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20 Cards in this Set

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The Bruce protocol is used to perform a/an:
A EGD.
B ENG.
C treadmill stress test.
D EEG.
C treadmill stress test.
The Bruce protocol specifies the progressively increasing speeds and increasing elevation of the walking platform that is used to perform a treadmill stress test.
Transferrin is:
A an enzyme used in digestion.
B a neurotransmitter.
C a serum protein which carries iron in the blood.
D a serum protein which carries copper in the blood.
C a serum protein which carries iron in the blood.
The term transferrin comes from trans meaning to move across and ferrum, which is Latin for iron. By itself, iron cannot move from the water-soluble environment of the blood across the fat-soluble membrane of cells, so it must be bound to a protein molecule called transferrin in order to pass from the blood into the cells where it is used or stored. This same concept is used for many biological substances that must be transported through the blood such as copper (bound to ceruloplasmin) and fats (bound to lipoproteins).
"IMAGING STUDIES: AP, lateral and oblique views of the right foot are negative for fracture, dislocation or sign of _______ injury. AP, lateral and mortise views of the ankle are negative for any fracture or signs of widening of the _______ or syndesmosis. AP and lateral views of the right tib/fib show an intermedullary nail in place. There is a midshaft tibia fracture as well as a fracture at the junction of the middle and distal third of the fibula, which are now completely healed in an acceptable alignment."

Which of the following would correctly fill in the blanks?
A blank 1-metatarsal, blank 2-carpal tunnel
B blank 1-Lisfranc, blank 2-mortise
C blank 1-left flank, blank 2-mortis
D blank 1-metacarpal, blank 2-carpal tunnel
B blank 1-Lisfranc, blank 2-mortise
Lisfranc refers collectively to the tarsometatarsal joints, or the three synovial spaces between the tarsal and metatarsal bones in the midfoot. The mortise is the articular space created by the distal ends of the tibia and fibula (lateral and medial malleoli) and the talus (the ankle bone). Answer B includes the homonym mortis, which means death. Answers C and D are excluded because metacarpal bones and the carpal tunnel are located in the hand.
A TORCH titer is often performed on patients who are:
A pregnant.
B suffering from pneumonia.
C suffering from dementia.
D severely burned.
A pregnant.
TORCH is the acronym formed by Toxoplasmosis, other infections, rubella, cytomegalovirus, herpes simplex virus. Pregnant women are tested for these infectious agents, because an active infection during pregnancy can cause birth defects. The concentration (titer) of antibodies found in the serum indicates past or present exposure. See also explanation of immunoglobulins under question #5.
The echocardiogram showed a small ______ effusion. Which of the following will complete this sentence?
A plural
B mural
C dural
D pleural
D pleural
The correct spelling is pleural. The homonym plural means more than one. The pleura is the serous membrane enveloping the lungs and lining the walls of the pleural cavity. A pleural indicates possible left-sided heart failure. When the left side of the heart is not pumping adequately, fluid backs up into the lungs. The increased fluid pressure in the lungs forces fluid through the capillary spaces of the lung and into the pleural space.
Laboratory values show chronically elevated ALT and AST. The patient will be scheduled for a biopsy to rule out _______. Which of the following best completes this sentence?
A xerosis
B cirrhosis
C cheilosis
D sclerosis
B cirrhosis
The enzymes ALT and AST are primarily associated with liver cells. Chronic elevations of these enzymes indicate liver cell death. Cirrhosis is characterized by loss of functional liver cells and an increase in fibrous, nonfunctional tissue. Xerosis refers to pathologic dryness of the skin or mucous membranes. Sclerosis is characterized by a hardness or thickening caused by excessive formation of connective fibers, especially in arterial walls or within the nervous system. Cheilosis is characterized by scaling and fissuring of the lips.
The class of drugs called bisphosphonates is used to treat:
A osteoporosis.
B elevated cholesterol.
C diabetes.
D hypertension.
A osteoporosis.
Although bone may be thought of as static or inactive, it is actually very dynamic. In a process called resorption, osteoclasts actively breakdown bone cells and release bone minerals (calcium, magnesium, and phosphates) into the blood stream to help regulate the levels of these minerals in the blood. Bisphosphonates inhibit the activity of the osteoclasts, therefore slowing down resorption of bone cells. In childhood, formation of bone happens at a greater rate than resorption, but as we age, resorption outpaces formation, resulting in osteopenia (reduction of bone cells) and osteoporosis (pathologic reduction in bone cells). Examples of bisphosphonates include etidronate (Didronel), pamidronate (Aredia), alendronate (Fosamax).
The root word ptosis means:
A programmed cell death.
B a bony projection.
C a sinking down or prolapse of an organ.
