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labs and imaging Flashcards

1
Q

What is the ED course?

A

it is instrumental in ruling or confirming the DDx that is generated from hx and PE. consists of lab & imaging results, procedures, medications given, consultations, reevaluations

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2
Q

describe a complete blood count (CBC) w/ differential

A

A measure of the number of red blood cells, white blood cells (WBC), and platelets (Plt), hematocrit (Hct), hemoglobin (Hgb) including the different types of white blood cells such as neutrophils (segs), lymphocytes (lymphs), monocytes (monos), and eosinophils (Eos)

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3
Q

what CBC results suggest anemia

A

low Hct and low Hgb

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4
Q

what CBC results suggest an infection

A

high WBC, high bands, and high differential cells (segs, lymphs, monos, eos)

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5
Q

describe basic metabolic panel (BMP)

A

it provides important information about the chemical and metabolic balance of the blood; main takeaway look at electrolyte imbalances, kidney problems, diabetic-related problems. includes Na, K, BUN, Creat, Gluc, HCO3, Cl

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6
Q

what BMP results suggest dehydration

A

low or high Na, high Cl

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7
Q

what BMP results suggest kidney problems

A

high BUN (blood urea nitrogen), high Creat, high K

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8
Q

what BMP results suggest diabetic-related problems

A

high or low Gluc

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9
Q

what is a comprehensive metabolic panel (CMP)

A

everything from the BMP plus liver function enzymes

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10
Q

wALT wALKs fAST to Bili!

A

liver function tests to watch out for. high levels of these point towards liver damage

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11
Q

what is the cardiac order set

A

*Trop, *EKG, CXR, CBC, BMP
these orders will placed for almost every adult pt who c/o chest pain

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12
Q

what does a high D-Dimer test suggest

A

D-dimer is a protein excreted by blood clots, therefore high D-dimer levels suggest a PE. a positive D-dimer does not necessarily mean a PE, but means a CTA chest needs to be ordered. a negative D-dimer means a PE can be excluded from the ddx

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13
Q

what do high levels of BNP (B-type natriuretic peptide) (B-nancy) suggest

A

congestive heart failure

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14
Q

what kind of problems do BNP, ABG, and VBG labs investigate

A

DKA and other respiratory problems

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15
Q

what do low readings of ABG and VBG labs suggest

A

blood acidosis, potentially from diabetic ketoacidosis

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16
Q

what is INR

A

international normalized ratio, measures the time it takes for blood to clot, especially while taking coumadin. pt who take coumadin should have INR btwn 2.0-3.0

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17
Q

what pancreatic enzymes help diagnose pancreatitis

A

lipase (lip)(strong correlation to pancreatitis) and amylase (amy)(possible pancreatitis)

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18
Q

describe the types of diabetes testing

A

serum ketone levels (high = DKA) and finger-stick blood glucose (Accu-Check or FSBG) (high = hyperglycemia, low = hypoglycemia)

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19
Q

what does a positive qualitative (urine/serum) HCG test mean

A

pregnant

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20
Q

what does a high quantitative HCG level mean

A

further along in pregnancy

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21
Q

why is it important for pregnant women to get a blood screen/blood type test? (T+S/ABO Rh)

A

to determine if the BT of the mother and baby are compatible. if Rh negative, then mother will need rhogam shot if pregnant

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22
Q

what is sepsis

A

an infection of the blood or that has spread to the blood

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23
Q

what tests are ordered if a pt is suspected to be septic

A

CBC w/ diff (signs of infection), lactate (cell death in the body or sepsis), blood cx

24
Q

t/f: blood cultures results typically come back on the same day as they are ordered

A

false, they never come back the same day

25
Q

how should you document if a culture was ordered in the chart

A

“___ culture was ordered, awaiting the results”

26
Q

what should you look for when ordering and reading a urinalysis

A

sign os UTIs, DM, and kidney stones; WBC, RBC, bacteria, epithelial cells

27
Q

what should you look for when testing the CSF? how is it collected?

