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Sam: Emergency Medicine > Diagnostics in the ED -- CA > Flashcards

Diagnostics in the ED -- CA Flashcards

1
Q

What four labs are considered to be “high frequency” in the ED?

A

BMP or CMP

CBC

UA

beta-hCG

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2
Q

What’s the difference between a Chem 7 and a Chem 8?

A

Calcium is included in a Chem 8

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3
Q

We would order this test for find out the current status of a person’s kidneys, electrolyte balance, acid/base balance, blood glucose, and calcium levels.

A

BMP

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4
Q

90% of cases of hypercalcemia are caused by these two things

A

Malignancy and hyperparathyroidism

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5
Q

What might a low carbon dioxide value cue you into?

A

Acidosis and possibly ketoacidosis

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6
Q

When we do we see low glucose?

A

Diabetic insulin overdose and sepsis

and yes we just learned hyperglycemia for sepsis. don’t ask me

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7
Q

Elevated BUN and Creatinine?

A

Renal failure

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8
Q

Elevated BUN but a normal creatinine?

A

Diureased

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9
Q

What does a CMP have that a BMP doesn’t?

Why would we order a CMP?

A

Albumin, ALP, AST, ALT, bilirubin and total protein

CMP also looks at liver function and nutritional status

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10
Q

What does low albumin indicate?

A

Malnutrition (possible liver disease or reaction to chemo)

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11
Q

What does increased alk phos likely indicate?

A

gallstones

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12
Q

What does increased AST, ALT likely indicate?

A

Hepatitis

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13
Q

What does increased total bilirubin likely indicate?

A

Cirrhosis, hepatitis

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14
Q

Low RBC, hemoglobin, and hematocrit – think about?

A

Blood loss vs. anemia or other blood dyscrasia

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15
Q

High RBC, hemoglobin, hematocrit, think about?

A

hemocentration due to dehydration vs polycythemia

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16
Q

Low platelets, think about?

A

acute infection, bleeding, DIC, HELLP syndrome, or preeclampsia during pregnancy

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17
Q

What does a differential white count do?

A

Breaks down the WBC count into types – neutrophils, lymphocytes, monocytes, eosinophils, and basophils

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18
Q

What type of white blood cell makes up the majority?

A

Neutrophils

followed by lymphocytes, monocytes, eosinophils, then basophils

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19
Q

High neutrophils, think about?

A

Acute bacterial infection

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20
Q

low neutrophils, think about?

A

severe widespread bacterial or viral infection – this is known as a left shift

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21
Q

High lymphocytes, think about?

A

Viral infection, such as mono, mumps, or measles

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22
Q

High eosinophils, think about?

A

Acute allergic reaction

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23
Q

Very high eosinophils, think about?

A

Parasitic infection

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24
Q

Urine glucose, think about?

A

Poorly controlled diabetes or possibly DKA

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25
Q

Positive nitrites and/or leukocyte esterase, think about?

A

UTI

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26
Q

UTI symptoms with negative nitrites and/or leukocyte esterase, think about?

A

Interstitial cystitis

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27
Q

What can serum beta-hCG do that urine beta-hCG can’t?

A

Allows for dating of pregnancy

28
Q

What is the primary test used to screen for syphilis?

A

Rapid plasma reagin (RPR)

29
Q

What do you do if a first screening test for syphilis is positive?

A

You do another blood test

30
Q

What test do we do for gonorrhea?

A

Nucleic acid amplification test

31
Q

Is a nucleic acid amplification test a blood or urine test?

A

Urine

32
Q

Whats the problem with using urine tests for STD’s?

A

They will not detect a vaginal, cervical, anal, or pharyngeal infection.

33
Q

What test do we do for chlamydia?

A

Nucleic acid amplification (NAA)

34
Q

Is the genital herpes test a blood or urine test?

A

Blooooood

35
Q

How many samples need to be collected for blood cultures?

A

two or three

36
Q

Do we use blood from the same vein for blood cultures?

A

No! Need different veins

37
Q

For what infections might we want to get blood cultures?

A

Meningitis, osteomyelitis, pneumonia, kidney infection, or sepsis

38
Q

Lactate is a marker for cellular ________.

A

hypoxia

39
Q

Once someone’s lactate is above _______ mmol/L the mortality rate increases form 7 percent to _____ percent.

A

4

27

40
Q

This test result can help in assessment of a patient’s gas exchange, ventilatory control and acid-base balance

A

Arterial blood gas

41
Q

What might cause metabolic acidosis?

A

DKA

42
Q

What might cause metabolic alkalosis?

A

Vomiting

43
Q

What might cause respiratory acidosis?

A

Hypoventilation due to pulmonary edema, pneumonia, chronic obstructive pulmonary disease, respiratory depression from drugs

44
Q

What might cause respiratory alkalosis?

A

Hyperventilation, pulmonary embolism, anxiety, pain

45
Q

Do we need to test urine to diagnose DKA?

A

No

46
Q

What should be measured in order to monitor the response to DKA treatment?

A

capillary blood ketones

47
Q

This test is used to evaluate a patient for the presence of thrombosis, pulmonary embolism, and clot

A

D-dimer

48
Q

This is secreted in response to volume overload and results in myocardial stretch

A

BNP

49
Q

Increased or persistent elevation in _______ despite treatment, suggests progression of disease or resistance to treatment.

*This is in reference to CHF

A

BNP

50
Q

Cardiac _________ are proteins essential to cardiac muscle contraction

A

troponins

51
Q

Troponin has replaced _______ as the biomarker of choice for detection of myocardial injury

A

CK-MB

52
Q

Which value evaluates the extrinsic pathway of coagulation?

A

PT/INR

53
Q

Is the intrinsic or extrinsic pathway responsible for most of the procoagulant activity within the body?

A

Extrinsic

54
Q

What drug inhibits the production of vitamin K dependent factors produced in the liver?

A

Coumadin

55
Q

What test is used to evaluate the intrinsic pathway of coagulation?

A

PTT

56
Q

The effect of what drug is measured using the PTT test?

A

Heparin

57
Q

What test will diagnose mononucleosis between 2 and 6 weeks after the onset of the illness?

A

Monospot

58
Q

What are some causes of a false-positive monospot?

A

Toxoplasmosis, rubella, lymphoma, and certain malignancies

59
Q

What is a cause of false negative “monospot” test?

A

Testing too early

60
Q

What is a rapid diagnostic test that is widely used in clinics to assist in the diagnosis of bacterial pharyngitis caused by group A strep?

A

Rapid strep

61
Q

Detects influenza A and B?

A

Influenza swab

62
Q

The digestive enzyme _______ is secreted by the pancreas and salivary glands

A

Amylase

63
Q

What is the main enzyme that breaks down fats?

A

Lipase

64
Q

Is Amylase or Lipase more specific to the pancreas?

A

Lipase

65
Q

According to Conley’s lecture, what are the two most common complaints in the ED?

A
  1. abdominal pain

2. chest pain

Sam: Emergency Medicine (12 decks)

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