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Sinners Review - Final NR511Questions and Answers 2024
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Sinners Review - Final NR511
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Sinners Review - Final NR511macrocytic anemia - answer increased MCV
-vitamin b12, iron deficiency, pernicious anemia, folate deficiency, liver disease, drugs
Mean Corpuscular Volume (MCV) - answer size of a red blood cell
normal: 76 to 96 fL
Microcytic anemia - answer decreased MCV (hypochromic with decreased MCHC)
-order serum iron, ferritin, and TIBC
what should level to check on kids before starting iron? - answer*LEAD LEVEL*
always check a lead level before starting iron on children because an increased lead
level will cause anemia despite normal iron level.
Ulcerative Colitis - answerFriability, erosions and bleeding
-characterized by bloody/purulent diarrhea
-total colectomy can completely cure but is not the first treatment option
C. Diff - Symptoms - answergenerally profuse, watery, mucoid diarrhea
-mild to mod: watery diarrhea 3 or more times/day for 2 or more days, mild
cramping/abd tenderness
-severe: 10-15 watery stools/day, strong odor, acute abd secondary to megacolon w/
perforation, distention, fever, N/V
inflammatory bowel disease - answerthe mucosal surface of the colon is inflamed, most
often occurs in the rectosigmoid areas but may involve the whole colon
diverticulitis - answermay present with bleeding, not associated with pain
may also present with N/V and LLQ tenderness and anorexia
-Need CT scan to R/O Diff Dx
*High fiber diet is the best management*
C Diff - diagnosis - answerElevated WBCs
-enzyme-linked immunodeficiency assay (ELISA) identifies toxins
-cell cytotoxicity: identifies the effects of bacterial toxins on human cells
-PCR: detects bacterial genes
-Endoscopy: if unresponsive to treatment, can show pseudomembranes that suggest C
Diff
, C Diff -risks - answerinfection of the large intestine which causes profuse, watery
mucoid diarrhea
-healthcare facility, long hospitalization, long term abx, long term meds that disrupt GI,
consuming infected objects
C Diff - treatment - answerMetronidazole, probiotics, maintain fluids, clear liquid diet, eat
starchy foods
avoid: caffeine, spice, foods, milk, grease
Severe cases: colectomy
GERD - answersymptoms: occurs at night, heartburn, dysphagia, regurgitation, painful
swallowing, belching, coughing, hoarseness
-avoid: caffeine, alcohol, chocolate, peppermint, spicy foods
-eat small meals, stop smoking, remain upright after eating
*If patient treated with omeprazole and diet modifications for 6 weeks without
improvement- endoscopy needed*
Peptic Ulcer Disease - answer*Hallmark sign: burning or gnawing sensation or pain in
the epigastrium which is often relieved by goods or antacids*
-Treatment: amoxicillin, clarithromycin, omeprazole for two weeks
Rotavirus - answercommon in children younger than 3
-symptoms: fever, loss of appetite, copious diarrhea, flatulence, vomiting, stomach
cramps
-treatment: fluids, supportive care, antibiotics
Appendicitis - answerconstant periumbilical pain, shifting to RLQ, vomiting follows pain,
small amount of diarrhea, fever, chills, malaise, loss of appetite, N/V
-mild elevated WBC in urine maybe (only super high with gangrene or perforation)
-Treatment: surgery, antibiotics
Obturator Sign - answertesting for appendicitis
patients right hip and knee flexed, examiner slowly rotates right leg internally which
stretches obturator muscle. Pain over RLQ is a positive sign
Gastroenteritis - answercharacterized by irritation and inflammation of the stomach
-s&s: watery diarrhea, N/V, abd pain and cramping, low grade fever, headache,
dehydration
Giardia - answercauses: ingestion of contaminated food or water
-s&s: diarrhea, abd cramps, nausea, bloating, gas and weight loss
-tx: oral meds (metronidazole or tinidazole), hand washing, hydrate
*avoid contaminated food or water*
Samonella - answercauses: consumption of raw or undercooked poultry, eggs, meat
and dairy products
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