(BRAND NEW!!!!) Chamberlain NR 511 Midterm Q
And A With Actual Questions And Verified Answers
With Latest Update
What are common causes of N/V associated with gastritis? - ANSWER:
Alcohol, NSAIDs, ASA, ABX, and illicit substances
What is the most common cause of nausea and vomiting? - ANSWER: Acute
Gastroenteritis (AGE)
What are some manifestations of AGE? - ANSWER: Nausea, vomiting, and
diarrhea, fever, abdominal pain. May also include fatigue, malaise, anorexia,
tenesmus and borborygmus.
How is the severity of AGE gauged? - ANSWER: Dehydration secondary to
profuse watery diarrhea, fever greater than 101ºF (38.3ºC), vomiting, or
dysentery.
What are important parts of a patient's history when AGE is suspected? -
ANSWER: Travel, dining locations, ABX history..
What happens to the pH of the stomach when antacids are taken and how
does this affect bacteria? - ANSWER: High pH can make it easier for bacteria
to survive and cause and infection.
How does motility of the GI tract affect bacteria colonization? - ANSWER:
Small bowel stasis as a result of obstruction, diverticulitis, or blind loop
syndrome frequently develop an overgrowth of bacteria within the stagnant
segment.
Which immunoglobulin may protect the GI tract against invading organisms? -
ANSWER: IgA...may also help protect against a future attack by the same
pathogen.
Onset of N/V begin within 6 hours after exposure. Is this bacterial or viral? -
ANSWER: Bacterial: time frame suggests food poisoning resulting from the
ingestion of a preformed toxin such as that of Bacillus cereus.
,What two indications are highly suggestive of viral AGE? - ANSWER:
Incubation periods greater than 14 hours and the initial symptom of vomiting.
If a patient presents with AGE and reports bloody stools, what can be
understood about the reason for blood in the stool/ - ANSWER: Mucosal
damage and inflammatory process secondary to invasive pathogens.
What do frothy stools and flatus suggest? - ANSWER: Malabsorption
problem.
Patients with prolonged AGE illness who are malnourished may present with
edema. What is the reason? - ANSWER: Hypoalbuminemia
T or F: Chronic diarrhea usually has a noninfectious etiology. - ANSWER:
True
T or F: Acute diarrhea usually is caused by infectious agents or toxins -
ANSWER: True
What is the most common viral pathogen causing AGE in adults? -
ANSWER: Norovirus
What is the most common viral pathogen causing AGE in pediatrics? -
ANSWER: Rotavirus. This has been greatly reduced since the introduction of
the rotavirus vaccine.
T or F: Stool studies are indicated in the absence of bloody diarrhea or
systemic disease - ANSWER: False
T or F: A CBC will help distinguish between viral and bacterial AGE -
ANSWER: False
When are stool studies warranted? - ANSWER: Severe or prolonged
diarrhea, a fever > 38.5ºC, bloody stools or stools that test positive for
leukocytes or occult blood.
What are common pathogens involved in Traveler's Diarrhea? - ANSWER:
Shigella, Campylobacter, and E. coli.
,What should the clinician do if the patient develops diarrhea after initiation of
completion of antibiotic therapy? - ANSWER: Test for C. diff.
What are some DDx of AGE, particularly in patients with persistent or chronic
diarrhea and severe abdominal pain? - ANSWER: IBS, IBD, ischemic bowel
disease, partial bowel obstruction, small bowel diverticulosis.
What are some red flag symptoms that may indicate the need for
hospitalization? - ANSWER: Hypovolemia, dehydration, abnormal
electrolytes, decreased renal function, bloody stool/rectal bleeding, weight
loss, severe abdominal pain, prolonged symptoms greater than 1 week,
pregnancy, advanced age, history of hospitalization or antibiotic use in the last
3-6 months.
What is the usual course of treatment for AGE? - ANSWER: Only supportive
treatment is initiated since AGE is usually self-limiting and resolves within 1
week after onset of symptoms.
How such patients with evidence of dehydration be treated initially? -
ANSWER: Fluid repletion and nutrition. Sports drinks aren't as effective as
specific electrolyte replenishing drinks.
At what point should a patient be referred to the hospital for dehydration? -
ANSWER: Signs of hypovolemia such as hypotension, tachycardia, pallor,
and poor skin turgor.
T of F: Empiric antimicrobial therapy is recommended for patients with severe
diarrhea suspected form traveling. - ANSWER: True. Bactrim, Ciprofloxacin,
Norfloxacin, Floxacin.
