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NP Prep > Gastro intestinal disorders > Flashcards

Gastro intestinal disorders Flashcards

1
Q

Adult patient complains of the acute onset of fever, nausea, and vomiting that is associated with rapid onset of abdominal pain that radiates to the mid back will get it in the epigastric region. Abdominal exam reveals guarding and tenderness over the epigastric area or the upper abdomen

A

Acute pancreatitis

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2
Q

Abdominal exam reveals a positive Cullen’s sign And gray turner sign.

A

Acute pancreatitis

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3
Q

Blue discoloration around umbilicus

A

Positive Cullen’s sign (acute pancreatitis)

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4
Q

Blue discoloration on the flanks

A

Gray turners sign (acute pancreatitis)

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5
Q

Elderly patient with acute onset of high fever, anorexia, nausea/vomiting, and left lower quadrant abdominal pain

A

Acute diverticulitis

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6
Q

Rebound tenderness, positive Rovsing’s sign, board like abdomen are all signs of

A

Acute abdomen

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7
Q

If a CBC shows a presence of band forms what does that mean

A

Severe bacterial infection as bands are immature neutrophils

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8
Q

A young adult complains of an Acute onset of Periumbilical pain that is steadily getting worse. Overtime the pain starts to localize at McBurney’s point the patient has no appetite

A

Acute appendicitis

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9
Q

Pain at McBurney’s point is indicative of

A

Acute appendicitis

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10
Q

Overweight female complains of severe right upper quadrant or epigastric pain that occurs within one hour of eating a fatty meal. Pain may radiate to the upper shoulder. Accompanied by nausea/vomiting and anorexia.

A

Acute cholecystitis

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11
Q

Right upper quadrant

A

Gallbladder

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12
Q

Left lower quadrant

A

Diverticulitis

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13
Q

A gastrinoma located on the pancreas or the stomach that secretes gastrin, stimulates high levels of acid production in the stomach. The end result is a development of multiple and severe ulcers in the stomach and Duodenum. Complains of epigastric to mid abdominal pain and stools may be a Tarry color

A

Zollinger-Ellison Syndrome

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14
Q

How do you screen for Zollinger-Ellison syndrome

A

Serum fasting gastrin level

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15
Q

Right lower quadrant intermittent abdominal pain. Lower abdominal pain one hour after eating. Diarrhea with mucus. Fever, malaise, and mild weight loss. Abnormal liquid stools. High-risk for colon cancer

A

Crohn’s disease

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16
Q

Right lower quadrant

A

ApPendix

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17
Q

This maneuver is used for acute appendicitis. Flex hip 90° and ask patient to push against resistance and straighten the leg

A

Psoas/Illiopsoas

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18
Q

Used for acute appendicitis. Rotate right hip through full range of motion. Positive sign if pain with the movement or flexion of the hip

A

Obturator sign

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19
Q

Deep palpation of the lower left quadrant of the abdomen results in referred pain to the right lower quadrant

A

Rovsing’s sign

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20
Q

Area located between the superior iliac crest and amble I guess in the right lower quadrant. Tenderness or pain is a sign of possible acute appendicitis

A

McBurney’s point

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21
Q

Instructed patient to raise heels, and then drop them suddenly. And alternative is to ask the patient to jump in place. Positive if pain is elicited or if patient refuses to perform because of the pain

A

Markel test

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22
Q

With abdominal palpation, the abdominal muscles reflexively become tense or boardlike

A

Involuntary guarding

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23
Q

Patient complains that the abdominal pain is worse when the palpating hand is released compared to the pain felt during deep palpation

A

Rebound tenderness

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24
Q

Press deeply on the upper right quadrant under the coastal border During inspiration. Mid inspiratory arrest is a positive sign

A

Murphy’s maneuver or Murphy’s sign

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25
Q

What is located in the right upper quadrant

A

Gallbladder

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26
Q

What is located in the right lower quadrant

A

Appendix

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27
Q

Left upper quadrant pain equals

A

Gastritis or pancreatitis

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28
Q

If a patient presents with cholecystitis, right lower lobe pneumonia, or acute hepatitis what area of the stomach would be involved

