NR576/NR 576 FINAL EXAM LATEST
2025 WITH CORRECT QUESTIONS
AND DETAILED ANSWERS/ALREADY
GRADED A+
Assessing 4rfor 4rprior 4rantibiotic 4ruse 4ris 4ra 4rcritical 4rpart 4rof 4rthe 4rhistory 4rin 4rpatients
4rwith 4rpresenting 4rwith 4r_______________ 4rdue 4rto_________________ 4r- 4rANS--
Diarrhea/CDiff
Irritable 4rbowel 4rsyndrome 4r- 4rANS--disorder 4rof 4rthe 4rbowel 4rfunction 4rnot 4rfrom
4ranatomic 4rabnormality--constipation, 4rdiarrhea, 4rbloating, 4rurgency 4rw/diarrhea
+s/s--result 4rfrom 4rdisordered 4rsensations 4ror 4rabnormal 4rfunction 4rof 4rthe 4rsmall
4rand 4rlarge 4rbowel
NOT 4rassociated 4rwith 4rserious 4rmedical 4rconditions, 4rIBD, 4rCA
Inflammatory 4rbowel 4rdisorder 4r- 4rANS--chronic 4rimmunologic 4rdisease 4rthat
4rmanifests 4rin 4rintestinal 4rinflammation
Ulcerative 4rcolitis
crohn's 4rdisease
Two 4rcommon 4rinflammatory 4rbowel 4rdiseases 4r- 4rANS--Ulcerative 4rcolitis-mucosal
4rsurface 4rof 4rthe 4rcolon 4ris 4rinflamed 4rand 4rultimately 4rresults 4rin 4rfrability, 4rerosions,
4rand 4rbleeding--most 4rcommon 4rin 4rrecto-sigmoid 4rcolon. 4rCan 4rinvolve 4rentire
4rcolon, 4rpain 4rin 4rRLQ
Crohns 4rdisease-inflammation 4rextends 4rdeeper 4rinto 4rthe 4rintestional 4rwall 4rand 4rcan
4rinvolve 4rall 4ror 4rany 4rlayer 4rof 4rthe 4rbowel 4rwall 4rand 4rany 4rportion 4rof 4rthe 4rGI
4rtract 4rfrom 4rthe 4rmouth 4rto 4rthe 4ranus--skipped 4rlesions, 4rpain 4rin 4rLLQ
Diverticulitis 4r- 4rANS--Symptoms: 4rLLQ 4rpain/tenderness, 4rfever, 4rN/V/D
Need 4rimagining 4respecially 4rif 4rperforation 4ror 4rperitonitis 4ris 4rsuspected--free
4rair=perforation; 4rpatient 4rmay 4rhave 4rileus, 4rsmall 4ror 4rlarge 4rbowel 4robstruction
Can 4ruse 4rplain 4rx-ray
CT 4ror 4rBarium 4renema 4rare 4rpreferred
CT 4rwith 4rcontrast 4ris 4rmore 4rsensitive 4rand 4raccurate
,Identify 4rthe 4rsignificance 4rof 4rBarrett's 4resophagus 4r- 4rANS--After 4rrepeated
4rexposure 4rto 4rgastric 4rcontents, 4rinflammation 4rof 4rthe 4resophageal 4rmucosa
4rbecomes 4rchronic
Blood 4rflow 4rincreases, 4rerosion 4roccurs
As 4rerosion 4rheals, 4rnormal 4rsquamous 4repithelium 4rreplaced 4rwith 4rmetaplastic
4rcolumnar 4repithelium 4rcontaining 4rgoblet 4rand 4rcolumnar 4rcells. 4r
More 4rresistant 4rto 4racid 4rand 4rsupports 4resophageal 4rhealing
Premalignant 4rtissue
40-fold 4rfrisk 4rfor 4rdeveloping 4resophageal 4radenocarcinma
Fibrosis 4rand 4rscarring 4rduring 4rhealing 4rof 4rerosions; 4rleads 4rto 4rstrictures
Diagnosis 4rof 4rGERD 4r- 4rANS--made 4ron 4rhistory 4ralone: 4rsensitivity 4rof 4r80% 4r
if 4rsymptoms 4rare 4runclear/patient 4rdoes 4rnot 4rrespond 4rto 4r4 4rweeks 4rof 4rempiric 4rtx
4r
made 4rby 4rambulatory 4resophageal 4rpH 4rmonitoring
pH 4r<4 4rabove 4rthe 4rlower 4resophageal 4rsphincter 4rcorrelates 4rwith 4rsymptoms 4r=
4rGERD 4r
EDG 4rwith 4rbiopsy-Barrett's 4resohagus
Normal 4rresults 4rin 4r50% 4rof 4rsymptomatic 4rpatients
Risks 4rof 4rGERD 4r- 4rANS--Obesity
Increase 4rafter 4rage 4r50
Equal 4racross 4rgender, 4rethnic, 4rand 4rcultural 4rgroups
Treatments 4rof 4rGERD 4r- 4rANS--Small 4rfrequent 4rmeals-main 4rmeal 4rin 4rmidday
Avoid 4rtrigger 4rfoods
No 4rbedtime 4rsnacks: 4rno 4reating 4r<4 4rhours 4rprior 4rto 4rbed
Eliminate 4rcaffeine, 4rstop 4rsmoking, 4ravoid 4rtight 4rfitting 4rclothing, 4rsleep 4rwith 4rhead
4rof 4rthe 4rbed 4relevated.
