Certified Medical Assistant (CMA AAMA) flashcards

When point-of-care control results fall outside the acceptable range, testing must stop and the device retested with fresh reagents/controls before patient use resumes.

• Never use a device on patients after failed QC
• Repeat with new control solution and new strip/cartridge
• Document QC failures and corrective actions per CLIA requirements

Memory trick: 'Failed control? Stop, swap, and retest before you test the rest.'

Reversing the right arm and left arm electrodes causes a global inversion of the P wave, QRS complex, and T wave in lead I, mimicking a cardiac abnormality.

• Lead I records between RA and LA electrodes
• Reversal inverts the entire waveform in lead I
• Should be ruled out before suspecting dextrocardia

Memory trick: Everything flipped in lead I? Arms got swapped, not the heart.

Body Mass Index using imperial units is calculated as (weight in pounds × 703) divided by (height in inches squared).

• Formula: (lb × 703) / in²
• BMI 18.5-24.9 = normal weight
• BMI 25-29.9 = overweight

Memory trick: Multiply by 703, divide by height squared

The average pressure in a patient's arteries during one cardiac cycle, reflecting perfusion of vital organs.

• Formula: MAP = DBP + 1/3(SBP − DBP)
• Normal MAP range: 70–100 mmHg
• A MAP below 60 mmHg risks inadequate organ perfusion

Memory trick: 'Diastolic plus a third of the difference.'

Standing height is measured with the patient shoeless, standing erect against a stadiometer with heels, buttocks, and shoulders touching the surface.

• Remove shoes and bulky headwear
• Patient looks straight ahead (Frankfort plane)
• Measurement taken at top of head with headpiece lowered

Memory trick: Shoes off, back flat, look straight ahead like standing at attention.

Normal respiratory rate for infants aged 0-12 months ranges from approximately 30-60 breaths per minute, higher than adult norms.

• Adult normal RR: 12-20 breaths/min
• Infant normal RR: 30-60 breaths/min
• Rates decrease with increasing age toward adulthood

Memory trick: Babies breathe faster—small lungs need more breaths per minute.

Special antisepsis and technique requirements for blood cultures to prevent false-positive results from skin flora.

• Use chlorhexidine or iodine-based antiseptic, not alcohol alone
• Allow antiseptic to fully air dry before puncture
• Avoid repalpating the site after skin prep; blood cultures are drawn first in order of draw

Memory trick: 'Let it dry before you pry (the needle in)'

The radial pulse is palpated at the lateral, thumb-side aspect of the anterior wrist over the radial artery.

• Most commonly used site for routine pulse checks
• Palpate with pads of fingers, not thumb
• Assess rate, rhythm, and volume

Memory trick: Radial = thumb side of wrist, like a ring on the thumb hand.

Family history documents health conditions of blood relatives, while past medical history documents the patient's own prior diagnoses, surgeries, and hospitalizations.

• Family history identifies hereditary risk factors
• Past medical history covers patient's own past illnesses/surgeries
• Social history covers lifestyle, occupation, habits

Memory trick: Family tree, personal story

Proper storage procedures for urine specimens to maintain accuracy of urinalysis results when testing is delayed.

• Test within 1 hour of collection or refrigerate
• Refrigeration slows bacterial growth and pH changes
• Delayed, unrefrigerated urine gives false results (e.g., increased pH, bacteria)

Memory trick: 'One hour or in the cooler' for urine samples

Lead II is the standard EKG lead used for continuous rhythm monitoring because it usually shows the clearest, most upright P wave for assessing cardiac rhythm.

• Standard lead for rhythm strips
• Provides clearest P wave visibility
• Runs from right arm to left leg electrode

Memory trick: 'Lead II is the rhythm king, clearest P wave every time'

The process of assessing a caller's symptoms by phone to determine the urgency of needed care, escalating to emergency services when life- or function-threatening signs are present.

• Stroke signs: sudden weakness, slurred speech, facial drooping (FAST)
• Time-sensitive symptoms require immediate 911 referral
• Never delay emergency referral for scheduling or self-care advice

Memory trick: 'FAST symptoms mean call fast—dial 911.'