A

Right upper quadrant

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29
Q

Patient presents with appendicitis, ovarian cyst, diverticulitis, endometriosis, urethral calculi what part of stomach will be involved

A

Right lower quadrant

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30
Q

Patient presents with diverticulitis what part of the stomach will be involved

A

Left lower quadrant

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31
Q

The patient presents with gastritis, pancreatitis, MI, left lower lobe pneumonia what part of the stomach will be involved

A

Left upper quadrant

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32
Q

Chronic GERD causes damage to squamous epithelium of the esophagus and may result in what disorder which is a pre-cancer and increases the risk of cancer of the esophagus

A

Barrett’s esophagus

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33
Q

Feeling of a lump in the throat

A

Clovis

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34
Q

Heartburn, dysphagia, hoarseness, chest pain, nausea, excessive salivation, and feeling of lump in throat are all symptoms of

A

Pathologic GERD

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35
Q

What position should a person be in after eating if they have Gerd

A

Patient must remain up right after eating meals

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36
Q

A premalignant lesion of the esophagus that is secondary to Gerd is termed

A

Barrett’s Esophagus

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37
Q

What are some lifestyle modifications for patients with Gerd

A

Avoid recumbence after eating, elevate head of bed when sleeping, reduce size of meals, reduce amount of fat, acid, spices, caffeine, sweets, peppermint, chocolate, and alcohol, and smoking cessation

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38
Q

What medication can be taken for mild Gerd symptoms

A

Antacid

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39
Q

What medication for Gerd provides relief for about 30 minutes and is the quickest but short-lived

A

Antacid

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40
Q

What medication decreases acid production and provides relief for 6-12 hours, but takes 60-120 minutes to provide relief

A

H2 agonists

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41
Q

Cimetidine (Tagamet), Ranitidine (Zantac), Famotidine (Pepcid), and Nizatidine (Axid) are all

A

H2 antagonist

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42
Q

What type of medication reduces gastric secretion and should be taken for four to eight weeks

A

Proton pump inhibitor’s

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43
Q

Prazole suffix is for

A

Proton pump inhibitor’s

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44
Q

When is referral to gastroenterologist recommended for Gerd

A

Symptoms persist for four weeks of b.i.d. PPI use, in conjunction with weight loss, in conjunction with anemia, in conjunction with difficulty swallowing, in conjunction with epigastric mass, and in conjunction with recurrent vomiting

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45
Q

Common long time complication of Gerd might be

A

Barrett’s esophagus

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46
Q

How is Barrett’s Esophagus diagnosed

A

Upper endoscopy with biopsy

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47
Q

Can a patient with Gerd have mints or caffeine

A

No

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48
Q

If a patient presents with severe mid epigastric pain that radiates to the mid back what does this indicate

A

Acute pancreatitis

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49
Q

If a patient has a positive psoas and obturator sign, then they have

A

Acute appendicitis

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50
Q

Any patient with at least a decade or more history of chronic heartburn should be referred to a gastroenterologist for an endoscopy to rule out

A

Barrett’s Esophagus

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51
Q

Young adult complains of intermittent episodes of moderate to severe cramping pain in the lower abdomen, especially on the left lower quadrant. Bloating with flatulence. Relief obtained after defecation. Stools range from diarrhea to constipation or both types with increased frequency of bowel movements.

A

Irritable bowel syndrome

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52
Q

Tenderness in the lower quadrants during an abdominal exam during an exacerbation. Otherwise the exam is normal. Rectal exam is normal with no blood or puss. Heme-negative stool’s.

A

Irritable bowel syndrome

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53
Q

How do you treat irritable bowel syndrome

A

Increase dietary fiber. Supplement fiber with Metamucil. Anti-spasmodic’s(Bentyl) as needed. Decrease life stress.