D a rounded swelling, especially one that is caused by a contracting muscle.
C a sinking down or prolapse of an organ.
Answer A, a rounded swelling, is the definition of a torus. Answer B, programmed cell death, is the definition of apoptosis, and answer C, a bony projection, is an exostosis.
"The patient has been suffering traumatic falls of unclear etiology. This does not sound cardiovascular given the lack of other concomitant symptoms." In this context, concomitant means:
A recurrent.
B preexisting.
C resultant.
D concurrent.
D concurrent.
Concomitant (kun-kom'-i-tunt) means associated, affiliated, concurrent or parallel. This word is often dictated in medical reports and can be difficult to hear clearly.
The discomfort in his chest is not ________ by exertion, but neither is it relieved with rest. Which of the following best completes this sentence?
A exacerbated
B exonerated
C exasperated
D eliminated
A exacerbated
Exacerbate means to worsen or aggravate. It is often confused with the word exasperate, which means to irritate or annoy. In this context, eliminate would not be appropriate since the phrase "but neither is it relieved" infers an opposite effect, and eliminate and relieve are not necessarily opposite in meaning.
Which of the following is transcribed correctly?
A The gram stain showed gram-positive cocci consistent with Staphylococcus.
B The Gram stain showed Gram-positive cocci consistent with staphylococcus.
C The patient was treated for Gram-positive cocci, later confirmed to be staphylococcus.
D The patient was treated for gram-positive cocci, later confirmed to be Staphylococcus aureus.
D The patient was treated for gram-positive cocci, later confirmed to be Staphylococcus aureus.
Gram stain is an eponym and should be capitalized. Like other eponyms, the adjective form of the eponym is not capitalized; therefore the compound adjective gram-positive is not capitalized. Genus names are always capitalized when listed with the species name, while the species name is never capitalized. Genus names are not capitalized when used in the vernacular (strep throat), when written without a species name (rule out klebsiella) or when used as an adjective (streptococcal pharyngitis).
"IMAGING STUDIES: AP, lateral and oblique views of the right foot are negative for fracture, dislocation or sign of _______ injury. AP, lateral and mortise views of the ankle are negative for any fracture or signs of widening of the _______ or syndesmosis. AP and lateral views of the right tib/fib show an intermedullary nail in place. There is a midshaft tibia fracture as well as a fracture at the junction of the middle and distal third of the fibula, which are now completely healed in an acceptable alignment."

Which of the following terms is transcribed incorrectly in the above passage?

A intermedullary
B midshaft
C syndesmosis
D mortise
A intermedullary
The correct term is intramedullary. As with all terms which begin with the prefixes inter and intra, special care must to be taken to choose the correct prefix based on the context and accepted terminology. It is nearly impossible to distinguish these prefixes on the basis of their pronunciation alone. An intramedullary nail is used to stabilize a bone while it heals a fracture. The nail goes through the cortical bone into the marrow or intramedullary space. Intermedullary would not be correct, since this would imply a nail which connects two medullary spaces. Also note that intermedullary will not pass a spell check. One might also hear inner medullary, but the word inner indicates a relative position that is farther toward the center. That would imply the possibility of two medullary nails-one in outer medulla and one in the inner medulla.
Which of the following is transcribed correctly?
A The patient was told to lay down and put her feet up.
B Please lie the chart on the table.
C The patient was laying on the table.
D The patient was asked to lay her hand on the support.
D The patient was asked to lay her hand on the support.
The verbs lay and lie are often quite confusing. The verb lay means to place or put and always requires an object. For example, in the phrase "lay the book," lay is the verb and "the book" is the object. Asking the question what? immediately following the verb will help you decide if it takes an object or not, e.g., lay what? the book. The verb lie, on the other hand, means to recline or stay at rest. It does not take an object. To determine which verb to use, ask the same question--lie what? In the phrase, "lie on the table," there is no answer to the question lie what? The prepositional phrase "on the table" tells where to lie, but not what to lie. Use of these verbs is further complicated by the fact that their conjugated forms overlap.
The following is an example of what type of sentence? "Although there are minimal soft-tissue pads, the stump appears to be intact without erythema or infection."
A complex
B simple
C compound
D incomplete
A complex
A simple sentence has one independent clause (a noun and a verb) and represents a complete thought (Mary ran.) A compound sentence consists of two independent clauses such as Mary ran, and I watched. A complex sentence contains one independent and at least one dependent clause. Many people have trouble distinguishing dependent and independent clauses. Dependent clauses technically are missing either a subject or a predicate, but often they are easy to spot because they leave you hanging, waiting for more information. For example, the phrase although there are minimal soft-tissue pads gives you the feeling that something else is about to be said, it is not a complete thought. The length of the clause is not a reliable indicator of complete or incomplete thoughts, because extraneous phrases such as prepositional phrases (on the floor, toward the tree) and appositives (explanatory phrases that describe the noun immediately preceding it such as [John,] my sister's husband) can add to the length of a clause but do not make them a complete thought.
