Clinical Assessment Definitions 319 Questions with Verified Answers
Acid-Fast Bacillus (AFB) Staining (Ziehl - Neelsen) - CORRECT ANSWER Used in
... [Show More] diagnosis of Tuberculosis, tuberculous infections and leprosy. Organisms will appear red against a blue background when stained by this method. Usually takes 2 -3 weeks to culture tubercle bacilli; results of the AFB stain can indicate the need for the immediate initiation of therapy.
Airway Resistance (Raw) - CORRECT ANSWER Estimated by determining the difference between peak airway pressure and plateau pressure. Used to determine the amount of pressure support necessary to overcome airway resistance. Most accurately measured by placing the patient in a body plethysmography in the PFT lab.
A measure of the impedance to airflow through the bronchopulmonary system. It is the reciprocal of airway conductance.
Raw = Change in Pressure/ Flow = cm H2O/ L/sec
Normal: 1.0 - 2.0 cm H2O/L/sec
Albumin - CORRECT ANSWER Normal value 3.5-5.0
Important in maintaining osmotic pressure of the blood and has a primary role in lipid metabolism. Decreased levels are seen in protein malnutrition and severe liver disease. Chronic inflammation, severe acute disease and kidney disease lead to low albumin levels. Severe hypoalbuminemia may result in a loss of fluid from the vascular space and contribute to pulmonary edema.
Angiogram - CORRECT ANSWER Serial roentgenograms (X-rays) of blood vessels taken in rapid sequence following injection of a radio opaque substance into a vessel.
Used to define the size, shape, and patency of veins and arteries. Can evaluate blood flow to the brain, heart, lungs, kidneys or liver.
Anion Gap - CORRECT ANSWER Normal range: 8 - 18 mEq/L
Formula: (Na+) - (Cl- + HCO3-)
Used to identify the cause of metabolic acidosis.
Loss of base results in a normal anion while the gain of fixed acids (lactic acidosis) results in an elevated anion gap. Is alos affected by serum albumin levels (rising when albumin does and vice versa)
Ascorbic Acid Level - CORRECT ANSWER Determination of the amount of ascorbic acid (vitamin c) in the blood
Apgar Score - CORRECT ANSWER System of scoring a newborn's condition at 1 minute and 5 mins after birth. HR, RR, muscle tone, reflex irritability & color are assigned a point value between zero & 2.
7 - 10 score indicate that the infant is stable.
6 - 4 score indicate stimulation, warmth, O2 administration & assist in ventilation.
0 - 3 score require immediate resuscitation.
Babinski Reflex - CORRECT ANSWER A neuro test used to evaluate the brainstem and spinal cord function. Performed by stroking the sole of the foot and observing the reaction of the toes. dorsiflexion of the toes in response to this stimulus is be helpful in stable, but unconscious patients. Normal in child, indicated neuro problem in adult
Basal Metabolic Rate - CORRECT ANSWER The rate at which energy is produced according to how much is available. Also referred to as (BEE) Basal Energy Expenditure or (MEE) Minimal Energy Expenditure. Determined through direct or indirect calorimetry. A time consuming test, but may be helpful in determining a patient's nutritional needs.
Basal Metabolic Panel (BMP) - CORRECT ANSWER Blood test that includes assessment of glucose, electrolytes, fluid levels and kidney function. This panel measures sodium, potassium, calcium, chloride, carbon dioxide, glucose, urea nitrogen and creatinine.
BCG vaccine - CORRECT ANSWER A vaccine (bacilli Calmette-Guerin) used against TB. Once a pt receives this vaccine, they will have a positive skin test for TB. An organism of the strain Mycobacterium bovis is in the vaccine.
Bilirubin Level - CORRECT ANSWER Bilirubin is the orange-yellow pigment of bile, formed by the breakdown of hemoglobin. Used as an indication of liver function. pt appears jaundice.
Norma level: 0.1 to 1.0 mg/dL
Blood Alcohol Level - CORRECT ANSWER Measurement of the amt of alcohol present in the pt's blood. Blood alcohol isn't always actually measured; it may also be estimated from the amt present in expired air (breathalyzer).
50 mg/dL = sedation or tranquility
< 80 mg/dL = legal driving level
50 - 150 mg/dL = lack of coordination
140 - 200 mg/dL = unconsciousness
> 400 mg/dL = may be fatal
Blood Digoxin Level - CORRECT ANSWER Digoxin is an inotropic agent used to increase cardiac contractility in pts with CHF.Toxicity may result in diarrhea, nausea, arrhythmias (PVC) and ECg changes in T waves.