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54
Q

Which also is more common duodenal or gastric

A

Duodenal

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55
Q

What bacteria is a common cause for both duodenal and gastric ulcers

A

H pylori

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56
Q

What type of drug taken chronically can cause peptic ulcers

A

NSAID and bisphosphonates such as Fosamax and Actonel

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57
Q

Middle aged adult complains of epigastric episodic pain, burning/gnawing pain, or AChe. Pain relieved by food and or antacids with recurrence 2 to 4 hours after a meal. Self-medicating with over-the-counter ant acid’s. Maybe taking NSAIDs or aspirin.

A

Peptic ulcer disease

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58
Q

What labs are indicated for peptic ulcer disease

A

CBC for anemia, fecal occult blood testing. If positive referral to gastroenterologist

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59
Q

How do you treat H pylori negative ulcers

A

Combine lifestyle changes with PPI’s or H2 blocker’s. Use PPIs or H2-blockers for 4 to 8 weeks.

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60
Q

How do you treat H pylori positive ulcers

A

Triple therapy with clarithromycin i.e. Biaxin b.i.d. plus amoxicillin 1 g b.i.d. for 14 days plus ppi b.i.d. for 6 to 8 weeks to allow also to heal

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61
Q

What is quadruple therapy for H pylori positive ulcers? This is the preferred treatment 💪🏽

A

Bismuth subsalicylate tab 600 mg four times a day plus Flagyl 250 mg QID plus tetracycline 500 mg QID for two weeks plus PPI daily for 4 to 6 weeks after or longer

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62
Q

The serology (tigers) for h. Pylori will show

A

IGg levels elevated plus signs of PUD. Treat with antibiotics plus PPI.

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63
Q

How do you treat irritable bowel syndrome

A

Increase fiber intake

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64
Q

Elderly patient presents with acute onset of fever with left lower quadrant abdominal pain with anorexia, nausea, vomiting. Abdominal palpation reveals tenderness on the left lower quadrant and hematochezia and anemia if hemorrhaging

A

Diverticulitis

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65
Q

What is hematochezia

A

Bloody stool

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66
Q

What are the labs for diverticulitis

A

CBC with leukocytosis, neutrophilia greater than 70% and shift to the left. The presence of Band forms. Refer to ED.

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67
Q

What is the treatment plan for diverticulitis

A

Ciprofloxacin 500 mg b.i.d. plus flagyl 500 mg TID for 10 to 14 days. Close follow up. If no response in 48 to 72 hours or worsens refer to ED

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68
Q

What is the treatment for diverticulosis

A

High-fiber diet with fiber supplement such as Metamucil. Avoidance of nuts and seeds is not necessary.

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69
Q

Acute inflammation of the pancreas secondary to many factors such as alcohol abuse, gallstones, elevated triglyceride levels, infections.

A

Acute pancreatitis

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70
Q

Elevated triglycerides greater than 800 mg are at very high risk for

A

Acute pancreatitis

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71
Q

Adult patient complains of the acute onset of fever, nausea, and vomiting that is associated with rapid onset of abdominal pain that radiates to the mid back located in the epigastric region. Abdominal exam reveals guarding and tenderness over the epigastric area or the upper abdomen. Positive Collins and great Turner’s sign. May have alias signs and symptoms of shock refer patient to ED

A

Acute pancreatitis

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72
Q

Hypo active bowel sounds

A

Ileus

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73
Q

What are the labs for acute pancreatitis

A

Elevated pancreatic enzymes such as serum amylase, lipase, and trypsin . Elevated AST, ALT, GGT, Bilirubin , Leukocytosis, Patient needs abdominal ultrasound and computed tomography.

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74
Q

Can acute pancreatitis cause diabetes

A

Yes

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75
Q

What are the labs for Clostridium difficile colitis

A

CBC with leukocytosis, stool assay for C. Dificil toxins.