Cystoscopy showed irritation of the bladder wall with normal _____ from both ureters. Which of the following will complete this sentence?
A reflex
B reflect
C reflux
D efflux
D efflux
Efflux describes something given off, as in a stream. When viewing the inside of the bladder, urine can be seen streaming out of the ureters as an efflux. In contrast, reflux means to flow back or return, so urine passing from the bladder back up the ureters, as in vesicoureteral reflux, would not be described as "normal."
Which of the following means (scant/little) + (month) + (flow)?
A menstruation
B dysmenorrhea
C amenorrhea
D oligomenorrhea
D oligomenorrhea
All of these words use the root word men which is Latin for month. This root word is used in reference to the hormonal cycling of the reproductive system because of its characteristic 28 to 29-day cycle (the length of a month). The prefix oligo means scant or small. The suffix -rrhea means a flow or flux. Oligomenorrhea literally means scant monthly flow. The prefix a means not or without and dys means bad or difficult, so amenorrhea is an absence of flow and dysmenorrhea refers to painful or difficult flow.
Which of the following is transcribed correctly?
A None of these are correct.
B The patient was noted to have ectopic beats on his most recent EKG, most likely PACs.
C The patient was noted to have atopic beats on his most recent EKG, most likely PACs.
D The rash covering his upper thigh and buttocks was thought to be ectopic dermatitis.
B The patient was noted to have ectopic beats on his most recent EKG, most likely PACs.
The terms atopy and ectopy (and their conjugated forms ectopic and atopic) may be difficult to discriminate when dictated, but the context will easily clarify the intended word. Atopy refers to a genetically inherited allergy which is often expressed as a rash, asthma or hay fever. Ectopy refers to a displacement or malposition, and in the context of the heart, describes a beat that does not originate from the sinoatrial node. These extra beats are often benign.
The physician dictates, "Her CMV IgM and IgG were negative." The patient was being evaluated for:
A cardiovascular disease.
B liver disease.
C past and/or present infection.
D allergies.
C past and/or present infection.
The patient is being evaluated for exposure to CMV (cytomegalovirus). The immunoglobulins IgG and IgM, commonly known as antibodies, are produced in response to foreign proteins (antigens such as a virus or bacteria. Antibodies are very specific. They fit with their corresponding antigen like a lock and key, making it possible to identify the antibody using specific laboratory tests. The immunoglobulin IgM is the first type of antibody to appear in the serum. IgG appears later in the course of the infection and remains in the serum, often for the remainder of the patient's life; although the concentration (titer) can fall extremely low after 10 or more years (hence the need to revaccinate for tetanus). A negative test for both classes indicates no exposure; a positive test for IgM indicates active infection; a positive test for IgG indicates past exposure and immunity; a positive test for IgM and IgG indicates the late phase of a current infection.
Factor VIII, factor IX and antithrombin III are:
A digestive enzymes.
B clotting factors.
C assessed to diagnose myocardial infarction.
D nutritional supplements.
B clotting factors.
The coagulation mechanism utilizes a dizzying number of factors to initiate, stop and otherwise modulate the clotting of blood. Hemophilia A is caused by an inherited deficiency of factor VIII, which prevents the blood from clotting. This disease primarily affects males because the gene which encodes for factor VIII is carried on the X chromosome. Unlike females who carry two X chromosome, males do not have a second X chromosome to compensate for the deficient gene. Hemophilia B, also called Christmas disease, is caused by an inherited deficiency of factor IX and has symptoms similar to hemophilia A. Antithrombin III has a regulating effect on the coagulation system, and a lack of antithrombin III will cause an increase in clotting activity, leading to clotting disorders such as recurrent vein thromboses or pulmonary embolism.
Which of the following means (many) + (shapes) + (nucleus)?
A trimorphism
B polymorphonuclear
C isomorphous
D multinucleosis
B polymorphonuclear
The root word morph means shape or form. The prefix iso- means same, therefore isomorphous describes two things that are shaped the same. Trimorphism describes an object that can take on three different shapes or forms. The term polymorphonuclear most often refers to a class of white cells, sometimes dictated as PMNs. This class of white cells includes those that have a multi-shaped nucleus as opposed to a single, rounded nucleus characteristic of mononuclear cells (monocytes and lymphocytes). Segmented neutrophils (often called "segs") are an example of PMNs. The nucleus of mature "segs" is broken into pieces or segments that resemble a string of sausages. Other white cells in this class of PMNs include basophils and eosinophils.