NM 703 EXAM 2 *FINAL SET* EXAM QUESTIONS AND
ANSWERS WITH COMPLETE SOLUTIONS GRADED A++
What medication do you start someone with a diagnosis of DM 2?
Metformin.
Do you consult, refer or collaborate for a diagnosis for DM 2?
Refer to diabetic educator or dietitian.
Labs needed for diagnosis of DM 2?
HgBA1C & Blood Glucose.
triumvirate
insulin resistance in muscle and liver and β-cell failure
How long for F/U for a diagnosis for DM 2?
New DM need to check sugars and can see sooner (1 month).
For A1C is 3 months.
What # is diagnostic for A1C?
>6.5%.
Can you diagnose someone with DM 2 if their FBS is 130, having them checked
once?
FBS x2.
To avoid sequela from DM 2, the A1C needs to be what?
<7.
A random BS of what is diagnostic?
Symptomatic and x 1 >200.
,Elevated TSH
decreased T3/4
What is her diagnosis?
Hypothyroidism.
Hypothyroidism symptoms?
Cold, Weight gain
Brittle Hair
Dry Skin
Slow pulse
Everything Slow & Heavy
1st line medication for hypothyroidism?
Levothyroxine.
F/U for hypothyroidism?
6 weeks.
Because when you adjust med it takes 6 weeks to reflect in labs.
Once stable can go further.
Pain behind sternum, now throat area. Tums used to work, after eating is bad and
after coffee. Can't sleep. What is my diagnosis?
GERD.
Heartburn symptoms?
Teeth erosion.
Throat clearing, cough.
Recent weight loss.
,Risk factor and family history for heartburn:
Smoking, medication.
Asthma and GERD:
One is a risk for the other.
PUD vs GERD: how can you differentiate one from the other when making a
diagnosis?
PUD relieved by food, and you will gain weight.
GERD physical exam
Look at mouth, throat, teeth, CV exam, resp exam, NSAID use (PUD vs GERD).
What might you find if you do abd exam for GERD?
Tenderness.
1st line treatment for GERD?
Trial of PPI x 8 weeks.
- zole (PPIs.
- dine (H2s).
When do you refer for GERD?
>50 years and has danger signs(dysphagia, anemia, blood in stool), (first time
symptoms). Sudden onset.
What labs do you need for GERD?
None initially.
Education for GERD:
, Do not stay on PPIs long term.
Expensive, can do H2.
GERD F/U:
8 weeks.
20 year old female, c/o severe abd pain. N/V for last 4 hrs, temp. 100.3 F. HR 104.
BP 100/80, RR 26, began dull ache around peri-umbilical area, now constant in
RLQ and now severe. What is her diagnosis?
Appendicitis.
During physical exam for abd pain, you want to assess for peritoneal signs and
ask client to raise her straightened right leg against resistance. What signs is
this?
Psoas.
Psoas sign:
passive hip extension cxes pain in RLQ r/t inflamed appendix
Obturator signs:
passive internal rotation increases pain d/t Peritoneal irritation or inflamed appendix
Rebound tenderness:
pain upon removal of pressure
Appendicitis.
Test after 24 hrs to let you know that is was not appendicitis?
CRP - R/O appendicitis.
Appendicitis is a referral or not?
Yes, referral.
ANSWERS WITH COMPLETE SOLUTIONS GRADED A++
What medication do you start someone with a diagnosis of DM 2?
Metformin.
Do you consult, refer or collaborate for a diagnosis for DM 2?
Refer to diabetic educator or dietitian.
Labs needed for diagnosis of DM 2?
HgBA1C & Blood Glucose.
triumvirate
insulin resistance in muscle and liver and β-cell failure
How long for F/U for a diagnosis for DM 2?
New DM need to check sugars and can see sooner (1 month).
For A1C is 3 months.
What # is diagnostic for A1C?
>6.5%.
Can you diagnose someone with DM 2 if their FBS is 130, having them checked
once?
FBS x2.
To avoid sequela from DM 2, the A1C needs to be what?
<7.
A random BS of what is diagnostic?
Symptomatic and x 1 >200.
,Elevated TSH
decreased T3/4
What is her diagnosis?
Hypothyroidism.
Hypothyroidism symptoms?
Cold, Weight gain
Brittle Hair
Dry Skin
Slow pulse
Everything Slow & Heavy
1st line medication for hypothyroidism?
Levothyroxine.
F/U for hypothyroidism?
6 weeks.
Because when you adjust med it takes 6 weeks to reflect in labs.
Once stable can go further.
Pain behind sternum, now throat area. Tums used to work, after eating is bad and
after coffee. Can't sleep. What is my diagnosis?
GERD.
Heartburn symptoms?
Teeth erosion.
Throat clearing, cough.
Recent weight loss.
,Risk factor and family history for heartburn:
Smoking, medication.
Asthma and GERD:
One is a risk for the other.
PUD vs GERD: how can you differentiate one from the other when making a
diagnosis?
PUD relieved by food, and you will gain weight.
GERD physical exam
Look at mouth, throat, teeth, CV exam, resp exam, NSAID use (PUD vs GERD).
What might you find if you do abd exam for GERD?
Tenderness.
1st line treatment for GERD?
Trial of PPI x 8 weeks.
- zole (PPIs.
- dine (H2s).
When do you refer for GERD?
>50 years and has danger signs(dysphagia, anemia, blood in stool), (first time
symptoms). Sudden onset.
What labs do you need for GERD?
None initially.
Education for GERD:
, Do not stay on PPIs long term.
Expensive, can do H2.
GERD F/U:
8 weeks.
20 year old female, c/o severe abd pain. N/V for last 4 hrs, temp. 100.3 F. HR 104.
BP 100/80, RR 26, began dull ache around peri-umbilical area, now constant in
RLQ and now severe. What is her diagnosis?
Appendicitis.
During physical exam for abd pain, you want to assess for peritoneal signs and
ask client to raise her straightened right leg against resistance. What signs is
this?
Psoas.
Psoas sign:
passive hip extension cxes pain in RLQ r/t inflamed appendix
Obturator signs:
passive internal rotation increases pain d/t Peritoneal irritation or inflamed appendix
Rebound tenderness:
pain upon removal of pressure
Appendicitis.
Test after 24 hrs to let you know that is was not appendicitis?
CRP - R/O appendicitis.
Appendicitis is a referral or not?
Yes, referral.
