NR 509 Final exam review | 2024 | Approved!!
What are you auscultating on abdomen? Answ - Bowel sounds x4 quadrants (may be
absent with perforation, peritonitis and BO)
Bruits (abdominal aorta, R/L renal, R/L iliac)
What are you percussing on abdomen? Answ - All 4 quadrants for dullness, tympany,
flatness
Liver size
Which abdominal organs are tympanic? Answ - Stomach
Small intestine
Large intestine
Which abdominal organs are dull? Answ - the DENSE ones (d for dull and dense)
Liver
Spleen
Intestines filled with stool
What are you palpating in abdomen? Answ - Masses
Tenderness
Liver edge
Spleen
What two conditions require special maneuvers when assessing abdomen? Answ -
Appendicitis (McBurney Point tenderness)
Cholecystitis (Positive Murphy's)
What causes visceral pain? Answ - Hollow organs (intestine or biliary tree) forcefully
contract and become distended or stretched
Solid organs (liver/spleen) can generate same pain when they swell against their
capsules [alcoholic hepatitis]
Visceral periumbilical in early acute appendicitis
What does visceral pain feel like? Answ - Difficult to localize
Gnawing, cramping, aching
Associated symptoms: sweating, pallor, N/V, restless
What causes somatic pain? What does it feel like? Answ - Pain caused by
inflammation of the parietal peritoneum
,localized or diffuse
steady aching
more severe than visceral
aggravated by movement
What does GERD feel like? Answ - rising retrosternal burning pain
may occur with coughing
What makes GERD worse? Answ - alcohol
chocolate
citrus
peppermint
coffee
bending over or lying after eating
What are 2 common causes of peptic ulcer disease? Answ - H. Pylori
NSAIDs
Gastric vs duodenal ulcers Answ - gastric ulcer pain right after eating
duodenal ulcer pain occurs hours after eating
Both:
GERD
hematemesis
melena
Treatment for PUD Answ - Stop irritating factors (Alcohol, NSAIDs, smoking)
PPIs, H2RA, antacids
Abx for treatment of H.pylori
6 maneuvers for appendicitis Answ - McBurney Point tenderness on direct palpation -
slowly apply pressure and quickly release to see if rebound tenderness
Rovsing - RLQ rebound tenderness when LLQ palpated
Psoas - Raise thigh (flexion) to contract psoas muscle (pain = positive sign)
Obturator - Flex right thigh at hip, bend knee and internally rotate to contract obturator
muscle
Rectal exam - right-sided rental tenderness
Pelvic exam - palpable inflamed appendix
Symptoms associated with appendicitis (besides pain) Answ - fever
increased WBC
N/V
bowel changes
,Diverticulosis vs diverticulitis Answ - Diverticulosis occurs when small, bulging
pouches (diverticula) develop in your digestive tract. When one or more of these
pouches become inflamed or infected, the condition is called diverticulitis.
Symptoms of diverticulitis Answ - LLQ pain, rebound tenderness
Constipation (abdominal mass)
Leukocytosis
Hematochezia
Fever
Hepatitis A transmission Answ - fecal-oral route
poor handwashing, food/water contamination
Hepatitis B transmission Answ - blood and body fluids
Hepatitis C transmission Answ - blood and body fluids
most common chronic blood borne disease
Are alcoholic hepatitis and alcoholic cirrhosis the same? Answ - Yes
What causes cholecystitis? Answ - Obstruction (usually related to GALLSTONES)
Symptoms of cholecystitis Answ - RUQ pain, fever, fat intolerance, nausea, heartburn,
jaundice, steatorrhea, positive Murphy's sign
IBS Answ - Different from IBD:
bloating
gas
Similar to IBD:
abdominal pain
cramping
changes in BM
Dx is CLINICAL
recurrent abdominal pain AND pain improves with BM OR onset associated with change
in BM frequency or consistency
IBD Answ - inflammatory bowel disease
Different from IBS:
Blood in stool
Fatigue
Weight loss
, Decreased appetite
Similar to IBS:
Abdominal pain
Cramping
Changes in BM
DX:
Chrons - skip lesions, anywhere in GI tract
UC - continuous lesions, large intestine
Signs of colon cancer Answ - Pencil-thin stools
Hematochezia
Rectal/abd pain
Sensation of incomplete emptying
Palpable mass (late stage)
+cologuard / fecal tests = colonoscopy
risk factors for colon cancer Answ - African American
men
elderly
IBD
family history
inactivity
low fiber diet
obesity
alcohol
smoking
Visceral vs. somatic: early appendicitis Answ - visceral (periumbilical)
Visceral vs. somatic: stomatitis Answ - somatic
Visceral vs. somatic: surgical incision pain Answ - somatic
Visceral vs. somatic: IBS Answ - visceral
Visceral vs. somatic: menstrual cramps Answ - visceral
Visceral vs. somatic: abdominal hematoma Answ - somatic
dyspepsia Answ - indigestion
Chronic, recurrent pain/discomfort of upper abdomen, sometimes described as pain,
burning, early satiety, excessive postprandial fullness