0.9 - 2.0 ng/mL = Therapeutic blood level
> 3.0 ng/mL = potentially toxic blood level
Blood Glucose Level - CORRECT ANSWER A blood test important in the evaluation of stable infants and patients with suspected diabetes.
Normal levels:
Preterm = 20 - 30 mg/100 mL
Term = > 30 mg/100 mL
Adults = 80 -120 mg/ 100 mL
Blood Magnesium Level - CORRECT ANSWER Normal level: 1.5 - 2.5 mEq/L
Deficiency may be present in pts with chronic diarrhea or diseases that interfere with food absorption
Blood Natriuretic Peptide (BNP) - CORRECT ANSWER Secreted by the cardiac muscle when heart failure or worsens. BNP levels useful to determine if the patient's symptoms are the result of CHP or another condition, such as COPD
Blood Type and Crossmatch - CORRECT ANSWER Blood typing refers to genetically determined antigens on the surface of the red blood cell used to determine blood groups (A, B, O).
Crossmatching is a procedure used to determine compatibility of a donor's blood with that of the recipient.
Both tests are performed prior to blood transfusion.
Blood Urea Nitrogen (BUN) - CORRECT ANSWER Normal: 7 - 20 mg/dL
Elevated BUN may indicate in the presence of renal disease
Bone Marrow Transplant - CORRECT ANSWER Bone marrow cells from a donor whose tissue and blood cells closely match those of the recipient are infused into a patient with aplastic anemia, leukemia, or immune deficiency syndromes.
Borg Scale - CORRECT ANSWER A numerical scale for assessing dyspnea, from 0 representing no dyspnea to 10 as maximal dyspnea.
Bowel Sounds - CORRECT ANSWER Auscultation over the abdomen. May be helpful to detect the presence of congenital diaphragmatic hernia in a newborn or the location of nasogastric (NG) in adult patients.
Bronchoalveolar Lavage (BAL) - CORRECT ANSWER Instillation and aspiration of the lungs using saline solution. This procedure may be performed during bronchoscopy to diagnose nosocomial pneumonia and VAP.
Bronchogram - CORRECT ANSWER X-ray examination of the bronchi after instillation of radiopaque contrast medium. Useful in diagnosing bronchiectasis or the presence of obstructing airway lesions.
Calcium Chloride - CORRECT ANSWER A salt used to raise the calcium content of the blood in disorders such as hypocalcemic tetany, or beta blocker and calcium channel blocker overdose. Administered IV in solution & compatible with epinephrine
Caloric Stimulation - CORRECT ANSWER Iced saline is injected into the external auditory canal to test for the presence of cranial reflexes, usually as part of the determination of brain death. If the reflex is present, it results in nystagmus and deviation of the eyes in which the ice saline is injected.
Calorimetry - CORRECT ANSWER Measurement of a pt's daily energy expenditure (calories) and is used to assess & manage the pt's nutritional status. Direct measurement is not feasible so an indirect method is utilized.
Capillary Blood Gas - CORRECT ANSWER Analysis of blood sample obtained by puncturing the skin of the infant's warmed heel. The blood sample is used to evaluate the infant's PCO2 and pH. However, capillary PO2 values should not be relied upon to monitor the appropriateness of oxygen therapy.
Capillary Refill - CORRECT ANSWER Assessed by pressing firmly for a brief period on the pt's fingernail and noting the speed at which the blood flow (color) returns.Excellent non-invasive way to evaluate circulation and perfusion.
Normal capillary refill time: < 2 seconds
Carboxyhemoglobin Level - CORRECT ANSWER Direct measurement of the amt of CO bound to hemoglobin in the RBC. Measured using co-oximetry or hemoximetry. Should be performed for any pt who may have been exposed to CO (victim of house fire, outdoor burning, car exhaust, etc)
Normal values:
1 - 3% in non-smokers
5 - 10% in smokers
> 20% indicates CO poisoning
Cardiac Catherizarion - CORRECT ANSWER Passing a catheter into the heart. The catheter may be inserted into the atria and ventricles to measure pressure and oxygen saturation, or through the coronary arteries to identify and treat blockages.
