ScribeAmerica Scribe Workbook Questions and Correct Solutions Graded to Pass

What lab order contains the "H&H" (hemoglobin and hematocrit)? - CBC (complete blood count) What is the difference between a BMP and a CMP? - A CMP is a BMP+liver function tests (LFT's) What part of the CBC does a "Differential" further characterize, RBC or WBC? - WBC (white blood cells) What does Creatine measure? - Kidney function (insufficiency or failure) and whether a CT can be done Is a high potassium level called "hyperkalemia" or "hypernatremia"? - Hyperkalemia What body organ do "LFT's" investigate? - Liver Would "Aspartate Transaminase" be documented as "AST" or "ALT"? - AST Which cardiac enzyme is more specific to heart damage, Troponin or CK-MB? - Troponin What does a negative D-Dimer mean? - No PE What does a positive D-Dimer mean? - Pt must be ruled out for PE; there is a blood clot somewhere. Pt must receive a CTA Chest or VQ scan What does an elevated BNP diagnose? - CHF Does the blood sample for an ABG come from a vein or an artery? - Artery Name two parts of the "cardiac order set". - CBC, BMP, CK/CK-MB, Troponin, EKG, CXR What procedure must first be performed before CSF can be obtained? - LP (lumbar puncture) What do "Coag" lab tests examine? - Ability to form blood clots Name one of the three "Coag" lab tests. - Prothrombin Time (PT), International Normalized Ratio (INR), Partial Thromboplastin Tine (PTT) What does Lipase diagnose? - Pancreatitis What do both "CRP" and "ESR" test for? - Active inflammation in the body What is the difference between a Urine Dip and a Urine Micro? - Urine dip is quick and simple test performed at bedside and urine micro is more complex and sent to lab Name one of the three labs that are particularly important to track for efficiency. - D-Dimer, Troponin, and Creatine (from BMP) What type of body structures are XR's best suited to examine? - Bones (dense tissue) Do emergency physicians interpret XR's or CT's? - Only XR's. CT's must be interpreted by a radiologist. What is the difference between CT and CTA? - CT is without IV contrast a CTA is with IV contrast What does an US of the RUQ rule out or diagnose? - Gallbladder problems (cholelithiasis or cholecystitis) Name one type of Orthopedic Procedure that may be performed by the EP. - Splint application, joint reduction, arthrocentesis What does I&D stand for? - Incision and drainage Name two procedures that qualify the patient for critical care. - Central line placement, endotracheal intubation, CPR, CPAP/BiPAP, cardioversion, chest tube placement What does LAD stand for as an EKG abbreviation? - Left Axis Deviation Name two diagnoses that would qualify a patient for critical care time. - Acute MI, Unstable Angina, Acute Coronary Syndrome (ACS), A-Fib with RVR, Aortic Dissection, Bowel Perforation, Ectopic Pregnancy, Severe GI Bleeding, Severe AMS, Acute CVA, Overdoses, Acute CHF, Acute COPD Exacerbation, Severe Hypoxia, Allergic Reaction, Pnuemothorax, Pulmonary Embolism, Sepsis, Severe Trauma, Critically abnormal vital signs, Critically abnormal lab test results, Renal failure, Rhabdomyolysis, Severe dehydration, DKA When might an ER doctor obtain a Physician Consult? - When needing a consult on a specialty or when deciding whether to admit or not. Do any pt complaints belong in the physical exam? - No If a pt says their abdomen feels very painful, can you automatically document "abdominal tenderness" in the physical exam? Why or why not? - No. Patient complaints are subjective and belong in the HPI. Only information coming from a physician belongs in the PE. Which of these two physical exam findings could a physician appreciate without auscultating the pt's lungs: a. No respiratory distress b. No rales - No respiratory distress What does PERRL stand for? - Pupils are Equal Round Reactive to Light What does AT/NC mean? - Atraumatic Normocephalic What does NAD stand for? - No Acute Distress If a pt has pale conjunctiva, what does that indicate? - Anemia What is scleral icterus, and what does it indicate? - Scleral icterus is yellowish pigmentation of the conjunctival membranes over the sclerae. This indicates liver failure. Name an instrument a physician may use to closely investigate the eyes? - Otoscope In which body system would you document "TM erythema and bulging"? - Ears What is the medical term for nostril? - Nares/Naris To describe a "runny nose" would the doctor use the word "epistaxis" or "rhinorrhea"? - Rhinorrhea