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Human Diseases Quiz 3 Essay

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How is urge incontinence different from stress incontinence?
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Urge incontinence is caused from an abnormal bladder contraction. Stress incontinence is caused from weak pelvic floor muscles.
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Why is cystitis more common in females?
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Females have short, wide and adjacent to areas w/ resident flora
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Patient has a malignant tumor of the bladder, what clinical manifest. is the initial symptom? a. fever b. frequency c. urinary retention d. painless hematuria
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d. painless hematuria
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Hematuria
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blood in the urine
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What is the glomerular filtration rate and what does it determine?
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Glomerular filtration rate is the speed of blood that moves through the glomerulus (cluster of capillaries). It determines the kidney function and the stage of kidney disease.
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Glomerulonephritis
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Nephrotic Syndrome
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Acute Renal Failure
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Chronic Renal Failure
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What is the complication for a patient w/ a large renal calculi? a. chronic hypertension b. hydronephrosis c. polyuria d. dysuria
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b. hydronephrosis
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Chronic hypertension
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Hydronephrosis
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abnormal dilation of the renal pelvis and the calyces of one or both kidneys
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Polyuria
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Dysuria
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What prevention strategy will you teach the patient w/ risk for renal calculi? a. avoid dairy products and other sources of Calcium b. start taking antibiotics w/ the first sign of a stone c. Avoid aspirin and aspirin containing products d. Drink at least 3-4 liters of fluid a day
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d. drink at least 3-4 liters of fluid a day
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Which assessment parameter most accurately determines fluid and sodium retention status in a patient w/ chronic kidney disease? a. capillary refill b. intake and output c. muscle strength d. weight and blood pressure
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d. weight and blood pressure
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Which vitamin in insufficient when there is a chronic alteration in kidney function? a. Vitamin A b. Vitamin D c. Vitamin E d. Vitamin K
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b. vitamin D
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Which of the following conditions is associated w/ over secretion of renin? a. hypertension b. renal calculi c. diabetes mellitus d. diabetes insipidus
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a. hypertension Rationale using RAAS; renin is secreted from the kidneys that is combined with angiotensinogen to create angiotensin I, ACE is added to create angiotensin II that acts on the pituitary gland- ADH (H2O absorption), adrenal gland- aldosterone(Na+, Cl- reabsorption, K+ excretion), arterioles (vasoconstriction) all which raise the blood pressure
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Whish laboratory result for a patient w/ chronic renal failure will require rapid action by the nurse? a. Blood urea nitrogen of 54 mg/dL b. Serum potassium of 7.1 mEq/L c. Hemoglobin of 10.4 g/dL d. Serum pH 7.34
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b. serum potassium of 7.1 mEq/L (K+ deals with the heart)
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Which results are normal in a urinalysis? a. protein small b. glucose negative c. leukocytes positive d. blood negative e. ketones negative
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b, d, and e there should be no protein or leukocytes in the urine
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What is erythropoietin?
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A hormone the kidneys release in response to hypoxia. It stimulates the bone marrow to produce more red blood cells (if iron stores are adequate, then increase of red blood cells increases oxygen-carrying capacity)
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Potassium
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Primary intracellular cation. Involved in: electrical conduction, acid-base balance, & metabolism. Shifts of K+ into intravascular space can be dangerous to the heart. Leaves little room for fluctuation, avg. 40-60 mEq
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Sodium
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Most significant cation, extracellular. Primary func. is to control serum osmolarity & water balance. Regulated by kidneys & aldosterone (adrenal cortex to retain Na+ or discard Na+)
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Bicarbonate
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Calcium
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99% found in bones & teeth, 1% ionized (unbound) in the blood; blood clotting, hormone secretion, receptor func, nerve transmission & muscular contraction. Inverse relationship w/ Phosphorus & synergistic relationship with Magnesium (needs Mg to func.) Avg. 800-1200 mg/day
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Phosphorus
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Mostly found in bones & small amount in bloodstream. Inverse relationship w/ Ca+; bone & tooth mineralization, cellular metabolism, acid-base balance, & cell membrane formation. Average 1,000 mg/day