T or F: Antibiotic prophylaxis for patients traveling to high-risk areas is
appropriate. - ANSWER: True
How effective is antibiotic prophylaxis for patients traveling to high-risk areas?
- ANSWER: 90% effective
What does antibiotic prophylaxis treatment consist of? - ANSWER: Bactrim,
Ciprofloxacin, Norfloxacin, or Floxacin given once daily until 2 days after
returning home.
, What is an appropriate symptomatic treatment for patients < 65 years or age
with moderate to severe diarrhea? - ANSWER: Two-day course of
Loperamide (Imodium)
What is an appropriate symptomatic treatment for patients < 65 years or age
with significant vomiting? - ANSWER: Two-day course of Zofran or
Phenergan.
What is the best way to prevent AGE? - ANSWER: Hand washing.
T or F: Kids can attend daycare with infectious diarrhea as long as they're
separated from other children. - ANSWER: False! Not until the diarrhea has
stopped.
If pain is present in the right lower quadrant, what might be the etiology related
to bowel disorders? - ANSWER: IBD, IBS, Infectious Colitis, and
Constipation
If pain is present in the left lower quadrant, what might be the etiology related
to bowel disorders? - ANSWER: Diverticulitis, IBS, IBD, Constipation, and
Infectious Colitis.
If pain is present in the left upper quadrant, what might be the etiology related
to bowel disorders? - ANSWER: Stomach ulcers, pancreatitis, and gastritis.
If pain is present in the right upper quadrant, what might be the etiology
related to bowel disorders? - ANSWER: Gall bladder, hepatitis, and
pancreatitis.
T or F: IBS is a disorder of bowel function in the absence of an atomic
abnormality. - ANSWER: True
What are common symptoms of IBS? - ANSWER: Changes in bowel habits
such as diarrhea (IBS-D), constipation (IBS-C), abdominal pain, bloating, rectal
urgency with diarrhea.
What are some extra-intestinal (outside the intestines) symptoms of IBS? -
ANSWER: Sexual dysfunction, loss of libido, dyspareunia, muscle aches and
pains, fatigue, fibromyalgia, headaches, back pain, urinary urgency, urinary
hesitation, or bladder spasms.
And A With Actual Questions And Verified Answers
With Latest Update
What are common causes of N/V associated with gastritis? - ANSWER:
Alcohol, NSAIDs, ASA, ABX, and illicit substances
What is the most common cause of nausea and vomiting? - ANSWER: Acute
Gastroenteritis (AGE)
What are some manifestations of AGE? - ANSWER: Nausea, vomiting, and
diarrhea, fever, abdominal pain. May also include fatigue, malaise, anorexia,
tenesmus and borborygmus.
How is the severity of AGE gauged? - ANSWER: Dehydration secondary to
profuse watery diarrhea, fever greater than 101ºF (38.3ºC), vomiting, or
dysentery.
What are important parts of a patient's history when AGE is suspected? -
ANSWER: Travel, dining locations, ABX history..
What happens to the pH of the stomach when antacids are taken and how
does this affect bacteria? - ANSWER: High pH can make it easier for bacteria
to survive and cause and infection.
How does motility of the GI tract affect bacteria colonization? - ANSWER:
Small bowel stasis as a result of obstruction, diverticulitis, or blind loop
syndrome frequently develop an overgrowth of bacteria within the stagnant
segment.
Which immunoglobulin may protect the GI tract against invading organisms? -
ANSWER: IgA...may also help protect against a future attack by the same
pathogen.
Onset of N/V begin within 6 hours after exposure. Is this bacterial or viral? -
ANSWER: Bacterial: time frame suggests food poisoning resulting from the
ingestion of a preformed toxin such as that of Bacillus cereus.
,What two indications are highly suggestive of viral AGE? - ANSWER:
Incubation periods greater than 14 hours and the initial symptom of vomiting.
If a patient presents with AGE and reports bloody stools, what can be
understood about the reason for blood in the stool/ - ANSWER: Mucosal
damage and inflammatory process secondary to invasive pathogens.
What do frothy stools and flatus suggest? - ANSWER: Malabsorption
problem.
