AMCA exam flashcards

Collection Tube Additives - EDTA and NA Citrate

anticlotting chemicals

Collection Tube Additives - Serum Separator gels

used to separate red blood cells and clotting factors from serum to maintain correct chemistry levels found in blood

Collection Tube Additives - Lithium Heparin

used as an anticlotting factor and preservative for some chemistry analysis

Collection Tube Additives - Sodium Fluoride

used to maintain glugose levels

Collection Tube Additives - Blood Culture Media

used to nourish microbes in blood culture tubes and bottles for identification and remediation of infections

Blood Collection Tubes - Red topped

No additive required. Commonly used for serum determinations in the following: Chemistry testing & Blood bank testing

Blood Collection Tubes - Blue topped

additive used is sodium citrate. Additive prevents coagulation by binding calcium; it is advised to draw 2 to 3 ml of blood in a tube without additives before drawing this tube; commonly used for coagulation tests/heparin therapy (PT, APTT, fibrinogen)

Blood Collection Tubes - Lavender and Pink topped

additive used is ethylenediaminetetraacetic acid (EDTA); additive binds the calcium needed for clot formation; commonly used for hematology testing (CBC, reticulocyte count) Used for ESR testing (Erythrocyte sedimentation)

Blood Collection Tubes - Dark(er) Green topped

additive used is Heparin, a natural anticoagulant that inhibits thrombin; commonly used for routine chemistry testing.

Blood Collection Tubes - Light Green topped

additive used is Lithium Heparin; this additive action is as an anticoagulant; not to be used for lithium levels; used for many chemistry tests

Blood Collection Tubes - Gray topped

additives used are sodium fluoride, a preservative that inhibits glycolytic action, and potassium oxalate, an anticoagulant that binds calcium; commonly used for glucose tolerance tests and lactic acid measurement

Blood Collection Tubes - Red/Gray (camouflage) topped

additives used are clot activator and serum gel separator; activator encourages clot formation while gel creates a barrier between the serum and the cells which prevents contamination of the serum; commonly used for chemistry and immunology testing

Blood Collection Tubes - Blood Culture tubes or bottles

microbial growth media; there are two major types: aerobic growth media and anaerobic growth media; there are also microbe specific tubes and bottles which are ordered by the provider

Blood Collection Tubes - Dark (Royal) Blue topped

additive is EDTA; EDTAQ inhibits clot formation; used for trace metal levels including lead

Smears

performed for visual examination of cells under a microscope; can be performed on blood (peripheral smear) and cervical epithelium (pap smear)

Snellen test

measures visual acuity which determines the amount of visual details at given distances on the Snellen eye chart

Ishyihara test

a color perception test that uses specialized color plates with numbers to assess for red-green color blindness

Tourniquet

a device used to make veins easier to find for venipuncturej; these non-latex bands usually measure .5 to 1 inch wide and 15 inches long

Vacutainer tubes

the most used tubes for laboratory blood collection, are color coded based on the presence of any additives within the tube. Anticoagulants, clot activators, and preservatives are a few of the additives that may be present in the tube.

Random Urine Specimens

collected for urinalysis; no special measures are needed; collected anytime

Midstream Specimen

also called a clean-voicded specimen or a clean-catch specimen; the perineal area is cleaned before the collected specimen is collected

24-hour Specimen

collected during a 24-hour period; urine is trypically chilled or refrigerated to prevent the growth of microbes

Urinalysis

a test used to identify components of the urine, is usually conducted on patients that are pregnant, have an illness, or are suspected of having abused an illegal substance

Sputum Specimens

sputum - not saliva - is tested usually due to disorders of the lungs, bronchi, etc.; studied for blood, microbes and abnormal cells

Stool Specimens

collected to identify any type of bacteria or virus that may be responsible for a patient experiencing diarrhea, abdominal pain or other related symptoms; must be collected in a clean, dry container and transported to the testing area in a container with a tightly fitted lid

