NR 511 ACUTE OTITIS EXTERNA CPG
COMPREHENSIVE REVIEW GUIDE 2026
◉ Ulcerative colitis. Answer: -Risk:family hx, early adulthood,
genetics,
-S: 4 loose BM/day, small blood and mucus in stool. severe:fever,
blood, tachycardia, we loss, 5-10BM/day, abd pain
-O: + pANCA,rectal bleeding, no abd mass, no fistula or stricture,
friable, granular mucosa
-dx: sigmoidoscopy- NO barium enema. colonoscopy
-Tx: topical mesalamine, sulfasalazine, steroid enemas, oral steroids
-Edu:no caffeine, raq fruit, veggie, low fiber. bland diet
◉ Giardia (parasite that causes traveler's diarrhea). Answer: -risk:
hypogammaglobulinemia and achlorhydria, oral-anal intercourse,
travelers diarrhea
-S: bloating, flatulence, nausea, and watery, noninflammatory
diarrhea, to chronic diarrhea, wt loss, anorexia and malabsorption
-dx: ELISA blood test
-Tx: fluid & electrolyte management, loperamide, bismuth
subsalicylate. Azithromycin 1000mg PO x1-3 days for severe
symptoms
Duration 1-6 weeks, incubation 1-4 weeks
,◉ H. pylori- causes duodenal ulcers. Answer: -risk: >60yo, 1/2
people worldwide have it, ingested in childhood, many people dont
even know
-S: burning sensation in epigastrium relieved by food or antacids,
nocturnal pain
-O: not useful- may have epigastric tenderness 2.5cm to the r of
midline
-Dx:fecal antigen assay, urea breath test, biopsy
-tx: 2 atb (clarithromycin & amox. or metron.), PPI(-azole) BID x2
weeks
◉ Pancreatitis. Answer: -risk:passing of gallstones, alcoholism,
mumps, hyperlipidemia, trauma, lasix, sulfonamides, thiazides
-S: abrupt onset of deep epigastric pain that persists for hours to
days. may radiate straight through back. refractory to large doses of
parenteral narcotics. aggravated by vigorous activity (coughing),
laying supine. N/V, sweating, weakness
-O:ABD tenderness (epigastric area), no rigidity or rebound
tenderness. HTN, Low grade temp, mild jaundice, pale cool skin
-dx: Abd pain, high amylase (3x higher) and/or lipase (high on day 1,
normal 3-7 days), CT scan, High HCT, (biliary pancreatitis=high
LFTs)
-tx: NPO, NG ,IV fluids, Demerol ( ATB, H2 antagonists not
recommended)
, -edu: if caused by gallbladder-needs removal, decr fat intake, avoid
ETOH
*Ranson's criteria assess severity & mortality. 0-8. worse is higher.
◉ Salmonella. Answer: -risk: summer & fall, found mainly in chicken,
eggs, and livestock
-S: n/v, abd pain, diarrhea, may have fever,
-Dx: stool sample
-tx:none unless fever and systemic disease. TMP/SMX or norfloxacin
400mg BID x7-10 days.
-edu: hand washing, food cooking, duration 2-5 days
◉ Shigella. Answer: -risk: poor hygiene, overcrowding, oral-fecal
route
-S: watery diarrhea, high fever. later: abd cramps, urgency, frequent
stools with blood and mucus,
-Dx: stool or rectal swab
-Tx: Bactrim BID x3 days if acquired in USA
Duration: 4-7 days, may cause colitis
◉ Epiglottis- acute, lifethreatning. Answer: -risk: more severe in
young children, bacterial infection
-S:odynophagia (swallowing pain) but pharyngeal findings are
unremarkable, dyspnea, drooling, stridor
COMPREHENSIVE REVIEW GUIDE 2026
◉ Ulcerative colitis. Answer: -Risk:family hx, early adulthood,
genetics,
-S: 4 loose BM/day, small blood and mucus in stool. severe:fever,
blood, tachycardia, we loss, 5-10BM/day, abd pain
-O: + pANCA,rectal bleeding, no abd mass, no fistula or stricture,
friable, granular mucosa
-dx: sigmoidoscopy- NO barium enema. colonoscopy
-Tx: topical mesalamine, sulfasalazine, steroid enemas, oral steroids
-Edu:no caffeine, raq fruit, veggie, low fiber. bland diet
◉ Giardia (parasite that causes traveler's diarrhea). Answer: -risk:
hypogammaglobulinemia and achlorhydria, oral-anal intercourse,
travelers diarrhea
-S: bloating, flatulence, nausea, and watery, noninflammatory
diarrhea, to chronic diarrhea, wt loss, anorexia and malabsorption
-dx: ELISA blood test
-Tx: fluid & electrolyte management, loperamide, bismuth
subsalicylate. Azithromycin 1000mg PO x1-3 days for severe
symptoms
Duration 1-6 weeks, incubation 1-4 weeks
,◉ H. pylori- causes duodenal ulcers. Answer: -risk: >60yo, 1/2
people worldwide have it, ingested in childhood, many people dont
even know
-S: burning sensation in epigastrium relieved by food or antacids,
nocturnal pain
-O: not useful- may have epigastric tenderness 2.5cm to the r of
midline
-Dx:fecal antigen assay, urea breath test, biopsy
-tx: 2 atb (clarithromycin & amox. or metron.), PPI(-azole) BID x2
weeks
◉ Pancreatitis. Answer: -risk:passing of gallstones, alcoholism,
mumps, hyperlipidemia, trauma, lasix, sulfonamides, thiazides
-S: abrupt onset of deep epigastric pain that persists for hours to
days. may radiate straight through back. refractory to large doses of
parenteral narcotics. aggravated by vigorous activity (coughing),
laying supine. N/V, sweating, weakness
-O:ABD tenderness (epigastric area), no rigidity or rebound
tenderness. HTN, Low grade temp, mild jaundice, pale cool skin
-dx: Abd pain, high amylase (3x higher) and/or lipase (high on day 1,
normal 3-7 days), CT scan, High HCT, (biliary pancreatitis=high
LFTs)
-tx: NPO, NG ,IV fluids, Demerol ( ATB, H2 antagonists not
recommended)
, -edu: if caused by gallbladder-needs removal, decr fat intake, avoid
ETOH
*Ranson's criteria assess severity & mortality. 0-8. worse is higher.
◉ Salmonella. Answer: -risk: summer & fall, found mainly in chicken,
eggs, and livestock
-S: n/v, abd pain, diarrhea, may have fever,
-Dx: stool sample
-tx:none unless fever and systemic disease. TMP/SMX or norfloxacin
400mg BID x7-10 days.
-edu: hand washing, food cooking, duration 2-5 days
◉ Shigella. Answer: -risk: poor hygiene, overcrowding, oral-fecal
route
-S: watery diarrhea, high fever. later: abd cramps, urgency, frequent
stools with blood and mucus,
-Dx: stool or rectal swab
-Tx: Bactrim BID x3 days if acquired in USA
Duration: 4-7 days, may cause colitis
◉ Epiglottis- acute, lifethreatning. Answer: -risk: more severe in
young children, bacterial infection
-S:odynophagia (swallowing pain) but pharyngeal findings are
unremarkable, dyspnea, drooling, stridor