Cardiac Enzymes/ CPK Isoenzymes - CORRECT ANSWER Measurement of the MB isoenzyme of creatine phosphokinase (CPK-MB) and troponin in order to detect myocardial damage. May be used to assess the degree of muscle damage in pt's who have had myocardial infarction.
Carotid Massage - CORRECT ANSWER Performed by rubbing the skin over the carotid artery in order to decrease the HR. May be used in the treatment of atrial TACHYCARDIA
Cerebral Perfusion Pressure (CPP) - CORRECT ANSWER The pressure gradient between the mean arterial pressure and the intracranial pressure (MAP - ICP)
Normal: 70 - 90 mm Hg
< 70 mm Hg result in reduction of blood flow to the brain and increase the risk of ischemia
Cerebrovascular accident (CVA)
Stroke/ Apoplexy - CORRECT ANSWER The sudden death of some brain cells due to lack of oxygen when the blood flow to the brain is impaired by blockage or rupture of an artery to the brain. The sudden onset of weakness, numbness, paralysis, slurred speech, aphasia, problems with vision and other manifestations of a sudden interruption of blood flow to a particular area of the brain.
Cerebrospinal Fluid (CSF) - CORRECT ANSWER Watery , clear and colorless fluid that flows through and protects the brain, subarachnoid space and spinal canal.
Normal CSF in adults: 100 - 140 mL
The pressure exerted by the CSF is determined by a lumbar puncture (spinal tap) and the initial pressure is = 10 - 15 cmH2O
Chaddock Reflex - CORRECT ANSWER Extension of great toe resulting from irritation around external malleolus. Flexion of wrist and fanning fingers when forearm is irritated above and near wrist.
Chest Fluoroscopy (Cardiac fluoroscopy) - CORRECT ANSWER Projection of serial x-ray images directly onto a screen for visual examination. Has limited diagnostic value and requires a relatively large dose of radiation. Has limited diagnostic value and requires a relatively large dose of radiation. May be worthwhile in initial assessment of patients with congenital heart disease or valvular disease.
Chest Radiogram
Chest X-ray
Chest Roentgenogram - CORRECT ANSWER Routine radiologic assessment of the chest. Indicated as one of the Basic Lab Tests in a stable pt
Coagulation Studies - CORRECT ANSWER Evaluation of the ability of the blood to form a clot.
The Activated Partial Thromboplastin (APTT) is used to monitor is used to monitor heparin therapy.
Normal value: 24 - 32 sec
The Prothrombin Time (PT) is used to monitor Warfarin (Coumadin) therapy.
Normal value: 12 - 15 sec
Coarctation of the Aorta (CoA) - CORRECT ANSWER The aorta is narrowed or constricted. This obstructs blood flow to the lower part of the body and increases blood pressure above the constriction. Usually there are no symptoms at birth, but they can develop as early as the first week of life. If severe symptoms of high blood pressure and congestive heart failure develop, surgery may be considered.
Hypertension in upper extremities, hypotension in lower, cyanotic despite FIO2
Colloid Osmotic (ONCOTIC) Pressure
Plasma Oncotic Pressure - CORRECT ANSWER Pressure created by serum albumin & globulin particles, which are large molecules which cannot diffuse through normal endothelium. May be used to determine the cause of pulmonary edema.
Colloid Infusion - CORRECT ANSWER Administration of an intravenous solution containing proteins such as albumin. Should not be administered to patients with leaky pulmonary capillaries such as ARDS
Computed Tomography Scan (CT Scan) - CORRECT ANSWER An X-ray technique that produces an image representing a detailed cross-section of tissue structure. Expensive but useful for the diagnosis of pulmonary embolism or bronchiectasis
Coomb's Test
(Antiglobulin Test)
(preNATAL and neoNATAL) - CORRECT ANSWER Testing for the presence of antibodies that coat and damage RBCs. Can detect Rh antibodies in maternal blood and is used to anticipate hemolytic disease in NEWBORNS. Also used to determine the compatibility of blood types
Used to determine anemia and transfusablility
Complete Blood Count (CBC) - CORRECT ANSWER Measurement of the major components of the blood, including RBC, hemoglobin, hematocrit, erythrocyte index, WBC, differential of WBC and platelets. Indicated as one of the Basic Lab Test in a stable pt.
