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NR 545 Final Exam Study Guide
1. Peptic Ulcer: Penetration of submucosa that can cause a perforation
2. Causes for peptic ulcer: H pylori, alcohol, caffeine, NSAIDS, inadequate blood
supply, atrophy to mucosa
3. Gastric ulcer symptoms: Epigastric pain, belching, burning sensation immedi-
ately after eating, antacids provide small relief
4. Duodenal Ulcer symptoms: Epigastric pain, burning 3-4 hours after eating, pain
worse at night, antacids relieves pain
5. Complications of peptic ulcers: hemorrhage, obstruction, perforation
6. Common blood type for peptic ulcers: Type "O"
7. Diagnostics of peptic ulcer: Fiberoptic endoscopy, barium Xray, stool antigen (h
pylori), Urea breath test
8. Treatment for peptic ulcer: PPI, Amoxicillin, clarithromycin
PPI, Clarithromycin, metronidazole PPI, Bismuth, tetracycline, metronidazole
9. Ulcerative Colitis: Inflammation that starts in the rectum up to the colon. Ulcers
develop. Tissue destruction interferes with absorption of fluids and electrolytes
10. Complication of Ulcerative colitis: Toxic megacolon (inflammation impairs
peristalsis, leading to obstruction and dilation of the colon)
11. Signs/symptoms ulcerative colitis: Watery diarrhea with blood and mucous,
abdominal pain and cramping, tenesmus (spasm in the rectum associated with the need to poop)
12. Treatment for ulcerative colitis: Anti-inflammatories (sulfasalazine)
Anti-diarrheal (loperamide) Diet (total parenteral nutrition or high protein, vitamin, calories and low fat) Antibiotics (metronidazole, cipro)
13. Appendicitis: Inflammation and infection of the appendix.
14. Causes of appendicitis: Obstruction, twisting, potential abscess formation and
perforation
15. Subjective data (appendicitis): Colicky pain when walking and coughing
Epigastric/periumbilical pain (RLQ) N/V Mild fever Shaking chills
16. Objective data (appendicitis): Positive McBurney sign
Positive Obturator sign Positive Psoas sign Positive Rovsign sign
Antibiotics
27. Gastroenteritis: inflammation of the stomach and intestines
28. Signs/symptoms of gastroenteritis: Vomiting, diarrhea, abdominal cramping
29. Diagnostics for gastroenteritis: CBC
Blood cultures stool cultures Abd imaging if suspected obstruction
30. Treatment for gastroenteritis: hydration
electrolyte replacement management of fever antibiotics (azithromycin, vancomycin, metronidazole)
31. Cholecystitis: Inflammation of the gallbladder due to obstruction of the cystic
duct by a gallstone
32. Subjective data (cholecystitis): Abdominal pain more than 6 hours
RUQ tenderness Nausea, vomiting Low grade fever Symptoms after fatty/large meal
33. Objective data (cholecystitis): Positive Murphy signs
Right subcostal pain
abdominal guarding diffuse abdominal pain (gallstone pancreatitis)
34. diagnostics for cholecystitis: CBC-elevated leukocytes CT
suspected perforation US reveal gallstones Liver enzymes elevated
35. Treatment for cholecystitis: ibuprofen
antispasmodics (scopolamine) Laparoscopic cholecystectomy
36. Mirizzi Syndrome: Cholecystitis complication where gallstones become
impact- ed in the cystic duct or neck of the gallbladder
37. H pylori: Bacteria known to secrete cytotoxins and the enzymes protease,
phospholipase and urease which cause damage to the mucosal defense.
