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Nurse Practitioner Certification Examination and Practice Preparation 4th Edition, Fitzgerald, 2015 | Nurse Practitioner (NP) School Study Aid
Appendicitis
- Mechanism and Characteristics
- Fecalith leading to obstruction and infection
- Most commonly affects teenagers
- Presentation
- Initial peri-umbilical visceral pain
- Subsequent somatic right lower quadrant pain
- Diagnosis
- Rebound tenderness
- Positive psoas sign
- Pain at McBurney's point
- Leukocytosis
- Fever
- Treatment
- Appendectomy
1 min
Acute Appendicitis Treatment
- Diagnosis
- CT Scan
- Treatment
- Immediate Appendectomy
- NPO
- IV Fluids
- Antibiotics
- Perforation
- Tertiary Intention
- Antibiotics Until Afebrile
2 mins
WBC Differential Lab Value
- White Blood Cells (WBC)
- 5-10 (5,000-10,000)
- Leukocyte Differential
- Neutrophils (50%-70%)
- Bands (2%-5%)
- Segs (50%-70%)
- Lymphocytes (20%-40%)
- Monocytes (4%-8%)
- Eosinophils (2%-4%)
- Basophils (0.5%-1.5%)
2 mins
Cholecystitis Assessment
- RUQ Pain
- Referred Shoulder Pain
- Clay Colored Stools
- Jaundice
- Nausea and Vomiting
- Dyspepsia (Indigestion)
- Fever
- Considerations
- Increased WBCs
- Fatty or Spicy Foods
- Ultrasound
2 mins
Cholecystitis Causes
- Gallbladder Inflammation
- 6 Fs
- Female
- Fair (Caucasian)
- Fat (Obese)
- Fertile (Pregnant)
- Forty (Advanced Age Over 40)
- Flatulence
2 mins
Cholecystitis Interventions
- Supportive Therapy
- Antibiotics
- Low Fat Diet
- NG Tube
- Analgesics
- Lithotripsy
- Cholecystectomy
- T Tube
2 mins
Cancer Warning Signs (CAUTION)
- CAUTION
- Change in Bowel or Bladder Habits
- A Sore That Does Not Heal
- Unusual Bleeding or Discharge
- Thickening or Lump in the Breast or Elsewhere
- Dyspepsia (Indigestion)
- Obvious Change to Warts or Moles
- Nagging Cough
1 min
Colorectal Cancer Assessment
- 3rd Most Common Cancer
- Assessment
- Change in Bowel Habits
- Bowel Obstruction
- Rectal Bleeding
- Anemia
- Weight Loss
- Ascites
- Considerations
- Colonoscopy
- FOBT and FIT
2 mins
Colorectal Cancer Interventions
- Interventions
- Surgical Colon Resection
- Radiation
- Chemotherapy
- Considerations
- Bowel Cleansing
- Screening
- Colostomy
- Dietary Consult
- Body Image
3 mins
Diverticulosis and Diverticulitis Assessment
- Diverticulosis
- Outpouching
- Diverticulitis
- Inflamed Diverticula
- Assessment
- Abdominal Pain
- Abdominal Distention
- Flatulence
- Fever
- Rectal Bleeding
- Alternating Constipation and Diarrhea
- Considerations
- Peritonitis
2 mins
Diverticulosis and Diverticulitis Interventions
- Interventions
- High Fiber Diet
- Reduce Intra-abdominal Pressure
- Stool Softeners
- Exercise
- Anticholinergics
- Considerations
- Antibiotics
- Bowel Resection
2 mins
Trimethoprim
- Mechanism of Action
- Bacteriostatic
- Inhibits Bacterial Dihydrofolate Reductase
- Causes Sequential Block of Folate Synthesis
- Used in Combination with Sulfamethoxazole
- Combination Used For Recurrent Urinary Tract Infections
- Indications
- Shigella
- Salmonella
- Pneumocystis Jiroveci Pneumonia
- Side Effects
- Decrease in Red and White Blood Cells
- Alleviated with Leucovorin Rescue
2 mins
Marfan Syndrome
- Mechanism
- Fibrillin-1 Mutation
- Symptoms
- Autosomal Dominant
- Tall
- Arachnodactyly
- Pectus Excavatum
- Hypermobile Joints
- Aortic Aneurysm And Dissection
