NSGl 533/l NSG533l Examl 1l –l Advancedl
Pharmacologyl Guide|l Wilkesl (Latestl
2026/l 2027l Update)l 100%l Verifiedl
Questionsl &l Answersl |l Gradel A
Q:l non-pharml treatmentl forl constipation
Answer:
fiberl +l fluidsl +l physicall activityl
scheduledl toileting,l addressl pelvicl floorl issues
removel offendingl meds
Q:l Pharml treatmentl forl constipation
Answer:
Bulkl formingl :l psylliuml (maintenancel ifl hydrated)
Osmotic:l PEG,l lactulose,l Mgl salts-l cautionl inl renal)l
Stimulants:l (senna/bisacodyl-shortl term/rescue)
Stooll softener:l (docusate-limitedl efficacyl butl mostl commonlyl used)
Rectall options:l glycerin,l enemas)
chronicl stimulant=lazyl bowel
Q:l PAMORAs
Answer:
Peripherally-actingl mul opioidl receptorl antagonistsl blockl thel opioidl inl thel gutl tol
decreasel opioid-inducedl constipation
methylnaltrexone
naloxegol
naldeminel
whenl laxativesl fail
,Q:l Pregnancyl safel constipationl meds
Answer:
bulkl fiberl (psyllium)l
PEGl
lactulose
Senna/bisacodyl:l shortl terml ifl needed
avoidl magnesiuml inl renall issues:l avoidl castorl oil
Q:l causesl ofl diarrhea
Answer:
Acutel <2l wks,l persistentl 2-4l wks,l chronicl >4l wksl
-l virall gastroenteritis
-l bacteriall gastroenteritisl
-l antibioticl therapy
-l inflammatoryl bowell disease
-l irritablel bowell syndrome
Q:l Universall treatmentl goalsl forl diarrhea
Answer:
prevent/treatl dehydrationl andl electrolytel lossl
identifyl redl flags:l blood,l fever,l severel pain,l immunocompromised,l elderly,l severel
dehydration)
symptoml controll whenl appropriate
treatl underlyingl cause
Q:l Medicationsl tol treatl diarrheal (noninfectios/mild)
Answer:
Orall rehydrationl
1)l atropinel +l diphenoxylatel (Lomotil)
2)l Loperamidel (Imodium):l avoidl ifl suspectedl invasicel bacteriall infection:l fever/bloodyl
stool
3)l Bismuth:l canl reducel stooll frequency,l alsol usedl inl travelersl phropylaxis/tx
,Q:l Infectiousl diarrhea
Answer:
morel cautiousl withl antil motilityl agentsl bcl trapl pathogenl
targetedl abxl dependingl onl severity,l organism,l host,l travell exposure
Q:l C.difficilel (AAD)
Answer:
goall isl eradicationl ofl Cl diffl +l preventl recurrentl (notl justl slowl gut)
1stl line:l orall vancol orl fidaxomicinl (stopl thel incitingl abxl whenl possible)
avoidl loperamidel inl suspectedl Cl diffl bcl riskl ofl toxicl megacolon
Q:l Traveler'sl diarrhea
Answer:
ETECl (Enterotoxigenicl Escherichial coli)l isl al commonl bacteriuml causingl traveler'sl
diarrheal andl infantl diarrhea,l transmittedl throughl contaminatedl food/water
Q:l Traveler'sl Diarrheal Treatment
Answer:
mild:l loperamidel (immodium)l orl bismuthl subsalicylate
moderate:l loperamidel +/-l ABX:l azithro.l (z-pak),l quinolone,l orl rifaximin
-azithro=l manyl areas,l rifaximin=noninvasivel cases,l fluroquinolonesl inl selectl regions)
severe:l azithrol (preferred),l quinolones,l orl rifaximin
Q:l Typesl ofl diarrhea
Answer:
-Large-Volume
l --Osmoticl
l --Secretoryl
-Small-Volumel
l -Inflammatoryl bowell disease
, l -Infectiousl disease
l -Irritablel colon
Q:l Whatl isl Typel 1l Diabetesl Mellitus?
Answer:
Autoimmunel destructionl ofl pancreaticl betal cellsl causingl absolutel insulinl deficiency.
Q:l Whatl isl Typel 2l Diabetesl Mellitus?
Answer:
Insulinl resistancel withl progressivel beta-celll dysfunction.
Q:l Whatl isl thel primaryl treatmentl forl Typel 1l Diabetes?
Answer:
Insulinl therapy.
Q:l Whatl isl thel first-linel treatmentl forl Typel 2l Diabetes?
Answer:
Lifestylel modificationl plusl metforminl unlessl contraindicated.
Q:l Whatl isl thel mainl goall ofl diabetesl treatment?
Answer:
Preventl microvascularl andl macrovascularl complications.
Q:l Whyl isl metforminl thel first-linel treatmentl inl Typel 2l Diabetes?
Answer:
Improvesl insulinl sensitivity,l lowl hypoglycemial risk,l cardiovascularl benefit,l lowl cost.
