GI- FNP sample Questions with
Verified Solutions
What is the cause of Peptic ulcer disease? - ANSWER-1. H. Pylori (present in >90% of
duodenal ulcers &
>75% of gastric ulcers)
2. Medications such as NSAIDs, ASA & Glucocorticoids
3. Etoh & dietary factors do not appear to cause ulcer
disease
4. Role of stress is uncertain: Type A personalities
What is the incidence of peptic ulcer disease? - ANSWER-1. More common in men
(3:1)
2. Duodenal ulcers between ages 30-55
3. Gastric ulcers between ages 55-65
4. more common in >1/2 PPD smokers
What are the signs/symptoms of peptic ulcer disease? - ANSWER-1. Gnawing
epigastric pain
2. Relief of pain with eating (duodenal)
3. Pain worsens with eating (gastric)
What are the physical findings with peptic ulcer disease? - ANSWER-1. Often
unremarkable; may note some mild
epigastric tenderness
2. GI bleeding (20% of cases): melena, hematemesis, or
coffee-ground emesis
3. Perforation (5-10% of cases): severe epigastric pain,
"board like" abdomen, quiet bowel sounds, rigidity, & other signs of an acute abdomen
What are the signs/symptoms of IBS? - ANSWER-1. abdominal cramping
2. abdominal pain relieved by defecation
3. Pt may be preoccupied with bowel symptoms
4. Changes in stool consistency &/or pattern
5. Dyspepsia (indigestion)
6. Fatigue
7. C/o anxiety and/or depression are common
What are the diagnostics for IBS? - ANSWER-The following may be considered but
usual findings are normal:
, a. sigmoidoscopy
b. barium studies
c. rectal exam
What is the management for IBS? - ANSWER-1. Emotional support: refer for
counseling/therapy prn
2. Recommend high fiber diet
3. SSRI's for pt who are depressed
4. For severe cases, may employ anticholinergics,
antidiarrheals, and/or antidepressant agents as warranted
What is cholecystitis? - ANSWER-inflammation of the gallbladder, associated with
gallstones in >90% of cases
What are the signs/symptoms of cholecystitis? - ANSWER-1. foten precipitated by a
large or fatty meal
2. Sudden appearance of steady, severe pain in epigastrium or right hypochondrium
3. Vomiting in many clients affords relief
What are the physical findings with cholecystitis? - ANSWER-1. Murphys sign: deep
pain on inspiration while fingers
are placed under the right rib cage
2. Right upper quadrant tenderness to palpation;
palpable gallbladder in 15% of cases
3. Muscle guarding & rebound pain
4. Fever
What are the laboratory/diagnostics with cholecystitis? - ANSWER-1. WBC's, serum
bilirubin, AST, ALT, LDH & amylase may be elevated
2. Plain films may show gallstones
3. Ultrasound: gold standard (most effective imaging
test)
What is the management of cholecystitis? - ANSWER-1. Pain management
2. For acutely ill patients refer for:
a. NGT for gastric decompression
b. IV crystalloids & broad spectrum antibiotics
c. GI/surgical consult
What are the causes/incidence of bowel obstruction? - ANSWER--hernia
-adhesions
-volvulus
-tumors
-fecal impaction
-ileus (functional obstruction)
Verified Solutions
What is the cause of Peptic ulcer disease? - ANSWER-1. H. Pylori (present in >90% of
duodenal ulcers &
>75% of gastric ulcers)
2. Medications such as NSAIDs, ASA & Glucocorticoids
3. Etoh & dietary factors do not appear to cause ulcer
disease
4. Role of stress is uncertain: Type A personalities
What is the incidence of peptic ulcer disease? - ANSWER-1. More common in men
(3:1)
2. Duodenal ulcers between ages 30-55
3. Gastric ulcers between ages 55-65
4. more common in >1/2 PPD smokers
What are the signs/symptoms of peptic ulcer disease? - ANSWER-1. Gnawing
epigastric pain
2. Relief of pain with eating (duodenal)
3. Pain worsens with eating (gastric)
What are the physical findings with peptic ulcer disease? - ANSWER-1. Often
unremarkable; may note some mild
epigastric tenderness
2. GI bleeding (20% of cases): melena, hematemesis, or
coffee-ground emesis
3. Perforation (5-10% of cases): severe epigastric pain,
"board like" abdomen, quiet bowel sounds, rigidity, & other signs of an acute abdomen
What are the signs/symptoms of IBS? - ANSWER-1. abdominal cramping
2. abdominal pain relieved by defecation
3. Pt may be preoccupied with bowel symptoms
4. Changes in stool consistency &/or pattern
5. Dyspepsia (indigestion)
6. Fatigue
7. C/o anxiety and/or depression are common
What are the diagnostics for IBS? - ANSWER-The following may be considered but
usual findings are normal:
, a. sigmoidoscopy
b. barium studies
c. rectal exam
What is the management for IBS? - ANSWER-1. Emotional support: refer for
counseling/therapy prn
2. Recommend high fiber diet
3. SSRI's for pt who are depressed
4. For severe cases, may employ anticholinergics,
antidiarrheals, and/or antidepressant agents as warranted
What is cholecystitis? - ANSWER-inflammation of the gallbladder, associated with
gallstones in >90% of cases
What are the signs/symptoms of cholecystitis? - ANSWER-1. foten precipitated by a
large or fatty meal
2. Sudden appearance of steady, severe pain in epigastrium or right hypochondrium
3. Vomiting in many clients affords relief
What are the physical findings with cholecystitis? - ANSWER-1. Murphys sign: deep
pain on inspiration while fingers
are placed under the right rib cage
2. Right upper quadrant tenderness to palpation;
palpable gallbladder in 15% of cases
3. Muscle guarding & rebound pain
4. Fever
What are the laboratory/diagnostics with cholecystitis? - ANSWER-1. WBC's, serum
bilirubin, AST, ALT, LDH & amylase may be elevated
2. Plain films may show gallstones
3. Ultrasound: gold standard (most effective imaging
test)
What is the management of cholecystitis? - ANSWER-1. Pain management
2. For acutely ill patients refer for:
a. NGT for gastric decompression
b. IV crystalloids & broad spectrum antibiotics
c. GI/surgical consult
What are the causes/incidence of bowel obstruction? - ANSWER--hernia
-adhesions
-volvulus
-tumors
-fecal impaction
-ileus (functional obstruction)