- Mitral Valve Prolapse (MVP)
- Subluxation of Lens (Superior)
2 mins
Peptic Ulcer Disease Assessment
- Mechanism/Cause
- Helicobacter Pylori
- NSAIDs
- Increased Stomach Acid
- Assessment
- Abdominal Pain
- Heartburn (Pyrosis)
- Melena
- Weight Changes
- GI Distress
- Considerations
- Most Commonly in Duodenum
- Duodenal: Pain Relieved by Eating
- Gastric: Pain Caused by Eating
2 mins
Peptic Ulcer Disease Interventions
- Combination Drug Therapy
- Two Antibiotics
- Proton Pump Inhibitor (PPI)
- Decrease Acid Secretion
- Avoid NSAIDs
- Diet and Lifestyle Changes
1 min
Celecoxib
- Indications
- Rheumatoid Arthritis
- Osteoarthritis
- Pain
- Mechanism of Action
- NSAID
- Selectively Inhibits COX-2
- Side Effects
- Sulfa Allergy
- Increased Risk of Thrombosis
- GI Bleed
- Contraindication
- Pregnancy > 30 Weeks
1 min
Helicobacter pylori Associations
- Gastritis
- Peptic Ulcer Disease
- Stomach Cancer
50 secs
Helicobacter Pylori
- Characteristics
- Gram-Negative
- Bacilli
- Curved
- Polar Flagellum
- Catalase-Positive
- Oxidase-Positive
- Disease
- Gastric and Duodenal Ulcers
- Ammonia
- Neutral Environment
- Gastric Adenocarcinoma
- MALT lymphoma
- Diagnosis
- Serology IgG antibody
- Stool Antigen
- Urease Positive Breath Test
- Biopsy
- Treatment
- 2 ABX and PPI
2 mins
NSAIDs
- Indications
- Anti-inflammatory
- Analgesic
- Fever
- Closure of Patent Ductus Arteriosus
- Mechanism of Action
- Reversible Inhibition of COX-1 and COX-2
- Block Prostaglandin Synthesis
- Side Effects
- Interstitial Nephritis
- Gastric Ulcer
- Renal Ischemia
1 min
Tetracycline Mechanism
- Binds to 30 S to Prevent Attachment of Aminoacyl tRNA
- Limited CNS Penetration
- Divalent Cations Inhibit Absorption
- Must Not Take with Milk, Antacids, Iron
1 min
Tetracycline Drug Names and Indications
- Drug Names
- Demeclocycline
- Minocycline
- Doxycycline
- Fecally Eliminated
- Can be Used in Renal Failure
- Indications
- Antidiuretic Hormone Antagonist
- Chlamydia
- Rickettsia
- Borrelia burgdorferi
- Helicobacter Pylori
- Mycoplasma Pneumonia
3 mins
Tetracycline Toxicities
- Inhibition of Bone Growth in Children
- Teratogen
- Discoloration of Teeth
- Photosensitivity
- GI Distress
2 mins
Proton Pump Inhibitors (PPIs)
- "-prazole" Suffix
- Indications
- Zollinger-Ellison Syndrome
- Gastritis
- Peptic Ulcer
- Gastroesophageal Reflux Disease (GERD)
- Mechanism
- Inhibit H+/K+/ATPase
- Side Effects
- Hip fracture
- Pneumonia
2 mins
Clostridioides difficile (Clostridium difficile)
- Characteristics
- Gram-Positive
- Bacillus
- Anaerobe
- Clindamycin and Ampicillin
- Toxin A Enterotoxin
- Damages Brush Border of Gut
- Toxin B Cytotoxin
- Damages Cytoskeletal Structure
- Signs and Symptoms
- Diarrhea
- Pseudomembranous Colitis
- Toxic Megacolon
- Diagnosis
- Detect Toxins in Stool
- Treatment
- Metronidazole
- Vancomycin
3 mins
Chronic Gastritis
- Type A
- Type A
- Fundus and Body
- Autoimmune
- Autoantibodies to Parietal Cells
- Pernicious Anemia
- Achlorhydria
- Type B
- Type B
- Most Common Type
- Helicobacter pylori
- Antrum
- Increased Risk of MALT Lymphoma
- Associations
- HIV/AIDS
- Crohn's Disease
3 mins
Cimetidine and Famotidine (H2 Receptor Blockers)
- -tidine Suffix
- Mechanism
- H2 Receptor Blocker
- Indications
- Suppress Gastric Acid Secretion
- Side Effects (All)
- Pneumonia
- Side Effects - Cimetidine
