Chamberlain
NR
511
Midterm
What
are
common
causes
of
N/V
associated
with
gastritis?
-
ANS
Alcohol,
NSAIDs,
ASA,
ABX,
and
illicit
substances
What
is
the
most
common
cause
of
nausea
and
vomiting?
-
ANS
Acute
Gastroenteritis
(AGE)
What
are
some
manifestations
of
AGE?
-
ANS
Nausea,
vomiting,
and
diarrhea,
fever,
abdominal
pain.
May
also
include
fatigue,
malaise,
anorexia,
tenesmus
and
borborygmus.
How
is
the
severity
of
AGE
gauged?
-
ANS
Dehydration
secondary
to
profuse
watery
diarrhea,
fever
greater
than
101ºF
(38.3ºC),
vomiting,
or
dysentery.
What
are
important
parts
of
a
patient's
history
when
AGE
is
suspected?
-
ANS
Travel,
dining
locations,
ABX
history..
What
happens
to
the
pH
of
the
stomach
when
antacids
are
taken
and
how
does
this
affect
bacteria?
-
ANS
High
pH
can
make
it
easier
for
bacteria
to
survive
and
cause
and
infection.
How
does
motility
of
the
GI
tract
affect
bacteria
colonization?
-
ANS
Small
bowel
stasis
as
a
result
of
obstruction,
diverticulitis,
or
blind
loop
syndrome
frequently
develop
an
overgrowth
of
bacteria
within
the
stagnant
segment.
Which
immunoglobulin
may
protect
the
GI
tract
against
invading
organisms?
-
ANS
IgA...may
also
help
protect
against
a
future
attack
by
the
same
pathogen.
Onset
of
N/V
begin
within
6
hours
after
exposure.
Is
this
bacterial
or
viral?
-
ANS
Bacterial:
time
frame
suggests
food
poisoning
resulting
from
the
ingestion
of
a
preformed
toxin
such
as
that
of
Bacillus
cereus.
What
two
indications
are
highly
suggestive
of
viral
AGE?
-
ANS
Incubation
periods
greater
than
14
hours
and
the
initial
symptom
of
vomiting.
If
a
patient
presents
with
AGE
and
reports
bloody
stools,
what
can
be
understood
about
the
reason
for
blood
in
the
stool/
-
ANS
Mucosal
damage
and
inflammatory
process
secondary
to
invasive
pathogens.
What
do
frothy
stools
and
flatus
suggest?
-
ANS
Malabsorption
problem.
Patients
with
prolonged
AGE
illness
who
are
malnourished
may
present
with
edema.
What
is
the
reason?
-
ANS
Hypoalbuminemia
T
or
F:
Chronic
diarrhea
usually
has
a
noninfectious
etiology.
-
ANS
True T
or
F:
Acute
diarrhea
usually
is
caused
by
infectious
agents
or
toxins
-
ANS
True
What
is
the
most
common
viral
pathogen
causing
AGE
in
adults?
-
ANS
Norovirus
What
is
the
most
common
viral
pathogen
causing
AGE
in
pediatrics?
-
ANS
Rotavirus.
This
has
been
greatly
reduced
since
the
introduction
of
the
rotavirus
vaccine.
T
or
F:
Stool
studies
are
indicated
in
the
absence
of
bloody
diarrhea
or
systemic
disease
-
ANS
False
T
or
F:
A
CBC
will
help
distinguish
between
viral
and
bacterial
AGE
-
ANS
False
When
are
stool
studies
warranted?
-
ANS
Severe
or
prolonged
diarrhea,
a
fever
>
38.5ºC,
bloody
stools
or
stools
that
test
positive
for
leukocytes
or
occult
blood.
What
are
common
pathogens
involved
in
Traveler's
Diarrhea?
-
ANS
Shigella,
Campylobacter,
and
E.
coli.
What
should
the
clinician
do
if
the
patient
develops
diarrhea
after
initiation
of
completion
of
antibiotic
therapy?
-
ANS
Test
for
C.
diff.
What
are
some
DDx
of
AGE,
particularly
in
patients
with
persistent
or
chronic
diarrhea
and
severe
abdominal
pain?
-
ANS
IBS,
IBD,
ischemic
bowel
disease,
partial
bowel
obstruction,
small
bowel
diverticulosis.
What
are
some
red
flag
symptoms
that
may
indicate
the
need
for
hospitalization?