Culture and Sensitivity

testing that refers to the process of cultivating a specimen in order to determine whether the developed organism is sensitive to antibiotics; the process begins with the collection of a direct specimen which is then cultivated in a special media, or agar; the special media functions to encourage the growth of present microorganisms in the specimen; when the growth of a microorganism is detected, the organism is tested against different antibiotics for sensitivity to antibiotics; an antibiotic is considered effective if it can stop or slow down the organism's growth in a controlled situation

Throat Culture

"performed on a patient to detect a disease-causing organism and determine an appropriate method of treatment; throat cultures are performed to identify bacteria that

Wound Culture

performed to identify the pathogen that is responsible for an infection of a patient's wound; specimens may be collected from animal bites, ulcers, and skin wounds; performed by swabbing the inside of a wound and placing the swab in a transport container

Special Procedures - 2-hour Post Prandial Glucose

(PP) means after a meal; glucose specimen is collected 2 hours after a patient eats a meal

Special Procedures - Glucose Tolerance Test

(GTT) is used to diagnose carbohydrate metabolism problems; patients must eat well balanced meals 3 days prior to the test and must fast at least 12 hours before the test; p[atients must drink glucose prior to testing and have 5 minutes to finish the drink; levels will peak within 30 minutes to an hour following glucose ingestion

Special Procedures - Lactose Tolerance Test

same procedures as GTT but the patient must drink lactose rather than glucose

Special Procedures - Bleeding Time Test

(BT) performed on the forearm and uses a blood pressure cuff inflated to 40 mm Hg; phlebotomists will use an automated incision device to puncture skin and will use filter paper to blot the blood drops; this is a timed test and phlebotomist will blot blood every 30 seconds until the patient stops bleeding

Special Procedures - Arterial Blood Gas (ABG)

most common site radial artery; use a Modified Allen Test to see if patient has adequate circulation; you must cleanse the site with alcohol and then clean with iodine; insert syringe needle at a 45-degree angle; when complete apply pressure for at least 3 to 5 minutes; this test is drawn in an inpatient setting and analyzed immediately after collection

Clinical Laboratories

an area in a healthcare facility where inpatient and outpatient diagnostic testing is conducted; certain areas of the medical laboratory are designated for clinical analysis, while others are for surgical and anatomical pathology analysis

Hematology Laboratory

this department deals with the handling of various blood specimens; tests performed in this department include WBC counts, RBC counts, hemoglobin, hematocrit (HCT), RBC indices, and platelet counts; the results of these tests indicate conditions such as dehydration, anemia, leukemia, and a wide variety of other diseases

Chemistry Laboratory

the most performed tests within this department include those for blood glucose levels, electrolytes (sodium, potassium, chloride), total protein etc.; the results of these tests can range from the confirmation of pregnancy to the presence of a liver disorder

Blood Bank Laboratory

this is the section of the laboratory where blood is collected, stored, and prepared for transfusion; it is essential for all staff members to comply with the standards for patient identification and specimen handling to ensure the safety of all the patients

Medical Record Formats

the way a medical recorde is organized is known as its format; two types of medical record formats are the source-oriented record and the problem-oriented record (POR)

Source-oriented records

used in most offices in the medical office for organizing a paper-based patient record; the documents in a source-oriented record are organized into sections based on the department, facility, or other source that generated the information

Problem-oriented medical record

are organized according to the patient's health problems, developed in 4 stages: establishing a database, compiling a problem list, devising a plan of action for each problem, following each problem with progress notes

Chronological Filing

system is based on dates; units are year, month, and day; most current date is filed first; most commonly used to file documents in a patient's chart

Reverse chronological order

the most recent document is placede on top or in front of the otherts, thus the oldest documents are on the bottom or at the end of that section

Alphabetic Filing

file the patient chart according to the spelling of the last name; if two or more patients have the same last name, then use the first name next followed by using the middle name

Numeric Filing

patients are assigned a number as they begin using the practice and their files are labeled as such; new patients are assigned the next number in order

Authentication

allows the healthcare worker to use the computer network with a password and a log in

Levels of Authorization

allow a computer network to have specific levels of authorization so that certain screens and certain functions are available onlyu to users with the correct level of authentication