- Anti-androgen Effects
- CNS Changes
2 mins
Gastroesophageal Reflux Disease (GERD) Assessment
- Pathophysiology
- Relaxed Lower Esophageal Sphincter
- Signs and Symptoms
- Dyspepsia (Indigestion)
- Belching
- Nighttime Coughing
- Dysphagia
- Epigastric Pain
- Regurgitation
- Heartburn (Pyrosis)
- Globus
2 mins
Barrett's Esophagus
- Histological findings
- Metaplasia in Lower Esophagus
- Columnar Epithelium
- Associated Pathologies
- Gastroesophageal Reflux Disease (GERD)
- Esophagitis
- Esophageal Ulcers
- Increased Risk of Esophageal Adenocarcinoma
1 min
Hepatitis A
- Characteristics
- Picornavirus
- 4 Week Incubation Period
- Fecal-oral
- Day Care Centers
- Travel to Developing Countries
- Signs and Symptoms
- Usually Asymptomatic
- Acute Disease
- Jaundice
- Fever
- Vomiting
2 mins
Hepatitis B Virus Disease
- Can turn chronic
- < 10% of adults become chronic carriers
- 90% of newborns become chronic carriers
- Cirrhosis
- Hepatocellular carcinoma
- Membranous Glomerulonephritis
- Polyarteritis nodosa
- Serum sickness like syndrome
2 mins
Hepatitis C
- Characteristics
- Enveloped
- RNA Virus
- Flavivirus
- Icosahedral
- SS positive Linear
- Clinical Features
- Most Cases are Due to IV Drug Use
- Turns to Chronic Hepatitis in Over 70% of Cases
- Cirrhosis
- Hepatocellular Carcinoma
- Most Common Indication for Liver Transplantation
- Associated With Type I MPGN
- Porphyria Cutanea Tarda
2 mins
Hepatitis B Virus Characteristics
- Hepadnavirus
- Enveloped
- Circular
- Partially Double-stranded DNA
- Has Reverse Transcriptase
- IV Drug Use
- Sex
- Maternal Fetal Routes
- 3 Month Incubation Period
2 mins
Hepatitis C (HCV) Assessment
- Transmission
- Blood Transmission
- High Risk Sex (rare)
- IV Drug Users
- Incubation
- 7 Weeks
- Chronic Disease
- Cirrhosis
- Considerations
- Barrier Protection
2 mins
Bilirubin Lab Value
- 0.2-1.2 mg/dL
- Increased Bilirubin Causes Jaundice
54 secs
Irritable Bowel Syndrome (IBS) Assessment
- Abdominal Pain
- Relieved by Defecation
- Alternating Diarrhea and Constipation
- Fatigue
- Excessive Flatulence
- Sensation of Incomplete Evacuation
- Considerations
- Stressors
- Food Intolerances
- More Common in Women
- Rule Out Other Disorders
2 mins
Irritable Bowel Syndrome (IBS) Interventions
- Interventions
- Identify Triggers
- Increase Fiber Intake
- Probiotics
- Anticholinergics
- Tricyclic Antidepressants (TCAs)
- Loperamide
- Linaclotide
- Medications for Women
- Tegaserod (Zelnorm)
- Lubiprostone (Amitiza)
- Alosetron (Lotronex)
2 mins
Crohn's Symptoms and Associations
- Diarrhea
- Malabsorption
- Bile-Wasting
- Pigment Gallstones
- Oxalate Kidney Stones
- Ankylosing Spondylitis
- Erythema Nodosum
- Uveitis
- Migratory Polyarthritis
2 mins
Fluoxetine (Prozac)
- Mechanism of Action
- Inhibits Reuptake of Serotonin
- Indications
- Depression
- Side Effects
- Sexual Dysfunction
- CNS Stimulation
- Weight Changes
- Serotonin Syndrome
- Contraindications
- No MAO-Is
- No Anticoagulants / Antiplatelets
- Considerations
- Suicide Risk
- Delayed Onset of Action
2 mins
Renal Calculi Assessment
- Cause/Mechanism
- Hypercalcemia (Most Commonly)
- Signs and Symptoms
- Flank Pain
- Radiates Toward Bladder
- Renal Colic
- Urinary Tract Infection
- Urinary Retention
- Hematuria
- Considerations
- Stone Recurrence
2 mins
Renal Calculi Interventions
- Interventions
