EOC NUTRITION EXAM QUESTIONS AND CORRECT DETAILED SOLUTIONS WITH RATIONALES LATEST UPDATED VERSION JUST RELEASED

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EOC NUTRITION EXAM QUESTIONS AND CORRECT
DETAILED SOLUTIONS WITH RATIONALES LATEST
UPDATED VERSION JUST RELEASED



Question: what is chariots triad? - ANSWER✔✔RUQ abd pain, fever, jaundice




Question: What is Reynolds Pentad? - ANSWER✔✔-RUQ abd pain, fever, jaundice, + AMS and

hypotension




Question: Jaundice and pruritus. Associated with IBD, cholangiocarcinoma, pancreatic cancer,

colorectal cancer - ANSWER✔✔Primary sclerosing cholangitis




Question: Stones in the gallbladder (or biliary tree) without signs of inflammation -

ANSWER✔✔Cholelithiasis




Question: Risk factors for cholelithiasis - ANSWER✔✔Fat, female, fertile, fair, forty

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Question: What types of stones are common in cholelithiasis? - ANSWER✔✔Cholesterol vs

pigment stones (bilirubin)




Q:43 yo woman who comes to the ED with a 12 hour history of RUQ abdominal pain. Severe but

waxes and wanes and is associated with nausea and some episodes of vomiting. The pain

sometimes radiates through the back. No diarrhea. Exam— obese, young woman in some

discomfort. Temp 100F, pulse 102, BP 130/70. No scleral icterus. Marked upper abdominal

tenderness with guarding in RUQ. Marked increase in pain when palpation of RUQ during

inspiration. What is the diagnosis, how to diagnose, and treatment? - ANSWER✔✔Dx:

Cholelithiasis


Dx w/: RUQ US


Tx: asymptomatic— no treatment, symptomatic— elective cholecystectomy




Question: Stones in the gallbladder, pain is secondary to contraction of the gallstone against

the obstructed cystic duct - ANSWER✔✔cholelithiasis




Question: Boas sign - ANSWER✔✔Right subscapular pain resulting from cholelithiasis

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Question: 49 yo female with a 2 day hx of RUQ, colicky abdominal pain, as well as nausea. The

pain began after eating a hamburger and French fries. Exam— significant pain with palpation of

the RUQ. Labs— elevated WBC count, alkaline phosphates, and bilirubin level. What is the

diagnosis, how to diagnose, and treatment? - ANSWER✔✔Dx: Acute Cholecystitis


**Remember 5 F's: Female, Fat, Forty, Fertile, Fair


** (+) Murphys sign— RUUQ pain with GB palpation on inspiration


Dx w/: US (initial), HIDA (gold standard)


Tx: cholecystectomy (in first 24-48 hours)




Question: Inflammation of the gallbladder, usually associated with gallstones -

ANSWER✔✔cholecystitis




Question: Stones in the common bile duct - ANSWER✔✔choledocholithiasis




Question: 58 yo male with acute onset of abdominal pain associated with fever and shaking

chills. The patient is hypotensive and febrile with a temperature of 102.2F. Although he is

confused and disoriented, he complains of RUQ pain during palpation of the abdomen. His

sclerae are icteric and the skin is jaundiced. What is the diagnosis, how to diagnose, and

treatment? - ANSWER✔✔Dx: cholangitis

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Dx w/: US (initial), ERCP (best)


Tx: potential life threatening and requires emergent treatment


—aggressive care and emergent removal of stones


— cipro + metro


— fluids and analgesia


— ERCP to remove stonees


—cholecystectomy




Question: Symptoms of cholelithiasis - ANSWER✔✔Biliary colic (RUQ or epigastric pain, after

fatty meals), may be asymptomatic




Question: First line in the diagnosis of cholelithiasis? - ANSWER✔✔US




Question: Management for cholelithiasis - ANSWER✔✔If symptomatic — cholecystectomy is

standard; asymptomatic often monitored