A patient position with the head of the exam table elevated to about 45 degrees, often used for patients with breathing difficulty.

• 45-degree head elevation
• Eases respiratory effort
• Distinct from full Fowler's (90 degrees)

Memory trick: Semi means half—half of 90 is 45.

Using an incorrectly sized BP cuff causes measurement error: too small overestimates, too large underestimates blood pressure.

• Cuff bladder width should be ~40% of arm circumference
• Too small cuff = falsely high reading
• Too large cuff = falsely low reading

Memory trick: Small cuff, big number

A systematic series of questions organized by body system used to identify symptoms the patient may not have mentioned in the chief complaint.

• Organized by system: HEENT, cardiovascular, respiratory, GI, etc.
• Distinct from HPI, which focuses only on the current complaint
• Helps uncover additional relevant clinical information

Memory trick: ROS = Review Of Systems, checking the body from head to toe like a checklist.

A temporary disappearance of Korotkoff sounds during blood pressure measurement, occurring between the true systolic and diastolic pressures, common in patients with hypertension.

• Can cause falsely low systolic reading if cuff isn't inflated high enough
• More common in patients with hypertension or arterial stiffness
• Palpate radial pulse first to estimate true systolic pressure and avoid missing it

Memory trick: Gap = the sound goes silent then returns, like a radio losing signal briefly.

Schedule III–V prescriptions may be refilled up to five times within six months of the original prescription date.

• Examples of Schedule III: codeine combinations, anabolic steroids
• Differs from Schedule II which allows no refills
• Applies uniformly to Schedules III, IV, and V

Memory trick: 'Three to Five: refill five times in six'

Gauge number is inversely related to needle diameter; lower numbers indicate larger bore needles suited for viscous or larger-volume medications.

• 18-20 gauge: drawing up medication or thick solutions
• 21-23 gauge: standard IM injections
• 25-27 gauge: subcutaneous or intradermal injections

Memory trick: 'Lower gauge, bigger hole, thicker flow'

A pediatric pain assessment tool using a series of facial expressions ranging from happy to crying, allowing children to indicate pain level without needing numeric literacy.

• Used for children ages 3 and older
• Faces range from smiling (no pain) to crying (worst pain)
• Alternative to numeric scales for nonverbal or young patients

Memory trick: Faces speak when words can't

Sequence for filling microcollection tubes during capillary puncture: blood gases first, then EDTA (hematology), then other additive tubes, then serum/chemistry tubes.

• Differs from venous order of draw
• Blood gases collected first due to air sensitivity
• EDTA tube next to prevent microclot formation
• Serum/chemistry tubes collected last

Memory trick: 'Gas first, then blood cells, then chemistry last' for capillary draws

The section of patient history that documents lifestyle factors such as tobacco, alcohol, and drug use, occupation, exercise, and living situation.

• Includes smoking pack-years and alcohol use
• Distinct from family (genetic relatives') history
• Helps assess risk factors for disease

Memory trick: Social = lifestyle choices, like smoking and drinking on a Saturday night.

The anterolateral thigh muscle used as the preferred IM injection site for infants and young children.

• Located between greater trochanter and knee
• Preferred for infants under 12 months
• Avoids sciatic nerve injury risk

Memory trick: 'Babies get it in the thigh, not the hip'

Normal pulse rates vary by age; infants (1–12 months) normally range from 100–160 bpm, much higher than adult norms.

• Newborns: 100-160 bpm
• Toddlers: 90-150 bpm
• Adults: 60-100 bpm

Memory trick: Little hearts beat faster

The standard order of steps a medical assistant follows when bringing a patient from the waiting area to the exam room.

• Begins with greeting and ID verification
• Followed by chief complaint and vital signs
• Gowning occurs last if required for exam

Memory trick: 'Greet, gather, gauge, then gown.'

