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106 Cards in this Set
- Front
- Back
blood test that provides information on liver and kidney function as well as electrolytes
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CMP
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What test is good for monitoring and diagnosing DM?
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glucose
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What two parameters for blood sugars signify a diagnosis of DM?
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fasting >126 and two hours after glucose load >200
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what four components within the CMP make up the electrolyte panel?
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K+, Na+, Cl, CO2
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Which four components of the CMP tell about liver function?
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ALT, AST, ALP, Bilirubin
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What does creatinine tell you about a patient?
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it diagnosis impaired renal function, and is a catabolic product of creatine phosphate from skeletal muscle.
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Liver problems do not affect BUN. True or False
Total Protein is a combination of? |
False, liver problems can minimally affect BUN
GAP-Globulins, Albumin, Prealbumin |
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where is albumin formed? and what does it do?
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in the liver and it makes up 60% of the total protein, albumin's main purpose is to maintain colloidal osmotic pressure in the blood.
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Increased albumin levels can mean...
Decreased albumin levels can mean... |
patient is dehydrated
liver disease, hepatitis, cirrhosis, hepatocellular necrosis and malnutrition |
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which lab finding is used to evaluate & monitor fluid and electrolyte balance and therapy?
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Sodium (Na+)
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Which lab finding within the CMP is especially important for persons taking diuretics and heart medications?
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Potassium (K+)
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Which electrolyte is important in maintaining membrane electrical potential ie neuromuscular cells.
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K+
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Which serum electrolyte is a major extracellular anion, serves as a buffer to assist in acid base balance and affects water balance?
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Chloride
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What can an increased chloride level mean?
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Dehydration
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Increased levels of CO2 signify ...
What can a decreased chloride level mean? |
metabolic acidosis, ketoacidosis
overhydration |
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If a pt presents with jaundice and you order a CMP and it comes back with normal ALT, what could be going on with this pt?
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RBC hemolysis
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If the same patient has a elevated ALT and jaundice, what could it signify?
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hepatitis, hepatic necrosis, liver failure
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Used to monitor and identify hepatocellular diseases.
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ALT alanine aminotransferase
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Used in the evaluation of suspected coronary artery occlusion and or hepatocellular disease.
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AST aspartate aminotransferase
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This enzyme is found in highly metabolic tissue like heart tissue, liver cells and skeletal muscle.
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AST apartate aminotransferase
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The higher the level of AST in the blood the greater amount of _______________________.
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damage has been done to cells.
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used to evaluate hemolytic anemias in adults and jaundice in neonates
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bilirubin
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used to detect and monitor diseases of the liver and the bone and is increased in intra and extrahepatic disorders
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ALP alkaline phosphatase
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Most sensitive test for Liver Cancer
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ALP alkaline phosphatase
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increased ALP can be caused by:
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primary cirrhosis, biliary obstruction, primary or metastatic liver tumor, childhood and fracture repair
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WHich two test are used to detect inflammation? Which one is more specific?
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Erythrocyte Sedimentation rate (ESR) and C-reactive protein (CRP). CRP is more specific.
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Which one of the CRP or the ESR is believed to be of value in predicting coronary events?
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CRP is also used in evaluating a pt with a MI
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AN acute phase protein used to indicate an inflammatory illness?
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CRP
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A nonspecific test used to detect acute and chronic inflammation
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ESR-sometimes not elevated in the face of active disease.
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what process of collecting urine would be appropriate for an uncomplicated (no fever) UTI?
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midstream clean catch
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Red cell clasts in the urine sediment are associated with what pathologic process?
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Glomerulonephritis
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A urine specific gravity of 1.001 (normal 1.005-1.025) indicates what condition?
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concentrated urine, dehydration
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using a urine sample, what finding in the urine would signal kidney damage the most?
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proteinuria
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Urinary sediment containing calcium oxalate and uric acid crystals might signal?
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Renal stone formation
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what lab test can differentiate between jaundice and RBC hemolysis?
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ALT
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A patient on diuretics needs to have what electrolyte measured often?
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Potassium (K+)
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What lab test can monitor hyperparathyroidism, renal failure and or renal transplant?
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Calcium
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Name two non-specific lab test indicators for infection:
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CRP and ESR
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define cretinism and its common physical presentations:
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cretinism-severe hypothyroidism causing under development and possible mental retardation and goiter.
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thyroiditis and hypothyroidism occurs when the TSH is low or high?
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high
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High levels of T4 can also be a seen with acute thyroiditis. T or F
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True
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Hypothyroidism occurs when the T4 level is increased or decreased
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decreased
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which test measures the average amount of glucose in the blood in the previous 3-4 months?
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A1c (HbA1c)
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post splenectomy patients are more apt to have increased or decreased A1c's?
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increased
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name the systolic murmurs:
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-Congenital pulmonic stenosis, -Congenital aortic stenosis, -Innocent murmurs,
-Mitral regurgitation (insufficiency), -Tricuspid regurgitation. (insufficiency), -Ventricular septal defect |
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name the diastolic murmurs:
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-mitral stenosis and
-aortic regurgitation |
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What is a Systolic murmurs:
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systolic murmur - a heart murmur that occurs during a heart muscle contraction. Systolic murmurs are divided into ejection murmurs (due to blood flow through a narrowed vessel or irregular valve) and regurgitant murmurs.