Cord pH - CORRECT ANSWER Measurement of the pH of the blood in the umbilical cord of a newborn. May be useful if arterial or capillary blood is not available.
Cromolyn Sodium - CORRECT ANSWER Preventative ONLY. Contraindicated in the presence of wheezing.
Deep Tendon Reflexes - CORRECT ANSWER A brisk contraction of a muscle in response to a sudden stretch induced by a sharp tap by a finger or rubber hammer on the tendon of insertion of the muscle. Absence of the reflec may be caused by damage to the muscle, peripheral nerve, nerve roots, or spinal cord at that level
Example:Rubber hammer on the knee cap.
Dubowitz Score - CORRECT ANSWER A method of estimating the gestational age of a Neonate based on 21 defined clinical signs. This method provides the correct gestational age +/- 2 weeks in 95% of infants. A score of 40 indicates a gestational age of 40 weeks.
Dysphagia - CORRECT ANSWER "difficulty swallowing."
It is the inability of food or liquids to pass easily from the mouth, into the throat, and down into the esophagus to the stomach during the process of swallowing. Tests to diagnose include: Oral-pharyngeal video swallow, Barium swallow/upper GI series, Endoscopy, Esophageal manometry, Laryngoscopy.
ELISA Test - CORRECT ANSWER Enzyme-Linked Immunosorbent Assay
Test commonly used to detect the presence of antibodies to specific infectious agents such as HIV test
Hering Breuer Inflation Reflex - CORRECT ANSWER Parasympathetic inflation reflex mediated by the lung's stretch receptors. Appears to influence the duration of the expiratory pause between spontaneous breaths. The inflation reflex stops inspiration and stimulates expiration, the deflation reflex inhibits expiration and initiates inspiration.
Treatment for Myasthenia Gravis - CORRECT ANSWER - Mestinon
- Neostigmine
Manitol (Osmitol) - CORRECT ANSWER ICP
Pentamadine - CORRECT ANSWER AIDS (600 mg monthly)
Aminophylline / Theophylline (xanthine) IV bronchodilator - CORRECT ANSWER 10-20 mcg in blood
Rifampin & Isoniazid INH - CORRECT ANSWER Tuberculosis
Survanta - CORRECT ANSWER 100 mL/kg, divide 4 doses, instill dose, vigorously ventilate for 30 sec, change position and repeat
Tine test - CORRECT ANSWER For ALLERGIES
HLTV-III Test - CORRECT ANSWER HIV testing
Methacholine Challenge Test
(Bronchial Provocation) - CORRECT ANSWER Performed by having the patient inhale methacholine followed by spirometry. The test is positive for airway hyperreactivity when there is a 20% decrease in the FEV1
Complete PFT
Rooting reflex - CORRECT ANSWER infant turns head toward anything that strokes its face
Reticulogranular - CORRECT ANSWER IRDS
Ground glass - CORRECT ANSWER ARDS
Transposition of Great Arteries (TGA) - CORRECT ANSWER "Egg-shaped" heart
"blue-baby syndrome"
A congenital (present at birth) heart defect. Due to abnormal development of the fetal heart during the first eight weeks of pregnancy, the large vessels that take blood away from the heart to the lungs, or to the body, are improperly connected.
In TGA, the aorta is connected to the right ventricle, and the pulmonary artery is connected to the left ventricle—the opposite of a normal heart's anatomy.
Tetralogy of Fallot (TOF / TET) - CORRECT ANSWER "Boot-shaped heart", right ventricular hypertrophy (SURGERY - confirm by ECG)
Is a condition of several related congenital (present at birth) defects that occur due to abnormal development of the fetal heart during the first eight weeks of pregnancy. These problems include the following: VSD, Pulmonary (or right ventricular outflow tract) obstruction, Overriding aorta, and right ventricle becomes enlarged as it tries to pump blood past the obstruction into the pulmonary artery.
Transposition of Great Vessels - CORRECT ANSWER Egg-shaped heart, aorta on right/pul. Artery on left (SURGERY)
Patent Ductus Arteriosis - CORRECT ANSWER > 15 mmHg difference of PO2 in pre-DA and post-DA arteries (SURGERY)
Meconium Aspiration - CORRECT ANSWER Meconium aspiration occurs when a baby breathes in amniotic fluid containing meconium (the baby's first stools). It usually occurs in babies born at term (37 to 41 weeks) or post-term (after 42 weeks).