38. McBurney Signs: RLQ pain with palpation
39. Obturator Sign: RLQ pain on rotation of a flexed right leg and knee
40. Psoas Sign: RLQ pain when lifting right leg against pressure
41. Rovsing's sign: RLQ pain after deep palpation of LLQ
42. Antacids: neutralize the acids in the stomach (Aluminum hydroxide gel,
calcium carbonate, pepto-bismol)
49. Diabetes type 1 treatment: Rapid onset-regular Humulin R
Intermediate acting- NPH Novolin Long Acting- Glargine, Lantus
50. Diabetes type 2: Decreased effectiveness of insulin or a relative deficit of
insulin. The body created resistance to insulin, increased production of glucose by the liver or both
51. Subjective data (type 2): Weight gain
often asymptomatic
52. Objective data (type 2): Hypertension
discoloration of body folds local fat deposits upper body obesity
53. Diabetes diagnostics: Urine glucose
urine ketones fasting plasma or serum glucose 126mg/dl more than one occasion A1C
54. Diabetes type 2 treatment: Diet
exercise Oral medications: metformin, glipizide, glimepiride, januvia
55. Diabetes complications: Ocular complications
Neuropathy Cardiovascular complications Skin & mucous membrane Bone & joint
56. Diabetes Insipidus: Deficit of antidiuretic hormone. May originate in the neu-
rohypophysis, sometimes the condition is nephrogenic when renal tubules do not respond to the hormone
57. Signs/symptoms diabetes insipidus: Polyuria with large volumes of dilute
urine Thirst with dehydration Glucose not present in urine
58. diabetes insipidus treatment: replacement therapy for ADH
59. Cushing Syndrome: Excess corticosteroids as a result of drugs or pituitary
corticotropin secreting tumor
60. Cushing syndrome causes: Pituitary tumor (increased ACHT & CORTISOL)
Adrenal cortex tumor (increased cortisol, decreased ACHT) Paraneoplastic syndrome (lung cancer) Increased cortisol and ACHT Iatrogenic (Ingested cortisol)
61. Signs of Cushing's syndrome: Cushion (buffalo hump, moon face, truncal
67. Addison Signs: Added pigmentation
Decreased weight, depressed Decreased BP, BG, energy Sodium loss Salt craving
68. Addisons disease diagnostics: Short corticotropin test 25 mcg
Low sodium, high potassium, low BG CBC-shows anemia Cortisol levels (AM) less than 3mcg/dl
69. Addison disease treatment: Glucocorticoid
hydrocortisone
70. Hyperthyroidism: Increased t3 & t
71. Hyperthyroidism signs: T3-T4 HIGH
Metabolic rate HIGH Goiter- presents with grave's disease Skin- Flushed & warm Temperature intolerance-HEAT Eyes- EXOPHTALAMOS Cardiovascular-TACHY, INCREASED BP Nervous system-RESTLESS, TREMORS Body weight-THIN but increased appetite
72. Thyroid storm: uncontrolled hyperthyroidism precipitated by infection or
surgery. Life threatening because of hyperthermia, tachycardia, heart failure and delirium
73. Hyperthyroidism Diagnostics: TSH low t3-
t3 elevated hypercalcemia, hypokalemia, low phosphorus Increased liver enzyme anemia Thyroid US
74. hyperthyroidism treatment: methimazole, propylthiouracil (preferred in preg-
nancy) Radioactive iodine, Beta blockers
75. Hypothyroidism: Thyroid gland can't make enough thyroid to keep the body
running normally Hashimoto is the most common
76. Subjective data (hypothyroidism): Weight gain
Lethargy depression menorrhagia cold intolerance raynauds disease
nausea, vomiting
86. Objective data (pyelonephritis): Fever
costovertebral angle tenderness Pelvic or perineal pain Hypertension
87. pyelonephritis diagnostics: Urine dipstick
urinalysis urine culture and sensitivity US (enlargement of kidney) CT (renal abscess or obstruction)
88. pyelonephritis treatment: Fluroquinolones: Cipro, levofloxacin
Antipseudomonal: meropenem, carbapenem Bactrim Amoxicillin **Fosfomycin (pregnancy)
89. Glomerulonephritis: damage to the glomeruli
90. acute glomerulonephritis: after strep infection the antigen-antibody lodges in
the glomerular capillaries causing inflammatory response in both kidneys
91. Subjective Data (Acute glomerulonephritis): Abdominal pain
decrease urine edema to face and ankles
92. Objective data (acute glomerulonephritis): hematuria
proteinuria hypertension edema
93. Chronic Glomerulonephritis: Caused by hypertension, diabetes, cancer
94. Subjective data (Chronic glomerulonephritis): night sweat, weight loss rash
muscle aches nighttime urination foamy urine
95. Objective data (chronic glomerulonephritis): hypercoagulability
96. glomerulonephritis diagnostics: Urinalysis-protein, blood, erythrocyte
CMP- elevated urea, creatinine, PH GFR-decreased
97. glomerulonephritis treatment: Penicillin (first) If
moderate-severe (ACE INHIBITORS OR ARBS) If fluid retention (FUROSEMIDE)
