AHN 554 Mod 2-GI Exam Study Guide 2024

AHN 554 Mod 2-GI Exam Study Guide 2024 Causes of severe aminotransferase elevations 15xnormal - Ans:-Acute viral hepatits (A-E, herpes) Meds/toxins Ischemic or Autoimmune hepatitis Wilson disease Acute bile duct obstruction Acute Budd Chiari syndrome Hepatic a. ligation EUS - endoscopic ultrasonography - Ans:-most sensitive test for detecting small lesions of the ampulla or pancreatic head and for detecting portal vein invasion by pancreatic cancer. It is also accurate for detecting or excluding bile duct stones. Hep A - essentials of dx - Ans:-Prodrome of anorexia, N/V, malaise, aversion to smoking. ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 2/16 Fever, enlarged and tender liver, jaundice Norm to low WBC, markedly elevated aminotransferases Hep A virus transmission - Ans:-fecal oral route person to person or contaminated food/water Acute Hep B essentials of dx - Ans:-prodrome of anorexia, N/V malaise, aversion to smoking Fever, enlarged and tender liver, jaundice Norm to low WBC, markedly elevated aminotransferases early in the course Liver bx - hepatocellular necrosis and monomuclear infiltrate, but is rarely indicated. Hep B transmission - Ans:-blood or blood products sexual -saliva, semen and vaginal secretions. HBsAg pos mothers may transmit at delivery - high risk of chronic infection in infant. HBsAg - Ans:-first evidence of infection, appears before biochemical evidence of liver dx, persists through clinical illness. Persistence for more than 6 months after acute illness signifies Chronic hep B Anti-HBc - Ans:-IgM anti-HBc appears shortly after HBsAg is detected. ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 3/16 Indicates acute Hepatitis B Can persists for 3-6 mo or longer HAV IgM - Ans:-acute infection - peak at 1st week of clinical dx and disappear w/in 3-6 mo. HAV IgG - Ans:-hepatitis A recovery or vaccination - "gone" HEV IgM - Ans:-acute Hep E HEV IgG - Ans:-recovery of Hep E HBeAg - Ans:-Active viral replication and infectivity Most common cause of vital hepatitis world wide - Ans:-Hep A Clinical signs and symptoms of appendicitis - Ans:-Early - vague, colicky periumbilical or epigastric pain. W/in 12 hrs - pain shifts to RLQ - steady ache worsened by walking or coughing. Assoc: nausea w/ 1-2 episodes of vomiting. (Protracted vomiting, or vomiting before pain suggests alt dx.) -Sense of constiaption, some diarrhea. ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 4/16 Low grade fever (below 38C); high fever or rigors suggest alt dx or perf. -PE: localized tenderness w/ guarding in RLQ with gentle palpation with 1 finger. When asked to cough - may be able to localize pain - a sign of peritoneal irritation. Light percussion may also illicit pain. Rebound tenderness is present, but unnecessary to illicit with other signs present. Psoas sign and obturator sign indicative of adjacent inflammation and strongly suggest appendicitis. Assessment findings "signs" of appendicitis - Ans:-Psoas sign - pain on passive extension