Automatic logoff

all users should log out of the computer network when leaving the workstation; if the user forgets to log out, the software has a feature that automatically logs a user off after a predetermined amount of time

Firewall

a system that protects a computer network from unauthorized access from users on its own network or another network on the internet

Encryption

refers to a process by which electronic information is changed into an unreadable form that requires ther original encryption software to reverse the process

HITECH

The Health Information Technology for Economic and Clinical Health Act; increases the security provisions of HIPAA and adds increased financial penalties for privacy violation; requires notifications of patients for unauthorized use and unencrypted disclosure is PHI (patient health information); breaches involving more than 500 patients must be reported to federal agencies and sometimes local media

ECG Leads - VLL

Left leg between hip and ankle

ECG Leads - VRL

Right leg between hip and ankle

ECG Leads - VLA

Left upper arm

ECG Leads - VRA

Right upper arm

Chest or Precordial Leads

V1, V2, V3, V4, V5, and V6

Pericardium

the layer or sac that surrounds the heart

Myocardium

the middle layer of the heart; where the electrical conduction system is located which is responsible for the regulation and the pumping action of the heart as well as the conduction of electrical impulses that causes the myocardium to contract

Endocardium

th innermost layer of the heart

Epicardium

the outtermost, or top, layer of the heart

Pacemaker cells

also known as cardiac muscle cells; an essential part of the conduction system; can be characterized by any of the following terms: excitability, conductivity, contractility, and automaticity

Sinoatrial node (SA Node)

the sinoatrial node begins the electrical activity of the heart; it is located in the wall of the right atrium and generates an impulse that flows to the atrioventricular node; the SA node is also known as the natural pacemaker of the heart because it generates the heart's rhythmic contractions

Atrioventricular node (AV node)

this node is located between the atria, just above the ventricles; after the impulse reaches the AV node, the atria contracts and the impulse is then sent to the Bundle of HIS

Bundle of HIS

this structure, also known as atrioventricular, AV bundle, is located between the ventricles and splits into two branches, forming the right and left bundle branches, before sending the impulse to the Purkinje fibers

Purkinje fibers

these fibers are located in the walls of the ventricles; as the impulse flows through the Purkinje fibers, it causes the ventricles to contract

Artifacts

erroneous lines/squiggles that are not part of the electrical conductivity of the heart and may interfere with the heart tracings; common problems caused by artifacts are wandering baseline, flat line, marks not part of tracing, uniform or small spikes, and large or erratic spikes

Handwashing

the most important means of preventing the spread of infection; a routine procedure uses plain soap to remove soil and transient bacteria; hand antisepsis requires the use of antimicrobial soap to remove, iill or inhibit transient microorganisms; the proper amount of time to wash one's hands is 1 to 2 minutes

Barrier Protection (PPE)

Personal Protective Equipment; masks, goggles, face shileds, respirators, etc., provide a barrier against infection to the person wearing it; proper disposal will assist in slowing the spread of infection

OSHA

Occupational Safety and Health Adminstration; assists employers in providing a safe and healthy working environment for their employees; developed the Bloodborne Pathogens Standard which must be followed by any employee with occupational exposure to pathogens; went into effect in 1992 to reduce the ristk of exposure to employees exposed to infectious disease

Ultrasonic Cleaning

used for delicate items and thosde with moving parts; sound waves move through the cleaning solution to clean the item

Disinfection

a technique used to destroy many but not all pathogenic organisms such as spores; caustic chemicals are used to disinfect medical equipment that is not able to be autoclaved; instruments and equipment that are disinfected are used externally such as stethoscopes, reflex hamnmers or visual occlude; types of disinfectants include sodium hypochlorite (household bleach 1:10 soultion), alcohol, iodophors, glutaraldehyde, and formaldehyde

Asepsis

being free of disease-producing microbes

Medical Asepsis

the practice of removing or destroying pathogens and to prevent pathogens from spreading from one person or place to another

Surgical Asepsis

the practice that keeps items free of all microbes; sterilization is the process of destroying all microbes; contamination is the process of becoming unclean; germicides are disinfectants applied to the skin, tissues and non-living objects

