HNG 574 Final Review

• The main cause of ulcers is H pylori
• The test to diagnose H Pylori is a breath test
• Treatment for H pylori includes omeprazole 20 mg BID, clarithromycin 500 mg BID, and metronidazole 500 mg BID x 14 days
• Patients with IBS should keep a symptom journal to identify triggering foods
• The diagnostic test of choice for cholecystitis is ultrasound
• The #1 cause of acute pancreatitis is gallstones
• Gastric ulcer pain worsens with eating; duodenal ulcer pain gets better with eating.
• If a patient has chronic constipation and a sudden increase in abdominal pain, your first action should be to obtain abdominal xray to rule out small bowel obstruction.
• Hepatitis A is acquired through food/fecal oral route.
• Hepatitis C is transmitted via IV drug use and blood
• Complicated UTIs are those in pregnant women and men
• The most common causative agent of a UTI is e coli
• The most common type of kidney stone in the general population is calcium oxalate
• The most common kind of kidney stone in the diabetic population is uric acid
• People with a vegetarian diet have a lower risk of developing renal stones.
• Alpha blockers (i.e. Terazosin) are the first line treatment for BPH
• Alpha blockers such as terazosin can cause hypotension and dizziness
• If a patient presents with erectile dysfunction, cardiac causes must first be ruled out
• If a patient is taking erectile dysfunction meds, they should avoid taking nitrates
• A patient presents with hematuria. First steps: DRE and PSA
• A patient has IBS with alternating diarrhea/constipation and asks the provider about dietary changes that may help with symptoms. What will the provider recommend?

  Food and symptom diary
• When reviewing the serologic test results of hepatitis workup, you know that the appearance of anti-HBs and the disappearance of HBAg indicate recovery from the hep b virus, non-infectivity, and protection from reinfection.
• Your 52 year old patient presents with complaints of heartburn and persistent stomach aches with recent increasing intensity. He reports pain in the upper abdomen, and the pain is relieved by eating. What do these findings suggest?

  Duodenal ulcer
• crohns can occur in any part of the gastrointestinal tract.
• A 50 year old man reports ED. What is an important response by the provider when developing a plan of care for this patient?

  Evaluating for cardiovascular disease
• Ultrasound is the confirmatory test for cholelithiasis/cholecystitis
• Diagnostic test to evaluate for small bowel obstruction is abdominal xray
• A patient with a perforated peptic ulcer will have abrupt onset severe epigastric pain, coffee ground emesis, and temporary improvement of pain 6-12 hours after perforation.
• The treatment for primary peritonitis is a 3rd/4th gen cephalosporin or quinolone until the culture is back.
• Men 65-76 years old with a positive smoking history should be screened for AAA.
• The first line treatment for duodenal ulcers is PPIs
• Meds that can cause GERD include beta agonists, alpha agonists, anticholinergics, CCBs, estrogens, narcotics, progesterone, TCAs, alendronate, NSAIDs, tetracycline, KCl tabs
• PPIs should be trialed for GERD symptoms for 8 weeks, taken once daily 30 minutes before breakfast
• Treatment for Hepatitis A is supportive care
• Hepatitis C is the most common blood borne infection in the US
• Management of a complicated UTI is with ciprofloxacin for 10 days or levofloxacin for 7-10 days
• Management of an uncomplicated UTI is bactrim, cipro, or macrobid for 3, 5 or 10 days.
• If a patient presents with a recent history of a complicated UTI, hematuria, vomiting, flank pain, CVA tenderness, and +pyuria, you should suspect pyelonephritis and treat as a complicated UTI.
• PSA <4 is normal. PSA >4 is abnormal and signifies early disease. PSA >10 is a red flag.
• BPH is when the prostate enlarges and acts like a "clamp on a hose", constricting the flow of urine.