FNP 652 MIDTERM EXAM ACTUAL QUESTIONS
AND ANSWERS GRADED A+
What is the most common cause of neonatal obstruction? - answer- Hirschsprung
Disease
What is the definition of Hirschsprung disease? - answer- Congenital absence of
ganglion cells in section of large intestine which results in lack of motility
What is the gold standard for diagnosis of Hirschsprung Disease? - answer- Biopsy
A 1 month old infant is brought in by his mother with complaints of multiple
episodes of forceful vomiting that is getting worse. What condition would you
suspect? - answer- Pyloric Stenosis
A 1 month old infant is brought in by his mother with constant hunger and weight
loss despite the mother trying to supplement his feeding. He has had regular bouts
of vomiting, which the mother thought was normal for infants. You palpate an
olive shaped mass in the right upper quadrant of the abdomen. What diagnosis do
you suspect? - answer- Pyloric Stenosis
What is the treatment for Zollinger-Ellison Syndrome? - answer- PPI
What percentage of weight loss is enough to improve obesity related co-
morbidities? - answer- 5-10%
What medication for obesity blocks the digestion and absorption of fat in the
stomach and small intestines? - answer- Orlistat
,What are the ranges for BMI for class I, II and III of obesity? - answer- I >30- <35
II >35-<40
III >40
What frequency and duration of GI symptoms constitutes irritable bowel
syndrome? - answer- Symptoms present at least 3 days a month for at least 3
months.
A 30 year old female patient presents with complaints of cramping abdominal pain
with frequent diarrhea for the past year. She has had no weight loss or blood in her
stool. She frequently feels bloated and as though she cannot go out with friends,
because she needs to use the restroom so frequently. What diagnosis do you
suspect? - answer- Irritable bowel syndrome
An emergent condition where one bowel segment becomes invaginated into
another - answer- Intussusception
Mother presents with her 2 year old child who is complaining of severe abdominal
pain and 4 episodes of vomiting in the last 24 hours. He has had 4 episodes of
"currant jelly" like stool, and the most recent one had blood in it. What diagnosis
do you suspect? - answer- Intussusception
What is the gold standard for diagnosis of intussusception? - answer- abdominal
ultrasound
What condition is associated with a "bulls eye" or "coiled spring" appearance when
seen on fluoroscopy or ultrasound? - answer- Intussusception
,What is the treatment for intussusception? - answer- Air contrast enema under
fluoroscopy
What types of viral hepatitis are self limiting and cause only acute viral disease and
have complete viral clearance? - answer- Hepatitis A and E
What types of viral hepatitis can result in chronic infections? - answer- Hepatitis B,
C, and D
A patient who is newly diagnosed with GERD should receive what type of
medication as first line treatment? - answer- H2 Antagonist (ex: Ranitidine,
Famotidine)
A 10 year old female patient presents to the clinic with her mother with complaints
of ongoing generalized abdominal pain over the last 6 months. Her stool is
negative for occult blood and she is absent of any alarm symptoms. All previous
imagining and work up has come back negative. The pain is intermittent, and is
unrelated to meals, movement or activity. Pain medications thus far have been
ineffective, and the school is sending letters home regarding the child's many
absences. What condition do you suspect? - answer- Functional Abdominal Pain
Which liver enzyme is typically higher in Non-alcoholic fatty liver disease? ALT
or AST? - answer- ALT
What are potential causes of non alcoholic fatty liver disease? - answer- Obesity,
DM, hypertriglyceridemia associated with insulin resistance as a part of metabolic
syndrome
What are the "2 hits" in non-alcoholic fatty liver disease? - answer- 1-insulin
resistance and altered lipid metabolism resulting in fatty acids infiltrating the liver.
, 2-Inflammation causes more liver injury, which can result in fibrosis and later
cirrhosis
A mother bring in her 5 year old son who was previously potty trained, but has
recently started having accidents daily and not using the toilet. What condition do
you suspect? - answer- Encopresis
What is Primary Encopresis? - answer- Child has never been toilet trained
successfully
What is secondary Encopresis? - answer- Child previously toilet trained, but begins
to soil
Treating a child with encopresis with constipation, what methods of disimpaction
should be utilized? - answer- Oral cathartics, enemas or combination
A child with encopresis with constipation just underwent bowel evacuation, what
should be initiated next? And what is the goal for their continuing bowel habits? -
answer- Laxative/stool softeners in order to achieve goal of 1-2 soft stools ad ay.
