Nonsense

Question 1

substance screening for young ppl

Answer 1

CRAFFT= car, relax, alone, forge, family/friends, trouble

Question 2

Most useful EtOH biomarkers

Answer 2

EtG- urine, hair, nail

Question 3

who is brief intervention useful for and what is the goal

Answer 3

non-dependent problem drinkers. Cut use (not abstinence)

Question 4

Steps in brief intervention

Answer 4

Advise (personal advice change), Assess (willingness to change), Assist (help make change), Arrange (reinforcement)

Question 5

four principles of MI

Answer 5

express empathy, develop discrepancy, roll with resistance, support self-efficacy

Question 6

MI techniques:

Answer 6

OARS: open-ended questions, Affirmations, Reflective listening, Summaries

Question 7

stages of change

Answer 7

precontemplation, contemplation, preparation, action, maintenance

Question 8

Limbic system in IBD

Answer 8

Anterior cingulate cortex determines how pain is emotionally experience. Increased activity in IBS

Question 9

changes in pain pathway in IBD

Answer 9

visceral hypersensitivity (increased awareness, central sensitization), hyperalgesia (peripheral sensitization, decreased PAG activity)

Question 10

HPA axis in IBD

Answer 10

affected by stress levels, impacts intestinal motility

Question 11

Serotonin in IBD

Answer 11

IBS-D=overproduction of serotonin, IBS-C=underproduction of serotonin

Question 12

most common psychiatric condition in IBD

Answer 12

Anxiety disorder

Question 13

Visceral anxiety in IBD

Answer 13

GI-specific anxiety. Hypervigilance of GI symptoms.

Question 14

Catastrophizing in IBD

Answer 14

Rumination about symptoms and their consequences. Feelings of helplessness

Question 15

what age group has 70% of diarrhea deaths? How has incidence and mortality of under5 diarrhea changed

Answer 15

under 2. Mortality down, incidence stayed the same.

Question 16

Global Enteric Multicenter Study (GEMS): what did it find

Answer 16

Rotavirus, cryptosporidium, ST-ETEC, shigella account for most diarrhea. Higher odds of death, decrease in linear growth

Question 17

Osmolarity of hydration salts? Of Normal Saline? What solutes does it contain? What other nutrients do you give them?

Answer 17

245 mmol/L, 154 mmol/L. Na, K, glucose to facilitate Na absorption, citrate. Zinc supplementation, antibiotics

Question 18

What can be done to prevent diarrhea

Answer 18

Exclusive breastfeeding for at least 6 months!!, vaccinate against rotavirus

Question 19

Cycle of Ascariasis, hookworm, trichuriasis (whipworm), W. bancrofti

Answer 19

ingested>portal>lungs>intestine.
Larvae penetrate skin>bloodstream>lungs>intestine>feed on blood
ingested>live in ascending colon>lay eggs in colon
Mosquito>lymphatics (causes lymphatic filariasis)>mosquito

Question 20

what is the definition of diarrhea

Answer 20

> 3 stools/day, >200 g/day

Question 21

most common cause of chronic (>4 wks) diarrhea seen in US

Answer 21

IBD

Question 22

Key difference b/w soap note and H&P

Answer 22

SOAP focuses on active problems and is used for daily progress updates

Question 23

what goes in subjective?

Answer 23

what patient tells you as well as key updates since the last time patient was seen (test results, concerns, etc)

Question 24

for pts with multiple problems, how do you write up the Assessment/plan

Answer 24

you group by problem (problem 1, plan 1, problem 2, plan 2)