What is viseral pain CORRECT ANSWER viscera (organs) -pain that is caused by distention or spasm of a hollow viscus
How would you describe parietal
... [Show More] pain and what abdominal disorder often causes it ? CORRECT ANSWER sharp well localized pain caused by irritation of the peritoneum ; often associated with appendicitis
abdominal pain that is described as colicky (comes and goes) may result from ? CORRECT ANSWER gallstones or renal stones
What is most common cause of constipation in the US? What is recommended to help? CORRECT ANSWER lack of dietary fiber; recommended amount is 30 grams daily
How would you treat constipation nonpharmaologically? CORRECT ANSWER *slowly increases fiber 25-35 grams with 12-15 grams in the morning; exercise after meals; uninterrupted toilet time; adequate hydration 64 ounces daily
Celiac disease is described as a malabsorption syndrome related to ? CORRECT ANSWER an immune reaction to gluten in the diet; more common in women ages 40-50
Gluten is found in food products that contain.... CORRECT ANSWER wheat barley and rye
What a patient with celiac disease have a history of ? CORRECT ANSWER chronic diarrhea, foul smelling stools, abdominal bloating, weakness and fatigue
What confirms the diagnosis of celiac disease? CORRECT ANSWER distal duodenal biopsy
How do you treat celiac disease? CORRECT ANSWER gluten free diet, and treatment of nutritional deficiencies such as iron, folate and vitamin B12
Epigastric discomfort, postprandial fullness, early satiety, anorexia, belching, nausea, heartburn, vomiting, bloating, borborygmi, dysphagia, and abdominal burning are symptoms of .... CORRECT ANSWER dyspepsia
GERD is the backward flow of stomach contents into the CORRECT ANSWER esophagus without associated retching or vomiting
What are some lifestyle modifications for GERD? CORRECT ANSWER smoking cessation, avoid tight clothing, diet, exercise, don’t eat 4 hours before bedtime, sleep with HOB elevated
The primary cause of GERD is the inappropriate, spontaneous CORRECT ANSWER transient relaxation of the lower esophageal sphincter(LES) to an unknown stimulus
Lifestyle modification are the first line treatment for GERD, name some?? CORRECT ANSWER elevating HOB, avoid large, high fat meals, avoid chocolate, alcohol, peppermint, caffeine, onions garlic, citrus and tomatoes; avoid lying down 3-4 hours after meal, avoid bedtime snacks, weight loss
If lifestyle modifications don’t work in the treatment of GERD what is the first "step up" treatment with non-erosive reflux? CORRECT ANSWER "tidine”: cimetidine, ranitidine, famotidine, nizatidine; if no improvement then PPIs are used
What is the initial therapy for patients with GERD who have erosive esophagitis or barretts esophagus CORRECT ANSWER PPI's (razole) such as omeprazole once a day 30 minutes before breakfast (8-week course)
For a patient with GERD and complications such as erosive esophagitis or barretts esophagus who is unresponsive to treatments what would your plan of action be ? CORRECT ANSWER surgical intervention: nissen fundoplication
GERD is a lifelong disease and patients should be evaluated on a regular basis , patients with mild to moderate symptoms should be instructed to treat how? CORRECT ANSWER lifestyle modifications and antacids or OTC H2-RAs (famotidine) for 4 weeks;
What are the lifestyle modifications for GERD? CORRECT ANSWER elevate HOB, no eating 3-4 hour before bed and no snacks, weight reeducation, smoking cessation, avoid large meals, tight clothing, avoid bending or straining, advise to eat small frequent meals
What are the most common causes of gastroenteritis? CORRECT ANSWER bacterial, viral and parasitic
A stool culture should be done on any patient who has what symptoms? CORRECT ANSWER severe diarrhea, fever >101.3, bloody stools, leukocytes, lactoferrin or occult blood bc there are indications of a bacterial pathogen
Any patient who develops diarrhea after initiation or completion of antibiotics therapy should have a ....... CORRECT ANSWER tissue culture assay or an ELISA test for possible C-Diff
Viral gastroenteritis should be suspected in any patient with ____ as their major symptoms CORRECT ANSWER vomiting; and in cases of possible food or water contamination
All patients who present with diarrhea should be treated with CORRECT ANSWER fluid and electrolyte management; patients who can take oral replacement should be instructed to
drink fluids with a sodium content 45-75 meq (pedialyte or gatorade)
Patients with diarrhea require a diet that includes calories that come from CORRECT ANSWER boiled starches and cereals (potatoes, rice, pasta wheat and oats), with the addition of salt
Patients with febrile dysentery should not receive anti- motility medications, why? CORRECT ANSWER because slowing the intraluminal time may prolong the duration of the disease
How would you treat travelers diarrhea? CORRECT ANSWER with trimethoprim-sulfamethoxazole (Bactrim DS); one double strength tablet twice a day for 3 days
what is the drug of choice for afebrile nondysenteric cases of acute diarrhea? CORRECT ANSWER loperamide (Imodium)
What would a break in the surface mucosa of the stomach or duodenum, which results when there is a disruption of the normal mucosal defenses and the tissue is exposed to the damaging effects of acid by pepsin> CORRECT ANSWER peptic ulcer disease (gastric and duodenal ulcers)
What are the 3 major causes of PUD? CORRECT ANSWER infection with H-pylori, chronic ingestion of ASA or other NSAID, acid hyper-secretion such as Zollinger-Ellison syndrome
Caffeine, alcohol, and spicy food are no longer considered to be a risk for what disease ? CORRECT ANSWER no longer considered ulcerogenic, PUD
Cigarette smoking, ASA, NSAIDs, and the bacteria Hpylori have been linked to ? CORRECT ANSWER PUD
The hallmark of PUD is ? CORRECT ANSWER complaint of burning or gnawing hunger sensation or pain (dyspepsia) in the epigastrium which is often relieved by foods or antacids
A patient comes in complaining of epigastric pain that clusters and last for minutes with episodes separated by periods of no symptoms, what would you suspect? CORRECT ANSWER PUD
The diagnostic standard for PUD is what? CORRECT ANSWER upper endoscopy
Zollinger-Ellison syndrome should be suspected in patients whose fasting serum gastrin level is above ___ and who have a basal acid output of more than ___? CORRECT ANSWER serum gastrin level 600, basal acid output 15 [Show Less]