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NR 511 Midterm Exam 2023/2024 With 100% Correct And Verified Answers Sensitivity - Correct answer-Few false negatives Specificity - Correct answer-Few false positives Predictive Value - Correct answer-Likelihood person has disease 3 key components that determine risk-based E&M codes - Correct answer-History Physical Medical Decision Making Complexity of a visit is based on three criteria (aka MDM) - Correct answer-Risk Data Diagnosis 13. Identify the 3 components required in determining an outpatient, office visit E&M code - Correct answer-Place of service Type of service (consult, office visit, hospital admit) Pt status (new vs established) SNAPPS - Correct answer--S: Summarize -N: Narrow
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Sensitivity - Correct answer-Few false negatives Specificity - Correct answer-Few false positives Predictive Value - Correct answer-Likelihood person has disease 3 key components that determine risk-based E&M codes - Correct answer-History Physical Medical Decision Making Complexity of a visit is based on three criteria (aka MDM) - Correct answer-Risk Data Diagnosis
UC - Correct answer-the mucosal surface of the colon is inflamed and ultimately results in friability, erosions, and bleeding.
Sensorineural Hearing Loss - Correct answer-Results from deterioration of cochlea -Loss of hair cells form the organ of Corti -Gradual and progressive -Not correctable but preventable Conductive - Correct answer-Obstruction between middle and outer ear -Most types are reversible Meniere's Disease - Correct answer-Sensory disorder of labyrinth (semi-circular canal system) and cochlea -S/S: -Vertigo -Hearing loss -Tinnitus Peritonsilar Abscess - Correct answer--Increasing unilateral ear and throat pain ipsilateral to the affected tonsil -Dysphagia -Drooling -Trismus -Erythema -Edema of the soft palate with fluctuance on palpation most common cause of viral pharyngitis - Correct answer--Adenovirus: MOST common -RSV -Influenza A&B -Epstein-Barr -coxsackie -enteroviruses -herpes simplex most common cause of acute nausea & vomiting - Correct answer-Gastroenteritis Colon CA Screening - Correct answer--Anyone over age 50 should have a routine c- scope -African American's should start screenings at age 40 -Individuals with a single first-degree relative with CRC or advanced adenomas diagnosed at age ≥60 years can be screened like average-risk persons. Red Flag Symptoms for GI - Correct answer-unintentional weight loss rectal bleeding diffuse lower abdomen pain new onset diarrhea/constipation early satiety loss of appetite
disorders related to conductive hearing loss - Correct answer--Chronic Otitis Media (OM) -middle ear effusion -mass -vascular anomaly -cholesteatoma - abnormal noncancerous skin growth in ear canal most common bacterial cause of pharyngitis - Correct answer--Group A Beta Hemolytic Streptococcus (GABHS) -Absence of cough -Tonsillar exudates -History of fever -Tender anterior cervical adenopathy clinical findings associated with mononucleosis - Correct answer--Fever -Malaise -Severe sore throat -Exudative tonsillitis (50% of cases) -Palatal petchiae -Rash ---Anterior/posterior cervical lymphadenopathy -Splenic enlargement -POC Monospot test: (+) common characteristics in a rash caused be Group A Strep - Correct answer- Sandpaper rash Fine, red, sparing hands & soles diagnosis of streptococcal pharyngitis can be made clinically based on the Centor criteria - Correct answer--Absence of cough -Tonsillar exudates -History of fever -Tender anterior cervical adenopathy intervention for a patient with gastroenteritis - Correct answer--Supportive care: fluid and nutrients -Low residue diet (BRAT) - no evidence that this helps, but may be more tolerable for pt -Viral cause = NO antibiotics -Education surrounding not prescribing antibiotics/not spreading germs/eating safe foods -Imodium/Zofran/Phenergan appropriate treatment for prophylaxis or treatment of traveler's diarrhea - Correct answer--ciprofloxacin (Cipro) 500 mg -norfloxacin (Noroxin) 400 mg -ofloxacin (Floxin) 300 mg -Bactrim
one effective treatment for IBS-C - Correct answer-o Psyllium (fiber) o docusate (softner) o bisacodyl/senna (stimulant/irritant) o loperamide (antidiarrheal) one effective treatment for IBS-D - Correct answer-odicyclomine (bentyl), hycosamine sulfate (Levsin) phenobarb/hycosamine (donnatal) anticholenergics - decrease motility of smooth muscle tone/decrease cramping, relaxes muscles in stomach/intestines oLinzess (linaclotide), Trulance (plecanatide), and Amitiza (lubiprostone): drugs work by acting locally on the apical membrane of the GI tract to increase intestinal fluid secretion and improve fecal transit -Antidepressants for depression/anxiety component one prescription medication for the treatment of chronic constipation - Correct answer- Linzess Trulance Amitiza Movtanik Miralax (OTC) Intrathorax flow disorders - Correct answer-originate from obstruction of distal/smaller airways -asthma -bronchiolitis -vascular ring -solid foreign body aspiration -lymph node enlargement pressure Extrathorax flow disorders - Correct answer-originate from obstruction of the larger airways -rhinitis with nasal obstruction, nasal polyp -cranio-facial malformation -obstructive sleep apnea -tonsil-adenoid hypertrophy -laryngo-tracheo-malacia -larynx papilloma -Diphtheria -croup, epiglottitis -thymus hypertrophy Measles (Rubeola) - Correct answer-skin is a reddish purple generalized macular and papular rash. oLesions start out on the head, particularly on the face or behind the ears, and spread down the body within 1-2 days
Rubella (German Measles) - Correct answer-skin rash will appear with "rose-pink" macules and papules ofirst present on the head and travel down the body. ofade in 1-2 days in the same order the lesions appeared Varicella (Chicken Pox) - Correct answer-arthralgia, then 1-2 days later the urticarial (or itching) erythematous macules & papules appear, quickly turn into vesicles & pustules. oThe rash starts on the face and chest then spreads quickly over the entire body. Roseola - Correct answer-The skin rash presents with light pink, erythematous macules and papules on the face, neck, and extremities. 5th's Disease - Correct answer-3 Stages:
Tinea Ungulum - Correct answer-Onychomycosis Tx: topical agent: Ciclopirox nail laquer 8% applied daily for months at the base of the nail Contact Dermatitis - Correct answer-allergic reaction to a substance that produces an immune reaction in your skin resulting in a very pruritic and erythemic rash -Example: Poison Ivy Atopic Dermatitis - Correct answer-a disorder that is the result of a gene variation that affects the skin's ability to retain moisture and protection from irritants -Example: Eczema Blepharitis - Correct answer-an inflammation around the eyelid margins that is caused by staphylococcal infection at the lash bases and dysfunctional Meibomian glands Chalazion - Correct answer-a chronic internal granulomatous reaction of the Meibomian gland that produces a mass in the lid Hordeolum - Correct answer-Stye: an abscess of the lid margin caused from a staph infection Conjunctivitis Types - Correct answer--Bacterial: Pink eye: purulent discharge -Viral: Adenovirus: watery or mucousy drainage: NOT purulent -Allergic: environmental: uniquely identifying "bumps" on the conjunctiva: follicles -Toxic: Overuse of eye drops: clear/watery discharge/red conjunctiva -HSV: Corneal infection with the hallmark "dendrite" appearance which chemical injury is associated with the most damage and highest risk to vision loss