Medications 4rfor 4rGERD 4r- 4rANS--antacids 4ror 4rOTC 4rH2 4r(Tagamet, 4rzantac, 4raxid)
Rx-strength 4rH2 4r(ranitidine 4r150mg 4rBID, 4rfamotidine 4r20mg 4rBID) 4ror 4rPPI
4r(pantoprazole 4r40mg 4rdaily, 4romeprazole 4r20mg 4rdaily)
PPI 4r(Omeprazole 4r40mg 4rdaily)
Surgery 4r(fundoplication)
Differential 4rdiagnosis 4rof 4racute 4rabd 4rpain 4r- 4rANS--Acute 4rappendicitis
Acute 4rpancreatitis
Acute 4rcholecystitis
Acute 4rappendicitis 4r- 4rANS--Inflammation 4rof 4rthe 4rvermiform 4rappendix; 4rdue 4rto
4robstruction 4ror 4rinfection
4rMost 4rcommon 4rsurgical 4remergency 4rof 4rthe 4rabdomen
4rHollow 4rtube 4r- 4rmost 4rcommon 4rcause 4ris 4robstruction 4rof 4rappendix
4rFecaltih 4r- 4rhard 4rlump 4rof 4rfecal 4rmatter
4rUndigested 4rseeds
4rPinworm 4rinfections
, 4rLymphoid 4rfollicle 4rgrowth/lymphoid 4rhyperplasia 4rSymptoms
4. 4rSymptoms
4rNausea/vomiting
4rRLQ 4rpain
4rGuarding
Acute 4rpancreatitis 4r- 4rANS--Sudden 4rinflammation 4rand 4rhemorrhaging 4rof 4rthe
4rpancreas 4rdue 4rto 4rdestruction 4rby 4rits 4rown 4rdigestive 4renzymes
1. 4rAutodigestion
4rMost 4rof 4rthe 4rtime 4rmild, 4rbut 4rcan 4rbe 4rsevere
4rPancreas 4r
4rLong 4rskinny 4rgland, 4rlength 4rof 4rdollar 4rbill
4rLocated 4rin 4rupper 4rabdomen
4rBehind 4rthe 4rstomach
4rEndocrine
4rAlpha/beta 4rcells 4rproduce 4rinsulin 4r& 4rglucagon 4rthat 4rare 4rsecreted 4rinto 4rthe
4rblood 4rstream
4rExocrine
4rLeading 4rcauses:
4rETOH 4rabuse
4rGallstones
4rOther 4rCauses 4rof 4racute 4rpancreatitis
1. 4rI 4rGet 4rSmashed
4rI 4r- 4ridoipathic
4rG- 4rgallstones
4rE- 4rETOH 4rabuse
4rT 4r- 4rtrauma
4rS 4r- 4rsteroids
4rM 4r- 4rmumps 4rvirus
4rA 4r- 4rautoimmune 4rdiseases
4rS 4r- 4rscorpion 4rstings
4rH 4r- 4rhypertriglyceridemia 4r& 4rhypercalcemia
4rE 4r- 4rERCP
4rD 4r- 4rdrugs 4r
Symptoms
Nausea
4rVomiting
4rHypocalcemia
4rCullen's 4rsign 4r- 4rbruising 4raround 4rumbilicus
4rGrey-Turner's 4rSign 4r- 4rBruising 4ralong 4rflank
4rNecrosis 4rinduced 4rhemorrhaging 4rspreads
Acute 4rcholecystitis 4r- 4rANS--Inflammation 4rof 4rgallbladder 4r(GB)
Usually 4rdue 4rto 4rgallstone 4rin 4rcystic 4rduct
1. 4rCystic 4rduct 4r- 4rleaves 4rgall 4rbladder 4r& 4rconnects 4rto 4rcommon 4rbile 4rduct
Symptoms
2025 WITH CORRECT QUESTIONS
AND DETAILED ANSWERS/ALREADY
GRADED A+
Assessing 4rfor 4rprior 4rantibiotic 4ruse 4ris 4ra 4rcritical 4rpart 4rof 4rthe 4rhistory 4rin 4rpatients
4rwith 4rpresenting 4rwith 4r_______________ 4rdue 4rto_________________ 4r- 4rANS--
Diarrhea/CDiff
Irritable 4rbowel 4rsyndrome 4r- 4rANS--disorder 4rof 4rthe 4rbowel 4rfunction 4rnot 4rfrom
4ranatomic 4rabnormality--constipation, 4rdiarrhea, 4rbloating, 4rurgency 4rw/diarrhea
+s/s--result 4rfrom 4rdisordered 4rsensations 4ror 4rabnormal 4rfunction 4rof 4rthe 4rsmall
