Sanners Review - Final NR511
Questions and Complete Detailed
Answers
macrocytic anemia - Answer: increased MCV
-vitamin b12, iron deficiency, pernicious anemia, folate deficiency, liver disease, drugs
Mean Corpuscular Volume (MCV) - Answer: size of a red blood cell
normal: 76 to 96 fL
Microcytic anemia - Answer: decreased MCV (hypochromic with decreased MCHC)
-order serum iron, ferritin, and TIBC
what should level to check on kids before starting iron? - Answer: *LEAD LEVEL*
always check a lead level before starting iron on children because an increased lead level will cause
anemia despite normal iron level.
Ulcerative Colitis - Answer: Friability, erosions and bleeding
-characterized by bloody/purulent diarrhea
-total colectomy can completely cure but is not the first treatment option
C. Diff - Symptoms - Answer: generally profuse, watery, mucoid diarrhea
-mild to mod: watery diarrhea 3 or more times/day for 2 or more days, mild cramping/abd
tenderness
-severe: 10-15 watery stools/day, strong odor, acute abd secondary to megacolon w/ perforation,
distention, fever, N/V
inflammatory bowel disease - Answer: the mucosal surface of the colon is inflamed, most often
occurs in the rectosigmoid areas but may involve the whole colon
, diverticulitis - Answer: may present with bleeding, not associated with pain
may also present with N/V and LLQ tenderness and anorexia
-Need CT scan to R/O Diff Dx
*High fiber diet is the best management*
C Diff - diagnosis - Answer: Elevated WBCs
-enzyme-linked immunodeficiency assay (ELISA) identifies toxins
-cell cytotoxicity: identifies the effects of bacterial toxins on human cells
-PCR: detects bacterial genes
-Endoscopy: if unresponsive to treatment, can show pseudomembranes that suggest C Diff
C Diff -risks - Answer: infection of the large intestine which causes profuse, watery mucoid diarrhea
-healthcare facility, long hospitalization, long term abx, long term meds that disrupt GI, consuming
infected objects
C Diff - treatment - Answer: Metronidazole, probiotics, maintain fluids, clear liquid diet, eat starchy
foods
avoid: caffeine, spice, foods, milk, grease
Severe cases: colectomy
GERD - Answer: symptoms: occurs at night, heartburn, dysphagia, regurgitation, painful swallowing,
belching, coughing, hoarseness
-avoid: caffeine, alcohol, chocolate, peppermint, spicy foods
-eat small meals, stop smoking, remain upright after eating
*If patient treated with omeprazole and diet modifications for 6 weeks without improvement-
endoscopy needed*
Peptic Ulcer Disease - Answer: *Hallmark sign: burning or gnawing sensation or pain in the
epigastrium which is often relieved by goods or antacids*
-Treatment: amoxicillin, clarithromycin, omeprazole for two weeks
Rotavirus - Answer: common in children younger than 3
-symptoms: fever, loss of appetite, copious diarrhea, flatulence, vomiting, stomach cramps
Questions and Complete Detailed
Answers
macrocytic anemia - Answer: increased MCV
-vitamin b12, iron deficiency, pernicious anemia, folate deficiency, liver disease, drugs
Mean Corpuscular Volume (MCV) - Answer: size of a red blood cell
normal: 76 to 96 fL
Microcytic anemia - Answer: decreased MCV (hypochromic with decreased MCHC)
-order serum iron, ferritin, and TIBC
what should level to check on kids before starting iron? - Answer: *LEAD LEVEL*
always check a lead level before starting iron on children because an increased lead level will cause
anemia despite normal iron level.
Ulcerative Colitis - Answer: Friability, erosions and bleeding
-characterized by bloody/purulent diarrhea
-total colectomy can completely cure but is not the first treatment option
C. Diff - Symptoms - Answer: generally profuse, watery, mucoid diarrhea
-mild to mod: watery diarrhea 3 or more times/day for 2 or more days, mild cramping/abd
tenderness
-severe: 10-15 watery stools/day, strong odor, acute abd secondary to megacolon w/ perforation,
distention, fever, N/V
inflammatory bowel disease - Answer: the mucosal surface of the colon is inflamed, most often
occurs in the rectosigmoid areas but may involve the whole colon
, diverticulitis - Answer: may present with bleeding, not associated with pain
may also present with N/V and LLQ tenderness and anorexia
-Need CT scan to R/O Diff Dx
*High fiber diet is the best management*
C Diff - diagnosis - Answer: Elevated WBCs
-enzyme-linked immunodeficiency assay (ELISA) identifies toxins
-cell cytotoxicity: identifies the effects of bacterial toxins on human cells
-PCR: detects bacterial genes
-Endoscopy: if unresponsive to treatment, can show pseudomembranes that suggest C Diff
C Diff -risks - Answer: infection of the large intestine which causes profuse, watery mucoid diarrhea
-healthcare facility, long hospitalization, long term abx, long term meds that disrupt GI, consuming
infected objects
C Diff - treatment - Answer: Metronidazole, probiotics, maintain fluids, clear liquid diet, eat starchy
foods
avoid: caffeine, spice, foods, milk, grease
Severe cases: colectomy
GERD - Answer: symptoms: occurs at night, heartburn, dysphagia, regurgitation, painful swallowing,
belching, coughing, hoarseness
-avoid: caffeine, alcohol, chocolate, peppermint, spicy foods
-eat small meals, stop smoking, remain upright after eating
*If patient treated with omeprazole and diet modifications for 6 weeks without improvement-
endoscopy needed*
Peptic Ulcer Disease - Answer: *Hallmark sign: burning or gnawing sensation or pain in the
epigastrium which is often relieved by goods or antacids*
-Treatment: amoxicillin, clarithromycin, omeprazole for two weeks
Rotavirus - Answer: common in children younger than 3
-symptoms: fever, loss of appetite, copious diarrhea, flatulence, vomiting, stomach cramps