A

lumbar puncture, looking for SAH (subarachnoid hemorrhage) and meningitis

28
Q

The provider is performing a lumbar puncture. This means they wants to rule out 1 of 2 concerning conditions in the ED. The CSF analysis can be used to diagnose (select all that apply)
- hyperglycemia, meningitis, UTI, SAH, ischemic stroke

A

meningitis and SAH

29
Q

what is an x-ray and what is it used to diagnose

A

produces images of the structures inside your body, especially bones. diagnoses bone fractures, infections, swallowed items, digestive tract problems

30
Q

what are some potential things that can be diagnosed by a chest x-ray

A

PNA, PTX, widened mediastinum (dissection), pleural effusion, CHF

31
Q

what can an acute abdominal series/kidneys ureters bladder (AAS/KUB) x ray diagnose

A

free air (rupture), SBO, constipation, large kidney stones

32
Q

what can be seen on all other x-rays

A

fractures, dislocation, joint effusion

33
Q

what are some pros and cons of x-rays

A

pros: simple, quick, easy to interpret, shows some soft tissue, especially beneficial for bones!
cons: radiation, not good for pregnant pts, cannot see other tissues or BV

34
Q

what is a CT scan and what is it used to diagnose

A

a series of x-rays to create cross-sections of the inside of the body, including bones, BV, and soft tissues. injuries from trauma, bone fractures, vascular disease, infections

35
Q

what are the 3 types of CTs

A

CT w/out contrast, CT w/ contrast, and CT abd/pelvis w/ PO contrast

36
Q

what is the difference between IV contrast and PO contrast

A

IV contrast is injected through the veins and travels to the arteries and by the time it returns to the veins it is very diluted, good for see arteries. PO contrast is taken orally therefore it is good for observing the GI tract, but it takes a while to travel

37
Q

what do you need to do before performing a CTA

A

CTAs are bad for the kidneys, so always check creatine levels. high creat = poor kidney fxn

38
Q

what are the pros and cons of CT scans

A

pro: very detailed (especially w soft tissue), IV contrast shows circulatory system (clots, blockages, aneurysms), PO contrast shows GI tract
cons: TONS of radiation, IV contrast could harm kidney function, PO contrast studies take forever

39
Q

what is an ultrasound/sonogram? what is it used to diagnose?

A

produce images of organs and show parts of the body in motion (e.g. heart beating or blood flowing through blood vessels). used to diagnose gallbladder disease, genital/prostate issues, blood flow problems, monitoring pregnancy

40
Q

what are some pros and cons of an US

A

pros: no radiation, takes videos to investigate flow and movement
cons: takes longer to get results (time for videos, time to interpret), only see superficial structures

41
Q

NSR

A

normal sinus rhythm

42
Q

BBB

A

bundle branch block

43
Q

LAD

A

left axis deviation

44
Q

if the clinician says “normal EKG at 80”, what would the scribe write

A

NSR at a rate of 80 bpm, no acute ST/T changes

45
Q

if the clinician says “sinus at 72” what would the scribe write

A

NSR at a rate of 72 bpm

46
Q

if the clinicians says “sinus at 114” what would the scribe write

A

sinus tachycardia at a rate of 114 bpm

47
Q

if the clinician says “sinus at 56” what would the scribe write

A

sinus bradycardia at a rate of 56 bpm

48
Q

dr says: sinus brady, scribe writes:

A

sinus bradycardia

49
Q

dr says: sinus tachy, scribe writes:

A

sinus tachycardia

50
Q

dr says: left/right bundle; scribe writes:

A

L/RBBB

51
Q

dr says: nothing acute; scribe writes:

A

no acute ST/T changes

52
Q

dr says: non specific changes; scribe writes:

A

nonspecific ST/T changes

53
Q

dr says: lead one, lead two, or lead three; scribe writes:

A

Lead I, Lead II or Lead III

54
Q

what is critical care

A

care provided to any pt that is at serious risk for deterioration that may lead to permanent bodily harm or death

55
Q

what steps should you take if a clinician asks you to document critical care

A
  1. how many minutes of critical care time were provided?
  2. ensure you have thorough documentation
56
Q

when do re-evaluations occur

A

when the clinicians want to 1. determine if pt’s status has changed, 2. to discuss discharge instructions or admission, 3. re-check abnormal vital signs re-checked, 4. determine if a particular treatment was effective

57
Q

what information needs to be included when documenting a consult

A

timestamp, name of provider being consulted, specialty of this provider, what was discussed

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