Suction mouth, THEN nose ASAP. Repeated, vigorous suction. INTUBATE tube may need to be replaced at least once.
IRDS Type II (TTN)
Transient Tachypnea of the Newborn - CORRECT ANSWER Late onset (~2 days)
Is a term for a mild respiratory problem of babies that begins after birth and lasts about three days.
This is due to the slow absorption of the fluid in the fetal lungs causes TTN. This fluid makes taking in oxygen harder and the baby breathes faster to compensate.
Treatments include: O2, CPAP
Diaphragmatic Hernia - CORRECT ANSWER Is a birth defect, which is an abnormality that occurs before birth as a fetus is forming in the mother's uterus. An opening is present in the diaphragm (the muscle that separates the chest cavity from the abdominal cavity). With this type of birth defect, some of the organs that are normally found in the abdomen move up into the chest cavity through this abnormal opening.
Nasogastric tube is key intervention. Bowel or bowel sounds in chest, mediastinal shift, barrel chest and scaphoid abdomen are all indicators.
Smoke/fire/burn - CORRECT ANSWER Intubate immediately
Tube position - CORRECT ANSWER 2 cm (1 in) past vocal cords
Myocardial infarction - CORRECT ANSWER Chest pain, cold and clammy skin, diaphoresis
V-fib - CORRECT ANSWER Defibrillate!
Pulseless v-tach - CORRECT ANSWER CPR
Laryngeal mask intubation - CORRECT ANSWER Temporary, non-emergent, as in surgery
Pickwickian syndrome - CORRECT ANSWER Obesity Hypoventialtion Sydrome, often accompanies OSA
BARKING cough - CORRECT ANSWER CROUP!! (laryngotracheobronchitis)
AVOID weaning if PIP is too high! - CORRECT ANSWER > 39 mmHg
Normal rise/fall of pul. artery catheter - CORRECT ANSWER Between 25 and 10 mmHg WITH a dicrotic notch.
No dicrotic notch - CORRECT ANSWER Pressure dampening. Either flush, rotate or inflate balloon and "sail" back into position
Rales - CORRECT ANSWER Diurese!
Choanal Atresia - CORRECT ANSWER Is a narrowing or blockage of the nasal airway by tissue. It is a congenital condition, meaning it is present at birth. Nasal tissue blockage, cyanotic, resp distress while feeding, fine the next
Exosurf dosing - CORRECT ANSWER 2.5 mL/kg divided into two doses
Place on one side, instill one dose, ventilate
Place on other side, instill other dose, ventilate
Pulmonary angiogram - CORRECT ANSWER Suspicion of Pulmonary Emboli, esp if V/Q scan is inconclusive
Potassium - CORRECT ANSWER For PVCs, Increased urine output, metabolic alkalosis
CSF protein test (spinal tap) - CORRECT ANSWER Tests for Guillain-Barre
Ribavirin dosing (for RSV) - CORRECT ANSWER 20 mg/mL, diluted in sterile water, via SPAG
Steeple sign Xray - CORRECT ANSWER Croup
Thumb sign Xray - CORRECT ANSWER Epiglottitis
Dobutamine - CORRECT ANSWER For heart failure and cardiogenic shock
Butterfly pattern Xray or fluffy infiltrates - CORRECT ANSWER Pulmonary edema
Wedge-shaped Xray - CORRECT ANSWER Pulmonary embolus
Hochsinger's Sign, Doll's eyes - CORRECT ANSWER Test for tetanus (NOT DONE)
MRSA infection control - CORRECT ANSWER Strict isolation
Contact precautions
Decadron (Dexamethasone) - CORRECT ANSWER Corticosteroid, PO or IV
For croup!
Plasmapheresis - CORRECT ANSWER Separate elements from the plasma. Maybe beneficial in treating Myasthenia Gravis and Guillain-Barre Syndrome
Verapamil - CORRECT ANSWER Controls HR
Electromyography (EMG) - CORRECT ANSWER Recording muscle activity induced by inserting needle electrodes into the muscles and passing electrical signals through them.
- Can use used to test for impending neurological muscle weakness
Eosinophils - CORRECT ANSWER Type of white blood cells. Increased levels in blood or sputum indicate allergic reaction, and perhaps Asthma. Level may decrease with steroid therapy.
Normally 1- 3% of WBC.
