NRNP 6540 WEEK 5 KNOWLEDGE CHECK: GASTROINTESTINAL AND
HEPATOBILIARY DISORDERS STUDY GUIDE EXAM SOLVED #7
Hepatitis markers - correct answer igg: G=gone (infection is gone)
Igm: M=antibody made Minute infected (acute infection)
Hbsag: hep B surface antigen = infection
Anti-hbs: hep B surface antibody = immunity
After HP shots - correct answer
Gastroesophageal reflux disease (GERD) - correct answer -backflow of contents of the
stomach into the esophagus, often resulting from abnormal function of the lower
esophageal sphincter, causing burning pain in the esophagus
-risk: obesity, hiatal hernia, drugs/chemicals that relax the LES (Anticholinergics,
nitrates, calcium channel blockers, nicotine), delayed gastric emptying (Gastroparesis,
ulcers)
-s/sx: pain after 1 hr fo eating, worse pain if lies down or ABD pressure increase r/t
coughing, vomiting, straining
-dx: esophageal endoscopy, tissue biopsy to assess dysplastic changes
-tx: ppis, weight loss, smoking cessation, elevate head, no tight clothing
Pancreatitis - correct answer -between ages 50-60, more in blacks
-risk: Obstructive binary tract disease, alcoholism, peptic ulcers, hyperlipidemia,
smoking and genetics
-acute and chronic
Acute live failure - correct answer -very rare, from severe impairment of liver cells
without preexisting liver disease or cirrhosis
-Acetaminophen is leading cause
-death of hepatocytes may be viral or toxic injury
-will develop 6-8 weeks after viral hepatitis or 5 days to 8 weeks after acetaminophen
OD
-elevated conjugated and unconjugated bilirubin
Chronic liver failure - correct answer
Gall bladder disease - correct answer -includes inflammation, infection, stones, or
obstruction of the gallbladder
-UQ abd pain
-Cholelithiasis=gallstone
-Cholecystitis=inflammation of the gallbladder
Diverticulitis - correct answer -inflammation of the diverticula
-predisposing factors: older age, genetics, obesity, smoking, ASA/nsaids
, -can occur anywhere in the GI tract
-s/sx: pain in lower ABD, diarrhea
Tx: ultrasound, sigmoidoscopy, colonoscopy, increase fiber intake to increase stool
weight to lower colonic pressures
Jaundice - correct answer -yellow pigmentation of the skin caused by hyperbilirubemia
(>2.5-3)
-cause: obstruction to bile flow (gallstones), intrahepatic obstruction (Cirrhosis),
excessive hemolysis of rbcs
Bilirubin - correct answer orange-yellow pigment in bile; formed by the breakdown of
hemoglobin when red blood cells are destroyed
Upper GI bleed - correct answer -in the esophagus, stomach, duodenum
-frank, bright red blood
-causes: Bleeding esophageal or gastric varies, a Mallory-Weiss tear at the esophageal-
gastric junction on , nsaids, ASA,
Lower GI bleed - correct answer -bleeding from the jejunum or ileum of the small
intestine, colon, rectum
-causes: polyps, IBD, diverticular disease
Hectic encephalopathy - correct answer -neurologic syndrome, impaired behavioral,
cognitive and motor function
-3 types: Type A (rapidly during acute fulminant hepatitis), Type B (after portosystemic
bypass or shunting w/out liver dx) and type C (slowly with cirrhosis)
-combo of biochemical and neurotransmission alterations, Free neurotoxins going to
brian
-most hazard is Ammonia which is the end products of intestinal protein digestion
-s/sx: memory loss, irritability, lethargy
Dx: test ammonia levels
Tx: correct F/E levels
Intra-abdominal infections - correct answer
Appendicitis - correct answer inflammation of the vermiform appendix at the juncture of
the large and small intestines
Kidney stones - correct answer -crystals, protein in kidneys, ureters and urinary bladder
-causes: (1) supersaturation of salts in the urine, (2) precipitation of the salts from a
liquid to a solid state (crystals), (3) growth through crystallization or
Agglomeration and (4) the effect of