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76
Q

What is the treatment for C. difficle

A

Flagyl TID for 10 to 14 days. Avoid opiates because they can worsen or prolong the disorder. Increase fluid intake and eat food as tolerated

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77
Q

What are some extra intestinal manifestations of Inflammatory bowel disease

A

Arthritis, rashes, eyes (uveitis, iritis)

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78
Q

If a stool specimen is positive for leukocytes i.e. white blood cells this may be associated with

A

Infection, inflammation, salmonella infection, Crohn’s disease, ulcerative colitis

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79
Q

At what age is colorectal cancer screening via colonoscopy recommended (gold standard)

A

50 or older

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80
Q

How long does it take for a polyp to turn to cancer

A

10 years

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81
Q

If using guaiac based fecal occult blood test for colorectal screening how often should it be used

A

Annually with three specimens

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82
Q

If using fecal immunochemical tests for colorectal cancer screening for how often should it be used

A

Annually with a single specimen. More sensitive than FOBT

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83
Q

If using stool FIT DNA i.e. Colo guard for Colorectal cancer screening how often should it be used

A

1 to 3 years

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84
Q

How often should a flexible sigmoidoscopy be used

A

Every five years

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85
Q

What lab measures the integrity of the liver

A

ALT/AST

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86
Q

What lab measures sympathetic activity of the liver

A

PT/albumin

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87
Q

What lab measures excretory function of the liver

A

Billirubin and ALP

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88
Q

If there is an elevation in AST/ALT, that means

A

Loss of liver cells

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89
Q

If there is an elevation in alkaline phosphate that means

A

Bone or liver problems

90
Q

A pregnant patient is found to have elevated alkaline phosphatase level. Is the etiology likely to be pathological?

A

No. This is an expected finding

91
Q

And adolescent is found to have elevated alkaline phosphatase level. Is the etiology likely to be pathological?

A

No. This is an expected finding due to growing

92
Q

What is the differential diagnosis for elevated ALT/AST?

A

Infectious, metabolic, alcohol or hepatotoxicity drug use, Automimmune liver disease, hereditary liver disease

93
Q

If the ALT is greater than the AST what is the likely cause

A

Viral hepatitis. think the L in ALT stands for liver

94
Q

If the AST is greater than eight ALT what is the likely cause?

A

Alcohol, drugs, liver disease. Think a as in acetaminophen, S as in statins and T as in tequila

95
Q

If the AST to ALT ratio is greater than two, what is the likely cause?

A

Alcoholic liver disease is extremely likely

96
Q

If the AST to ALT ratio is greater than one what is the likely cause?

A

Consider alcohol, liver disease

97
Q

If the AST to ALT ratio is greater is less than one what is the likely cause?

A

Fatty liver disease

98
Q

Liver infiltrated by FAT. Number one reason for liver transplant in the United States and can progress to cirrhosis

A

Nonalcoholic fatty liver disease

99
Q

In viral hepatitis is the ALT greater or less than the AST

A

Greater

100
Q

What types of hepatitis can cause chronic infections

A

B, C, and D

101
Q

Which immunoglobulin for hepatitis markers is the first one to be produced during an acute infection i.e. a cute infection

A

IgM

M=minute

102
Q

Which immunoglobulin for hepatitis is produced when the infection is gone

A

IGG

G=gone

103
Q

(+) anti-HAV IgG

A

Immune

104
Q

(+) anti-HAV IgM

A

Acute infection

105
Q

(-) anti-HAV IgM & (-) IgG

A

No immunity, needs immunization

106
Q

HBsAg

A

Hep B surface antigen

Antigen=infection

107
Q

anti-HBs

A

Hepatitis B surface antibody

Antibody=immunity

108
Q

anti-HBc

A

Totally hepatitis B core antibody
Core= rotten to the core
Patient has it now, or in the past
Indicates current or previous infection