- Increase Fluid Intake
- Opioids
- NSAIDs
- Antibiotics
- Lithotripsy
- Surgical Stone Removal
- Considerations
- Identify Type CT-KUB
- Low Sodium Diet
2 mins
Ulcerative Colitis Characteristics
- Autoimmune
- Mucosal and Submucosal Only
- Rectal Involvement
- Stepwise Lesions
- Friable Pseudopolyp
- Crypt Abscess
- Loss of Haustra
- Lead Pipe Appearance
- Bloody Diarrhea
2 mins
Ulcerative Colitis Associations
- Associations
- Toxic Megacolon
- Colorectal Carcinoma
- Anterior Uveitis
- Pyoderma Gangrenosum
- Ankylosing Spondylitis
- Primary Sclerosing Cholangitis
- P-ANCA
1 min
Metoclopramide
- Indications
- Antiemetic
- Promotility Agent
- Mechanism
- Increased Resting Tone
- Antagonist at D2 Receptor
- Side Effects
- Parkinsonian Symptoms
- Galactorrhea
- Contraindication
- Small Bowel Obstruction
- Parkinson's Disease
2 mins
Crohn's Disease Assessment
- Diarrhea
- 5-6 per day
- Cramping Abdominal Pain
- Fever
- Weight Loss
- Malabsorption
- Anemia
- Complications
- Obstruction
- Fistulas
2 mins
Crohn's Disease Characteristics
- Terminal Ileum and Colon
- Rectal Sparing
- Transmural Inflammation
- Granulomas
- Skip Lesions
- Cobblestone Mucosa
- Fissures
- Fistulas
- Perianal Disease
- Creeping Fat
- Lymphoid Aggregates
- String Sign on Barium Swallow
2 mins
Metronidazole
- Mechanism of Action
- Bactericidal
- Forms Free Radical Toxic Metabolites
- Damages DNA
- Indications
- Giardia lamblia
- Entamoeba Histolytica
- Trichomonas
- Gardnerella
- Anaerobes
- Side Effects
- Metallic taste
- Disulfiram like Reaction with Alcohol
2 mins
Celiac Disease Characteristics
- Epidemiology
- European Descent
- HLA-DQ2
- HLA-DQ8
- Pathophysiology
- Autoimmune-mediated Intolerance of Gliadin
- Symptoms
- Dermatitis Herpetiformis
- Weight Loss
- Failure to Thrive
- Decreased Bone Density
- Steatorrhea
- Anemia
2 mins
Celiac Disease Diagnosis and Treatment
- Diagnosis
- Blunting of Intestinal Villi
- Lymphocytes in Lamina Propria
- Anti-gliadin Antibodies (IgA)
- Anti-endomysial Antibodies (IgA)
- Anti-tissue Transglutaminase Antibodies (IgA)
- Treatment
- Gluten-Free Diet
- Corticosteroids
- Dapsone
- Complications
- Intestinal Lymphoma
2 mins
Acute Pancreatitis Assessment
- Mechanism
- Heavy Alcohol Use and Gallstones
- Signs and Symptoms
- Abdominal Pain
- Nausea/Vomiting/Anorexia
- Abdominal Rigidity/Guarding
- Decreased or Absent Bowel Sounds
- Hypotension and Tachycardia
- Jaundice
- Increased White Blood Cells
2 mins
Acute Pancreatitis Causes
- "GET SMASHHED" Mnemonic
- Gallstones
- (Ethanol) Alcohol
- Trauma
- Steroids
- Mumps
- Autoimmune
- Scorpion Sting
- Hypercalcemia
- Hypertriglyceridemia > 1000
- ERCP
- Drugs
1 min
Acute Pancreatitis Disease
- Autodigestion of Pancreas by Pancreatic Enzymes
- Symptoms
- Epigastric Abdominal Pain Radiating to Back
- Anorexia
- Nausea
- Labs
- Increased Amylase and Lipase
- Complications
- Disseminated Intravascular Coagulation (DIC)
- Infection
- Hypocalcemia
- Systemic Inflammatory Response Syndrome (SIRS)
- Acute Respiratory Distress Syndrome (ARDS)
- Pancreatic Pseudocyst
- Hemorrhage
3 mins
Acute Pancreatitis Interventions
- NPO with NG Tube to Suction
- Pain Management
- Albumin
- Lactated Ringers Solution
- Proton Pump Inhibitor (PPI)
- Antibiotics
- Surgery
- Nutrition
2 mins
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