Anatomy + Physiology
20-21%of exam
Administrative Assisting
26-27%of exam
Clinical Procedures
18-19%of exam
AsepsisOSHAInstrumentsSpecimensCLIA
Patient Interaction
33-34%of exam
Quick Facts
- Exam
- RMA
- Credential
- Registered Medical Assistant
- Owner
- AMT
- Questions
- 210 MCQ
- Time
- 2.0 hours
- Pass
- Scaled 70
- Fee
- $150
- Retake
- 45 days
- Weights
- 20.9/26.7/18.6/33.8
Type 1 vs Type 2
Type 1
- Autoimmune
- Insulin absent
- Often younger
Type 2
- Resistance
- Relative deficiency
- Often adult
Absent vs resistant
Body Systems
- Cardio
- Pump + vessels
- Respiratory
- Gas exchange
- Endocrine
- Hormone signaling
- Nervous
- Rapid control
- Digestive
- Absorb nutrients
- Urinary
- Filter wastes
- Lymphatic
- Fluid + immunity
- Musculoskeletal
- Support + movement
Terminology
- Hyper
- High/excess
- Hypo
- Low/deficient
- Tachy
- Fast
- Brady
- Slow
- Dys
- Bad/difficult
- Ectomy
- Removal
- Itis
- Inflammation
- Scopy
- Visual exam
Pathology Signals
- Type 1 DM
- Insulin absent
- Type 2 DM
- Insulin resistance
- HTN
- Elevated pressure
- COPD
- Obstructed airflow
- CHF
- Pump failure
- Anemia
- Low oxygen capacity
- UTI
- Urinary infection
- Edema
- Fluid swelling
SOAP Note
Story signs assessment plan.
SubjectiveObjectiveAssessmentPlan
ICD-10-CM vs CPT
ICD-10-CM
- Diagnosis
- Medical necessity
- Why visit
CPT
- Procedure
- Service performed
- What done
Why vs what
Admin Picker
- Why patient came→ICD-10-CM
- What was done→CPT
- Supply/DME billed→HCPCS II
- Payer says no→Appeal
- Records requested→Signed ROI
- Suspected abuse→Mandatory report
- Urgent symptoms→Provider triage
Exam Logistics
- Items
- 210 questions
- Format
- Four-option MCQ
- Time
- 120 minutes
- Pace
- 34 seconds
- Score
- Scaled 0-100
- Pass
- 70 or higher
- Retake
- Entire exam
- Attempts
- Four maximum
Malpractice Four Ds
Duty dereliction direct cause damages.
DutyDerelictionDirect causeDamages
Privacy vs Security
Privacy
- PHI use
- Disclosure limits
- Patient rights
Security
- ePHI safeguards
- Access controls
- Audit trails
Use vs protect
Admin Workflow
- Registration
- Demographics + consent
- Scheduling
- Match visit need
- Triage call
- Urgency screen
- Referral
- Specialty authorization
- Preauth
- Payer approval
- Claim
- Payment request
- EOB
- Payer explanation
- Appeal
- Denial response
Claim vs EOB
Claim
- Sent to payer
- Requests payment
- Codes charges
EOB
- Payer response
- Explains benefits
- Shows responsibility
Request vs response
Coding + Records
- ICD-10-CM
- Diagnosis code
- CPT
- Procedure code
- HCPCS II
- Supplies/DME
- CMS-1500
- Professional claim
- SOAP
- Subjective/objective plan
- POMR
- Problem-oriented record
- PHI
- Protected health info
- ROI
- Release authorization
Law + Ethics
- HIPAA Privacy
- Use/disclosure rules
- HIPAA Security
- ePHI safeguards
- Consent
- Informed permission
- Scope
- Allowed duties
- Negligence
- Careless breach
- Malpractice
- Professional negligence
- Abandonment
- Improper termination
- Mandatory report
- Required disclosure
Infection Chain
Agent reservoir exit transmission entry host.