Pharmacologyl Guide|l Wilkesl (Latestl
2026/l 2027l Update)l 100%l Verifiedl
Questionsl &l Answersl |l Gradel A
Q:l non-pharml treatmentl forl constipation
Answer:
fiberl +l fluidsl +l physicall activityl
scheduledl toileting,l addressl pelvicl floorl issues
removel offendingl meds
Q:l Pharml treatmentl forl constipation
Answer:
Bulkl formingl :l psylliuml (maintenancel ifl hydrated)
Osmotic:l PEG,l lactulose,l Mgl salts-l cautionl inl renal)l
Stimulants:l (senna/bisacodyl-shortl term/rescue)
Stooll softener:l (docusate-limitedl efficacyl butl mostl commonlyl used)
Rectall options:l glycerin,l enemas)
chronicl stimulant=lazyl bowel
Q:l PAMORAs
Answer:
Peripherally-actingl mul opioidl receptorl antagonistsl blockl thel opioidl inl thel gutl tol
decreasel opioid-inducedl constipation
methylnaltrexone
naloxegol
naldeminel
whenl laxativesl fail
,Q:l Pregnancyl safel constipationl meds
Answer:
bulkl fiberl (psyllium)l
PEGl
lactulose
Senna/bisacodyl:l shortl terml ifl needed
avoidl magnesiuml inl renall issues:l avoidl castorl oil
Q:l causesl ofl diarrhea
Answer:
Acutel <2l wks,l persistentl 2-4l wks,l chronicl >4l wksl
-l virall gastroenteritis
-l bacteriall gastroenteritisl
-l antibioticl therapy
-l inflammatoryl bowell disease
-l irritablel bowell syndrome
Q:l Universall treatmentl goalsl forl diarrhea
Answer:
prevent/treatl dehydrationl andl electrolytel lossl
identifyl redl flags:l blood,l fever,l severel pain,l immunocompromised,l elderly,l severel
dehydration)
symptoml controll whenl appropriate
treatl underlyingl cause
Q:l Medicationsl tol treatl diarrheal (noninfectios/mild)
Answer:
Orall rehydrationl
1)l atropinel +l diphenoxylatel (Lomotil)
2)l Loperamidel (Imodium):l avoidl ifl suspectedl invasicel bacteriall infection:l fever/bloodyl
stool
3)l Bismuth:l canl reducel stooll frequency,l alsol usedl inl travelersl phropylaxis/tx
,Q:l Infectiousl diarrhea
Answer:
morel cautiousl withl antil motilityl agentsl bcl trapl pathogenl
targetedl abxl dependingl onl severity,l organism,l host,l travell exposure
Q:l C.difficilel (AAD)
Answer:
goall isl eradicationl ofl Cl diffl +l preventl recurrentl (notl justl slowl gut)
1stl line:l orall vancol orl fidaxomicinl (stopl thel incitingl abxl whenl possible)
avoidl loperamidel inl suspectedl Cl diffl bcl riskl ofl toxicl megacolon
Q:l Traveler'sl diarrhea
Answer:
ETECl (Enterotoxigenicl Escherichial coli)l isl al commonl bacteriuml causingl traveler'sl
diarrheal andl infantl diarrhea,l transmittedl throughl contaminatedl food/water
Q:l Traveler'sl Diarrheal Treatment
Answer:
mild:l loperamidel (immodium)l orl bismuthl subsalicylate
moderate:l loperamidel +/-l ABX:l azithro.l (z-pak),l quinolone,l orl rifaximin
-azithro=l manyl areas,l rifaximin=noninvasivel cases,l fluroquinolonesl inl selectl regions)
severe:l azithrol (preferred),l quinolones,l orl rifaximin
Q:l Typesl ofl diarrhea
Answer:
-Large-Volume
l --Osmoticl
l --Secretoryl
-Small-Volumel
l -Inflammatoryl bowell disease
, l -Infectiousl disease
l -Irritablel colon
Q:l Whatl isl Typel 1l Diabetesl Mellitus?
Answer:
Autoimmunel destructionl ofl pancreaticl betal cellsl causingl absolutel insulinl deficiency.
Q:l Whatl isl Typel 2l Diabetesl Mellitus?
Answer:
Insulinl resistancel withl progressivel beta-celll dysfunction.
Q:l Whatl isl thel primaryl treatmentl forl Typel 1l Diabetes?
Answer:
Insulinl therapy.
Q:l Whatl isl thel first-linel treatmentl forl Typel 2l Diabetes?
Answer:
Lifestylel modificationl plusl metforminl unlessl contraindicated.
Q:l Whatl isl thel mainl goall ofl diabetesl treatment?
Answer:
Preventl microvascularl andl macrovascularl complications.
Q:l Whyl isl metforminl thel first-linel treatmentl inl Typel 2l Diabetes?
Answer:
Improvesl insulinl sensitivity,l lowl hypoglycemial risk,l cardiovascularl benefit,l lowl cost.