Hemolysis is the rupture of red blood cells releasing hemoglobin into serum/plasma, most often caused by improper technique such as vigorous mixing, small-gauge needles, or forcing blood through a needle.

• Causes include vigorous shaking, too-small needle gauge, wet alcohol at site
• Hemolysis affects potassium, LDH, and other chemistry results
• Gently invert tubes with additive per manufacturer instructions, never shake

Memory trick: 'Shake it and break it'—rough handling bursts red cells.

A supine position with hips and knees flexed and feet supported in stirrups, used for pelvic, vaginal, and rectal exams.

• Patient lies on back with feet in stirrups
• Provides access for speculum exams and pap smears
• Also used for childbirth and some urologic procedures

Memory trick: 'Lithotomy = Legs in stirrups for Lower exams'

The difference between the apical and radial pulse rates, measured simultaneously by two people.

• Formula: Apical pulse − Radial pulse
• Indicates ineffective heartbeats not reaching the periphery
• Often associated with arrhythmias like atrial fibrillation

Memory trick: 'Apical minus radial reveals the deficit dial.'

A significant drop in blood pressure that occurs when a patient moves from sitting or lying to standing, often causing dizziness.

• Diagnostic criteria: SBP drop ≥20 mmHg or DBP drop ≥10 mmHg
• Measured within 2–3 minutes of standing
• Common causes include dehydration and certain medications

Memory trick: 'Twenty systolic or ten diastolic signals a drop.'

Patient kneels with chest and shoulders down on the table and hips raised, used for rectal and sigmoidoscopy exams.

• Buttocks elevated, knees and chest support weight
• Often uncomfortable; used briefly
• Common for proctologic exams

Memory trick: 'Kneel to peek' — knee-chest position for rectal peeking exams

Lead aVR should normally show a negative QRS deflection; a positive aVR suggests limb lead misplacement, commonly right/left arm reversal.

• aVR views heart from right shoulder
• Normally negative deflection
• Positive aVR = check for arm lead swap

Memory trick: aVR Always Reversed (negative)—if it's not, arms are switched.

Injections given into the fatty layer below the dermis, typically using a short needle at a 45-degree angle.

• Needle length: 5/8 inch (sometimes 1/2 inch)
• Angle: 45 degrees (90 degrees if pinching skin fold in obese patients)
• Common sites: abdomen, upper arm, thigh

Memory trick: '15 for ID, 45 for SubQ, 90 for IM'

Quality control practices required for CLIA-waived tests like glucose meters to ensure reliable results before patient use.

• Run high and low level liquid controls per schedule
• New reagent lots require QC verification
• QC results must fall within manufacturer's acceptable range before reporting patient results

Memory trick: 'Control before patient, high and low'

A seated position with the head of the table elevated 90 degrees (full Fowler's) or 45 degrees (semi-Fowler's), used to ease breathing and for upper body exams.

• Full Fowler's = 90 degrees upright
• Semi-Fowler's = 45 degrees
• Used for respiratory distress and upper GI/chest exams

Memory trick: 'Fowler sits up to breathe easy'—straight up like a chair.

V6 electrode is placed at the left midaxillary line, on the same horizontal level as V4 and V5, completing the horizontal line of chest leads.

• Left midaxillary line
• Same level as V4 and V5
• Final chest lead in the standard placement sequence

Memory trick: 'V1 to V6 walks across the chest to the armpit' — V6 ends at the midaxillary line

The expected resting breathing rate for a healthy adult, used as a baseline vital sign.

• Normal range: 12–20 breaths/min
• Below 12 = bradypnea
• Above 20 = tachypnea

Memory trick: '12 to 20 keeps breathing serene.'

The standardized color scheme for placing the four limb electrodes to ensure correct lead vector orientation.

• White = Right Arm (RA)
• Black = Left Arm (LA)
• Green = Right Leg (RL, ground)
• Red = Left Leg (LL)

Memory trick: 'White is right, smoke over fire' (white-black over red-green)

An IM injection method where the skin is pulled taut and offset before needle insertion to seal medication within the muscle and prevent leakage or staining.

