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AG-ACNP II: GI (Questions With Accurate Answers)
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AG-ACNP II: GI (Questions With Accurate Answers)
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AG-ACNP II: GI (Questions With Accurate Answers)What is mesenteric ischemia? Right Ans - Failure of blood supply of the
mesentery to carry enough oxygen to meet intestinal needs
What are the most common causes of mesenteric ischemia? Right Ans -
Arterial embolisms, arterial thrombi, and low flow states
How do low flow states happen in mesenteric ischemia? Right Ans - Shock,
vasopressors, CHF, aortic stenosis
What are the two best diagnostics for evaluating mesenteric ischemia?
Right Ans - Mesenteric arteriography to evaluate arteries, and the contrast
MRA (best of the two)
Treatment choices for mesenteric ischemia: Right Ans - Surgeon referral
(possible colon resection), declot, stent, bypass, restore blood flow and
oxygenation
What are the common S/S of mesenteric ischemia? Right Ans - Cramping,
abdominal pain with no other reason, possible rectal bleeding, and
hypotension
What is the best diagnostic of choice for appendicitis? Right Ans - CT of
abdomen
What is the initial presentation of appendicitis? Right Ans - Vague,
periumbilical pain, before progressing to RLQ pain
What are the antibiotics of choice for appendicitis? Right Ans - Broad
spectrum, specific to gram negative and anaerobic
Antibiotic choice for unruptured appendicitis: Right Ans - Cefoxitin
(Mefoxin)
Antibiotic choices for ruptured or gangrenous appendicitis: Right Ans -
Ampicillin, Gentamycin, Clindamycin, Flagyl, Primaxin
, Psoas Sign: Right Ans - Pain with right thigh extension, while the patient
lies on their back and attempts to raise leg with resistance
Obturator Sign: Right Ans - Pain during flexion of right thigh and then
internally rotated with knee bent.
Rovsing's Sign: Right Ans - Pain on the RLQ during palpation of left
abdomen
McBurney's Point: Right Ans - The lower 1/3 of the way up from the iliac
crest
Which type of test has the highest accuracy for detecting a small bowel
obstruction? Right Ans - CT with oral contrast
How might a SBO appear on an abdominal plain film? Right Ans - Ladder-
like pattern with air-fluid levels on upright, with possible thickening of
abdominal wall
How do you manage an SBO? Right Ans - NGT to LIWS, IVF for hydration,
pain control, and surgical consult for possible resection or release of
adhesions
When are antibiotics recommended for SBO? Right Ans - Only if
strangulation or necrosis is present
Cholecystitis: Right Ans - Inflammation of the gallbladder
Cholelithiasis: Right Ans - Stones in the gallbladder
Choleydocholithiasis: Right Ans - Stones in the common bile duct
Murphy's Sign: Right Ans - Pain experienced when you place your fingers
in the RUQ (just below the rib cage) and the patient takes a deep breath
Indicative of Cholecystitis
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