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Magnesium
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Intracellular cation, stored in bone & muscle; helps maintain normal muscle & nerve func, regular cardiac rhythm, a healthy immune system, bone strength, blood glucose levels, & normal blood pressure. Avg 400 mg/day
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Albumin
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Protein of the blood plasma, regulate the osmotic blood pressure; produced in the liver
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Protein
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should not show up in the urine
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BUN
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Blood Urea Nitrogen, test that measures nitrogen in blood from urea. Sees how well the kidneys are working
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Creatinine
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Chemical waste from muscle metabolism, produced from creatine. Transported through bloodstream to kidneys and excreted; if largely increased can cause renal failure
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Which of the following cancers of the female genitourinary tract is the most easily detected & cured? a. cancer of the vulva b. cancer of the cervix c. cancer of the ovary d. cancer of the endometrium
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b. cancer of the cervix
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Ovarian cancer: a. is often asymptomatic until disease is far advanced b. is easily detected using the serum marker PSA c. is easily detected during a pelvic exam d. can be detected w/ the Pap smear
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a. is often asymptomatic until disease is far advanced PSA is for prostate cancer, isn’t easily detected with pelvic exam or with Pap smear (no good screening for ovarian cancer, BRCA1 & 2 help predict the likelihood)
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Reason that antibiotic therapy predisposes women to vulvovaginal candidiasis is that it: a. produces a decrease in immune function b. increases vaginal pH leading to yeast overgrowth c. decreases pH of vaginal secretions d. increases vaginal glycogen stores
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b. increases vaginal pH leading to yeast overgrowth becomes more alkaline- increases the risk for yeast infections
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Which patient is most likely to have erectile dysfunction? A. middle-aged man who first had sexual intercourse at age 15 B. middle-aged man who has had diabetes mellitus for 25 yrs C. young man who had a myocardial infarction 2 yrs ago D. young man who is the president of a corporation/ large debt
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B. middle-aged man who has had diabetes mellitus for 25 years (decrease in blood circulation)
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Without treatment, which infection may progress to damage the aorta, liver, & central nervous system? a. syphilis b. gonorrhea c. chlamydia d. trichomoniasis
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a. syphilis (can lead to death & affect the baby)
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Which of the following types of vaginal discharge is characteristic of a trichomonas infection? a. mucopurulent b. thin & watery c. copious frothy green or yellow & foul smelling d. homogenous fishy smelling w/ pH above 4.5
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c. copious frothy green or yellow & foul smelling trichomonas infection- caused by a parasite
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Which assessment finding in the patient indicates the highest risk of a malignant breast lesion? a. ill-defined painful rubbery lump in the outer breast quadrant b. 1-cm freely mobile rubbery mass discovered by the patient c. backache & breast fungal infection d. nipple discharge & dimpling
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d. nipple discharge & dimpling the rubbery lump is ill-defined but not painful and it can be mobile in early stages, but not at the highest risk then breast fungal infection (associated w/ lactation) is mastitis
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Uterine prolapse, cystocele, & rectocele may all be the result of: a. repeated infections b. chronic constipation c. hormonal abnormalities d. pregnancy & childbirth
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d. pregnancy & childbirth cause lots of stress on the pelvic floor muscles, weakening them
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Which of the following infections would increase risk for cancer development in the genital region? a. syphilis b. chancroid c. cytomegalovirus d. human papillomavirus
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d. human papillomavirus chancroid- venereal infection causing ulceration of the lymph nodes in the groin cytomegalovirus- part of the herpes viruses; can cause mental retardation & fetal death w/ maternal infections
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Prostate cancer can be defined as: a. a rare malignancy b. slow-growing tumor often confined to the prostate c. most common among Caucasian men d. none of the above
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b. slow-growing tumor often confined to the prostate
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Herpes
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Viral STI; infection that causes blisters on the genitals & in the reproductive tract, caused by herpes simplex virus (HSV) HSV1- above the waist, cold sores HSV2- (70%) occurs below the waist; transmissible through skin-to-skin contact, though increased risk when blisters are present (reoccurence of both types, more common in 2)
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Condylomata acuminate
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Viral STI, genital warts; benign growths caused by HPV. Occur on external genital, vaginal wall, cervix, anus, thighs, lips, mouth, & throat. Lesions vary in appearance (cauliflower-like, rough, flat smooth, etc.) treat -preventative HPV vaccine, growth removal for aesthetic