Extracorporeal Membrane Oxygenation (ECMO) - CORRECT ANSWER Procedure that supports the heart and lungs. Blood is removed from the body, passes though a membrane oxygenator which adds O2 and removes CO2, reheated, and returned to the patient. A roller pump provides support and control of circulation and perfusion. Used during open heart surgery and in an intensive care unit to provide temporary support to pts with severe cardiac and/or pulmonary pathologies, such as ARDS/ IRDS, PPHN, cardiomyopathy, or ventricular failure.
Corneal Reflex - CORRECT ANSWER Closure of eyelids resulting from direct corneal irritation.
Coronary Angiogram (Angiography) - CORRECT ANSWER Serial X-rays of the coronary arteries taken in rapid sequence following injection of a radiopaque substance.
Used to define the size, shape and patency of the blood vessels. May be useful in evaluating coronary blood flow following acute myocardial infarction.
Creatinine - CORRECT ANSWER Substance formed from the metabolism of creatine and found in the blood, urine, and muscle tissue. Measure in the blood as an indicator or renal function and may be a more accurate indicator than BUN.
Normal: 0.60 - 1.5 mg/dL
Creatinine Clearance - CORRECT ANSWER Measurement of the amt of creatinine present in a 24 hr urine collection. Useful indicator of renal function.
Normal: 90 - 120 mL/min
Culture and Sensitivity (C&S) - CORRECT ANSWER Sputum or blood samples are cultures in an appropriate medium for 24 hours, and then organisms present are identified. The organisms are then exposed to different antibiotics to evaluate their effectiveness. The results of these tests re generally not available for at least 48 hours.
D-Dimer - CORRECT ANSWER One of the fibrin degradation products (FDP) measurable in the blood after a clot has formed and is in the process of breaking down. May be indicated to determine the presence of a pulmonary embolus
Delee Suction Device - CORRECT ANSWER A suction device designed to remove meconium from the upper airway of a neonate. The operator provides negative pressure using his or her mouth.
Deep Pain Response - CORRECT ANSWER The pt's response to a painful stimulation, such as a sternal rub, pinching of the skin, insertion of a needle or catheter, etc. Lack of this response indicates a deep level of unconsciousness, anesthesia, or a neurologic deficit.
Dextrostix - CORRECT ANSWER A cellulose strip impregnated with enzyme reagents that gives approximate results for glucose concentration with one drop of whole or capillary blood. The strip changes color and is then compared to a reference color chart provided on the side of the bottle. Provides a rapid means of identifying hypo- or hyperglycemia but is not accurate enough for quantitative determination of glucose.
Drug Toxicology Screen - CORRECT ANSWER A blood test to identify the presence and amount of commonly abused drugs. Indicated during assessment of a pt with suspected drug overdose or ingestion of a toxic substance.
Echocardiogram
Echocardiography - CORRECT ANSWER A non-invasive diagnostic method of evaluating the structure and function of the heart using sound waves (ultrasound). May be indicated in neonates and children to determine the presence of a congenital heart defect. Also helpful in adults to determine the severity of valve pathologies (prolapse or stenosis), pericardial effusion, or acquired heart disease
Electroencephalography (EEG) - CORRECT ANSWER A recording of brain-wave activity obtained by placing electrodes on the head. The test is used to evaluate seizure disorders, brain stem disorders, and the presence of focal lesions. Also used during sleep studies (polysomnogram) to determine stages of sleep
Electrolytes
Serum Electrolytes - CORRECT ANSWER Measurement of the level of K+, Na, Cl-, Mg, Ca, HCO3-, in the blood. Indicated as a Basic Lab test in a stable patient
End Tidal CO2 Level (ETCO2 Level) - CORRECT ANSWER The partial pressure (or percent) of CO2 at the end of exhalation. Measured with a capnograph or capnometer and is a valuable, non-invasive way to monitor ventilation.
Normal:
25 - 35 torr
3 - 5 %
Esophageal pH Monitoring - CORRECT ANSWER Performed during esophageal manometry to determine gastroesophageal reflux
Gag Reflex
Pharyngeal Reflex - CORRECT ANSWER Stimulated by touching the soft palate or posterior pharynx. Tests the integrity of the vagus and glossopharyngeal nerves. One of the first reflexes to disappear in anesthetized pts or those suffering from myasthenia gravis or a drug overdose. Should not be evaluated in pts without an artificial airway bec the pt may aspirate.
