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Chamberlain NR 511 Midterm Questions
and Answers | 100% Pass
What are common causes of N/V associated with gastritis? - Answer✔✔-Alcohol, NSAIDs, ASA, ABX, and
illicit substances
What is the most common cause of nausea and vomiting? - Answer✔✔-Acute Gastroenteritis (AGE)
What are some manifestations of AGE? - Answer✔✔-Nausea, vomiting, and diarrhea, fever, abdominal
pain. May also include fatigue, malaise, anorexia, tenesmus and borborygmus.
How is the severity of AGE gauged? - Answer✔✔-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? - Answer✔✔-Travel, dining
locations, ABX history..
What happens to the pH of the stomach when antacids are taken and how does this affect bacteria? -
Answer✔✔-High pH can make it easier for bacteria to survive and cause and infection.
How does motility of the GI tract affect bacteria colonization? - Answer✔✔-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? - Answer✔✔-IgA...may also
help protect against a future attack by the same pathogen.
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Onset of N/V begin within 6 hours after exposure. Is this bacterial or viral? - Answer✔✔-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? - Answer✔✔-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/ - Answer✔✔-Mucosal damage and inflammatory process secondary to invasive
pathogens.
What do frothy stools and flatus suggest? - Answer✔✔-Malabsorption problem.
Patients with prolonged AGE illness who are malnourished may present with edema. What is the
reason? - Answer✔✔-Hypoalbuminemia
T or F: Chronic diarrhea usually has a noninfectious etiology. - Answer✔✔-True
T or F: Acute diarrhea usually is caused by infectious agents or toxins - Answer✔✔-True
What is the most common viral pathogen causing AGE in adults? - Answer✔✔-Norovirus
What is the most common viral pathogen causing AGE in pediatrics? - Answer✔✔-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 - Answer✔✔-
False
T or F: A CBC will help distinguish between viral and bacterial AGE - Answer✔✔-False
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When are stool studies warranted? - Answer✔✔-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? - Answer✔✔-Shigella, Campylobacter, and
E. coli.
What should the clinician do if the patient develops diarrhea after initiation of completion of antibiotic
therapy? - Answer✔✔-Test for C. diff.
What are some DDx of AGE, particularly in patients with persistent or chronic diarrhea and severe
abdominal pain? - Answer✔✔-IBS, IBD, ischemic bowel disease, partial bowel obstruction, small bowel
diverticulosis.
What are some red flag symptoms that may indicate the need for hospitalization? - Answer✔✔-
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? - Answer✔✔-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? - Answer✔✔-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? - Answer✔✔-Signs of
hypovolemia such as hypotension, tachycardia, pallor, and poor skin turgor.
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T of F: Empiric antimicrobial therapy is recommended for patients with severe diarrhea suspected form
traveling. - Answer✔✔-True. Bactrim, Ciprofloxacin, Norfloxacin, Floxacin.
T or F: Antibiotic prophylaxis for patients traveling to high-risk areas is appropriate. - Answer✔✔-True
How effective is antibiotic prophylaxis for patients traveling to high-risk areas? - Answer✔✔-90%
effective
What does antibiotic prophylaxis treatment consist of? - Answer✔✔-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? - Answer✔✔-Two-day course of Loperamide (Imodium)
What is an appropriate symptomatic treatment for patients < 65 years or age with significant vomiting? -
Answer✔✔-Two-day course of Zofran or Phenergan.
What is the best way to prevent AGE? - Answer✔✔-Hand washing.
T or F: Kids can attend daycare with infectious diarrhea as long as they're separated from other children.
- Answer✔✔-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? -
Answer✔✔-IBD, IBS, Infectious Colitis, and Constipation
If pain is present in the left lower quadrant, what might be the etiology related to bowel disorders? -
Answer✔✔-Diverticulitis, IBS, IBD, Constipation, and Infectious Colitis.
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