• Used for irritating or staining medications like iron dextran
• Skin is displaced about 1 inch before injection
• Needle is held in place briefly after injection before withdrawal

Memory trick: 'Zigzag seals the stain away'

The process of maintaining an accurate and current list of a patient's medications, including prescriptions, over-the-counter drugs, and supplements, updated at every visit.

• Include start/stop dates and reasons for changes when possible
• Involves prescription, OTC, and herbal/supplement use
• Critical for preventing medication errors and interactions

Memory trick: Reconcile like balancing a checkbook—every medication in or out must be recorded.

A 0-10 scale used to quantify pain intensity in adults and older children who can verbally describe their pain level.

• 0 = no pain
• 1-3 = mild, 4-6 = moderate, 7-10 = severe
• Alternative scales (e.g., Wong-Baker FACES) used for young children

Memory trick: Think of a stoplight: 0-3 green (mild), 4-6 yellow (moderate), 7-10 red (severe).

Light blue-top tubes must be filled to the exact volume mark to maintain the required 9:1 ratio of blood to sodium citrate anticoagulant for accurate coagulation testing.

• 9:1 blood-to-citrate ratio required
• Underfilling causes falsely prolonged PT/PTT results
• Used for coagulation studies like PT and PTT

Memory trick: '9 parts blood, 1 part citrate — fill it right or throw a fit'

Both low and high control levels must fall within acceptable ranges before a point-of-care device can be used for patient testing; failure at either level requires troubleshooting before use.

• Both levels of QC must pass independently
• Failure at any level halts patient testing
• Troubleshoot and repeat QC before resuming testing

Memory trick: 'Both lights must be green before you go' — both QC levels must pass

Pulse oximetry readings can be affected by nail polish, poor peripheral perfusion (cold extremities), and motion artifact, all of which should be addressed before recording results.

• Dark nail polish can block light transmission
• Cold or poor perfusion reduces signal accuracy
• Alternate sites include earlobe or forehead

Memory trick: Polish and cold fool the probe

Blood and body fluid specimens must be labeled immediately after collection, before leaving the patient, to ensure correct identification and prevent errors.

• Label tubes at bedside immediately post-collection
• Include patient name, DOB/ID, date, time, and collector initials
• Never label tubes before collection is confirmed successful

Memory trick: 'Label before you leave the patient's side.'

A mathematical formula used to convert body temperature readings between Celsius and Fahrenheit scales.

• Formula: F = (C × 9/5) + 32
• Normal body temp: 37°C = 98.6°F
• Fever generally defined as ≥100.4°F (38°C)

Memory trick: 'Times nine-fifths, then plus thirty-two.'

Rapid immunoassay for urine hCG relying on a control line to validate results and a test line to indicate pregnancy status.

• Control line must appear for the test to be valid
• Test line present + control line = positive
• Control line only, no test line = negative; no control line = invalid test

Memory trick: 'Control confirms, test line tells'

For infants under 3 months, rectal temperature is the most accurate method because it closely reflects core body temperature and avoids inaccuracies from small ear canals or improper oral technique.

• Rectal is gold standard for infants <3 months
• Tympanic unreliable in small ear canals
• Axillary is least accurate, used only as an estimate

Memory trick: Tiny ears, trust the rectal

START triage classifies mass casualty patients into four color categories: red (immediate), yellow (delayed), green (minor), and black (deceased/expectant, non-salvageable).

• Black = apneic after airway repositioning
• Red = immediate life-threatening but salvageable
• Yellow = delayed, stable but injured
• Green = minor, walking wounded

Memory trick: Reposition airway, no breath means black

For infants under 12 months, capillary punctures are performed on the plantar surface of the heel, avoiding the posterior curvature to prevent bone injury.

• Use lateral or medial plantar heel surface
• Avoid posterior curvature (risk of calcaneus injury)
• Finger sticks reserved for children over 1 year and adults

Memory trick: 'Baby's heel, not the wheel (bone)'—stick the sides, not the back.

