NR571 final 2 UPDATED ACTUAL Questions and CORRECT Answers
Appendicitis inflammation (appendix), a thin, tube-like organ attached to the large intestine. 10-
30yrs, blocked by bacterial infection, stagnation of waste matter, parasites,
inflammatory bowel disease, or other gastrointestinal conditions.
Appendicitis Complications a burst appendix, development of an abscess (pocket of pus) in one location, and
peritonitis: a widespread infection of the abdominal cavity.
liver helps your body digest food, store energy, and remove poisons.
Hepatitis A is a swelling of the liver, can lead to scarring, called cirrhosis, or cancer, mostly
due to virus
gallbladder a small hollow organ located beneath the liver, Gallstones form from hard
deposits in digestive fluid, form in
pancreas an organ located behind the stomach, secretes digestive enzymes into the
intestine through lower bile duct.
pancreatitis lower bile duct becomes blocked, digestive enzymes cannot leave become
harmful, inflamed and painful this is
Peptic ulcer disease formation of ulcers (open sores) due to excess stomach acid damages the
protective mucus-covered gastrointestinal lining, to the first section of the small
intestine (duodenum).
gastric ulcers Peptic ulcers in the stomach are called
Peptic ulcers causes a bacterial infection or the long-term use of (NSAIDs)are the causes
duodenal ulcers Peptic ulcers in the duodenum are called
(H. pylori) and NSAIDs such as aspirin and ibuprofen increase acidity and inflammation in the stomach
they are
Peptic ulcers common symptoms common symptoms include dull abdominal pain, feeling full or bloated,
indigestion, heartburn, and nausea of
Peptic ulcers severe symptoms include vomiting (including vomiting blood), dark, bloody stool, unexplained
weight loss or appetite changes, fatigue, and having trouble breathing
PUD Treatment 1.Lifestyle modifications and over-the-counter antacids or H2 blockers, 2.H. pylori
testing & Treatment with PPIs.
Treatment for H. pylori All regimens include a PPI plus antibiotics to treat
, Triple therapy for H. pylori PPI plus Clarithromycin: 500 mg twice daily, or Metronidazole: 500 mg twice daily,
Amoxicillin: 1 gm twice daily, Treat for 10 to 14 days.
Quadruple therapy for H. pylori PPI plus Metronidazole: 250 mg four times/day, Tetracycline: 500 mg four
times/day, Bismuth subsalicylate: 525 mg four times/day, Treat for 10 to 14 days.
Usually used as second-line therapy in patients who fail first-line therapy.
Levofloxacin-based triple therapy PPI: twice daily, Levofloxacin: 250 to 500 mg twice daily, Amoxicillin: 1 gm twice
daily, Treat for 10 to 14 days. Second-line or rescue therapy
LFTS for screening infection, for liver disease, severity of the disease, progression of
disease, effectiveness of treatment, and for side effects of meds you need
acute care setting- LFTs to evaluate jaundice, weight loss, abdominal pain, and alcohol abuse. are order
where
Need LFTs liver function by detecting liver cell damage, bile flow interference, and hepatic
synthetic function you need
hepatocellular damage ALT, AST, LDH (non-specific) you need for evaluation of
bile flow interference Bilirubin, Alkaline Phosphatase, GGT, Bile Acids, 5'NT you need for evaluation of
synthetic function damage PT, Albumin you need for the evaluation of
abnormal LFTs always consider pts risk factors, symptoms, comorbid conditions, medications,
and physical exam in
Aminotransferases are enzymes that help distinguish (elevations)hepatocellular damage from
cholestatic dysfunction, low to no changes are seen in obstructive disease.
Markers of Hepatocellular Damage ALT and AST, normal 10-40 IU/L. Enzyme values > 3 times the upper limit of normal
are considered clinically significant
liver enzyme alteration magnitude, rate, and nature (mild fluctuation vs. progressive increase), related to
(AST) found in body highest to lowest concentration=Liver, Cardiac muscles, Skeletal muscles, Kidney,
Brain, Pancreas, Lungs, WBCs, RBCs have
AST elevations other conditions such as ischemic heart disease, congestive heart failure,
hemolysis, and myopathic processes may show
high ALT high in liver and low in kidney, skeletal muscle; therefore, it is a more useful test in
detecting the presence of liver pathology
ALT & AST ? elevated more than ? in extrahepatic biliary obstruction but is less sensitive than
AST in detecting alcoholic-induced disease
acute hepatocellular disorders the ALT level > the AST level
Appendicitis inflammation (appendix), a thin, tube-like organ attached to the large intestine. 10-
30yrs, blocked by bacterial infection, stagnation of waste matter, parasites,
inflammatory bowel disease, or other gastrointestinal conditions.