Gastroesophageal Reflux Disease (GERD) - CORRECT ANSWER Backflow of stomach contents into the esophagus. The acidity of the gastric juices causes burning pain in the esophagus (heartburn). Aspiration of the gastric contents into the lungs may cause asthma-like symptoms.
Glucose Tolerance Test - CORRECT ANSWER A test of the body's ability to metabolize carbohydrates by administering a standard dose of glucose and measuring the blood and urine for glucose at regular intervals. Useful in diagnosis of diabetes.
Glasgow Coma Scale (GCS)
Glasgow Coma Score - CORRECT ANSWER The Glasgow Coma Scale is an assessment tool used in cases of traumatic brain injury. A scoring system for evaluating the severity of CNS involvement in head injury, which measures 3 parameters—motor response, verbal response and eye opening response—from 0 (brain death) to a maximum score of 15 for normal cerebral function. The Glasgow Coma Scale is used to estimate and categorise the probable outcomes of patients with brain injury based on overall social capability or dependence on others.
13-15 - Mild
9-12 - Moderate Disability
3-8 - Severe Disability (Coma)
Gram Stain - CORRECT ANSWER Microorganisms present in a sputum or blood sample are stained with a violet stain, followed by an iodine solution, decolorizing with alcohol or acetone, and then counterstained with safranin. Gram positive organism retain the violet stain while gram negative organisms appear pink. The results may be available in approximately one hour. Gram staining may be followed by C&S to identify the specific bacteria present and appropriate antibiotic therapy.
Grimace
Reflex Irritability - CORRECT ANSWER One of the components evaluated as part of the APGAR score in a neonate. Elicited by tactile stimulation or insertion of a catheter into the nares.
Heel Stick - CORRECT ANSWER Method of obtaining a blood sample from a neonate. Also called capillary sample or astrup
Holter Monitor - CORRECT ANSWER Portable recording device for electrocardiographic data while pt conducts normal daily activities. Useful for obtaining a record of cardiac electrical activity that would not be discovered by means of a static ECG.
Hyperbaric Oxygen Therapy
(HBO Therapy) - CORRECT ANSWER O2 therapy administered at greater than normal atmospheric pressure. Useful in treating decompression sickness (bends), CO poisoning, anaerobic infections, and to facilitate wound healing. Treatment is usually conducted at 2 - 3 atmospheres.
Slow for decompression, 2 ATM
Rapid for CO poisoning or infection, 3 ATM, 90 min TID/BID
Indirect Calorimetry - CORRECT ANSWER Uses measurements of O2 consumption (VO2), CO2 production (VCO2) and urinary N2 (UN) to calculate: RER, REE, RQ and Kcal. Used to assess the nutritional status of the patient.
Induce Vomiting - CORRECT ANSWER Causing the patient to vomit by administering syrup of ipecac. May be used to treat ingestion of certain types of poison or drug overdose.
Induced (Therapeutic) Hypothermia - CORRECT ANSWER A medical treatment that lowers a pt's body temp in order to help reduce the risk of ischemic injury to tissue following an episode of insufficient blood flow. These episodes may be due to cardiac arrest or stroke. Therapeutic hypothermia may be induced by invasive means, in which a catheter is placed int he inferior vena cava via the femoral vein, or by non-invasive means, usually involving a chilled water blanket or torso vest and leg wraps in direct contact with the pt's skin.
Inductive Plethysmography - CORRECT ANSWER A series of elastic bands placed around the chest to measure chest movement and breathing frequency. Used in sleep studies to monitor chest motion.
IgE Levels - CORRECT ANSWER IgE is an immunoglobulin (antibody) that attaches to the mast cell in the respiratory and intestinal tracts and has a major role in allergic reactions. About 50% of pts with allergies have elevated IgE levels.
Inotropic Agents - CORRECT ANSWER Drugs that increase the strength or force of contraction of the myocardium.
I.e: Digitalis and Digoxin
Intraocular Pressure - CORRECT ANSWER The internal pressure of the eye. It increases with physical stress and neurologic factors. It is time-consuming and generally not necessary for evaluating pts with respiratory or cardiac disease.
