NR576/NR 576 FINAL EXAM
QUESTIONS AND DETAILED
ANSWERS 2026
Assessing for prior antibiotic use is a critical part of the history in patients
with presenting with _______________ due to_________________ -
ANSWER ✔✔Diarrhea/CDiff
Irritable bowel syndrome - ANSWER ✔✔disorder of the bowel
function not from anatomic abnormality--constipation, diarrhea, bloating,
urgency w/diarrhea
+s/s--result from disordered sensations or abnormal function of the small
and large bowel
NOT associated with serious medical conditions, IBD, CA
,Inflammatory bowel disorder - ANSWER ✔✔chronic immunologic
disease that manifests in intestinal inflammation
Ulcerative colitis
crohn's disease
Two common inflammatory bowel diseases - ANSWER ✔✔Ulcerative
colitis-mucosal surface of the colon is inflamed and ultimately results in
frability, erosions, and bleeding--most common in recto-sigmoid colon.
Can involve entire colon, pain in RLQ
Crohns disease-inflammation extends deeper into the intestional wall
and can involve all or any layer of the bowel wall and any portion of the
GI tract from the mouth to the anus--skipped lesions, pain in LLQ
Diverticulitis - ANSWER ✔✔Symptoms: LLQ pain/tenderness, fever,
N/V/D
Need imagining especially if perforation or peritonitis is suspected--free
air=perforation; patient may have ileus, small or large bowel obstruction
Can use plain x-ray
CT or Barium enema are preferred
CT with contrast is more sensitive and accurate
,Identify the significance of Barrett's esophagus - ANSWER ✔✔After
repeated exposure to gastric contents, inflammation of the esophageal
mucosa becomes chronic
Blood flow increases, erosion occurs
As erosion heals, normal squamous epithelium replaced with
metaplastic columnar epithelium containing goblet and columnar cells.
More resistant to acid and supports esophageal healing
Premalignant tissue
40-fold frisk for developing esophageal adenocarcinma
Fibrosis and scarring during healing of erosions; leads to strictures
Diagnosis of GERD - ANSWER ✔✔made on history alone: sensitivity
of 80%
if symptoms are unclear/patient does not respond to 4 weeks of empiric
tx
made by ambulatory esophageal pH monitoring
pH <4 above the lower esophageal sphincter correlates with symptoms
= GERD
EDG with biopsy-Barrett's esohagus
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2026. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
3
, Normal results in 50% of symptomatic patients
Risks of GERD - ANSWER ✔✔Obesity
Increase after age 50
Equal across gender, ethnic, and cultural groups
Treatments of GERD - ANSWER ✔✔Small frequent meals-main meal
in midday
Avoid trigger foods
No bedtime snacks: no eating <4 hours prior to bed
Eliminate caffeine, stop smoking, avoid tight fitting clothing, sleep with
head of the bed elevated.
Medications for GERD - ANSWER ✔✔antacids or OTC H2 (Tagamet,
zantac, axid)
Rx-strength H2 (ranitidine 150mg BID, famotidine 20mg BID) or PPI
(pantoprazole 40mg daily, omeprazole 20mg daily)
PPI (Omeprazole 40mg daily)
Surgery (fundoplication)
Differential diagnosis of acute abd pain - ANSWER ✔✔Acute
appendicitis
QUESTIONS AND DETAILED
ANSWERS 2026
Assessing for prior antibiotic use is a critical part of the history in patients
with presenting with _______________ due to_________________ -
ANSWER ✔✔Diarrhea/CDiff
Irritable bowel syndrome - ANSWER ✔✔disorder of the bowel
function not from anatomic abnormality--constipation, diarrhea, bloating,
urgency w/diarrhea
+s/s--result from disordered sensations or abnormal function of the small
and large bowel
NOT associated with serious medical conditions, IBD, CA
,Inflammatory bowel disorder - ANSWER ✔✔chronic immunologic
disease that manifests in intestinal inflammation
Ulcerative colitis
crohn's disease
Two common inflammatory bowel diseases - ANSWER ✔✔Ulcerative
colitis-mucosal surface of the colon is inflamed and ultimately results in
frability, erosions, and bleeding--most common in recto-sigmoid colon.
Can involve entire colon, pain in RLQ
Crohns disease-inflammation extends deeper into the intestional wall
and can involve all or any layer of the bowel wall and any portion of the
GI tract from the mouth to the anus--skipped lesions, pain in LLQ
Diverticulitis - ANSWER ✔✔Symptoms: LLQ pain/tenderness, fever,
N/V/D
Need imagining especially if perforation or peritonitis is suspected--free
air=perforation; patient may have ileus, small or large bowel obstruction
Can use plain x-ray
CT or Barium enema are preferred
CT with contrast is more sensitive and accurate
,Identify the significance of Barrett's esophagus - ANSWER ✔✔After
repeated exposure to gastric contents, inflammation of the esophageal
mucosa becomes chronic
Blood flow increases, erosion occurs
As erosion heals, normal squamous epithelium replaced with
metaplastic columnar epithelium containing goblet and columnar cells.
More resistant to acid and supports esophageal healing
Premalignant tissue
40-fold frisk for developing esophageal adenocarcinma
Fibrosis and scarring during healing of erosions; leads to strictures
Diagnosis of GERD - ANSWER ✔✔made on history alone: sensitivity
of 80%
if symptoms are unclear/patient does not respond to 4 weeks of empiric
tx
made by ambulatory esophageal pH monitoring
pH <4 above the lower esophageal sphincter correlates with symptoms
= GERD
EDG with biopsy-Barrett's esohagus
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2026. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
3
, Normal results in 50% of symptomatic patients
Risks of GERD - ANSWER ✔✔Obesity
Increase after age 50
Equal across gender, ethnic, and cultural groups
Treatments of GERD - ANSWER ✔✔Small frequent meals-main meal
in midday
Avoid trigger foods
No bedtime snacks: no eating <4 hours prior to bed
Eliminate caffeine, stop smoking, avoid tight fitting clothing, sleep with
head of the bed elevated.
Medications for GERD - ANSWER ✔✔antacids or OTC H2 (Tagamet,
zantac, axid)
Rx-strength H2 (ranitidine 150mg BID, famotidine 20mg BID) or PPI
(pantoprazole 40mg daily, omeprazole 20mg daily)
PPI (Omeprazole 40mg daily)
Surgery (fundoplication)
Differential diagnosis of acute abd pain - ANSWER ✔✔Acute
appendicitis
