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What lab order contains the “H&H” (hemoglobin and hematocrit)?
CBC- Complete Blood Count
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What is the difference between a BMP and a CMP?
- BMP- Basic metabolic panel. Contains electrolytes, kidney function, and glucose levels.
- CMP- comprehensive metabolic panel. BMP in addition to LFTs (liver function tests)
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What part of the CBC does a “Differential” further characterize, RBC or WBC?
WBC
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-
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Low Platelets =?
- thrombocytopenia
- prone to bleeding
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High Bands =?
- bandemia
- serious infection
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High Creat/BUN?
renal insufficiency or failure
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What does Creatinine measure?
Renal function
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Is a high potassium level called “hyperkalemia” or “hypernatremia”?
HYPERkalemia
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What body organ do “LFT’s” investigate?
Liver
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High LFTs =?
liver failure/damage
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High Troponin =?
heart damage
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Would “Aspartate Transaminase” be documented as “AST” or “ALT”?
AST
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Which cardiac enzyme is more specific to heart damage, Troponin or CK-MB?
Troponin
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What does a negative D-Dimer mean?
No evidence of a Pulmonary Embolism
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What does a positive D-Dimer mean?
Possible PE, must order a CTA Chest or VQ Scan
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What does an elevated BNP diagnose?
Congestive Heart Failure
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Does the blood sample for an ABG come from a vein or an artery?
artery
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Name the parts of the “Cardiac Order Set.”
CBC, BMP, TROP, EKG, CXR
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What procedure must first be performed before CSF can be obtained?
Lumbar Puncture
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How many tubes of CSF are obtained during a lumbar puncture and why?
4 b/c it helps to rule out any abnormalities
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What do “Coag” lab tests examine?
Blood coagulation (how fast the blood clots) / Coumadin levels
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Name one of the three “Coag” lab tests.
PT, PTT, INR
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What does Lipase diagnose?
Pancreatitis
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What do both “CRP” and “ESR” test for?
- Inflammation.
- CRP- C-Reactive Protein.
- ESR- Erythrocyte Sedimentation Rate
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High TSH levels =?
possible hypothyroidism
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Low TSH levels =?
possible hyperthyroidism
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Low t3/t4 levels =?
hypothyroidism
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Will culture's ever result during a patient’s ED visit?
No
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What is the difference between a Urine Dip and a Urine Micro?
- Urine Dip- done bedside and detects leuks, nitrite, glucose, blood.
- Urine Micro- in lab and detects WBC, RBC, bacteria
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Name three labs that are particularly important to track for efficiency.
- Troponin: acute MI - give ASA, NTG, beta-blockers, heparin
- Creatinine: >1.4 means pt cannot receive IV contrast
- D-Dimer: if high, possible PE - must order CTA chest or VQ scan (but first check creat from BMP before getting CTA)
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What type of body structures are XR’s best suited to examine?
Bones
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Do emergency physicians interpret XR’s or CT’s?
XR’s
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What is the difference between a CTA and a CT?
- CTA - CT angiogram looks at the arteries (uses IV contrast)
- CT - no IV contrast but may or may not use PO contrast
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What do positive/negative HCG tests determine?
- pos = pregnant
- neg = not pregnant
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What do subtherapeutic INR levels mean?
at risk for clots
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What do supratherapeutic INR levels mean?
at risk for bleed
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What does an US of the RUQ rule out or diagnose?
Cholelithiasis, cholecystitis, Gallbladder wall thickening, bile sludge, bile duct obstruction
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Name one type of Orthopedic Procedure that may be performed by the EP.
- Splinting
- joint reduction
- arthrocentesis
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What is a splint application done for?
joint injuries
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What is a joint reduction done for?
dislocations
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What is the purpose of an arthrocentesis?
joint effusion
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What does I&D stand for?
Incision and Drainage
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What is the purpose of a lumbar puncture?
to rule out meningitis or subarachnoid hemorrhage (SAH)
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When is a central line placement needed?
for intravenous access for Abc or fluid resuscitation
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When is a Chest tube needed?
for PTX or hemothorax
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When is cardioversion needed?
for atrial fibrillation or abnormal rhythm
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Name two procedures that qualify the patient for critical care.
- Cardioversion
- central line placement
- endotracheal intubation
- chest tube placement
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What does LAD stand for as an EKG abbreviation?
Left Axis Deviation
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Name a few diagnoses that would qualify a patient for critical care time.
- AFIB with RVR
- CVA
- MI
- SEPSIS
- DKA
- CPR
- Severe hypotension/hypertension
- Severe anemia
- PTX
- PE
- Overdose
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When might an ER doctor obtain a Physician Consult?
- Regarding admission
- advice over treatment plan
- inform primary physician of results, etc.
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Arterial Blood Gas
Blood taken from an artery
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Serum
The clear liquid separated from clotted blood
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Coagulation
The change of blood from liquid to solid
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General anesthesia
Medication that suppresses the central nervous system that results in unconsciousness and lack of sensation
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Cultures
The propagation of microorganisms or of living tissue cells in media conducive to their growth.
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Critical Care Time
Care provided to any patient that is at serious risk for deterioration that may lead to permanent bodily harm or death.
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What does CBC w/diff measure?
- infection (WBC)
- anemia (H&H)
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What does BMP measure?
- electrolytes (Na + K)
- Renal Function (BUN + Creat)
- Glucose
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What does CMP measure?
BMP + LFTs (liver function)
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What does Troponin measure?
Acute MI (if high)
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What does uDip + UA measure?
UTI or blood (possible kidney stone)
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What does BNP measure?
acute CHF (if high)
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What do Coags measure?
risk for bleeding (if high)
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What does ABG measure?
respiratory function (hypoxia)
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What does D-Dimer measure?
possible blood clot (if high, need to check Creat before CTA chest)
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