CMN 568 Unit 4 Exam With Correct Solutions 2024

CMN 568 Unit 4 Exam With Correct
Solutions 2024


Acute .onset .of .severe .pain .and .vomiting .suggests .what? .- .correct .answer.+ .Peritoneal
.irritation

+ .Acute .gastric .or .intestinal .obstruction
+ .Pancreaticobiliary .disease

(McPhee .p .588)

Persistent .vomiting .suggests .what? .- .correct .answer.+ .Pregnancy
+ .Gastric .outlet .obstruction
+ .Gastroparesis
+ .Intestinal .dysmotility
+ .Psychogenic .disorders
+ .CNS .or .systemic .disorders
.

(McPhee .p .589)

Vomiting .in .the .morning .suggests .what? .- .correct .answer.+ .Pregnancy
+ .Uremia
+ .ETOH .intake
+ .↑ .ICP

Vomiting .after .meals .suggests .what? .- .correct .answer.+ .Bulimia
+ .Peptic .ulcer .disease
+ .Other .psychogenic .causes

(McPhee .p .589, .Shimp .p .373)

Vomiting .of .undigested .food .1-2 .hours .after .a .meal .suggests .what? .- .correct .answer.+
.Gastroparesis

+ .Small .bowel .obstruction
+ .Gastric .outlet .obstruction .

NOTE: .Sucussion .splash .often .heard .on .auscultation

(McPhee .p .589, .Shimp .p .373)

,4 .causes .of .nausea .and .vomiting .- .correct .answer.1) .Visceral .afferent .stimulation
.(seratonin .receptors)

2) .Vestibular .disorders .(fibers .↑ .in .histamine .and .muscarinic .receptors)
3) .CNS .disorders .
4) .Irritation .of .chemoreceptor .trigger .zone .

(McPhee .Table .15.1)

Ways .to .stimulate .the .chemoreceptor .trigger .zone .and .cause .vomiting .- .correct
.answer.1) .Chemo

2) .Medications .and .drugs
3) .Radiation .therapy
4) .Systemic .disorders

CNS .disorders .that .can .cause .vomiting .- .correct .answer.1) .Migraine
2) .↑ .ICP
3) .Infections .(e.g. .meningitis, .encephalitis)
4) .Psychogenic

Vestibular .disorders .that .can .cause .vomiting .- .correct .answer.Labyrinthitis, .Meniere
.syndrome, .motion .sickness




Define .RETCHING .- .correct .answer.Strong, .spasmodic, .involuntary .effort .to .vomit
.without .bringing .up .emesis.




(McPhee .and .Shimp)

Define .REGURGITATION .- .correct .answer.Effortless .return .of .gas .or .small .amounts .of
.food .from .stomach .(McPhee .and .Shimp)




Common .causes .of .vomiting .in .infants .- .correct .answer.1) .Any .acute .illness .(esp
.gastroenteritis)

2) .Hypertrophic .pyloric .stenosis .(2 .- .8 .weeks .of .life, .may .feel .an ."olive" .in .epigastric .area
.after .feeding)

3) .Intussisception .(6 .- .18 .months .of .life, .sausage-shaped .mass .and ."currant .jelly" .stools)
4) .Regurgitation .("spitting .up") .-- .usually .normal .and .usually .resolves .by .6 .- .12 .months.

(Shimp)

Medications .associated .with .N/V .- .correct .answer.+ .Antidepressants .
--SSRIs
--venlafaxine

+ .Cardiac .meds .
--antiarrhythmics

, --anti-HTN .meds .(diuretics, .beta .blockers, .CCBs)
-- .↓ .CHO .meds .(statins, .gemfibrozil, .niacin)
-- .Digoxin

+ .Chemotherapy .agents

+ .GI .meds .
--sulfasalazine .(for .tx .of .UC)
--azathioprine .(tx .of .Crohns .or .UC)

+ .Meds .to .treat .infectious .diseases
-- .Acyclovir
-- .Anti-fungals
-- .ABX
-- .UTI .meds
-- .TB .meds

+ .Pain .meds
-- .Anti-gout .meds
-- .Aspirin
-- .NSAIDs
-- .Opioids

+ .Others
-- .Lithium
-- .Metformin
-- .BC .pills
-- .Quinidine

(Shimp .Table .46-2)

OLD .CART .- .correct .answer.*O*nset .-- .When .did .it .start
*L*ocation .-- .Can .you .pinpoint .it? .Does .it .radiate?
*D*uration .-- .How .long .have .you .had .it?

*C*haracter-- .Is .it .sharp, .dull, .throbbing, .burning, .crampy, .colicky?
*A*ggravating .factors .-- .What .makes .it .worse?
*R*elieving .factors .-- .What .makes .it .better?
*T*iming .-- .Is .the .pain .constant .or .intermittent? .Does .it .occur .at .a .certain .time .of .day?

Antiemetic .medications .- .correct .answer.1) .Seratonin-receptor .antagonists
.(McPhee/Shimp)

- .Ondansetron .(and .other .-setrons)
2) .Corticosteroids .(McPhee)
- .Dexamethasone .and .methylprednisolone .(used .to .enhance .action .of .seratonin-receptor
.antagonists .used .for .post-operative .and .chemo-related .n/v)