109
Q

IgM anti-HBc

A

IgM antibody to hep B antigen

Acute hep b in less than or equal to 6 months

110
Q

HBsAg -
anti-HBc -
anti-HBs -

A

Susceptible

Needs immunization

111
Q

HBsAg -
anti-HBc +
anti-HBs +

A

Immune due to natural infection

112
Q

HBsAg -
anti-HBc -
anti-HBs +

A

Immune due to hepatitis b vaccine

113
Q

HBsAg +
anti-HBc +
IgM anti-HBc +
anti-HBs -

A

Acutely infected

114
Q

HBsAg +
anti-HBc +
IgM anti-HBc -
anti-HBs -

A

Chronically infected

115
Q
  • HBsAg
  • anti-HBs
  • anti-HBc
A

No immunity, no infection. Needs immunization

116
Q
  • HBsAg
    + anti-HBs
  • anti-HBc
A

Immunity secondary to immunization

117
Q

+ HBsAg
- IgM anti-HBc
+ anti-HBc
- anti-HBs

A

Chronic hep b

118
Q
  • HBsAg
    + anti-HBs
    + anti-HBc
A

Immune secondary to infection

119
Q

+ HBsAg
- anti-HBs
+ IgM anti-HBc
+ anti-HBc

A

Acute infection

120
Q

What lab do you order for hepatitis C

A

Anti-HCV

121
Q

If the patient was exposed with in the last six months to hepatitis C what other lab needs to be ordered

A

HCV RNA

122
Q

How long does it take for anti-HCV to become positive after exposure

A

Eight weeks

123
Q

If an anti-– HCV test is positive what is the confirmatory test

A

HCV RNA

124
Q

If a patient has hepatitis can they take Lipitor

A

No

125
Q

If a patient has hepatitis what is their treatment plan

A

Referred to G.I.

126
Q

What are lifestyle modifications for hepatitis

A

Abstinence from alcohol, avoiding large doses of acetaminophen, iron, and drugs metabolized by the liver. Also blood precautions for patients with hepatitis B and C

127
Q

Left lower quadrant pain with fever

A

Diverticulitis

128
Q

What is the definitive test for diverticulitis and how is it treated

A

CT scan and it is treated with Ciproflioxicin nd Flagyl

129
Q

Adult with positive McBurney’s point

A

Appendicitis

130
Q

What is the definitive test for appendicitis

A

CT scan

131
Q

Pain in the upper right quadrant

A

Cholecystitis

132
Q

What is the initial test for cholecystitis and if it is inconclusive what is the next test

A

Ultrasound and then if inconclusive hida scan

133
Q

Abdominal pain associated with a dilated loops of bowel

A

Bowel obstruction

134
Q

What is the initial test for bowel obstruction

A

Flats and erect of abdomen that will show Ileus

135
Q

Absent bowel sounds

A

Ileus

136
Q

What is the initial test for Ileus

A

Flat and erect of abdomen

137
Q

Adults with acute Periumbilical pain

A

Appendicitis

138
Q

Elevated Bilirubin level, other LFTs normal

A

Gilberts disease

139
Q

Inspiratory arrest with deep palpation on the right upper quadrant

A

Cholecystitis

+ Murphy’s sign

140
Q

Elevated triglyceride levels and acute abdominal pain

A

Pancreatitis

141
Q

What is the serum test for pancreatitis

A

Amylase and lipase

142
Q

Painless bleeding with bowel movements

A

Colorectal cancer

143
Q

Painful bleeding with bowel movements

A

Anal Fissure, hemorrhoids, ulcerative colitis

144
Q

Tinkling bowel sounds accompanied by abdominal pain

A

Bowel obstruction

145
Q

What is the definitive test for towel obstruction

A

Flat and erect of abdomen

146
Q

Adults with acute pain in the left upper quadrant for the past 60 minutes

A

MI

147
Q

What is the initial test for an MI

A

EKG

148
Q

Which medication may worsen the symptoms of Gerd

A

Calcium channel blocker such as amlodipine

149
Q

What type of Gerd medication increases the risk of fractures

A

Ppi

150
Q

If a patient presents with diarrhea and a CBC demonstrates anemia and an increase in the sedimentation rate and CRP what is the most likely cause