4rand 4rlarge 4rbowel
NOT 4rassociated 4rwith 4rserious 4rmedical 4rconditions, 4rIBD, 4rCA
Inflammatory 4rbowel 4rdisorder 4r- 4rANS--chronic 4rimmunologic 4rdisease 4rthat
4rmanifests 4rin 4rintestinal 4rinflammation
Ulcerative 4rcolitis
crohn's 4rdisease
Two 4rcommon 4rinflammatory 4rbowel 4rdiseases 4r- 4rANS--Ulcerative 4rcolitis-mucosal
4rsurface 4rof 4rthe 4rcolon 4ris 4rinflamed 4rand 4rultimately 4rresults 4rin 4rfrability, 4rerosions,
4rand 4rbleeding--most 4rcommon 4rin 4rrecto-sigmoid 4rcolon. 4rCan 4rinvolve 4rentire
4rcolon, 4rpain 4rin 4rRLQ
Crohns 4rdisease-inflammation 4rextends 4rdeeper 4rinto 4rthe 4rintestional 4rwall 4rand 4rcan
4rinvolve 4rall 4ror 4rany 4rlayer 4rof 4rthe 4rbowel 4rwall 4rand 4rany 4rportion 4rof 4rthe 4rGI
4rtract 4rfrom 4rthe 4rmouth 4rto 4rthe 4ranus--skipped 4rlesions, 4rpain 4rin 4rLLQ
Diverticulitis 4r- 4rANS--Symptoms: 4rLLQ 4rpain/tenderness, 4rfever, 4rN/V/D
Need 4rimagining 4respecially 4rif 4rperforation 4ror 4rperitonitis 4ris 4rsuspected--free
4rair=perforation; 4rpatient 4rmay 4rhave 4rileus, 4rsmall 4ror 4rlarge 4rbowel 4robstruction
Can 4ruse 4rplain 4rx-ray
CT 4ror 4rBarium 4renema 4rare 4rpreferred
CT 4rwith 4rcontrast 4ris 4rmore 4rsensitive 4rand 4raccurate
,Identify 4rthe 4rsignificance 4rof 4rBarrett's 4resophagus 4r- 4rANS--After 4rrepeated
4rexposure 4rto 4rgastric 4rcontents, 4rinflammation 4rof 4rthe 4resophageal 4rmucosa
4rbecomes 4rchronic
Blood 4rflow 4rincreases, 4rerosion 4roccurs
As 4rerosion 4rheals, 4rnormal 4rsquamous 4repithelium 4rreplaced 4rwith 4rmetaplastic
4rcolumnar 4repithelium 4rcontaining 4rgoblet 4rand 4rcolumnar 4rcells. 4r
More 4rresistant 4rto 4racid 4rand 4rsupports 4resophageal 4rhealing
Premalignant 4rtissue
40-fold 4rfrisk 4rfor 4rdeveloping 4resophageal 4radenocarcinma
Fibrosis 4rand 4rscarring 4rduring 4rhealing 4rof 4rerosions; 4rleads 4rto 4rstrictures
Diagnosis 4rof 4rGERD 4r- 4rANS--made 4ron 4rhistory 4ralone: 4rsensitivity 4rof 4r80% 4r
if 4rsymptoms 4rare 4runclear/patient 4rdoes 4rnot 4rrespond 4rto 4r4 4rweeks 4rof 4rempiric 4rtx
4r
made 4rby 4rambulatory 4resophageal 4rpH 4rmonitoring
pH 4r<4 4rabove 4rthe 4rlower 4resophageal 4rsphincter 4rcorrelates 4rwith 4rsymptoms 4r=
4rGERD 4r
EDG 4rwith 4rbiopsy-Barrett's 4resohagus
Normal 4rresults 4rin 4r50% 4rof 4rsymptomatic 4rpatients
Risks 4rof 4rGERD 4r- 4rANS--Obesity
Increase 4rafter 4rage 4r50
Equal 4racross 4rgender, 4rethnic, 4rand 4rcultural 4rgroups
Treatments 4rof 4rGERD 4r- 4rANS--Small 4rfrequent 4rmeals-main 4rmeal 4rin 4rmidday
Avoid 4rtrigger 4rfoods
No 4rbedtime 4rsnacks: 4rno 4reating 4r<4 4rhours 4rprior 4rto 4rbed
Eliminate 4rcaffeine, 4rstop 4rsmoking, 4ravoid 4rtight 4rfitting 4rclothing, 4rsleep 4rwith 4rhead
4rof 4rthe 4rbed 4relevated.