What are you auscultating on abdomen? Answ - Bowel sounds x4 quadrants (may be
absent with perforation, peritonitis and BO)
Bruits (abdominal aorta, R/L renal, R/L iliac)
What are you percussing on abdomen? Answ - All 4 quadrants for dullness, tympany,
flatness
Liver size
Which abdominal organs are tympanic? Answ - Stomach
Small intestine
Large intestine
Which abdominal organs are dull? Answ - the DENSE ones (d for dull and dense)
Liver
Spleen
Intestines filled with stool
What are you palpating in abdomen? Answ - Masses
Tenderness
Liver edge
Spleen
What two conditions require special maneuvers when assessing abdomen? Answ -
Appendicitis (McBurney Point tenderness)
Cholecystitis (Positive Murphy's)
What causes visceral pain? Answ - Hollow organs (intestine or biliary tree) forcefully
contract and become distended or stretched
Solid organs (liver/spleen) can generate same pain when they swell against their
capsules [alcoholic hepatitis]
Visceral periumbilical in early acute appendicitis
What does visceral pain feel like? Answ - Difficult to localize
Gnawing, cramping, aching
Associated symptoms: sweating, pallor, N/V, restless
What causes somatic pain? What does it feel like? Answ - Pain caused by
inflammation of the parietal peritoneum
,localized or diffuse
steady aching
more severe than visceral
aggravated by movement
What does GERD feel like? Answ - rising retrosternal burning pain
may occur with coughing
What makes GERD worse? Answ - alcohol
chocolate
citrus
peppermint
coffee
bending over or lying after eating
What are 2 common causes of peptic ulcer disease? Answ - H. Pylori
NSAIDs
Gastric vs duodenal ulcers Answ - gastric ulcer pain right after eating
duodenal ulcer pain occurs hours after eating
Both:
GERD
hematemesis
melena
Treatment for PUD Answ - Stop irritating factors (Alcohol, NSAIDs, smoking)
PPIs, H2RA, antacids
Abx for treatment of H.pylori
6 maneuvers for appendicitis Answ - McBurney Point tenderness on direct palpation -
slowly apply pressure and quickly release to see if rebound tenderness
Rovsing - RLQ rebound tenderness when LLQ palpated
Psoas - Raise thigh (flexion) to contract psoas muscle (pain = positive sign)
Obturator - Flex right thigh at hip, bend knee and internally rotate to contract obturator
muscle
Rectal exam - right-sided rental tenderness
Pelvic exam - palpable inflamed appendix
Symptoms associated with appendicitis (besides pain) Answ - fever
increased WBC
N/V
bowel changes
,Diverticulosis vs diverticulitis Answ - Diverticulosis occurs when small, bulging
pouches (diverticula) develop in your digestive tract. When one or more of these
pouches become inflamed or infected, the condition is called diverticulitis.
Symptoms of diverticulitis Answ - LLQ pain, rebound tenderness
Constipation (abdominal mass)
Leukocytosis
Hematochezia
Fever
Hepatitis A transmission Answ - fecal-oral route
poor handwashing, food/water contamination
Hepatitis B transmission Answ - blood and body fluids
Hepatitis C transmission Answ - blood and body fluids
most common chronic blood borne disease
Are alcoholic hepatitis and alcoholic cirrhosis the same? Answ - Yes
What causes cholecystitis? Answ - Obstruction (usually related to GALLSTONES)
Symptoms of cholecystitis Answ - RUQ pain, fever, fat intolerance, nausea, heartburn,
jaundice, steatorrhea, positive Murphy's sign
IBS Answ - Different from IBD:
bloating
gas
Similar to IBD:
abdominal pain
cramping
changes in BM
Dx is CLINICAL
recurrent abdominal pain AND pain improves with BM OR onset associated with change
in BM frequency or consistency
IBD Answ - inflammatory bowel disease
Different from IBS:
Blood in stool
Fatigue
Weight loss
, Decreased appetite
Similar to IBS:
Abdominal pain
Cramping
Changes in BM
DX:
Chrons - skip lesions, anywhere in GI tract
UC - continuous lesions, large intestine
Signs of colon cancer Answ - Pencil-thin stools
Hematochezia
Rectal/abd pain
Sensation of incomplete emptying
Palpable mass (late stage)
+cologuard / fecal tests = colonoscopy
risk factors for colon cancer Answ - African American
men
elderly
IBD
family history
inactivity
low fiber diet
obesity
alcohol
smoking
Visceral vs. somatic: early appendicitis Answ - visceral (periumbilical)
Visceral vs. somatic: stomatitis Answ - somatic
Visceral vs. somatic: surgical incision pain Answ - somatic
Visceral vs. somatic: IBS Answ - visceral
Visceral vs. somatic: menstrual cramps Answ - visceral
Visceral vs. somatic: abdominal hematoma Answ - somatic
dyspepsia Answ - indigestion
Chronic, recurrent pain/discomfort of upper abdomen, sometimes described as pain,
burning, early satiety, excessive postprandial fullness
