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ScribeAmerica ED Classroom Training > Course 5: Labs and Imaging > Flashcards

Course 5: Labs and Imaging Flashcards

1
Q

Function of the ED course

A
  1. The ED course is instrumental in ruling out or confirming the DDx
  2. Contains the remaining objective workup after the physical exam
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2
Q

ED Course Contents

A

Lab and imaging results, Procedures, Medications given, Consultations, Reevaluations

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3
Q

Complete Blood Count (CBC) with Differentials

A

White Blood Cells (WBC), Hemoglobin (Hgb), Hematocrit (Hct), Platelets (Plt), Bands cells (Bands), Segmented neutrophils (Segs), Lymphocytes (Lymphs), Monocytes (Monos), Eosinophils (Eos)

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4
Q

White Blood Cells (WBC) Significance

A

High → Leukocytosis (infection)

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5
Q

Hemoglobin (Hgb) Significance

A

Low → Anemia

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6
Q

Hematocrit (Hct) Significance

A

Low → Anemia

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7
Q

Platelets (Plt) Significance

A

Low → Thrombocytopenia (prone to bleeding)

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8
Q

Bands Cells (Bands) Significance

A

High → Bandemia (infection)

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9
Q

Segmented Neutrophils (Segs), Lymphocytes (Lymphs), Monocytes (Monos), Eosinophils (Eos) Significance

A

High → Infection

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10
Q

Basic Metabolic Panel (BMP)

A

Sodium (Na), Potassium (K), Blood urea nitrogen (BUN), Creatinine (Creat), Glucose (Gluc), Bicarbonate (HCO3), Chloride (Cl)

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11
Q

Sodium (Na) Significance

A

High → Hypernatremia (dehydration)

Low → Hyponatremia (dehydration)

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12
Q

Potassium (K) Significance

A

High → Hyperkalemia (poor kidney function)

Low → Hypokalemia

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13
Q

Blood urea nitrogen (BUN) and Creatinine (Creat) Significance

A

High → Renal insufficiency or renal failure

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14
Q

Glucose (Gluc) Significance

A

High → Hyperglycemia

Low → Hypoglycemia

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15
Q

Bicarbonate (HCO3) Significance

A

High → Possible respiratory disease

Low → Hyperventilation

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16
Q

Chloride (Cl) Significance

A

High → Dehydration

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17
Q

Comprehensive Metabolic Panel (CMP)

A

Sodium (Na), Potassium (K), Blood urea nitrogen (BUN), Creatinine (Creat), Glucose (Gluc), Bicarbonate (HCO3), Chloride (Cl), Total protein (T Prot), Albumin (Alb), Total bilirubin (T Bili), Aspartate transaminase (AST or SGOT), Alanine transaminase (ALT or SGPT), Alkaline phosphatase (Alk Phos)

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18
Q

Total Protein (T Prot) Significance

A

Low → Hemorrhage, liver disease, kidney disease

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19
Q

Albumin (Alb) Significance

A

Low → Liver or kidney problem

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20
Q

Total Bilirubin (T Bili), Aspartate Transaminase (AST or SGOT), Alanine Transaminase (ALT or SGPT), Alkaline Phosphatase (Alk Phos) Significance

A

High → Liver damage

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21
Q

Cardiac Order Set

A

Troponin (Trop), EKG, CXR, CBC, BMP

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22
Q

D-Dimer Significance

A

High → Must rule out pulmonary embolism

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23
Q

Respiratory Labs

A

B-type natriuretic peptide (BNP), Arterial blood gas (ABG), Venous blood gas (VBG)