A

Inflammatory bowel disease

151
Q

Nocturnal diarrhea with blood

A

Inflammatory bowel disease such as ulcerative colitis or Crohn’s disease

152
Q

What hereditary liver disease demonstrates copper in the liver

A

Wilson’s disease

153
Q

Excessive alcohol consumption may cause these two diseases

A

Hepatitis or pancreatitis

154
Q

Positive Murphy’s sign

A

Cholecystitis

155
Q

Imaging study of choice is CT scan of lower abdomen for these two diseases

A

Diverticulitis and appendicitis

156
Q

What is the imaging study of choice for children with appendicitis

A

Ultrasound

157
Q

Which hepatitis is transmitted via sexual, blood, blood products, or organs

A

Hepatitis B

158
Q

Which type of hepatitis is transmitted via intravenous drug use that 50%, blood or blood products, sexual intercourse

A

Hepatitis C

159
Q

Sexually Active adult complains of a new onset of fatigue, nausea, and dark colored urine for several days. New sexual partner in less than three months

A

Acute hepatitis

160
Q

What type of hepatitis has the highest risk of cirrhosis and liver cancer

A

Hepatitis C

161
Q

A lone elevation in the GGT is a sensitive indicator of

A

Possible alcoholism

162
Q

Is alkaline phosphatase normally elevated during the teen years

A

Yes

163
Q

In order for a person to become infected with hepatitis C what must that person have

A

Hepatitis B

164
Q

Is the ALT or AST more sensitive to liver damage

A

ALT

165
Q

Does Metformin cause constipation

A

No

166
Q

What medication could be used to increase appetite in an anorexic patient

A

Megestrol

167
Q

Muscle mass that is lost due to aging is called

A

Sarcopenia

168
Q

The three most common causes of bacterial diarrhea in the US are

A

Salmonella, Campylobacter, and Shigella

169
Q

How often should a patient with ulcerative colitis have colonoscopies

A

Every 1 to 5 years

170
Q

How many hours after eating do duodenal ulcer symptoms show

A

2 to 5 hours

171
Q

The most common place for indirect inguinal hernia’s to develop is

A

The internal inguinal ring

172
Q

What is a major symptom of GERD

A

Pyrosis (heartburn)

173
Q

How soon would a C. Difficile enzyme immunoassay yield results?

A

About 24 hours

174
Q

Bright red blood in the stools is characteristic of

A

Cancer of the sigmoid colon

175
Q

Is an inguinal hernia nodular, silky, firm, or bumpy

A

Silky

176
Q

If a patient is on a Statin and calcium channel blocker and drinks grapefruit juice, what happens

A

Elevated liver enzyme’s

177
Q

The most common reason that older adults develop peptic ulcer disease

A

H. Pylori infection

178
Q

An 85-year-old adults has chronic constipation. How should this be managed initially

A

Avoid all constipating medication and foods when possible

179
Q

What type of reflux rarely occurs At night time

A

Physiologic reflux

180
Q

What would be a common finding in a patient with biliary colic

A

Pain in upper abdomen in response to eating fatty foods

181
Q

A syndrome of underlying illness that is accompanied by loss of muscle mass

A

Cachexia

182
Q

What syndrome is associated with Biliary atresia in an infant

A

Acholic stools (clay colored stools)

183
Q

What type of hernia would present as a small midline protrusion through a defect in the linea alba

A

Epigastric hernia

184
Q

When performing a rectal exam what is the best position to put the patient in

A

Lateral decubitus or left side lying position

185
Q

Bowel sounds may be increased in the presence of

A

Early intestinal obstruction

186
Q

Inspiratory arrest with deep palpation of the upper right quadrant is

A

A positive Murphy’s sign

187
Q

What are signs and symptoms associated with diabetic gastroparesis

A

Vomiting of undigested food, weight loss, erratic glucose levels, and Gerd

188
Q

A feeling of constantly needing to pass stool is termed

A

Tenesmus

189
Q

When performing a rectal exam a purulent bloody discharge mixed with fecal matter is oozing from the rectum. This finding is consistent with