What is the first line for management of encopresis? - answer- Behavior
modification therapy
What is the major contributing factor for recurrence of diverticulitis? - answer-
Chronic low grade inflammation
A patient presents with acute left lower abdominal pain with tenderness, palpable
mass, fever, and leukocytosis. What condition do you suspect? - answer-
Diverticulitis
AND ANSWERS GRADED A+
What is the most common cause of neonatal obstruction? - answer- Hirschsprung
Disease
What is the definition of Hirschsprung disease? - answer- Congenital absence of
ganglion cells in section of large intestine which results in lack of motility
What is the gold standard for diagnosis of Hirschsprung Disease? - answer- Biopsy
A 1 month old infant is brought in by his mother with complaints of multiple
episodes of forceful vomiting that is getting worse. What condition would you
suspect? - answer- Pyloric Stenosis
A 1 month old infant is brought in by his mother with constant hunger and weight
loss despite the mother trying to supplement his feeding. He has had regular bouts
of vomiting, which the mother thought was normal for infants. You palpate an
olive shaped mass in the right upper quadrant of the abdomen. What diagnosis do
you suspect? - answer- Pyloric Stenosis
What is the treatment for Zollinger-Ellison Syndrome? - answer- PPI
What percentage of weight loss is enough to improve obesity related co-
morbidities? - answer- 5-10%
What medication for obesity blocks the digestion and absorption of fat in the
stomach and small intestines? - answer- Orlistat
,What are the ranges for BMI for class I, II and III of obesity? - answer- I >30- <35
II >35-<40
III >40
What frequency and duration of GI symptoms constitutes irritable bowel
syndrome? - answer- Symptoms present at least 3 days a month for at least 3
months.
A 30 year old female patient presents with complaints of cramping abdominal pain
with frequent diarrhea for the past year. She has had no weight loss or blood in her
stool. She frequently feels bloated and as though she cannot go out with friends,
because she needs to use the restroom so frequently. What diagnosis do you
suspect? - answer- Irritable bowel syndrome
An emergent condition where one bowel segment becomes invaginated into
another - answer- Intussusception
Mother presents with her 2 year old child who is complaining of severe abdominal
pain and 4 episodes of vomiting in the last 24 hours. He has had 4 episodes of
"currant jelly" like stool, and the most recent one had blood in it. What diagnosis
do you suspect? - answer- Intussusception
What is the gold standard for diagnosis of intussusception? - answer- abdominal
ultrasound
What condition is associated with a "bulls eye" or "coiled spring" appearance when
seen on fluoroscopy or ultrasound? - answer- Intussusception
,What is the treatment for intussusception? - answer- Air contrast enema under
fluoroscopy
What types of viral hepatitis are self limiting and cause only acute viral disease and
have complete viral clearance? - answer- Hepatitis A and E
What types of viral hepatitis can result in chronic infections? - answer- Hepatitis B,
C, and D
A patient who is newly diagnosed with GERD should receive what type of
medication as first line treatment? - answer- H2 Antagonist (ex: Ranitidine,
Famotidine)
A 10 year old female patient presents to the clinic with her mother with complaints
of ongoing generalized abdominal pain over the last 6 months. Her stool is
negative for occult blood and she is absent of any alarm symptoms. All previous
imagining and work up has come back negative. The pain is intermittent, and is
unrelated to meals, movement or activity. Pain medications thus far have been
ineffective, and the school is sending letters home regarding the child's many
absences. What condition do you suspect? - answer- Functional Abdominal Pain
Which liver enzyme is typically higher in Non-alcoholic fatty liver disease? ALT
or AST? - answer- ALT
What are potential causes of non alcoholic fatty liver disease? - answer- Obesity,
DM, hypertriglyceridemia associated with insulin resistance as a part of metabolic
syndrome
What are the "2 hits" in non-alcoholic fatty liver disease? - answer- 1-insulin
resistance and altered lipid metabolism resulting in fatty acids infiltrating the liver.
, 2-Inflammation causes more liver injury, which can result in fibrosis and later
cirrhosis
A mother bring in her 5 year old son who was previously potty trained, but has
recently started having accidents daily and not using the toilet. What condition do
you suspect? - answer- Encopresis
What is Primary Encopresis? - answer- Child has never been toilet trained
successfully
What is secondary Encopresis? - answer- Child previously toilet trained, but begins
to soil
Treating a child with encopresis with constipation, what methods of disimpaction
should be utilized? - answer- Oral cathartics, enemas or combination
A child with encopresis with constipation just underwent bowel evacuation, what
should be initiated next? And what is the goal for their continuing bowel habits? -
answer- Laxative/stool softeners in order to achieve goal of 1-2 soft stools ad ay.
What is the first line for management of encopresis? - answer- Behavior
modification therapy
What is the major contributing factor for recurrence of diverticulitis? - answer-
Chronic low grade inflammation
A patient presents with acute left lower abdominal pain with tenderness, palpable
mass, fever, and leukocytosis. What condition do you suspect? - answer-
Diverticulitis