Medications 4rfor 4rGERD 4r- 4rANS--antacids 4ror 4rOTC 4rH2 4r(Tagamet, 4rzantac, 4raxid)
Rx-strength 4rH2 4r(ranitidine 4r150mg 4rBID, 4rfamotidine 4r20mg 4rBID) 4ror 4rPPI
4r(pantoprazole 4r40mg 4rdaily, 4romeprazole 4r20mg 4rdaily)
PPI 4r(Omeprazole 4r40mg 4rdaily)
Surgery 4r(fundoplication)
Differential 4rdiagnosis 4rof 4racute 4rabd 4rpain 4r- 4rANS--Acute 4rappendicitis
Acute 4rpancreatitis
Acute 4rcholecystitis
Acute 4rappendicitis 4r- 4rANS--Inflammation 4rof 4rthe 4rvermiform 4rappendix; 4rdue 4rto
4robstruction 4ror 4rinfection
4rMost 4rcommon 4rsurgical 4remergency 4rof 4rthe 4rabdomen
4rHollow 4rtube 4r- 4rmost 4rcommon 4rcause 4ris 4robstruction 4rof 4rappendix
4rFecaltih 4r- 4rhard 4rlump 4rof 4rfecal 4rmatter
4rUndigested 4rseeds
4rPinworm 4rinfections
, 4rLymphoid 4rfollicle 4rgrowth/lymphoid 4rhyperplasia 4rSymptoms
4. 4rSymptoms
4rNausea/vomiting
4rRLQ 4rpain
4rGuarding
Acute 4rpancreatitis 4r- 4rANS--Sudden 4rinflammation 4rand 4rhemorrhaging 4rof 4rthe
4rpancreas 4rdue 4rto 4rdestruction 4rby 4rits 4rown 4rdigestive 4renzymes
1. 4rAutodigestion
4rMost 4rof 4rthe 4rtime 4rmild, 4rbut 4rcan 4rbe 4rsevere
4rPancreas 4r
4rLong 4rskinny 4rgland, 4rlength 4rof 4rdollar 4rbill
4rLocated 4rin 4rupper 4rabdomen
4rBehind 4rthe 4rstomach
4rEndocrine
4rAlpha/beta 4rcells 4rproduce 4rinsulin 4r& 4rglucagon 4rthat 4rare 4rsecreted 4rinto 4rthe
4rblood 4rstream
4rExocrine
4rLeading 4rcauses:
4rETOH 4rabuse
4rGallstones
4rOther 4rCauses 4rof 4racute 4rpancreatitis
1. 4rI 4rGet 4rSmashed
4rI 4r- 4ridoipathic
4rG- 4rgallstones
4rE- 4rETOH 4rabuse
4rT 4r- 4rtrauma
4rS 4r- 4rsteroids
4rM 4r- 4rmumps 4rvirus
4rA 4r- 4rautoimmune 4rdiseases
4rS 4r- 4rscorpion 4rstings
4rH 4r- 4rhypertriglyceridemia 4r& 4rhypercalcemia
4rE 4r- 4rERCP
4rD 4r- 4rdrugs 4r
Symptoms
Nausea
4rVomiting
4rHypocalcemia
4rCullen's 4rsign 4r- 4rbruising 4raround 4rumbilicus
4rGrey-Turner's 4rSign 4r- 4rBruising 4ralong 4rflank
4rNecrosis 4rinduced 4rhemorrhaging 4rspreads
Acute 4rcholecystitis 4r- 4rANS--Inflammation 4rof 4rgallbladder 4r(GB)
Usually 4rdue 4rto 4rgallstone 4rin 4rcystic 4rduct
1. 4rCystic 4rduct 4r- 4rleaves 4rgall 4rbladder 4r& 4rconnects 4rto 4rcommon 4rbile 4rduct
Symptoms
