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Gastrointestinal NP
Info & Q: NP EXAM
| Question | Answer |
|---|---|
| Which drugs should be avoided in pts with GERD because it will exacerbate their symptoms? | CCB - muscle control the sphincter, calcium makes muscles contract thus loosens the LES |
| What is pyrosis? | Heartburn |
| Mechanism of Action: Antacids | Raise pH |
| How soon and how long do Antacids work? | Fastest relief for about 30 minutes |
| Name some Antacids: | 1. Maalox 2. Gaviscon 3. Rolaids 4. Tums |
| Mechanism of Action: H2 Blockers | Decrease acid production |
| How soon and how long do H2 Blockers work? | Relief in 1-2 hours and last about 6-12 hours. |
| H2 Blockers suffix: | tidine |
| Name some H2 Blockers: | 1. Cimetidine (Tagamet) 2. Ranitidine (Zantac) 3. Famotidine (Pepcid) 4. Nizatidine (Axid) |
| What are the Cadillac drugs for tx GERD: | Proton Pump Inhibitors (PPI) |
| Mechanism of Action: Proton Pump Inhibitor (PPI) | reduce gastric secretion; shuts down the proton (H) pump |
| Proton Pump Inhibitor (PPI) suffix: | prazole |
| How soon and how long do PPIs work? | Usually not PRN because take 2-3 days to begin and take for 4-8 weeks |
| Name some PPIs: | 1. lansoprazole (Prevacid) 2. omeprazole (Prilosec) 3. pantoprazole (Protonix) 4. esomeprazole (Nexium) 5. rabeprazole (Aciphex) |
| Coumadin is a very dirty drug? T or F | True |
| Tagamet is a very dirty drug? T or F | True |
| Pts with recurrent or chronic GERD OR atypical symptoms ie hoarse, sore throat are at increase risk of what? | Barret's esophageal |
| What should we do/order if we suspect Barret's esophageal? | Refer/Endoscopy |
| What is the most common tx for H. pylori? | Triple Therapy: 2 Antibiotics and 1 PPI |
| When pt c/o diarrhea it is very important to get a good and thorough history? T or F | TRUE |
| Diarrhea asso with gastroenteritis usually progresses in this manner: | Upper GI - vomiting followed by Lower GI - diarrhea |
| Stool smear positive for WBCs think 2 things: | 1. bacterial infection 2. inflammation |
| What intervention for a pt c/o diarrhea for 36 hrs and mild dehydration: | Oral rehydration with Pedi-lyte |
| Common symptoms of diverticulitis include? | LLQ pain and fever |
| Describe a positive Murphy's sign: | Ask pt to exhale then press RUQ then Pt breathes in. During inspiration abd contents are pushed down as the diaphragm moves down. Pt stops breathing in as the GB is tender & in move down comes in contact with the examiner's fingers; test is pos |
| McBurney's Point | very tender with app |
| Psoas Test | lie down; have pt bring R knee to chest while you push it away thus causing contraction of the psoas muscle and abd pain; APP |
| Obtruator | lie down; external rotate hip stretching obtruator thus abd pain; APP |
| Jar Test | Stand and bounce on heels; pain; APP |
| AST and ALT measure liver for what? | integrity |
| PT and Albumin measure liver ability for what? | to synthesize things |
| Bilirubin, GGT, Alkaline Phosphatase measure liver for what? | excretory function |
| ALT vs AST: | 1. ALT is higher than AST think - liver viral hepatis 2. AST is higher than ALT think - consumption Acetominophen, Statins, Tequilla |
| Elevated Alkaline Phosphatase think? | possible bone or liver disease |
| Note that Alkaline phosphatase may be elevated in normal situations such as (2: | 1. adolescence (rapid bone turnover) 2. pregnancy |
| What are the 5 types of Hepatitis? | A, B, C, D, E |
| Which types of hepatitis can cause chronic disease? | B, C, D |
| How did you get hepatitis A? | Ate something (bad oysters, water, fecal matter) |
| What is an immunoglobulin? | an Antibody |
| Elevated IgM means? | IgM - You Feel Miserable; first to rescue; start producing them; acute infection |
| Elevated IgG means? | IgG - Gone Infection; you have gotten over your illness; |
| No IgM or IgG means? | Never had whatever it is? Vaccinate if available. |
| How did you get Hepatitis B? | Blood and Body fluid |
| Hepatitis B surface antigen means? | Postive means Hep B bug is in you Negative means Hep B bug is gone |
| Hepatitis B core means | Positive core equals you had bug Negative core equals you only had vaccine |
Created by:
dprest
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