A

Anorectal fistula

190
Q

Stools that a pencil like in shape or more likely

A

An early side of colon cancer

191
Q

When performing a digital rectal exam a soft pedunculated lesion is palpated. This finding is most likely

A

Rectal polyp

192
Q

If abdominal pain persists when the patient raises his head and shoulders the origin of the tenderness is probably

A

In the abdominal wall

193
Q

A patient presents with complaints of black tarry stool for the last week. This symptom is seen in conditions related to

A

Ascending colon

194
Q

An enlarged liver with a firm nontender edge maybe suggestive of

A

Cirrhosis

195
Q

Where are the patient would you palpate the liver

A

Approximately 3 cm below the right coastal region in the midclavicular line

196
Q

When performing a rectal exam a reddish moist protruding mass is noted At the anal opening. This finding is most likely

A

A prolapsed internal hemorrhoid

197
Q

What is the definitive test for Hirschsprung’s disease

A

Rectal biopsy

198
Q

When percussing an abdomen and tympany is audible what can this suggest

A

Intestinal obstruction, increased gas production, or paralytic ileus

199
Q

Deep palpation of the abdomen requires what part of the fingers

A

Palmar surfaces of the fingers

200
Q

What assessment finding is the result of the presence of a stone in the common bile duct

A

Jaundice

201
Q

An enlarged liver with a smooth tender edge may suggest

A

Right-sided heart failure

202
Q

Indicators of Oropharyngeal dysphagia include

A

Drawling, nasopharyngeal regurgitation, and cough from aspiration

203
Q

On examination of the abdomen, loud rumbling noises are audible without a stethoscope. These sounds are termed

A

Borborygmus

204
Q

When performing a rectal exam if the anal sphincter presents with laxity consider

A

A neurologic disease

205
Q

A patient complains of an unpleasant abdominal fullness after a light meal. This complaint may be consistent with

A

Diabetic gastroparesis

206
Q

Peritoneal inflammation produces abdominal pain and tenderness. What technique can be used to assess a tender abdomen suspected to be secondary to peritoneal inflammation

A

Ask the patient to cough prior to palpation

207
Q

Bowel sounds may be decreased in the presence of

A

Peritonitis

208
Q

Helminths can be transmitted by

A

The bite of a blood sucking insect

209
Q

What symptom is seen in infants with pyloric stenosis

A

Visible peristalsis

210
Q

Acholic stools are associated with

A

Obstructive jaundice

211
Q

Chronic intake of NSAIDs can cause what disorder

A

Gastritis

212
Q

Referred pain to the opposite side of the abdomen after release of palpation

A

Rovsing’s sign

213
Q

What is not a symptom of irritable bowel syndrome

A

Weight loss

214
Q

A 70-year-old patient presents with left lower quadrant abdominal pain, a markedly tender palpable abdominal wall, fever, and leukocytosis. Of the following terms which correctly describes the suspected condition

A

Diverticulitis

215
Q

Is alkaline phosphatase usually elevated in nephrotic syndrome?

A

No

216
Q

A patient who has been prescribed Imodium for symptoms of IBS should be advised to seek immediate medical assistance if he experiences

A

Vomiting

217
Q

The patient reports to the nurse practitioner that he was diagnosed with hepatitis B one year ago and has not been seen by a healthcare provider since then. What information shared this patient be given

A

About 10% of affected persons become carriers, and are at increased risk for hepatocellular carcinoma

218
Q

What other conditions can present similarly to acute cholecystitis

A

GER, angina and PUD

219
Q

An eight-year-old female has been brought to the nurse practitioner on five occasions in the past nine weeks with a complaint of abdominal pain. The evaluation each time is negative, but her mother is convinced that the child is truly experiencing pain. The most likely diagnosis is

A

Recurrent abdominal pain which is defined as at least three episodes of abdominal pain over a three-month period.

220
Q

What type of medication is recommended for short term uncomplicated peptic ulcer disease

A

Misoprostol (cytotec)

NP Prep (20 decks)

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