NR 511 Midterm
Sensitivity - Answer Few false negatives
Specificity - Answer Few false positives
Predictive Value - Answer Likelihood person has disease
3 key components that determine risk-based E&M codes - Answer History
Physical
Medical Decision Making
Complexity of a visit is based on three criteria (aka MDM) - Answer Risk
Data
Diagnosis
13. Identify the 3 components required in determining an outpatient, office visit E&M
code - Answer Place of service
Type of service (consult, office visit, hospital admit)
Pt status (new vs established)
SNAPPS - Answer -S: Summarize
-N: Narrow
-A: Analyze
-P: Probe
-P: Plan
-S: Self-directed learning
most common type of pathogen responsible for acute gastroenteritis - Answer Viral:
Norovirus (Leading cause for adults)
-Rotovirus (Leading cause for peds up to 2 years old)
IBS - Answer disorder of bowel function not from anatomic abnormality
-constipation, diarrhea, bloating, urgency w/ diarrhea
-NOT assoc w/ serious medical consequences, IBD or CA
+S/S: result from disordered sensation or abnormal function of the small and large
bowel
IBD - Answer chronic immunologic disease that manifests in intestinal inflammation
- UC/CD
UC - Answer the mucosal surface of the colon is inflamed and ultimately results in
friability, erosions, and bleeding.
- Most common in recto-sigmoid colon. Can involve entire colon
- Pain in RLQ
, NR 511 Midterm
Chrons - Answer the inflammation extends deeper into the intestinal wall and can
involve all or any layer of the bowel wall and any portion of the GI tract from the mouth
to the anus.
- Skipped lesions
- Pain in LLQ
Diverticulitis - Answer Symptoms: LLQ pain/ tenderness, fever, N/V/D
Need imaging especially if perforation or peritonitis is suspected; free air = perforation;
patient may have ileus, small or large bowel obstruction
Can use plain x-ray
CT or barium enema are preferred
CT with contrast is more sensitive and accurate
Barrett's Esophagus - Answer After repeated exposure to gastric contents, inflammation
of the esophageal mucosa becomes chronic.
· Blood flow increases, erosion occurs
·Premalignant tissue
·Increased risk for development of esophageal adenocarcinoma
· Fibrosis and scarring during healing of erosions; leads to strictures
Acute Appendicitis - Answer N/V
RLQ pain
Guarding
Rebound Tenderness
Dx: Elevated WBC, CT
Tx: Remove appendix, ATB
Acute Pancreatitis - Answer N/V
Cullen's Sign (bruising around umbilicus)
Grey-Turner's Sign (bruising in flank)
Dx: Amylase/Lipase, CT, US
Tx: Bowel rest, fluids, ATB
Acute Cholecystitis - Answer Mid epigastric pain
N/V
Fever
Rebound tenderness
Murphy's sign
Dx: US, HIDA scan, ERCP, MRCP
Tx: Removal, IV fluids, ATB
Sensorineural Hearing Loss - Answer Results from deterioration of cochlea
-Loss of hair cells form the organ of Corti
-Gradual and progressive
-Not correctable but preventable
Sensitivity - Answer Few false negatives
Specificity - Answer Few false positives
Predictive Value - Answer Likelihood person has disease
3 key components that determine risk-based E&M codes - Answer History
Physical
Medical Decision Making
Complexity of a visit is based on three criteria (aka MDM) - Answer Risk
Data
Diagnosis
13. Identify the 3 components required in determining an outpatient, office visit E&M
code - Answer Place of service
Type of service (consult, office visit, hospital admit)
Pt status (new vs established)
SNAPPS - Answer -S: Summarize
-N: Narrow
-A: Analyze
-P: Probe
-P: Plan
-S: Self-directed learning
most common type of pathogen responsible for acute gastroenteritis - Answer Viral:
Norovirus (Leading cause for adults)
-Rotovirus (Leading cause for peds up to 2 years old)
IBS - Answer disorder of bowel function not from anatomic abnormality
-constipation, diarrhea, bloating, urgency w/ diarrhea
-NOT assoc w/ serious medical consequences, IBD or CA
+S/S: result from disordered sensation or abnormal function of the small and large
bowel
IBD - Answer chronic immunologic disease that manifests in intestinal inflammation
- UC/CD
UC - Answer the mucosal surface of the colon is inflamed and ultimately results in
friability, erosions, and bleeding.
- Most common in recto-sigmoid colon. Can involve entire colon
- Pain in RLQ
, NR 511 Midterm
Chrons - Answer the inflammation extends deeper into the intestinal wall and can
involve all or any layer of the bowel wall and any portion of the GI tract from the mouth
to the anus.
- Skipped lesions
- Pain in LLQ
Diverticulitis - Answer Symptoms: LLQ pain/ tenderness, fever, N/V/D
Need imaging especially if perforation or peritonitis is suspected; free air = perforation;
patient may have ileus, small or large bowel obstruction
Can use plain x-ray
CT or barium enema are preferred
CT with contrast is more sensitive and accurate
Barrett's Esophagus - Answer After repeated exposure to gastric contents, inflammation
of the esophageal mucosa becomes chronic.
· Blood flow increases, erosion occurs
·Premalignant tissue
·Increased risk for development of esophageal adenocarcinoma
· Fibrosis and scarring during healing of erosions; leads to strictures
Acute Appendicitis - Answer N/V
RLQ pain
Guarding
Rebound Tenderness
Dx: Elevated WBC, CT
Tx: Remove appendix, ATB
Acute Pancreatitis - Answer N/V
Cullen's Sign (bruising around umbilicus)
Grey-Turner's Sign (bruising in flank)
Dx: Amylase/Lipase, CT, US
Tx: Bowel rest, fluids, ATB
Acute Cholecystitis - Answer Mid epigastric pain
N/V
Fever
Rebound tenderness
Murphy's sign
Dx: US, HIDA scan, ERCP, MRCP
Tx: Removal, IV fluids, ATB
Sensorineural Hearing Loss - Answer Results from deterioration of cochlea
-Loss of hair cells form the organ of Corti
-Gradual and progressive
-Not correctable but preventable