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24
Q

B-Type Natriuretic Peptide (BNP) Significance

A

High → Congestive heart failure

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25
Arterial Blood Gas (ABG) Significance
Low pH → Acidosis High/low HCO3 → Metabolic problem High/low pCO2 → Respiratory problem Low pO2 → Hypoxia
26
Venous Blood Gas (VBG) Significance
Low pH → Acidosis High pH → Alkalosis
27
Coagulation Studies (Coags)
Prothrombin time (PT), International normalized ratio (INR)
28
Prothrombin Time (PT) Significance
High → Blood that clots too slowly
29
International Normalized Ratio (INR) Significance
\> 3 → Too much Coumadin = Supratherapeutic 2-3 → Normal if on Coumadin = Therapeutic \< 2-3 → Too low = Subtherapeutic 1 → Normal if not on Coumadin
30
Pancreatic Enzymes
Lipase (Lip), Amylase (Amy)
31
Lipase (Lip) Significance
High → Pancreatitis
32
Amylase (Amy) Significance
High → Possible pancreatitis
33
Diabetes Testing
Serum ketones, Finger-stick blood glucose (Accu-Check or FSBG)
34
Serum Ketones Significance
High → Diabetic ketoacidosis (DKA)
35
Finger-stick blood glucose (Accu-Check or FSBG) Significance
High → High blood sugar (hyperglycemia) Low → Low blood sugar (hypoglycemia)
36
Obstetrics
Urine βHCG (HCG), Serum βHCG qualitative (HCG), Serum βHCG quantitative (HCG Quant), Type and screen/blood type (T+S/ABO Rh), Type and cross (T+X)
37
Urine βHCG (HCG) Significance
Positive → Pregnant
38
Serum βHCG Qualitative (HCG) Significance
Positive → Pregnant
39
Serum βHCG Quantitative (HCG Quant) Significance
High → Further along in pregnancy
40
Type and Screen/Blood Type (T+S/ABO Rh) Significance
Blood type → In case blood transfusion needed Rh negative → Will need Rhogam shot if pregnant
41
Type and Cross (T+X) Significance
Blood type → Gets blood ready for transfusion
42
Sepsis
Complete blood count (CBC) with differentials, Lactate or lactic acid, Blood cultures (Blood Cx)
43
Complete Blood Count (CBC) with Differentials Significance
High WBC → Leukocytosis (possible sepsis) High bands → Bandemia (possible sepsis)
44
Lactate or Lactic Acid Significance
High → Sepsis or cell death in the body
45
Blood Cultures (Blood Cx) Significance
Positive growth → Sepsis
46
Cultures
Blood culture (BCx), Urine culture (UCx), Wound culture (WCx), Stool culture (SCx)
47
Blood Culture (BCx) Significance
Positive growth → Sepsis
48
Urine Culture (UCx) Significance
Positive growth → Urinary tract infection (UTI)
49
Wound Culture (WCx) and Stool Culture (SCx) Significance
Positive growth → Infection
50
Microscopic Urinalysis
White blood cells (WBC), Red blood cells (RBC), Bacteria, Epithelial cells (Epi)
51
White Blood Cells (WBC) Urine Significance
Many → Urinary tract infection (UTI)
52
Red Blood Cells (RBC) Urine Significance
Many → Possible urinary tract infection (UTI) or kidney stones
53
Bacteria Urine Significance
Many → Urinary tract infection (UTI)
54
Epithelial Cells (Epi) Urine Significance
Many → Contaminated specimen
55
ENT
Rapid Strep test, Mononucleosis, Influenza A+B, Respiratory syncytial virus (RSV), Covid-19 antigen
56
Rapit Strep Test Significance
Positive → Strep throat
57
Mononucleosis Significance
Positive → Mononucleosis
58
Influenza A+B Significance
Positive → Influenza
59
Respiratory Syncytial Virus (RSV) Significance
Positive → Respiratory syncytial virus (RSV)
60
Covid-19 Antigen Significance
Positive → Covid-19
61
Genital
Vaginal wet mount (wet prep), Gonococcus (GC), Chlamydia trachomatis (CT), Genital culture
62
Vaginal Wet Mount (Wet Prep) Significance
Positive clue cells → Bacterial vaginosis (BV) Positive trichomonas → Trichomoniasis (STD) Positive yeast → Vaginal yeast infection
63
Gonococcus (GC) Significance
Positive → Gonorrhea (STI)
64
Chlamydia Trachomatis (CT) Significance
Positive → Chlamydia (STI)
65
Genital Culture Significance
Positive growth → Infection
66
Cerebrospinal Fluid (CSF)
CSF glucose, CSF protein, CSF red blood cells (RBC), CSF white blood cells (WBC), CSF Gram stain
67
CSF Glucose Significance
Low → Possible bacterial meningitis
68
CSF Protein Significance
High → Possible meningitis
69
CSF Red Blood Cells (RBC) Significance
Greater than 4 in tube 4 → Subarachnoid hemorrhage