AgentReservoirExitTransmissionEntryHost
Medical vs Surgical Asepsis
Medical
- Clean technique
- Reduce microbes
- Routine care
Surgical
- Sterile technique
- Eliminate microbes
- Invasive care
Reduce vs eliminate
Specimen Picker
- Urine culture→Clean catch(Midstream)
- Glucose check→Capillary stick(Waived)
- CBC order→Venipuncture(Lavender tube)
- Strep screen→Throat swab(Avoid tongue)
- Drug screen→Chain custody(Document transfer)
- Occult blood→FOBT card(Stool sample)
Asepsis + Safety
- Medical asepsis
- Reduce microbes
- Surgical asepsis
- Eliminate microbes
- Standard precautions
- All patients
- PPE
- Barrier protection
- Sharps
- Puncture container
- SDS
- Chemical safety
- BBP
- Bloodborne pathogens
- Exposure
- Wash/report/document
Sterilization vs Disinfection
Sterilization
- Destroys all
- Autoclave
- Surgical instruments
Disinfection
- Reduces pathogens
- Surfaces
- Noncritical items
All vs most
Instruments + Sterile
- Scalpel
- Cut tissue
- Forceps
- Grasp tissue
- Hemostat
- Clamp vessels
- Retractor
- Hold tissue
- Needle holder
- Drive suture
- Autoclave
- Steam sterilize
- Sterile field
- Waist-up visible
- Contaminated
- Below waist
Lab Specimens
- Clean catch
- Midstream urine
- Timed urine
- Collected interval
- Venipuncture
- Vein blood
- Capillary
- Finger/heel stick
- Throat swab
- Culture sample
- FOBT
- Occult blood
- CLIA waived
- Low complexity
- Chain custody
- Tracked handling
Medication Rights
Patient drug dose route time document.
PatientDrugDoseRouteTimeDocument
Subjective vs Objective
Subjective
- Patient says
- Symptoms
- Pain report
Objective
- You measure
- Signs
- Vitals/labs
Says vs shows
Injection Picker
- TB skin test→Intradermal(10-15 deg)
- Insulin order→SubQ(45 deg)
- Vaccine adult→Deltoid IM(90 deg)
- Large IM→Ventrogluteal(Adult site)
- Irritating drug→Z-track(Seal tissue)
- Needle used→Sharps box(No recap)
Vitals + Exams
- Temp
- 97.8-99.1 F
- Pulse
- 60-100 bpm
- Resp
- 12-20/min
- BP
- Under 120/80
- Pain
- Patient reported
- SpO2
- Oxygen saturation
- Fowler
- Sitting position
- Lithotomy
- Pelvic exam
Limb Lead Colors
White right, black left, green ground.
RA whiteLA blackRL greenLL red
ID vs SubQ vs IM
ID/SubQ
- Skin/fat
- 10-45 deg
- Small volume
IM
- Muscle
- 90 deg
- Larger volume
Depth drives angle
Patient Care Picker
- Unclear instructions→Teach-back
- Low literacy→Plain language
- Chest pain→Immediate escalation
- Wrong ID→Stop procedure
- ECG wandering→Reduce movement
- High BP→Repeat correctly
- Fall risk→Assist transfer
Pharmacology
- Right patient
- Two identifiers
- Right drug
- Match order
- Right dose
- Verify amount
- Right route
- Correct path
- Right time
- Scheduled window
- Documentation
- Record immediately
- ID
- 10-15 deg
- SubQ
- 45 deg
- IM
- 90 deg
ECG + Emergency
- 12-lead ECG
- 10 electrodes
- RA
- White limb
- LA
- Black limb
- RL
- Green ground
- LL
- Red limb
- Artifact
- False tracing
- CPR
- 30:2 compressions
- AED
- Defibrillator prompts
Common Traps
Scaled Score Trap
70 points ≠ 70 percent
PHI Trap
Minimum necessary ≠ Casual sharing
Specimen Trap
Label bedside ≠ Label later
Sharps Trap
Discard immediately ≠ Recap needles
ECG Trap
10 electrodes ≠ 12 electrodes
BP Trap
Arm heart-level ≠ Arm dangling
Asepsis Trap
Sterile field visible ≠ Turned-away field
Scope Trap
Assist provider ≠ Diagnose patient
Last Minute
- 1.Clinical interaction is largest domain
- 2.70 is scaled, not percent
- 3.ICD diagnosis; CPT procedure
- 4.HIPAA minimum necessary always
- 5.Two identifiers before procedures
- 6.Label specimens before leaving
- 7.Never recap used needles
- 8.ID 10-15; SubQ 45; IM 90
- 9.ECG uses 10 electrodes
- 10.Medical asepsis reduces microbes
- 11.Surgical asepsis eliminates microbes
- 12.Retake means entire exam
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