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Chlamydia
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Bacterial STI, intracellular parasite; neonatal conjunctivitis (eye infection- blindness), PID, epididymitis, prostatitis, infertility, & eptopic pregnancy S/S: dysuria, discharge (purulent), testicular tenderness/pain, rectal pain, & painful sexual intercourse. Treat- antibiotic azithromycin (zithromax), doxycycline, or erythromycin
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Gonorrhea
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Bacterial STI, (the clap or the drip), aerobic bacterium w/ many drug-resistant strain. Attaches to the mucosa of the vag, mouth, or anus causing irritation & inflammation; complications like chlamydia & in other parts of the body- arthritis, dermatitis, & endocarditis. Manifest- dysuria, urinary frequency/urgency, discharge (white, yellow, or green), redness or edema at urinary meatus (in men), pharyngitis, white blisters that darken & disappear. Treat- antibiotics
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Syphilis
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Bacterial STI, ulcerative infection spiral-shaped bacterium. Ulcerative lesions- chancres. Primary- one chancre forms, painless & goes away; bacteria goes dormant. Secondary- nonpruritic, brown-red rash, malaise, fever, & patchy hair loss; go away & dormant Latent/ Tertiary- final stage, spreads to brain, nervous system, heart, skin, & bones. Can cause blindness, paralysis, dementia, cardiovascular disease, & death. Treat- early on antibiotics like penicillin, etc. not effective in latent phase syphilis
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Trichomoniasis
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Protozoan STI, the trick, a one-celled anaerobic organism. Parasite can burrow under the mucosal lining. Women- reside in vag & symptomatic when microbial imbalances occur, contracted through prolonged moisture exposure. Men usually have symptoms & resolve without treatment. Manifest- copious amounts of odorous, frothy, white or yellow-green discharge, irritates vag & vulva; itching, painful intercourse, & dysuria. Treat- antibiotic, metronidazole (Flagyl)
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Prostate Cancer
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Most common cancer in men, usually confined to prostate. Prostate enlarges & impedes the urethra (difficulty urination & erectile disfunc), blood semen & hematuria Treat- prostatectomy or angiotestosterone drug therapy
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Testicular Cancer
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Uncommon cancer, young (15-35 yr old men), slow growing or fast growing. Risk- history, infection, trauma, tobacco use, testicle abnormalities. Usually affects one testicle, metastasize to nearby lymph, lungs, liver, bone & brain. Manifest- hard, painless, palpable mass that does not transilluminate; discomfort, enlargement, & female-like breast). Highly curable; treat- orchiectomy, chemo/ radiation
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Breast Cancer
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Most common malignancy in women, can occur in men; advancing age, early onset menstruation, history, genetics (BRCA1/2 genes), obesity, etc. Manifest- movable mass, hard, uneven edges, usually painless, change in nipple appearance (dimple, redness, or puckering), nipple drainage (bloody, clear-yellow/green or purulent) Treat- aggressive multimethod (chemo, radiation, surgery, & hormone therapy)
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Cervical Cancer
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Pap smear can detect precancerous cells, which are 100% treatable. Usually caused by HPV, & asymptomatic when manifest- discharge (pale, watery, pink, brown, bloody, or foul smelling), abnormal vaginal bleeding, menorrhagia (abnormal heavy bleeding) Advanced cancer- anorexia, weight loss, fatigue, pelvic, back or leg pain, unilateral lower extremity edema, heavy bleeding, leaking urine or feces from vag, & bone fractures Treat- loop electrosurgical excision procedure, cryotherapy, laser therapy, adv- chemo, radiation, & surgery
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Ovarian Cancer
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9th most common cancer in women, no reliable screening test, difficult to treat, & metastasize at time of diagnosis. Risks- genetic (BRCA1/2), advancing age, infertility, excessive estrogen exposure, obesity, & androgen hormone therapy Manifest- abdominal distention, pelvic pain, & eating disturbances, bowel pattern changes, GI discomfort, pair during intercourse, malaise, urine frequency, & menstruation changes. Treat- surgery, chemo, salpingo-oopho-rectomy (ovary & fallopian tube removal) & hysterectomy
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Which of the four types of gastritis is the most common? a. chemical gastropathy b. multifocal atrophic c. autoimmune d. helicobacter pylori (H. pylori)
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d. helicobacter pylori
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Chron’s disease is characterized by: a. sharply demarcated granulomatous skip lesions of the bowel b. ulcerative lesions of the mucosal layer of the colon c. increased risk of colon cancer d. lack of systemic involvement
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a. sharply demarcated granulomatous skip lesions of the bowel
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Which of the following patients is most at risk for developing hepatitis B: a. 54- yr old woman who takes acetaminophen (Tylenol) daily for headaches b. 24- yr old college student who has had several sexual partners c. 33- yr old business man who travels frequently d. 23- yr old college student that binge drinks
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b. 24- yr old college student who has had several sexual partners Tylenol is a risk if large amounts are consumed