Formula: (Desired dose ÷ Have dose) × Volume = Amount to give.

• Always convert units before calculating
• Double-check by verifying the ratio makes sense
• Common error: transposing numerator and denominator

Memory trick: 'Desired over Have, times Volume, gives you the answer to have'

V1 is positioned at the fourth intercostal space along the right sternal border, serving as the starting reference point for placing the remaining precordial leads.

• V1: 4th ICS, right sternal border
• V2: 4th ICS, left sternal border
• V4: 5th ICS, midclavicular line; V6: midaxillary line same level as V4

Memory trick: 'V1 right, V2 left—same rib, different side' then walk left to V6.

A documented process that tracks the handling, transfer, and storage of a specimen from collection to final disposition, ensuring legal accountability, often used in forensic or workplace drug testing.

• Requires signatures and dates at each transfer
• Ensures specimen has not been tampered with
• Common for legal/forensic and employment drug testing

Memory trick: Every hand that touches it signs the chain.

Distortions in EKG tracings caused by patient movement, poor electrode contact, or electrical interference rather than true cardiac activity.

• Somatic tremor: irregular, coarse artifact from muscle movement
• Wandering baseline: slow drift from loose electrodes or lotion/oil on skin
• AC interference: fine, regular 60 Hz spikes from nearby electrical equipment

Memory trick: '60 Hz hum = electrical interference drum'

A tourniquet should not remain on the arm longer than one minute to avoid hemoconcentration, which can skew laboratory results.

• Release tourniquet within 1 minute of application
• Prolonged use raises protein, cellular, and enzyme levels falsely
• If vein is hard to find, release and reapply after 2 minutes

Memory trick: 'One minute max, or the blood gets stacked' (hemoconcentration).

A class of antihypertensive drugs ending in '-pril' that block angiotensin-converting enzyme, reducing vasoconstriction and blood pressure.

• Examples: lisinopril, enalapril, captopril
• Common side effect: dry cough
• Used for hypertension and heart failure

Memory trick: 'Pril spills pressure down'

A non-additive or clotting tube drawn before a coagulation tube when using a butterfly set to eliminate air in the tubing.

• Butterfly tubing contains air that would underfill the first tube
• Discard tube prevents inaccurate blood-to-citrate ratio
• Discard tube can be another light blue or a non-additive tube, per facility policy

Memory trick: 'Butterfly needs a warm-up tube before the real one'

The apical pulse is auscultated at the fifth intercostal space, midclavicular line, and should be counted for a full 60 seconds when irregular.

• Located at point of maximal impulse (PMI)
• Full minute count needed for irregular rhythms
• Used often in infants and cardiac patients

Memory trick: Apex needs a full sixty seconds

Standard EKG calibration is 10 mm = 1 mV, meaning each millimeter of deflection equals 0.1 mV of electrical voltage.

• Standard calibration: 10 mm = 1 mV
• Each mm = 0.1 mV
• Used to verify accurate machine calibration and voltage measurement

Memory trick: Ten millimeters, one millivolt—divide by ten for each mm.

Sounds heard through a stethoscope during manual blood pressure measurement that indicate systolic and diastolic pressures.

• Phase I: first tapping sound = systolic
• Phase V: sounds disappear = diastolic
• Five phases total describe sound changes during cuff deflation

Memory trick: 'First sound starts systolic, silence signals diastolic.'

Controlled substances with the lowest abuse potential, sometimes available without a prescription but requiring pharmacy purchaser logs.

• Examples: cough syrups with small amounts of codeine, some antidiarrheal agents
• Purchaser must show ID and be logged by pharmacist in states allowing OTC sale
• Still classified as controlled due to trace narcotic content

Memory trick: 'V is for Very low risk, sometimes OTC'

A supine position with the head lower than the feet, used to treat shock and improve venous return to vital organs.

• Feet elevated above head level
• Used for shock, hypotension, and certain surgical procedures
• Contraindicated in patients with respiratory or increased intracranial pressure issues

Memory trick: 'Trendelenburg tips the trunk to save the shocked.'