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What is a diastolic murmur:
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diastolic murmur - a heart murmur that occurs during heart muscle relaxation between beats. Diastolic murmurs are due to a narrowing (stenosis) of the mitral or tricuspid valves, or regurgitation of the aortic or pulmonary valves.
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An abnormal heart sound (murmur) resulting from pulmonary or aortic congestion:
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systolic murmur
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audible systolic murmur heard best in the 2nd right ICS and often radiates to the carotids:
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aortic stenosis
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a diastolic rumbling murmur heard best at the apex and after pt is positioned on their left lateral decubitus position?
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aortic regurgitation
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leaning forward and exhaling while listening at the 2nd RICS would make which murmur louder?
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MItral
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What is happening during S2?
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aortic valves are closing
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What is happening during S1?
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Mitral valve closes
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Which heart sound is heard best at the base of the heart?
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S2
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Lying in the lateral decubitus position accentuates what type of murmur?
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Mitral Murmurs
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holosystolic murmur occurs:
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begins with S1 and is continuos until the end of S2
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a holosystolic murmur that can be heard at the apex and radiates to the left axilla:
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mitral regurgitation
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a diastolic mumur that has a decrescendo, low-pitched rumble heard best with the bell:
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mitral stenosis
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S3 and S4 are heard best with the bell or diaphragm?
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bell
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hematocrit is used in evaluating what:
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Circulating RBC's by %
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test used to measure the total blood volume that is made up of RBC's?
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(MCV) Mean Corpuscular Volume
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If hemoglobin is 15, then hematocrit would be__________________?
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45% (#x3)
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test used to measure if bone marrow is functioning in a response to an anemia?
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Reticulocyte count
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When MCV is decreased, how are the RBC's described?
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microcytic
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hypochromasia is seen in RBC's when MCHC is increased or decreased?
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decreased MCHC
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Which WBC type is elevated during a viral infection?
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Lymphocytes
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An increase in immature neutrophils represents:
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a shift to the left
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band or stab cells in the peripheral circulation indicate what clinical problem?
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a bacterial infection
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Which WBC is elevated in an allergic reaction?
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Eosinophils
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Lab test to evaluate the adequacy of the extrinsic system of the coagulation cascade?
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Prothrombin time (PT)
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Lab test to evaluate the adequacy of the intrinsic system of the coagulation cascade?
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Partial thromboplastin tie (PTT)
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Troponin T & I
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an important indicator of cardiac muscle injury
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Creatine Kinase:
(What is it for.) |
used to diagnose myocardial muscle injury, but also can indicate neurologic or skeletal muscle disease.
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HDL when increased is associated with a decrease in CAD. T or F?
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True
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What test in the lipid profile is elevated during pregnancy?
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Triglycerides
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BNP is used to evaluate the progression of which clinical condition?
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CHF
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When does troponin T levels return after an acute increase?
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10 days
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Cotton Wool patches typically present:
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are ovoid lesions with irregular soft borders that result from infarcted nerve fibers and are seen with HTN.
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Papilledema occurs most often from what condition?
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Venous Stasis
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Glaucomatous cupping occurs most often from which condition?
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Hypertension-increased pressure within the eye.
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What is the first step to performing a funduscopic exam?`
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turning off the lights
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absence of a red reflex is indicative of what?
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Lens opacities
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how far away does Bates state you should be when first examining a pt with your ophthalmoscope?
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15 inches
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WHere is the fundus of the eye located?
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in the posterior portion of the eye
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described as undigested cellular debris in the eye that can sometimes be mistaken for cotton wool spots
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Drusen
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Where within the eye would you look for A/V nicking?
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on the retina
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what is the difference between a thrombosis and thrombophlebitis?
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thrombosis-a clot formation deep within a vein. thrombophlebitis- a clot formation and acute inflammation in a superficial vein.
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what angle should the catheter of an IV be during insertion?
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15-30 degrees
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which vein is the largest and least painful for IV insertion?
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Median cubital vein
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WHich test in a lipid profile, when increased is associated with CAD
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Low density lipids LDL's
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Which test is used to determine MI's directly after onset of a potential MI?
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Troponin T&I
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What is a split S2?
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a delay in the pulmonic valve closure, when both pulmonic and aortic valves should close at the same time (s2), resulting in the pulmonic valve closure splitting the aortic valve closure and causing a split sounding S2.
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the difference between systolic and diastolic?
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systole is pumping and diastole is filling
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pulmonic valve murmurs are usually best heard where?
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2nd and 3rd ICS but sometimes at higher or lower levels.
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describe decrescendo:
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one with an intensity that gradually decreases. Heard during diastole in aortic or pulmonary valvular insufficiency.
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describe crescendo
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one marked by progressively increasing loudness
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displacement of PMI lateral to the midclavicular line or greater than 10 cm lateral to midsternal line suggests:
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Left ventricular hypertrophy.
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which valves make up the semilunar valves?
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aortic and pulmonic
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which valves make up the atrioventricular valves?
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tricuspid and mitral
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closure of the mitral valve produces: S1 or S2?
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S1
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closure of the aortic valve produces S1 or S2?
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S2
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Murmur that usually disappears when patient sits up
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innocent murmur
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Where do systolic and diastolic murmurs present in regard to S1 and S2?
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-systolic murmurs present between S1 and S2 and
-diastolic murmurs present S2 and S1. |
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Murmurs that coincide with carotid upstroke are systolic. T or F
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True
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high levels of creatine kinase may signify:
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muscle trauma and can be increased with heavy work out regimine.
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