Patients with prolonged AGE illness who are malnourished may present with
edema. What is the reason? - ANSWER: Hypoalbuminemia
T or F: Chronic diarrhea usually has a noninfectious etiology. - ANSWER:
True
T or F: Acute diarrhea usually is caused by infectious agents or toxins -
ANSWER: True
What is the most common viral pathogen causing AGE in adults? -
ANSWER: Norovirus
What is the most common viral pathogen causing AGE in pediatrics? -
ANSWER: Rotavirus. This has been greatly reduced since the introduction of
the rotavirus vaccine.
T or F: Stool studies are indicated in the absence of bloody diarrhea or
systemic disease - ANSWER: False
T or F: A CBC will help distinguish between viral and bacterial AGE -
ANSWER: False
When are stool studies warranted? - ANSWER: Severe or prolonged
diarrhea, a fever > 38.5ºC, bloody stools or stools that test positive for
leukocytes or occult blood.
What are common pathogens involved in Traveler's Diarrhea? - ANSWER:
Shigella, Campylobacter, and E. coli.
,What should the clinician do if the patient develops diarrhea after initiation of
completion of antibiotic therapy? - ANSWER: Test for C. diff.
What are some DDx of AGE, particularly in patients with persistent or chronic
diarrhea and severe abdominal pain? - ANSWER: IBS, IBD, ischemic bowel
disease, partial bowel obstruction, small bowel diverticulosis.
What are some red flag symptoms that may indicate the need for
hospitalization? - ANSWER: Hypovolemia, dehydration, abnormal
electrolytes, decreased renal function, bloody stool/rectal bleeding, weight
loss, severe abdominal pain, prolonged symptoms greater than 1 week,
pregnancy, advanced age, history of hospitalization or antibiotic use in the last
3-6 months.
What is the usual course of treatment for AGE? - ANSWER: Only supportive
treatment is initiated since AGE is usually self-limiting and resolves within 1
week after onset of symptoms.
How such patients with evidence of dehydration be treated initially? -
ANSWER: Fluid repletion and nutrition. Sports drinks aren't as effective as
specific electrolyte replenishing drinks.
At what point should a patient be referred to the hospital for dehydration? -
ANSWER: Signs of hypovolemia such as hypotension, tachycardia, pallor,
and poor skin turgor.
T of F: Empiric antimicrobial therapy is recommended for patients with severe
diarrhea suspected form traveling. - ANSWER: True. Bactrim, Ciprofloxacin,
Norfloxacin, Floxacin.
T or F: Antibiotic prophylaxis for patients traveling to high-risk areas is
appropriate. - ANSWER: True
How effective is antibiotic prophylaxis for patients traveling to high-risk areas?
- ANSWER: 90% effective
What does antibiotic prophylaxis treatment consist of? - ANSWER: Bactrim,
Ciprofloxacin, Norfloxacin, or Floxacin given once daily until 2 days after
returning home.
, What is an appropriate symptomatic treatment for patients < 65 years or age
with moderate to severe diarrhea? - ANSWER: Two-day course of
Loperamide (Imodium)
What is an appropriate symptomatic treatment for patients < 65 years or age
with significant vomiting? - ANSWER: Two-day course of Zofran or
Phenergan.
What is the best way to prevent AGE? - ANSWER: Hand washing.
T or F: Kids can attend daycare with infectious diarrhea as long as they're
separated from other children. - ANSWER: False! Not until the diarrhea has
stopped.
If pain is present in the right lower quadrant, what might be the etiology related
to bowel disorders? - ANSWER: IBD, IBS, Infectious Colitis, and
Constipation
If pain is present in the left lower quadrant, what might be the etiology related
to bowel disorders? - ANSWER: Diverticulitis, IBS, IBD, Constipation, and
Infectious Colitis.
If pain is present in the left upper quadrant, what might be the etiology related
to bowel disorders? - ANSWER: Stomach ulcers, pancreatitis, and gastritis.
If pain is present in the right upper quadrant, what might be the etiology
related to bowel disorders? - ANSWER: Gall bladder, hepatitis, and
pancreatitis.
T or F: IBS is a disorder of bowel function in the absence of an atomic
abnormality. - ANSWER: True
What are common symptoms of IBS? - ANSWER: Changes in bowel habits
such as diarrhea (IBS-D), constipation (IBS-C), abdominal pain, bloating, rectal
urgency with diarrhea.
What are some extra-intestinal (outside the intestines) symptoms of IBS? -
ANSWER: Sexual dysfunction, loss of libido, dyspareunia, muscle aches and
pains, fatigue, fibromyalgia, headaches, back pain, urinary urgency, urinary
hesitation, or bladder spasms.