70
CSF White Blood Cells (WBC) Significance
Greater than 3 in tube 4 → Possible meningitis
71
CSF Gram Stain Significance
Positive bacteria → Meningitis
72
Types of Imaging Studies
X-ray, CT, Ultrasound/sonogram
73
X-Ray Description
Produce images of the structures inside of the body, especially bones
74
X-Ray Diagnostic Utility
Bone fractures, infections, swallowed items, digestive tract problems
75
CT Description
A series of x-rays to create a to create cross sections of the inside of the body, including bones, blood vessels, and soft tissues
76
CT Diagnostic Utility
Injuries from trauma, bone fractures, vascular disease, infections
77
Ultrasound/Sonogram Description
Produce images of organs and show parts of the body in motion e.g. heart beating or blood flowing through blood vessels
78
Chest X-Ray (CXR) Potential Findings
Pneumonia, pneumothorax, widened mediastinum (dissection), pleural effusion, congestive heart failure
79
Acute Abdominal Series (AAS)/Kidneys Ureters Bladder (KUB) Potential Findings
Free air (rupture), small bowel obstruction (SBO), constipation, large kidney stones
80
All Other X-Rays Potential Findings
Fracture, dislocation, joint effusion
81
CT without IV Contrast Potential Findings
CT head: Large hemorrhagic or ischemic CVA CT C-spine/T-spine/L-spine: Cervical/thoracic/lumbar spine fracture or subluxation (partial dislocation) CT chest: Pneumonia (PNA), pneumothorax (PTX), pleural effusion, rib fracture CT abdomen/pelvis: Kidney stones, pyelonephritis
82
CT Angiogram (CTA)/CT with IV Contrast Potential Findings
CTA head: Hemorrhagic CVA, ischemic CVA CTA neck: Carotid dissection, carotid occlusion CTA chest: Pulmonary embolism, aortic dissection
83
CT Abdomen/Pelvis with PO Contrast Potential Findings
CT abdomen/pelvis: Appendicitis, small bowel obstruction (SBO), diverticulitis, ischemic gut
84
Ultrasound Doppler Lower Extremities Potential Findings
Deep vein thrombosis (DVT
85
Abdominal Ultrasound of RUQ Potential Findings
Cholelithiasis, cholecystitis, bile sludge, gallbladder wall thickening, bile duct obstruction
86
Ultrasound Obstetrics/Transvaginal Potential Findings
Intrauterine pregnancy (IUP), ectopic pregnancy, ovarian cyst, ovarian torsion
87
Ultrasound Scrotum Potential Findings
Testicular torsion, testicular mass
88
Clinician says “Normal EKG at 80 (bpm)”
Scribe documents “NSR at a rate of 80 bpm, no acute ST/T changes”
89
Clinician says “Sinus at 72”
Scribe documents “Normal sinus rhythm at a rate of 72 bpm”
90
Clinician says “Sinus at 114”
Scribe documents “Sinus tachycardia at a rate of 114 bpm”
91
Clinician says “Sinus at 56”
Scribe documents “Sinus bradycardia at a rate of 56 bpm”
92
Clinician says “Sinus brady”
Scribe documents “Sinus bradycardia"
93
Clinician says “Sinus tachy”
Scribe documents “Sinus tachycardia”
94
Clinician says “Left bundle”
Scribe documents “LBBB”
95
Clinician says “Right bundle”
Scribe documents “RBBB”
96
Clinician says “Left axis”
Scribe documents “LAD”
97
Clinician says “Nothing acute”
Scribe documents “No acute ST/T changes”
98
Clinician says “Non specific changes”
Scribe documents “Nonspecific ST/T changes”
99
Clinician says “Lead one, lead two, or lead three”
Scribe documents “Lead I, Lead II, or Lead III”
100
Critical Care Scribe Role
1. Ask “How many minutes of critical care time were provided?” 2. Ensure you have thorough documentation
101
Reevaluations occur when the clinician wants to…
* Determine whether the patient's status is improving, unchanged, or worsening * Discuss discharge instructions or admission * Re-check abnormal vital signs * Determine if a particular treatment was effective
102
Consults are completed if the provider needs to…
* Admit a patient to the hospital * Gain a specialist's advice * Inform the patient's PCP that they were evaluated in the ED
103
What to include when documenting a consult…
* Timestamp * Name of provider being consulted * Specialty of provider being consulted * What was discussed
104
Disposition Options
* Discharged to home * Discharged to nursing facility * Admitted * Transferred * Left against medical advice (AMA) * Expired

ScribeAmerica ED Classroom Training (5 decks)

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