NR511 Final Exam Study Guide for Differential Diagnosis and
Primary Care Practicum
Ulcerative Colitis a disease of only the ______
colon
Inflammatory bowel disease
the mucosal surface of the colon is inflamed-most often occurs in the recto-sigmoid
areas, must may involve the entire colon
Inflammatory bowel disease results in
friability, erosions, and bleeding
• IBD is characterized by
bloody and purulent diarrhea
Tx for Inflammatory Bowel Disease
While it is not the first treatment choice, total colectomy is a treatment option that
can completely resolve this problem.
patients with diverticulitis present with
bleeding not associated with pain or discomfort.
High risk for diverticulitis includes
obesity
S/s of inflamed diverticula
fever, chills, and tachycardia
pts with diverticulitis present with
localized pain and tenderness in the LLQ of the abdomen with associated anorexia, n/v
differential dx for diverticulitis and how to rule them out
,CT scan with contrast may sometimes be done to r/o if the gynecologic etiology (ovarian
cyst or tumor) as well as bowel pathology such as abdominal abscess.
best tx for diverticulitis
high-fiber diet
C-diff is an infection of the _______ intenstine
large
C-diff can exist in.....
air, water, soil, processed food and human feces
c-diff causes
profuse, watery, mucoid diarrhea
risk factors for c-diff
Working in healthcare facility
Long duration hospitalization
Long-term use of antibiotics that affects normal GI flora Long-term use of medications that
reduce GI acidity Consumption of contaminated food or water
Touching infected soil, objects and surfaces
T or F: most patients with c-diff are asymptomatic
true
S/S of mild/moderate c-diff infection
Watery diarrhea 3+ times/day for 2+ days
Mild abdominal cramping and tenderness
S/S of SEVERE c-diff infection
Watery diarrhea (10-15 stools/day)
Strong foul odor
Acute abdomen secondary to toxic megacolon with perforation
Abdominal distention
Fever
, Nausea/vomiting/dehydration requiring hospitalization
Blood or pus in the stools (severe cases)
dx of c-diff includes
CBC: elevated WBC
Enzyme-linked immunodeficiency assay (ELISA): identifies toxins that produce C. diff
bacteria
Cell cytotoxicity assay: identifies the effects of bacterial toxins on human cells
Polymerase chain reaction (PCR): detects bacterial genes
Endoscopy: if the patient is unresponsive to treatment; will show pseudomembranes that
suggest c-diff infection
TX for c-diff
Metronidazole
Probiotics- to restore the healthy growth of normal GI bacteria
Colectomy in severe cases
Maintain fluids
Clear liquid diet
Eat starchy foods to prevent diarrhea
Avoid caffeine, spicy foods, milk and greasy foods
May require a GI consult
S/s of GERD
Symptoms occur at night with regurgitation; heartburn is classic for GERD (mild to
severe). Dysphagia is frequently a prominent symptom of GERD.
It is usually associated with other symptoms, including regurgitation, water brash (reflex
salivation), sour taste in the mouth in the morning, odynophagia, belching, coughing,
hoarseness, or wheezing, usually at night.
TX for GERD
1st: diet modifications and 6 weeks of omeprazole without improvement of symptoms,
Primary Care Practicum
Ulcerative Colitis a disease of only the ______
colon
Inflammatory bowel disease
the mucosal surface of the colon is inflamed-most often occurs in the recto-sigmoid
areas, must may involve the entire colon
Inflammatory bowel disease results in
friability, erosions, and bleeding
• IBD is characterized by
bloody and purulent diarrhea
Tx for Inflammatory Bowel Disease
While it is not the first treatment choice, total colectomy is a treatment option that
can completely resolve this problem.
patients with diverticulitis present with
bleeding not associated with pain or discomfort.
High risk for diverticulitis includes
obesity
S/s of inflamed diverticula
fever, chills, and tachycardia
pts with diverticulitis present with
localized pain and tenderness in the LLQ of the abdomen with associated anorexia, n/v
differential dx for diverticulitis and how to rule them out
,CT scan with contrast may sometimes be done to r/o if the gynecologic etiology (ovarian
cyst or tumor) as well as bowel pathology such as abdominal abscess.
best tx for diverticulitis
high-fiber diet
C-diff is an infection of the _______ intenstine
large
C-diff can exist in.....
air, water, soil, processed food and human feces
c-diff causes
profuse, watery, mucoid diarrhea
risk factors for c-diff
Working in healthcare facility
Long duration hospitalization
Long-term use of antibiotics that affects normal GI flora Long-term use of medications that
reduce GI acidity Consumption of contaminated food or water
Touching infected soil, objects and surfaces
T or F: most patients with c-diff are asymptomatic
true
S/S of mild/moderate c-diff infection
Watery diarrhea 3+ times/day for 2+ days
Mild abdominal cramping and tenderness
S/S of SEVERE c-diff infection
Watery diarrhea (10-15 stools/day)
Strong foul odor
Acute abdomen secondary to toxic megacolon with perforation
Abdominal distention
Fever
, Nausea/vomiting/dehydration requiring hospitalization
Blood or pus in the stools (severe cases)
dx of c-diff includes
CBC: elevated WBC
Enzyme-linked immunodeficiency assay (ELISA): identifies toxins that produce C. diff
bacteria
Cell cytotoxicity assay: identifies the effects of bacterial toxins on human cells
Polymerase chain reaction (PCR): detects bacterial genes
Endoscopy: if the patient is unresponsive to treatment; will show pseudomembranes that
suggest c-diff infection
TX for c-diff
Metronidazole
Probiotics- to restore the healthy growth of normal GI bacteria
Colectomy in severe cases
Maintain fluids
Clear liquid diet
Eat starchy foods to prevent diarrhea
Avoid caffeine, spicy foods, milk and greasy foods
May require a GI consult
S/s of GERD
Symptoms occur at night with regurgitation; heartburn is classic for GERD (mild to
severe). Dysphagia is frequently a prominent symptom of GERD.
It is usually associated with other symptoms, including regurgitation, water brash (reflex
salivation), sour taste in the mouth in the morning, odynophagia, belching, coughing,
hoarseness, or wheezing, usually at night.
TX for GERD
1st: diet modifications and 6 weeks of omeprazole without improvement of symptoms,
