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Chamberlain NR 511 Midterm Exam 2024/2025 Questions With Completed & Verified Solutions.
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Chamberlain NR 511 Midterm Exam 2024/2025 Questions With Completed & Verified Solutions.
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Chamberlain NR 511 Midterm__________ ___________ is a common condition found in the outpatient setting that
presents with inflammation of the auditory canal, benign and self-limiting but painful. -
ANS - Otitis externa
\____________ hearing loss is gradual and progressive, high frequency loss, and
deterioration of the cochlea. - ANS - Sensorineural
*This deals with the inner ear and its components
\____________ is the sensation of wound without an exogenous sound source. What
causes this sensation? - ANS - 1. Tinnitis
2. Poorly understood, might be from chronic noise exposure that may damage the cilia
and auditory hair cells or spontaneous activity in individual auditory nerve fibers.
\____________ sign can help with the diagnosis of cholecystitis and is performed by
applying pressure at the subcostal region of the right upper quadrant on inspiration. -
ANS - Murphy's
\_____________ is age related hearing loss and is a form of sensorineural hearing loss. -
ANS - presbycusis
\_______________ is scarring after the tympanic membrane has ruptured and healed.
What might this scarring be caused from? - ANS - Otosclerosis. AOM or tympanovstomy
tubes that are expelled.
\Acute infection of the middle ear may cause a relative ischemia in drum concurrent with
increased pressure in the middle ear space. What does this lead to? - ANS - Tear or
rupture of the tympanic membrane.
\Acute pancreatitis may be a result from what two physical circumstances? - ANS - 1.
Injury to the acinar cells
2. Impaired secretion of proenzymes
\Although diverticula con occur anywhere in the intestines, where is the most common
place for them to arise? - ANS - Descending and sigmoid colon
\As the autodigestion and bleeding occur in the pancreas, what is the end result? - ANS -
Liquification of pancreatic tissues known as: liquefactive hemorrhagic necrosis.
\At what age should a colonoscopy begin to be a routine part of a physical exam? - ANS -
50 years old
\At what point are systemic antibiotics needed for acute otitis externa treatment? What
do these antibiotics need to cover? - ANS - 1. With refractory cases or auricle cellulitis
2. Pseudomonas and s. aureus.
\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.
\At what severity are pharmacological measures taken in patients with IBS? Mild,
moderate, or severe? - ANS - Moderate to severe
\Bacteria eventually make their way through the gall bladder wall and into the
_____________ causing _____________. This results in ____________ tenderness. - ANS
- 1. peritoneum
,2. peritonitis
3. rebound
\Common causes of constipation? - ANS - 1. Idiopathic
2. Narcotics
3. Tricyclics antidepressants
4. Iron supplements
5. Anticholinergics
6. Antidiarrheals
7. Antipsychotics
8. Calcium supplements
9. Can be a symptom of colorectal cancer
\Crohn's Disease represents an abnormality in intestinal immune response. What is the
result of this abnormality with regard to the bowel tissue and subsequent complications?
- ANS - 1. Causes fibrosis which thickens the bowel wall
2. Narrows the lumen of the bowel leading to obstructions, fistulas, and ulcerations.
\Describe acute pancreatitis in one sentence... - ANS - Acute pancreatitis is the sudden
inflammation and hemorrhaging of the pancreas due to destruction by its own digestive
enzymes, also called auto digestion.
\Describe IBS as it pertains to its effect on the bowels... - ANS - Disordered sensation or
abnormal function of the small or large intestine.
\Differential diagnosis for conductive hearing loss... - ANS - 1. Cerumen accumulation or
impaction (ceruminosis)
2. Foreign body in the external canal
3. Otitis externa
4. Chroic otitis media
5. Middle ear effusion
6. Otosclerosis
7. Vascular anomaly
8. Cholesteatoma
\Differential diagnosis for sensorineural hearing loss... - ANS - 1. Ototoxicity
2. Exposure to loud noises
3. Autoimmune issue
4. Acoustic neuroma
5. Ménière's disease
\Fill out the acronym "I GET SMASHED" in order to show the varied causes of acute
pancreatitis. - ANS - I: idiopathic
G: gallstones
E: ethanol abuse
T: trauma (i.e. knife wound, not just a punch)
S: steroids
M: mumps virus
A: autoimmune diseases
S: scorpion stings
H: hypertriglyceridemia and hypercalcemia
, E: endoscopic retrogrande cholangiopancreatography (ERCP).
D: drugs --> sulfa, reverse transcriptase inhibitors and protease inhibitors.
\How are abscesses treated non-pharmacologically? - ANS - 1. Keep the area clean
2. Apply warm compresses TID
3. Cover if draining
\How are abscesses treated pharmacologically? - ANS - 1. Broad spectrum antibiotic
after I&D until culture results obtained to ensure coverage.
2. Cover with mupirocin (bactroban) ointment and non-stick bandage.
\How are zymogens used to digest food? - ANS - They are secreted into the pancreatic
duct and enter the duodenum where they are activated by the protease trypsin.
\How do gallstones cause acute pancreatitis? - ANS - They can become lodged in the
Sphincter of Oddi which is the opening of the of the common bile duct into the
duodenum. This results in much the same results as alcohol induced acute pancreatitis
(because of the plug)
\How does acute pancreatitis affect the body's ability to clot? - ANS - It affects the
systemic activation of coagulation factors which may result in disseminated
intravascular coagulation (DIC).
\How does acute pancreatitis affect the body's respiratory system? - ANS - May lead to
acute respiratory distress syndrome (ARDS) where massive pancreatic inflammation
leads to leaky blood vessels throughout the body making it harder to breath. #1 killer in
patients with acute pancreatitis.
\How does alcohol induce acute pancreatitis? - ANS - 1. Alcohol increases zymogen
secretion from acinar cells. Simultaneously, it decreases fluid and bicarbonate in the
ducts of the pancreas. This results in thick pancreatic juices that can form a protein plug
in the pancreatic ducts and therefore cause a blockage.
2. Backed up pancreatic juices increase pressure and may distend ducts. Membrane
trafficking* becomes chaotic. Zymogen granules may fuse with lysosomes. This brings
trypsinogen into contact with lysosomal digestive enzymes. Trypsinogen then converts
to trypsinogen which starts a cascade of enzyme activation resulting in AUTODIGESTION
of the pancreas = acute pancreatic.
3. It stimulates release of cytokines which attracts a strong immune reaction. Neutrophils
arrive and release superoxide and proteases which contributes to the problem.
4. High alcohol consumption and oxidative metabolism of alcohol produces reactive
oxygen species which may overwhelm cellular defenses.
*Membrane trafficking is the process by which proteins and other macromolecules are
distributed throughout the cell, and released to or internalised from the extracellular
space. Membrane trafficking uses membrane-bound vesicles as transport intermediaries.
\How does diverticulosis differ from diverticulitis? - ANS - The latter occurs when the
former becomes inflamed and subsequently has the potential to rupture
\How does folliculitis present? - ANS - Pustules and erythema around hair follicle.
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