding, common in pregnancy

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11
Q

Skene’s glands

A

posterior to and on each side of urethral meatus

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12
Q

Bartholin’s glands

A

located posteriorly on each side of vaginal orifice, not usually visible

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13
Q

Cervix characteristics

A

2.5cm in diameter, protrudes 1-3cm into vagina, may have darker red epithelial tissue around os if squamocolumnar junction is on ectocervix

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14
Q

Uterus characteristics

A

smooth, rounded, mobile, non tender
5.5-8cm long in nulliparous women
may be 2-3 cm longer in multiparous women

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15
Q

Ovary characteristics

A

smooth, firm, mobile, slightly tender

size during reproductive years 3cm x2cm x1cm

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16
Q

Prostate gland

A

heart shaped
4x3x2cm
smooth, rubbery, non tender

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17
Q

RBC count

A

measurements per cubic millimeter of blood

adult female: 4.2-5.4 million/mm

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18
Q

Low RBC count

A

hemorrhage, hemolysis, dietary deficiencies, hemoglobinopathies, bone marrow failure, chronic illness, medications

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19
Q

Elevated RBC count

A

dehydration, diseases causing chronic hypoxia such as congenital heart disease, polycythemia vera, medications

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20
Q

Hematocrit values (pregnant/non-pregnant)

A

percentage of total blood volume that is made of RBCs
Non pregnant female: 37-47%
Pregnant: >33% 1st/3rd trimester and >32% 2nd trimester

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21
Q

Hemoglobin values (pregnant/non-pregnant)

A

measurement of total Hgb with carries oxygen
non pregnant female: 12-16 g/dL
pregnant: >11g/dL in 1st/3rd trimesters, >10.5g/dL in 2nd trimester

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22
Q

Causes of low Hgb/Hct

A

anemia, hemoglobinopathies, cirrhosis, hemorrhage, dietary deficiency, renal disease, chronic illness

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23
Q

Causes of elevated hgb/hct

A

erythrocytosis, polycythemia vera, severe dehydration, severe COPD

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24
Q

MCV values

A

Mean corpuscular volume- average size of single RBC

80-95mm, normocytic

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25
Q

Microcytic (low MCV and low MCH)

A

iron-deficiency anemia and thlassemia

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26
Q

Macrocytic (high MCV and high MCH)

A

megaloblastic anemias such as vitamin B deficiency and folic acid deficiency

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27
Q

MCH values

A

mean corpuscular hemoglobin- average amount or weight of hgb within an RBC
27-31pg/cell

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28
Q

What is a peripheral blood smear used for?

A

Examination of smear to examine RBCs, platelets and leukocytes

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29
Q

WBC values

A

5000-10,000/mm

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30
Q

Low WBC

A

bone marrow suppression, autoimmune disorders, immunosuppressive disorders, overwhelming infection, cancer that spreads to bone marrow

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31
Q

Elevated WBC

A

dehydration, infection, inflammatory conditions, may be elevated in late pregnancy/during labor, traumatic injury

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32
Q

Elevated neutrophils

A

acute bacterial infection, inflammation, increased immature forms (band/stabs) sometimes called left shift with ongoing acute bacterial infection

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33
Q

Elevated basophils

A

hypersensitivity reaction, chronic inflammatory disorders, uremia

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34
Q

Elevated eosinophils

A

allergic reaction, parasitic infections, chronic inflammatory disorders

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35
Q

Elevated lymphocytes

A

acute viral infections, chronic bacterial infections, chronic inflammatory disorders

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36
Q

Elevated monocytes

A

chronic infections, recovery phase of infections

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37
Q

Platelet Count

A

Normal finding: 150,000-400,000/mm

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38
Q

Low platelet count

A

thrombocytopenia

autoimmune disorders, cirrhosis, sepsis, hemorrhage, leukemia, cancer chemotherapy, viral infection

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39
Q

elevated platelet count

A

thrombocytosis

malignant disorders, polycythemia vera, rheumatoid arthritis

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40
Q

PT/PTT

A

Measures number of seconds it takes for clot to form in a blood sample with prolonged indicating that blood clotting is taking longer than normal

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41
Q

American diabetes association criteria for diagnosis of DM (3 things)