Intracranial Pressure (ICP) - CORRECT ANSWER Normal is 5-10 mm Hg
Pressure inside the head. ICP monitoring is useful for pts with neurological diseases or trauma to the head. Usually want to keep them hyperventilated with PCO2 of about 25 - 30 mm Hg
Intravenous Pyelogram (IVP) - CORRECT ANSWER An x-ray examinations of the kidneys, ureters and urinary bladder that uses contrast material injected into a vein
Jugular Vein Distention (JVD) - CORRECT ANSWER Enlargement of the jugular veins. It is normally present when the pt is in the supine position, but is considered abnormal when present with the patient in an upright position. May be a result of CHF, pneumothorax, or cardiac tamponade
Lactate Dehydrogenase (LDH) - CORRECT ANSWER An enzyme found int he cytoplasm of most body tissues. It is monitored as an indicator of anaerobic carbohydrate metabolism and as a serum indicator of myocardial infarction and muscular dystrophies. Serum levels generally rise 1 - 18 hours following myocardial infarction.
Lactate Levels - CORRECT ANSWER Generally increase in the presence of anaerobic metabolism. Can rise during intense exercise, shock, heart failure, and lung disease.
Normal: 4.5 - 19.8 mg/dL
Lactated Ringer's Solution - CORRECT ANSWER A solution for IV administration which contains glucose, electrolytes and other nutrients. USed interchangeably with normal saline for fluid administration during resuscitation
Lecithin/ Sphingomyelin (L/S) Ratio - CORRECT ANSWER Calculated by measurement of the amount of lecithin and sphingomyelin in amniotic fluid. Used to predict the degree of lung maturity of a fetus. An L/S ratio of 2:1 or greater indicates the lungs are mature enough to sustain life outside of the uterus
Liver Enzymes - CORRECT ANSWER Elevated levels of the following enzymes may indicate liver disease: AST, ALT, LDH
Lumbar Puncture (Spinal Tap) - CORRECT ANSWER Introduction of a needle into the subarachnoid space of the lumbar portion of the spinal column. The pressure of the CSF is measured and the CSF is sent to the lab for analysis. May be useful in diagnosing Guillain-Barre syndrome, which is characterized by elevated levels of protein in the CSF.
Lung Fluoroscopy - CORRECT ANSWER Projection of serial X-ray images of the lung directly onto a screen for visual examination. Has limited diagnostic value and requires a relatively large dose of radiation
M-Mode Echocardiography - CORRECT ANSWER Early echocardiography technique which uses a single scan line. Its high frequency response makes it excellent to measure valve operation and chamber motion
Magnetic Resonance Imaging (MRI) - CORRECT ANSWER Medical imaging that uses radiofrequency radiation as its source. Has limited application in diagnosing lung disease, but may be useful in identifying hilar lymph node enlargement and invasion of the chest wall by tumores. May be helpful in detecting edema and tumors in the brain.
Maxillomandibular - CORRECT ANSWER Concerning the maxilla & mandible
Mantoux Test - CORRECT ANSWER A tuberculin skin test that consists of intradermal injection of a purified protein derivative (PPD) of mycobacterium tuberculosis. Most reliable test for TB sensitivity. A positive test is determined when a hardened, raised red area appears 24 to 72 hours after injection.
Medroxyprogesterone (Provera) - CORRECT ANSWER A form of progesterone, which is a female hormone that helps regulate ovulation and menstrual periods. It is used to test abnormal menstruation, irregular vaginal bleeding, and also to prevent overgrowth of the lining of the uterus to possibly decrease the risk of cancer of the uterus in pts who are taking estrogen
Methemoglobin Level - CORRECT ANSWER Amt of hemoglobin in which the ferrous ion has been oxidized to the ferric state. There is almost always some methemoglobin present int he body; however the enzyme methemoglobin reductase keeps the level below 1%. The level may be increased by nitric oxide (NO) therapy or by ingestion of compounds containing nitrites.
Military Anti-Shock Trousers (MAST) - CORRECT ANSWER A garment designed to put external pressure on the lower extremities, keeping the blood volume in the pts abdomen and thorax. May be indicated in situation in which blood pressure is very low, such as in severe blood loss or high spinal cord injury.
Moro Reflex - CORRECT ANSWER Also called startle reflex, this is present in newborns in response t o any surprise, such as a loud noise. The normal response consists of flexion of the legs, drawing of the arms across the chest, and usually a brief cry.
Muller's Maneuver - CORRECT ANSWER A forced inspiratory effort against a closed glottis. Opposite of a valsalva maneuver [Show Less]