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Which of the following patients is at risk for intestinal obstruction? a. an elderly patient who is on bedrest bc post-operative abdominal surgery b. Jewish patient who smokes & consumes high amounts of caffeine c. an individual eating a low-fiber, high fat diet d. an adult diagnosed w/ cirrhosis of the liver
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a. an elderly patient who is on bedrest bc post-operative abdominal surgery abdominal surgery needs to be moving asap, & is often given meds that can cause intestinal obstruction
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Decreased synthesis of which substance in the patient diagnosed w/ liver failure would be responsible for development of ascites? a. bile b. glucose c. albumin d. carbohydrates
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c. albumin -regulates fluid balance & is in the liver
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Colorectal cancer w/ visible peristaltic wavers & auscultations, hear high-pitched bowel sounds match: a. patient’s tumor has metastasized to the liver & biliary tract b. patient’s tumor has caused a intussusception of the intestine c. patient’s growing tumor has caused a partial bowel obstruction d. patient has developed toxic megacolon from the growing tumor
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c. patient’s growing tumor has caused a partial bowel obstruction -showed by high pitched sounds intussusception- intestine folds into itself- telescope toxic megacolon- complication of IBD
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What is the underlying pathology experienced by people w/ irritable bowel syndrome? a. impaired colonic reflexes resulting in decreased peristalsis b. excessive gastric secretions resulting in ulcer formation c. changes in mucous cell structure resulting in steatorrhea d. increased response to stretching & discomfort resulting in intestinal motility
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d. increased response to stretching & discomfort resulting in intestinal motility steatorrhea- abnormal amount of fat in feces
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Acute right lower quadrant pain associated w/ rebound tenderness & systemic signs of inflammation are indicative of: a. gastritis b. peritonitis c. appendicitis d. cholecystitis
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c. appendicitis gastritis- inflammation of stomach’s mucosal lining peritonitis- inflammation of peritoneum (lining of the abdominal wall & abdominal organs) cholecystitis- inflammation caused by calculi in biliary system
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Patient admitted to healthcare facility w/ a diagnosis of a bleeding gastric ulcer, nurse expects stool to be: a. coffee-ground like b. clay-colored c. black & tarry d. bright red
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c. black & tarry – blood travels through GI tract & loses the color coffee-ground- blood in vomit clay-colored- biliary system problem (lack of bile salts)
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Oral cancer can be defined as: a. painless, whitish thickening lesions b. can occur anywhere in the mouth c. alcohol & tobacco increase risk of oral cancer d. all of the above
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d. all of the above
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Hepatitis A
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Type A- waterborne (fecal-oral), abrupt; fever, nausea & jaundice in children, mild severity Type B- perinatal (blood/skin), insidious; nausea & jaundice, moderate severity Type C- sexual (blood/skin), insidious; nausea, mild severity Type D- sexual (blood/skin), insidious; fever, nausea & jaundice, moderate-severe Type E- waterborne (fecal-oral), abrupt; fever, nausea & jaundice, severe
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Pancreatitis
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inflammation of pancreas acute- medical emergency; upper abdominal pain radiates to back & worsens after eating, nausea/ vomiting, mild jaundice, low fever, blood pressure & pulse changes chronic- upper abdominal pain, indigestion, losing weight, streatorrhea, constipation, & flatulence Treat- no eating; intravenous nutrition (TPN), pancreatic enzyme supplements when diet is resumed, maintain hydration-intravenous, antibiotic if infected, pain management, etc.
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Peptic ulcer
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Lesions affecting the the lining of the stomach or duodenum. Vary in severity based on depth of ulcer superficial erosion- complete penetration through wall
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Cholelithiasis
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Gallstones (calculi in gallbladder), varying in sizes & shapes. More common in fair-skinned women. Risks- age, obesity, rapid weight loss, pregnancy, hormone replacement, some chronic diseases. Cholecystitis calculi cause inflammation or infection in biliary system, small asymptomatic, large -obstruct bile flow; gallbladder rupture, fistula formation, gangrene, hepatitis, pancreatitis, & carcinoma Manifest- abdominal pain, distension, nausea, clay-colored stool, fever, leukocytosis Treat- low-fat diet, meds to dissolve calculi, surgical removal
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Gastric ulcer
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Ulcer in stomach lining- related to malignancy & NSAID use; pain worsens w/ eating
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Duodenal ulcer
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Ulcer in duodenum- asociated w/ excess acid; epigastric pain relieved by food
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Gastroesophageal reflux disease
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Chyme backs up into the esophagus, & occasionally bile. From: certain foods (chocolate, spicy or fatty, etc.), smoking, alcohol, obesity, pregnancy, meds, etc. Manifest- heartburn, epigastric pain (after meal), dysphagia, nausea (after eating), dry cough, “lump in throat” feeling, regurgitation of food, etc. Treat- avoid triggers, avoid NSAIDs, loose clothing, small frequent meals, reduce stress, losing weight, antacids, etc.