Sanitization

the scrubbing of instruments with special brushes and detergents to remove blood, mucous, etc

Autoclave

a device that forces the temperature of steam above the boiling point of water to sterlize instruments and equipment; most microorganisms are killed in a few minutes at temperatures ranging from 130° C to 150° C

Microorganism

are tiny living plants or animals that cannot been seen by the naked eye; some microorganisms are bacteria, viruses, protozoa, fungi, and animal parasites

Infection

a condition in which the body is invaded by a pathogen

Pathogen

a disease producing microorganism

Modes of Transmission - Direct contact

occurs through skin-to-skin contact, kissing, and sexual intercourse

Modes of Transmission - Indirect transmission

the transfer of an infectious agent from a reservoir to a host by suspended air particles, inanimate objects (vehicles), or animate intermediaries (vectors)

Modes of Transmission - Airborne transmission

occurs when infectious agents are carried by dust or droplet suspended in air; airborne dust includes material that has settled on surfaces and become resuspended by air currents as well as infectious particles blown from the soil by the wind

Modes of Transmission - Vectors

mosquitoes, fleas, and ticks may carry an infectious agent through purely mechanical means or may support growth or changes in the agent and transmit to a human being

Modes of Transmission - Droplet spread

refers to spray with relatively large, short-range aerosols produced by sneezing, coughing, or even talking; droplet spread is classified as direct because transmission is by direct spray over a few feet, before the droplets fall to the ground

Modes of Transmission - Vehicle

include food, water, biological products (blood), and fomites (inanimate objects such as handkerchiefs, bedding, or surgical scalpels); a vehicle may passively carry a pathogen. The vehicle may provide an environment in which the agent grows, multiplies, or produces toxin

Antiseptic

an agent that functions to kill or inhibit the growth of microorganisms

Standard Precautions

a set of infection control practices used to prevent transmission of diseases that can be acquired by contact with blood, body fluids, non-intact skin (including rashes), and mucous membranes; these measures are to be used when providing care to all individuals, whether they appear infectious or symptomatic

Transmission-Based Precautions

the second tier of precautions is to be used when the patient is known or suspected of being infected with contagious disease; to be used in addition to standard precautions; in all situations, whether used alone or in combination, using the utmost care regarding patient and employee is crucial; transmission based precautions are contact precautions, airborne precautions, and droplet precautions

Contact Precautions

Infectious agents (bacteria, viruses or parasites) transmitted directly or indirectly from one infected or colonized person to a susceptible host (patient), often on the contaminated hands of a health worker

Airborne Precautions

are designed to reduce the nosocomial transmission of particles 0.001mm or less in size that can remain in the air for several hours and be widely dispersed; special air handling and ventilation are required to prevent airborne transmission

Droplet Precautions

reduce the risks for nosocomial transmission of pathogens spread wholly or partly by droplets larger than 0.001 mm in size; pathogens are microbes that can cause disease; are simpler than airborne precautions because the particles only remain in the air for a short time and travel only a few feet; therefore, contact with the source must be close for a susceptible host to become infected

Nosocomial infections

any infection that first occurs during a patient's stay at a healthcare facility, regardless of whether it is detected during the stay or after; usually transmitted to the patient by a healthcare worker; best method of preventing the spread is proper hand washing techniques

Professionalism

behavior based on a body of knowledge and ethical standards to serve the public

Medical Assistant's Ethical Responsibilities

to admit mistakes, stay within his/her training and legal scope of practice, maintain confidentiality, stay current and uphold the honor of the profession

Ethics

the knowledge of what is right conduct versus what is wrong conduct

Closed questions

questions that give a yes or no response

Open-ended quesitons

questions that encourage the patient to provide more information

Direct statements

a helpful way to get a response from a patient without feeling questioned (example: Tell me about your pain.)

Non-verbal communication

also known as body language, includes body posture, position, gestures, facial expressions, and intonation

Grammar

a term for the accepted rules to create meaningful sentences in a language

Problem list

list of major problems facing the patient that may be contributing to the patient's medical condition; problems can include: physical symptoms, social, emotional, or financial difficulties