ACTUAL Questions and CORRECT
Answers
Azotemia - CORRECT ANSWER -presence of urea or other nitrogenous compounds in
the blood
Gastroesophageal Reflux Disease (GERD) - CORRECT ANSWER -backflow of gastric
juices from the stomach to enter the esophagus. DO NOT IGNORE HEARTBURN - it can lead
to throat cancer
S/S Gastroesophageal Reflux Disease (GERD) - CORRECT ANSWER -Pain is worse
when lying down or bending over. Patients will complain of having to sleep in a recliner or with
the head of the bed elevated to relieve the pain.
NOTE: Gastroesophageal Reflux Disease - CORRECT ANSWER -This pain can mimic a
heart attack because the stomach is so close to the heart - or - patients with heart problems tell
themselves they are just "having heartburn" and delay going to the ER for a cardiac workup.
Teach patients not to assume their chest pain is heartburn!
Rx Gastroesophageal Reflux Disease (GERD) - CORRECT ANSWER -Stop Smoking and
avoid 2nd hand smoke (increases gastric irritation and causes vasoconstriction which decreases
healing); stop caffeine; check for gluten intolerance; Acid-suppressing medications.
cardiac cocktail
pain is worse when the patient lies down
Hiatal Hernia - CORRECT ANSWER -Expansion of esophagus diaphragm pre-spincter
that can become filled with stomach acid. Px
Hiatal Hernia Risk Factors - CORRECT ANSWER -Pregnancy
Age
,Weightlifting while holding breath
habitual vomiting
PUD - CORRECT ANSWER -Peptic Ulcer Disease
Px epigastric
H. pylori bacteria (specific for ulcers)
Px starts 2 hrs. after eating (PUD not gallbladder)
Cured ABX and Proton Pump Inhibitor (PPI)
H. Pylori - CORRECT ANSWER -common bacteria found in ulcers
Upper Gastric Internal Bleeding (UGIB) - CORRECT ANSWER -Hematemesis-Frank
bleed
Black "coffee grounds" vomitus -ulcer gastric bleeding
Lower Gastric Internal Bleed (LGIB) - CORRECT ANSWER -Occult Blood- hidden
blood (Fecal chemical paper change)
Melena- Larger amount of digested blood + smell
Hematochezia-Frank Bleed-hemroids
Irritable Bowel Syndrome (IBS) - CORRECT ANSWER -*NO DAMAGE* to intestine --
>Px
abnormalities:
psychosocial
Motility
sensory
CNS processing
, Inflammatory Bowel Disease - CORRECT ANSWER -Crohns-Anywhere intestines. Skip
lesions involve all layers
Ulcerative Colitis-Erosion of lining of large colon and rectum in the mucosal layer-->Toxic
Megacolon
S/S Crohns - CORRECT ANSWER -Abdominal Px
Tenderness
Nausea/Vomiting
Severe Diarrhea
Low Grade fever
Bloody Stools -->Anemia
Severe malabsorption-->Weight Loss
Dehydration-->Electrolyte imbalance
Fistulas - CORRECT ANSWER -tunneling into different areas
Cirrhosis of the Liver - CORRECT ANSWER -clogged hepatic portal vein can cause back
in the veins leading to portal hypertension-->organ engorgement, splenomegaly, ascites
esophageal varices-->hematemesis
Protein Loss-->low osmotic pressure
Esophageal Varices - CORRECT ANSWER -enlarged and swollen veins at the lower end
of the esophagus
S/S Cirrhosis of the Liver - CORRECT ANSWER -Ascites
Gynecomastia
Caput medusa
Umbilical hernia
Dependent Edema