Med Sure 3 Final Questions With Complete
Solutions
Why does acute upper GI bleed occur?
Peptic ulcer disease, stress ulcer, mallory-weirs
tear, and esophageal varices
What shock is at risk with acute upper GI bleed?
Hypovolemic
Peptic Ulcer Disease Risk Factors
1. Smoking
2. Helicobacter pylori bacteria
3. Drugs: Non-steroidal anti-inflammatory drugs
(NSAIDs), aminosalicylic acid (ASA), steroids
4. Alcohol
Ischemic Stress Ulcer
Decreased blood flow due to hemorrhage, trauma,
and burns
Cushing's Stress Ulcer
Decreased blood flow and hyper secretion of acid
Esophageal Varices
Portal hypertension where the veins become
distended and varices develop
,Varices Assessment
1. Blood loss (color, amount, consistency of
emesis and stool)
2. Symptoms of Hypovolemia (hypotension,
tachycardia, and dizzy)
3. Pain or discomfort
Treatment for Variceal Bleeding
Somatostatin or Vasopressin Drip
Acute Pancreatitis
Inflammation of pancreas that impairs exocrine
and endocrine function
Why does acute pancreatitis occur?
Alcoholism, biliary tract disease, meds, trauma,
and idiopathic
Signs and Symptoms of Acute Pancreatitis
1. Severe pain
- Epigastric or mid abdominal
- Radiates to back
2. Nausea and vomiting
3. Abdominal distention
4. Ascites and jaundice (severe)
5. Retroperitoneal hemorrhage
,- Turner’s sign (discoloration of flank)
- Cullen’s sign (discoloration around umbilicus)
Treatment for Acute Pancreatitis
Volume Replacement
Vasopressors
Electrolyte replacement
- Calcium
- Potassium
Treatment of hyperglycemia
Complications of Pancreatitis
1. Hypovolemic shock
2. Pulmonary complications (atelectasis, ARDS,
effusion)
3. DIC
4. Pseudocytes
5. Renal failure
6. High glucose and triglycerides, low Ca+
Hepatic Failure
Hepatitis
Decreased perfusion
Cirrhosis
Fatty liver disease
, Symptoms of Hepatitis
GI pain
Fever, chills
Jaundice
Brown urine
Right upper quadrant pain
Clay-colored stools
Management of Hepatitis
No definitive treatment
Rest
Nutritional support
Prevention of spread of the virus
Cirrhosis Assessment
Liver enlarges due to increased fat accumulation
Inflammation and necrosis of cells
Yellow, orange, fatty, and scarred liver
Early Signs of Cirrhosis
- Anorexia
- Dyspepsia
- Flatulence
- N+V
- Changes in bowel
Late Signs of Cirrhosis
Solutions
Why does acute upper GI bleed occur?
Peptic ulcer disease, stress ulcer, mallory-weirs
tear, and esophageal varices
What shock is at risk with acute upper GI bleed?
Hypovolemic
Peptic Ulcer Disease Risk Factors
1. Smoking
2. Helicobacter pylori bacteria
3. Drugs: Non-steroidal anti-inflammatory drugs
(NSAIDs), aminosalicylic acid (ASA), steroids
4. Alcohol
Ischemic Stress Ulcer
Decreased blood flow due to hemorrhage, trauma,
and burns
Cushing's Stress Ulcer
Decreased blood flow and hyper secretion of acid
Esophageal Varices
Portal hypertension where the veins become
distended and varices develop
,Varices Assessment
1. Blood loss (color, amount, consistency of
emesis and stool)
2. Symptoms of Hypovolemia (hypotension,
tachycardia, and dizzy)
3. Pain or discomfort
Treatment for Variceal Bleeding
Somatostatin or Vasopressin Drip
Acute Pancreatitis
Inflammation of pancreas that impairs exocrine
and endocrine function
Why does acute pancreatitis occur?
Alcoholism, biliary tract disease, meds, trauma,
and idiopathic
Signs and Symptoms of Acute Pancreatitis
1. Severe pain
- Epigastric or mid abdominal
- Radiates to back
2. Nausea and vomiting
3. Abdominal distention
4. Ascites and jaundice (severe)
5. Retroperitoneal hemorrhage
,- Turner’s sign (discoloration of flank)
- Cullen’s sign (discoloration around umbilicus)
Treatment for Acute Pancreatitis
Volume Replacement
Vasopressors
Electrolyte replacement
- Calcium
- Potassium
Treatment of hyperglycemia
Complications of Pancreatitis
1. Hypovolemic shock
2. Pulmonary complications (atelectasis, ARDS,
effusion)
3. DIC
4. Pseudocytes
5. Renal failure
6. High glucose and triglycerides, low Ca+
Hepatic Failure
Hepatitis
Decreased perfusion
Cirrhosis
Fatty liver disease
, Symptoms of Hepatitis
GI pain
Fever, chills
Jaundice
Brown urine
Right upper quadrant pain
Clay-colored stools
Management of Hepatitis
No definitive treatment
Rest
Nutritional support
Prevention of spread of the virus
Cirrhosis Assessment
Liver enlarges due to increased fat accumulation
Inflammation and necrosis of cells
Yellow, orange, fatty, and scarred liver
Early Signs of Cirrhosis
- Anorexia
- Dyspepsia
- Flatulence
- N+V
- Changes in bowel
Late Signs of Cirrhosis
