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AGACNP AACN Board Review - Gastrointestinal Disorders
Questions with Detailed Verified Answers
Peptic Ulcer disease causes and incidence Ans: ✓ ✓ ✓ h. pylori
men 3:1
smokers
NSAIDs, ASA, glucocorticoids
alcohol and dietary factors don't seem to contribute
zollinger ellison syndrome which is a gastric secreting tumor
What is Zollinger-Ellison syndrome? Ans: ✓ ✓ ✓ rare condition characterized by gastrin-producing
tumors in the duodenum and/or pancreas that lead to oversecretion of gastrin, which lead to
gastric and duodenal ulcers that result in gastric bleeding. treatment is same as PUD +/- tumor
resection
PUD s/s Ans: ✓ ✓ ✓ gnawing epigastric pain
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relief of pain with eating (duodenal)
if pain worsens with eating then (epigastric)
duodenal ulcer Ans: ✓ ✓ ✓ age 30-55
pain relief with EATING
gastric ulcer Ans: ✓ ✓ ✓ ages 55-65
pain worse with EATING
physical findings of PUD Ans: ✓ ✓ ✓ often unremarkable but might have epigastric tenderness
GI bleeding 20% of causes- melena, hematemesis or coffee ground emesis
perforation s/s Ans: ✓ ✓ ✓ board like abdomen
quiet bowel sounds
RIGIDITY - peritonitis - hole in lumina of GI tract- requires immediate surgery (washout with abx)
other acute abdomen causes Ans: ✓ ✓ ✓ crohn's disease
ruptured diverticulum
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ruptured appendix
labs/diagnostics for ulcer Ans: ✓ ✓ ✓ can show anemia
endoscopy after 8-12 weeks of treatment
h. pylori testing
PPI vs H2RA Ans: ✓ ✓ ✓ PPI indicated for acute ulceration
Medical management - H2 receptor antagonist - start with dyspepsia
"tidine" Ans: ✓ ✓ ✓ cimetidine (tagamet) - 800mg/HS
Famotidine (pepcid) - 40mg/HS
nizatidine (axid) - 300mg/HS
start at HS, then BID, then add PPI
medical management - PPI - start if pepcid ulcer disease suspected
"prazole" Ans: ✓ ✓ ✓ lansoprazole (pravacid) - 15mg/day
pantoprazole (protonix) - 20mg/day
© Get it right 2025 Getaway - Stuvia US All rights reserved
AGACNP AACN Board Review - Gastrointestinal Disorders
Questions with Detailed Verified Answers
Peptic Ulcer disease causes and incidence Ans: ✓ ✓ ✓ h. pylori
men 3:1
smokers
NSAIDs, ASA, glucocorticoids
alcohol and dietary factors don't seem to contribute
zollinger ellison syndrome which is a gastric secreting tumor
What is Zollinger-Ellison syndrome? Ans: ✓ ✓ ✓ rare condition characterized by gastrin-producing
tumors in the duodenum and/or pancreas that lead to oversecretion of gastrin, which lead to
gastric and duodenal ulcers that result in gastric bleeding. treatment is same as PUD +/- tumor
resection
PUD s/s Ans: ✓ ✓ ✓ gnawing epigastric pain
© Get it right 2025 Getaway - Stuvia US All rights reserved
,Click here for more: Scholars nexus
relief of pain with eating (duodenal)
if pain worsens with eating then (epigastric)
duodenal ulcer Ans: ✓ ✓ ✓ age 30-55
pain relief with EATING
gastric ulcer Ans: ✓ ✓ ✓ ages 55-65
pain worse with EATING
physical findings of PUD Ans: ✓ ✓ ✓ often unremarkable but might have epigastric tenderness
GI bleeding 20% of causes- melena, hematemesis or coffee ground emesis
perforation s/s Ans: ✓ ✓ ✓ board like abdomen
quiet bowel sounds
RIGIDITY - peritonitis - hole in lumina of GI tract- requires immediate surgery (washout with abx)
other acute abdomen causes Ans: ✓ ✓ ✓ crohn's disease
ruptured diverticulum
© Get it right 2025 Getaway - Stuvia US All rights reserved
, Click here for more: Scholars nexus
ruptured appendix
labs/diagnostics for ulcer Ans: ✓ ✓ ✓ can show anemia
endoscopy after 8-12 weeks of treatment
h. pylori testing
PPI vs H2RA Ans: ✓ ✓ ✓ PPI indicated for acute ulceration
Medical management - H2 receptor antagonist - start with dyspepsia
"tidine" Ans: ✓ ✓ ✓ cimetidine (tagamet) - 800mg/HS
Famotidine (pepcid) - 40mg/HS
nizatidine (axid) - 300mg/HS
start at HS, then BID, then add PPI
medical management - PPI - start if pepcid ulcer disease suspected
"prazole" Ans: ✓ ✓ ✓ lansoprazole (pravacid) - 15mg/day
pantoprazole (protonix) - 20mg/day
© Get it right 2025 Getaway - Stuvia US All rights reserved