Appendicitis Complications a burst appendix, development of an abscess (pocket of pus) in one location, and
peritonitis: a widespread infection of the abdominal cavity.
liver helps your body digest food, store energy, and remove poisons.
Hepatitis A is a swelling of the liver, can lead to scarring, called cirrhosis, or cancer, mostly
due to virus
gallbladder a small hollow organ located beneath the liver, Gallstones form from hard
deposits in digestive fluid, form in
pancreas an organ located behind the stomach, secretes digestive enzymes into the
intestine through lower bile duct.
pancreatitis lower bile duct becomes blocked, digestive enzymes cannot leave become
harmful, inflamed and painful this is
Peptic ulcer disease formation of ulcers (open sores) due to excess stomach acid damages the
protective mucus-covered gastrointestinal lining, to the first section of the small
intestine (duodenum).
gastric ulcers Peptic ulcers in the stomach are called
Peptic ulcers causes a bacterial infection or the long-term use of (NSAIDs)are the causes
duodenal ulcers Peptic ulcers in the duodenum are called
(H. pylori) and NSAIDs such as aspirin and ibuprofen increase acidity and inflammation in the stomach
they are
Peptic ulcers common symptoms common symptoms include dull abdominal pain, feeling full or bloated,
indigestion, heartburn, and nausea of
Peptic ulcers severe symptoms include vomiting (including vomiting blood), dark, bloody stool, unexplained
weight loss or appetite changes, fatigue, and having trouble breathing
PUD Treatment 1.Lifestyle modifications and over-the-counter antacids or H2 blockers, 2.H. pylori
testing & Treatment with PPIs.
Treatment for H. pylori All regimens include a PPI plus antibiotics to treat
, Triple therapy for H. pylori PPI plus Clarithromycin: 500 mg twice daily, or Metronidazole: 500 mg twice daily,
Amoxicillin: 1 gm twice daily, Treat for 10 to 14 days.
Quadruple therapy for H. pylori PPI plus Metronidazole: 250 mg four times/day, Tetracycline: 500 mg four
times/day, Bismuth subsalicylate: 525 mg four times/day, Treat for 10 to 14 days.
Usually used as second-line therapy in patients who fail first-line therapy.
Levofloxacin-based triple therapy PPI: twice daily, Levofloxacin: 250 to 500 mg twice daily, Amoxicillin: 1 gm twice
daily, Treat for 10 to 14 days. Second-line or rescue therapy
LFTS for screening infection, for liver disease, severity of the disease, progression of
disease, effectiveness of treatment, and for side effects of meds you need
acute care setting- LFTs to evaluate jaundice, weight loss, abdominal pain, and alcohol abuse. are order
where
Need LFTs liver function by detecting liver cell damage, bile flow interference, and hepatic
synthetic function you need
hepatocellular damage ALT, AST, LDH (non-specific) you need for evaluation of
bile flow interference Bilirubin, Alkaline Phosphatase, GGT, Bile Acids, 5'NT you need for evaluation of
synthetic function damage PT, Albumin you need for the evaluation of
abnormal LFTs always consider pts risk factors, symptoms, comorbid conditions, medications,
and physical exam in
Aminotransferases are enzymes that help distinguish (elevations)hepatocellular damage from
cholestatic dysfunction, low to no changes are seen in obstructive disease.
Markers of Hepatocellular Damage ALT and AST, normal 10-40 IU/L. Enzyme values > 3 times the upper limit of normal
are considered clinically significant
liver enzyme alteration magnitude, rate, and nature (mild fluctuation vs. progressive increase), related to
(AST) found in body highest to lowest concentration=Liver, Cardiac muscles, Skeletal muscles, Kidney,
Brain, Pancreas, Lungs, WBCs, RBCs have
AST elevations other conditions such as ischemic heart disease, congestive heart failure,
hemolysis, and myopathic processes may show
high ALT high in liver and low in kidney, skeletal muscle; therefore, it is a more useful test in
detecting the presence of liver pathology
ALT & AST ? elevated more than ? in extrahepatic biliary obstruction but is less sensitive than
AST in detecting alcoholic-induced disease
acute hepatocellular disorders the ALT level > the AST level
