Module 1 Flashcards
Complete Blood Count (CBC) with Differentials
(total of 9)
fishbone consists of (4)
WBC HBG HCT PLT RBC Mean Corpuscular Volume (MCV) Mean Corpuscular Hemoglobin (MCH) Mean Corpuscular Hemoglobin Concentration (MCHC) Red Cell Distribution Width (RDW)
WBC, HBG, HCT, PLT
coagulation studies fishbone consists of (3)
total of 6:
PT
PTT
INR
• Platelet Count • Prothrombin Time (PT) • Partial Thromboplastin Time (PTT) • International Normalized Ration (INR) Other labs to consider: • Factor V • Fibrinogen level
BMP
Fishbone consists of 7
• Sodium (Na) • Potassium (K) • Chloride (Cl) • Bicarbonate (HC03) • Blood Urea Nitrogen (BUN) • Creatinine \+ Glucose
Liver Function tests
ALT
AST
ALP
GGT
Total, indirect and direct bilirubin checked
Total proteins and albumin
Comprehensive Metabolic panel (CMP)
14
Glucose Calcium Sodium Potassium CO2 Chloride Albumin Total Protein BUN Creatinine ALP AST ALT Bilirubin
if recent acute exposure to
HCV is suspected test for
HCV antibody reactive means
HCV RNA
current or past HCV infection that has resolved
Conjunctivitis
__conjunctivitis is an ophthalmologic emergency.
Gonococcal
Consider noninfectious causes (eg, allergy, contact lens deposits, trauma)
Cultures are usually unnecessary unless chlamydia or gonorrhea is suspected or the case is severe.
Hospital-acquired pneumonia
Most cases are related to
Blood cultures for bacteria are often negative (80%).
Ventilator-associated pneumonia (VAP) is difficult to diagnose.
Suspect VAP in a patient with fever, leukocytosis, purulent respiratory secretions or a progressive radiographic pulmonary infiltrate.
aspiration.
Hospital-acquired aspiration pneumonia is associated with intubation and the use of broad-spectrum antibiotics.
Mendelson syndrome
is due to acute aspiration of gastric contents (eg, during anesthesia or drowning).
Hospital-acquired pneumonia is the __most common nosocomial infection, accounting for 25% of all ICU infections.
second
UTI
Urinalysis and culture reveal the two most important signs: bacteriuria and pyuria (>10 WBCs/mcL).
Cystitis (95%) is diagnosed by >102 CFU/mL of bacteria; other urinary infections (90%) by >105 CFU/mL
Predisposing factors for cellulitis include
diabetes mellitus, edema, peripheral vascular disease, venous insufficiency, leg ulcer or wound, tinea pedis, dry skin, obesity, and history of cellulitis
Consider updating anti-tetanus prophylaxis for all wounds.
_ _ is indicated when pyelonephritis is suspected.
Urine culture
Urinalysis will usually show pyuria (>5 WBC/hpf) and may show WBC casts.
Patients usually present with fever, chills, nausea, vomiting, and costovertebral angle tenderness.
20–30% of pregnant women with untreated bacteriuria develop pyelonephritis.
Community acquired pneumonia
Aspiration pneumonias are most commonly associated with stroke, alcoholism, drug abuse, sedation, and periodontal disease
Approval and widespread use of pneumococcal conjugate vaccine (PCV13) for at-risk populations has been effective prevention strategy.
Hepatitis A
in areas of poor hygiene and low socioeconomic conditions. The virus is transmitted primarily by the fecal-oral route, and it is spread by close person-to-person contact and by food- and water-borne epidemics.
overcrowded situations and in high-density institutions and centers, such as prisons and health care or day care centers.
Anti-HAV IgM usually falls to an undetectable level by 6 months after HAV infection.
Anti-HAV IgG levels rise quickly once the virus is cleared and may persist for many years.
the 5 W’s
What – Laboratory studies and diagnostic Tests
• Who – Patient population
• Why – Rationale for ordering the tests
• When – Acuity level
• Where (Location of body part and/or Location of test centers)
Gonococcal conjunctivitis is an
ophthalmologic emergency.
Pharyngitis
Most laboratories only report group A streptococcus from throat culture.
About 60% of cases of community-acquired pneumonia are from
Pneumatoceles suggest S. aureus but are also reported with pneumococcus, group A streptococcus, H influenzae, and Enterobacteriaceae (in neonates).
diagnostic error is what?
The definition frames diagnostic error from the __ perspective, because a patient bears the ultimate risk of harm from diagnostic errors.
“the failure to (a) establish an accurate
and timely explanation of the patient’s health problem(s) or (b) communicate that
explanation to the patient.”
patients
_ _ are the leading type of paid medical malpractice claims and are almost twice as likely to have resulted in the patient’s death compared to other claims.
a broader focus on improving diagnosis is warranted.
diagnostic errors
8 goals
POC testing
Advantages: quick turn around time small volume specimen many fluid analyzed without processing works within clinical flow
disadvantages: cost quality billing compliance documentation
POC qualitative test examples:
L for letters
hcg strep drug abuse flu urinalysis
Quantitative tests poc:
N for numbers
glucose blood gases electrolytes creatine hb1ac d dimer trop