A

classic symptoms of hyperglycemia plus random glucose >200mg/dL
fasting >126mg/dL
2 hour glucose >200
Always repeat testing on subsequent day to confirm

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42
Q

HbA1C values

A

> 6.5% is diagnosis for diabetes

5.7%-6.4% is pre diabetes

43
Q

Total cholesterol value

A

<200mg/dL

May be elevated in pregnancy

44
Q

Triglyceride value

A

35-135mg/dL

May be elevated in pregnancy

45
Q

HDL value and what it does

A

removes cholesterol from peripheral tissues and transports to liver
>40mg/dL is normal

46
Q

LDL value and what it does

A

cholesterol carried by LDL can be deposited into peripheral tissues
<130mg/dL is normal

47
Q

BUN value and what it is

A

Indirect measure of renal/liver function

10-20mg/dL is normal

48
Q

Increased/Decreased BUN

A

Increased: dehydration, GI bleeding, sepsis
Decreased: liver failure, malnutrition

49
Q

Creatinine value and what it is

A

Indirect measure of renal function

0.5-1.1 mg/dL

50
Q

Increased/Decreased Creatinine

A

Increased: renal disorders, dehydration
Decreased: debilitation and decreased muscle mass

51
Q

Urine protein/creatinine (PC) ratio

A

Helps to evaluate kidney function when significant protein is found on urinalysis
May indicate kidney disease/damage, associated with pre e and diabetes

52
Q

Thyroid stimulating hormone (TSH)

A

Normal: 0.4-4.12 mU/mL

53
Q

Increased TSH

A

Seen with primary hypothyroidism and thyroiditis

54
Q

Decreased TSH

A

Secondary hypothyroidism, hyperthyroidism, suppressive doses of thyroid medication

55
Q

Free thyroxine (FT4)

A

Normal: 0.58-1.64 ng/dL

56
Q

Increased FT4

A

hyperthyroidism and thyroiditis

57
Q

Decreased FT4

A

hypothyrodism

58
Q

Total/Indirect/Direct Bilirubin Values

A

Total: 0.3-1.0 mg/dL
Indirect: 0.2-0.8 mg/dL
Direct: 0.1-0.3 mg/dL

59
Q

Albumin

A

Normal: 3.5-5.0 g/dL

60
Q

Increased/Decreased Albumin

A

Increased: dehydration
Decreased: liver disease, malabsorption syndromes, malnutrition

61
Q

Presence of Hgb S

A

Indicates sickle cell disease or trait

62
Q

Definitive test performed after positive Hgb S

A

Hgb electrophoresis identities Hgb type and quantity

63
Q

What is autoantibodies/antinuclear antibodies (ANA) used for?

A

Diagnostic workup for SLE and other autoimmune disorders

64
Q

Reproductive hormone studies: reasons for increased/decreased estradiol E2

A

Increased: adrenal tumor, estrogen-producing tumor, hyperthyroidism
Decreased: postmenopause, ovarian failure, primary/secondary hypogonadism, Turner’s syndrome

65
Q

Reproductive hormone studies: reasons for increased/decreased progesterone

A

Increased: pregnancy, ovulation, progesterone secreting ovarian tumor/cyst, hydatiform mole, congenital adrenal hyperplasia
Decreased: primary/secondary hypogonadism, threatened abortion, fetal demise, pre e or short luteal phase syndrome

66
Q

Reproductive hormone studies: reasons for increased/decreased follicle stimulated hormone (FSH)

A

Increased: postmenopause, gonadotropin secreting pituitary tumor, ovarian failure, primary hypogonadism, Turner’s syndrome
Decreased: pregnancy, pituitary/hypothalamic dysfunction, hyperprolactinemia

67
Q

Reproductive hormone studies: reasons for increased/decreased lutenizing hormone

A

increased: postmenopause, primary hypogonadism, gonadal failure
decreased: pituitary or hypothalamic dysfunction

68
Q

Normal pH for urinalysis

A

4.6-8.0

69
Q

Normal protein for urinalysis

A

0-8 mg/dL

70
Q

Normal specific gravity

A

1.005-1.030

71
Q

Positive urine culture

A

Single type of bacteria at >100,000 CFU/mL

72
Q

Normal wet prep results

A

Vaginal pH 3.8-4.5
Negative whiff
Epithelial cells/few or no WBCs, lactobacilli

73
Q

Bacterial Vaginosis wet prep

A

pH >4.5
positive whiff
>20% of epithelial cells are clue cells, 0-1 WBCs per epithelial cells, lactobacilli reduced/absent

