Unit 4 -CMN 568, , Differential dx of abd pain 1 & 2 QUESTIONS WITH 100% Verified Solutions

Unit 4 -CMN 568, , Differential dx of abd pain 1 & 2 QUESTIONS WITH 100% Verified Solutions who is at risk for pancreatitis - ANSWER gallstone hx, heavy alc use, hyperlipidemia, certain medications, abdominal trauma symptoms of pancreatitis - ANSWER nausea, Vomitting, epigastric pain radiate to back, pain increases with movement, patient prefers to lean forward or be still signs of pancreatitis - ANSWER abdom. tenderness, no guarding, no rigidity, no rebound. abd. distention, absent bowel sounds fever, tachycardia, pallor, hypotension. labs and imagining for pancreatitis - ANSWER increased amylase, lipase, wbc, ALT, imaging KUB, CT of the abdomen. REfer or don't refer pancreatitits - ANSWER always REFER Gastroenterits is mostly due to - ANSWER viruses-adenovirus or Norwalk from contaiminated food. NORWALK is seen on the cruise ship (I neither run NORWALK on a cruise ship-I sit!) what are secondary causes of gastroenteritis - ANSWER 80 percent are by viruses but 20 percent bacterial and a few parasites Viral symptoms of Gastroenteritis (different from bacterial or parasitic) - ANSWER Watery stool, no blood, 1-2 days long, abd cramps, N/V Bacterial Gastroenteritis causes - ANSWER BLOODY DIARRHEA (not always, but it is a sign) look for C.Diff after florouqionlone exposure-ESPECIALLY CLINDAMYCIN difference between viral and parasitic diarrhea from gasteroenteritis - ANSWER viral last 1-2 days whereas parasitic is going to have prolonged watery diarrhea When to test for stool culture for gastroenteritis - ANSWER less than 3 months old, greater than 70 years, old, more than 3 days of diarrhea, or in service where transmission is likely (food service) do we want to give infants and children a BRATS diet if they have diarrhea? - ANSWER opinion has shifted on this, we want them to get proper nutrition-adults can go no dairy, no caffeine, and brats when are u allowed to use a antimotility agent like immodium or kaopectate (bismuth subsalicylate) - ANSWER for adults, when there is no high fever, bloody diarrhea, or systemic toxicity. symtoms of diverticultiis - ANSWER USUALLY LLQ pain, NV- symptoms are usually mild signs of diverticultis - ANSWER low grade fever, LLQ tenderness, palpable mass if abscess, positive occult blood two types of diverticulitis and difference between the two? - ANSWER mild-microperforation severe-perforated diverticulum with abscess and peritonitis how to tx mild diverticulitis - ANSWER empiric antibiotic treatment w/o imaging once the diverticultis flair up is controlled do what - ANSWER schedule a colonscopy to r/o colon cancer mild symptom tx for diverticultiis is - ANSWER outpatient tx with clear liquid diet THREE OPTIONS FOR TX IN DIVERTICULTIS KNOW THIS BY HEART - ANSWER augmentin BID OR Bactrim BID PLUS flaygl TID OR Cipro BID plus Flagyl TID ABX 7-10 days advance from clear liquid diet if symptoms improve in 3 days, high fiber diet on resolution Severe symptoms of diverticulitis refer for - ANSWER inpatient tx, IV abd, possible sx what are two diseases that cause disruption of GI mucosal lining - ANSWER GERD, PUD most common symptom of GERD is - ANSWER heartburn, occurring 30-60 minutes after meals ALARM symptoms of GERD - ANSWER older than 55, anemia, melena, hematemesis, dysphagia, wewight loss, painful swallowing non GI symptoms of GERD are - ANSWER asthma, laryngitis, non-cardiac chest pain, chronic cough, sleep disturbance If a patent has an alarm symptom of GERD do what - ANSWER refer for upper GI endoscopy if a patient under 55 w/no alarm symptoms has GERD can you treat empirically - ANSWER YES ! YES! YES!!! lifestyle GERD tx for mild or intermittent symptoms - ANSWER smaller meals, no acidic/spicy foods, eliminate fatty, ETOH, Choc., peppermint and foods that increase GERD, elevate HOB, eat 3 hrs before sleeping, weight loss, PRN H2 receptor antagonist (Pepcid, zantac, Tagamet)