AG-ACNP DRT #2 q&A

Pt demonstrating AMS and free water restriction with euvolemia. Urine osmolality 270, BUN 14/0.6, urine Na 30. You suspect hyponatremia. What is the most likely cause? - Answer- SIADH 45 yo. F s/p double mastectomy 2 months ago. Now complaining of pain at the incision site. What type of pain is she experiencing? - Answer- Neuropathic pain caused by nerve damage during the double mastectomy. 31 M presents with blowing murmur occurring during S1 and a galloping additional heart sound. Murmur is heard best at the base of the heart. What is most likely? - Answer- Mitral Regurgitation 25 yo. F with no significant PMH asks you as the ACNP how often she should come in for a physical examination. You would tell her? - Answer- q5-6 years 65 yo. M presents with complaints of nausea, vomiting, and constipation x several days and a 6 lb weight loss. Pt is s/p total knee replacement several weeks ago and reports not really getting off the couch. What electrolyte abnormality is most likley? - Answer- Hypercalcemia related to immobility s/p TKR 34 yo. M presents to ED with mother who reports that patient "downed an entire bottle of Tylenol". PMH significant for schizophrenia. What is the initial management in this patient? - Answer- OGT and GI lavage r/t AMS and ARF aspiration. Then followed by N-Acetyclcystine (Mucomyst) 140 mg loading dose. 53 yo. M presents with complaints of dribbling and nocturia. You suspect BPH. PSA level is elevated. What confirms this diagnosis? - Answer- Transrectal ultrasound is confirmation of BPH in presence of elevated PSA level. Your 52 yo. F patient expresses concerns for side effects associated with hormonal replacement therapy (HRT). What are the associated side effects? - Answer- Gallstones Blood clots CVA Hormonal replacement therapy (HRT) has been shown to improve what dx? - Answer- Osteoporosis What diagnostic is used to distinguish intrarenal or postrenal etiology of acute renal failure? - Answer- Urinary sediment Intrarenal - urinary sediment has granular white casts Postrenal - urinary sediment is normal