74
Q

Trichomonas wet prep

A

pH >4.5
positive/negative whiff
motile trichomondas, >1 WBC per epithelial cells, lactobacilli reduced or absent

75
Q

Vulvovaginal candidiasis (VVC)

A

pH <4.5
Whiff negative
hyphae/spores (seen on KOH slide), >1 WBC per epithelial cell, lactobacilli present

76
Q

HIV testing, what is it?

A

enzyme immunoassay (EIA)

77
Q

What is used to confirm positive EIA when testing for HIV?

A

Western blot or immunofluorescence assay (IFA) is used to confirm reactive EIA

78
Q

What test is used for to assess titer to rubella?

A

Hemagglutination inhibition (HAI) or rubella IgM antibody titer

79
Q

What does a rubella titer of 1:10 mean?

A

Immunity to rubella

80
Q

What does a rubella titer of >1:64 mean?

A

may indicate current rubella infection

81
Q

When do IgM antibodies appear/disappear after infection with rubella?

A

1-2 days after onset of rash and then disappear 5-6 weeks after infection

82
Q

What does Hepatitis B surface antigen (HBsAg) indicate?

A

Active HBV infection, this person is infectious

83
Q

What does hepatitis B surface antibody (HbsAb) indicate?

A

The end of acute infectious phase and signifies immunity. Also indicates immunity after administration of HBV vaccine

84
Q

What does hepatitis B core antibody (HBcAb) indicate?

A

Past infection and chronic hepatitis

85
Q

What does positive hepatitis c (HCV) antibody assay indicate and what do you do?

A

Follow a positive antibody test with HCV RNA. If positive, current HCV infection. If negative, infection has resolved.

86
Q

PPD positive guidelines based on risk (high, moderate and general population)

A

High: >5mm
Moderate: >10mm
General population: >15mm

87
Q

What can cause a false negative PPD?

A

incorrect administration, administration after recent live virus vaccine or immunosuppression

88
Q

What can cause false positive PPD?

A

prior immunization with calmette-Guerin (BCG) vaccine

89
Q

What do IgG antibodies do?

A

Positive IgG antibodies indicates protection d/t previous infection

90
Q

What do IgM antibodies do?

A

Indicates current infection

91
Q

What is somatic mutation and what causes it?

A

It is acquired and occurs after conception. D/t ionizing radiation, chemicals or viruses during gestation or later in life

92
Q

What is germ cell mutation and when does it occur?

A

Inherited mutation. Occurs during conception

93
Q

What does it mean if something is autosomal dominant?

A

Only one mutated copy of gene in each cell. One affected parent.

94
Q

What are examples of autosomal dominant genetic conditions?

A

huntington disease and BRCA1/BRCA2

95
Q

What does autosomal recessive mean?

A

Two mutated copies need to be present to have disease. Usually both parents are just carriers

96
Q

What are examples of autosomal recessive genetic conditions and the likelihood if both parents are carriers?

A

Cystic fibrosis, sickle cell anemia.

50% chance of being carrier, 25% chance of having disease and 25% chance of being unaffected

97
Q

What does x-linked dominant mean?

A

Mutation in genes on x chromosome. Females more often affected. fathers cannot pass to sons.

98
Q

What is an example of a x-linked dominant genetic condition and the chances of having it if the mother is affected?

A

Fragile x syndrome

If mother is affected, both male and female offspring have 50% of inheriting the disorder

99
Q

What does x-linked recessive mean?

A

Mutation in genes on x chromosome. Males more frequently affected than females. Fathers cannot pass to sons.

100
Q

What is an example of a x-linked recessive genetic condition and how do they inherit condition?

A

Hemophilia
Females need to inherit affected x from both parents to have condition.
Males only need to inherit the affected x from the mother to have the condition

101
Q

What is a normal T score in bone density testing?

A

> -1

102
Q

What T score indicates osteopenia?

A

-1 to -2.5

103
Q

What T score indicates osteoporosis?

A

< -2.5

Midwifery (10 decks)

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