-
ANS
Hypovolemia,
dehydration,
abnormal
electrolytes,
decreased
renal
function,
bloody
stool/rectal
bleeding,
weight
loss,
severe
abdominal
pain,
prolonged
symptoms
greater
than
1
week,
pregnancy,
advanced
age,
history
of
hospitalization
or
antibiotic
use
in
the
last
3-6
months.
What
is
the
usual
course
of
treatment
for
AGE?
-
ANS
Only
supportive
treatment
is
initiated
since
AGE
is
usually
self-limiting
and
resolves
within
1
week
after
onset
of
symptoms.
How
such
patients
with
evidence
of
dehydration
be
treated
initially?
-
ANS
Fluid
repletion
and
nutrition.
Sports
drinks
aren't
as
effective
as
specific
electrolyte
replenishing
drinks.
At
what
point
should
a
patient
be
referred
to
the
hospital
for
dehydration?
-
ANS
Signs
of
hypovolemia
such
as
hypotension,
tachycardia,
pallor,
and
poor
skin
turgor.
T
of
F:
Empiric
antimicrobial
therapy
is
recommended
for
patients
with
severe
diarrhea
suspected
form
traveling.
-
ANS
True.
Bactrim,
Ciprofloxacin,
Norfloxacin,
Floxacin.
T
or
F:
Antibiotic
prophylaxis
for
patients
traveling
to
high-risk
areas
is
appropriate.
-
ANS
True How
effective
is
antibiotic
prophylaxis
for
patients
traveling
to
high-risk
areas?
-
ANS
90%
effective
What
does
antibiotic
prophylaxis
treatment
consist
of?
-
ANS
Bactrim,
Ciprofloxacin,
Norfloxacin,
or
Floxacin
given
once
daily
until
2
days
after
returning
home.
What
is
an
appropriate
symptomatic
treatment
for
patients
<
65
years
or
age
with
moderate
to
severe
diarrhea?
-
ANS
Two-day
course
of
Loperamide
(Imodium)
What
is
an
appropriate
symptomatic
treatment
for
patients
<
65
years
or
age
with
significant
vomiting?
-
ANS
Two-day
course
of
Zofran
or
Phenergan.
What
is
the
best
way
to
prevent
AGE?
-
ANS
Hand
washing.
T
or
F:
Kids
can
attend
daycare
with
infectious
diarrhea
as
long
as
they're
separated
from
other
children.
-
ANS
False!
Not
until
the
diarrhea
has
stopped.
If
pain
is
present
in
the
right
lower
quadrant,
what
might
be
the
etiology
related
to
bowel
disorders?
-
ANS
IBD,
IBS,
Infectious
Colitis,
and
Constipation
If
pain
is
present
in
the
left
lower
quadrant,
what
might
be
the
etiology
related
to
bowel
disorders?
-
ANS
Diverticulitis,
IBS,
IBD,
Constipation,
and
Infectious
Colitis.
If
pain
is
present
in
the
left
upper
quadrant,
what
might
be
the
etiology
related
to
bowel
disorders?
-
ANS
Stomach
ulcers,
pancreatitis,
and
gastritis.
If
pain
is
present
in
the
right
upper
quadrant,
what
might
be
the
etiology
related
to
bowel
disorders?
-
ANS
Gall
bladder,
hepatitis,
and
pancreatitis.
T
or
F:
IBS
is
a
disorder
of
bowel
function
in
the
absence
of
an
atomic
abnormality.
-
ANS
True
What
are
common
symptoms
of
IBS?
-
ANS
Changes
in
bowel
habits
such
as
diarrhea
(IBS-D),
constipation
(IBS-C),
abdominal
pain,
bloating,
rectal
urgency
with
diarrhea.
What
are
some
extra-intestinal
(outside
the
intestines)
symptoms
of
IBS?
-
ANS
Sexual
dysfunction,
loss
of
libido,
dyspareunia,
muscle
aches
and
pains,
fatigue,
fibromyalgia,
headaches,
back
pain,
urinary
urgency,
urinary
hesitation,
or
bladder
spasms.
T
or
F:
IBS
results
in
serious
medical
consequences
-
ANS
False,
prognosis
for
IBS
is
excellent.
T
or
F:
IBS
is
a
risk
factor
for
IBD
(Crohn's
and
UC)
and
colon
cancer.
-
ANS
False
What
are
the
two
most
common
types
of
bowel
disorders
under
the
Inflammatory
Bowel
Disease
(IBD)
umbrella?
-
ANS
Ulcerative
Colitis
(UC)
and
Crohn's
Disease
