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CMSRN Final Exam Prep With Complete
Solution A+ Graded
Crohn's Disease (Cause/Symptoms/Diagnosis/Treatment) - ANSWER Causes: IBD in small intestine, varies severity.
Symptoms: Abdominal pain, cramping, diarrhea, bloody stool, low appetite, weight loss.
Diagnosis: CBC, fecal blood test, colonoscopy (to check damage, find granulomas-inflamed cells that trigger symptoms)
Treatment: anti-inflammatories, corticosteroids, oral 5-aminosalicylates. No cure.
Ulcerative Colitis (Cause/Symptoms/Diagnosis/Treatment) - ANSWER Causes: Inflammation, ulcers, sores in GI tract, large intestine, rectum.
Symptoms: Diarrhea, with blood or pus, abdominal pain, rectal bleeding, urgency to defacate
Diagnosis: proctosigmoiditis causes inflamed rectum and sigmoid colon with bloody diarrhea, left-sided colitis from sigmoid and descending colon, and pancolitis in entire colon. Colonoscopy to confirm.
Treatment: antibiotics, corticosteroids reduce recurring flare-ups. No cure.
Cholecystitis (Cause/Risks/Symptoms/Diagnosis/Treatment) - ANSWER Causes: inflammation of gallbladder from cystic duct blockage by gallstones.
Risks: elderly, women, overweight, weight loss.
Symptoms: RUQ pain, N/V, jaundice, fever, tender gallbladder, gangrene if untreated.
Diagnosis: LFT, RUQ ultrasound (best for women to rule out pregnancy).
Treatment: antibiotics, cholecystectomy, treat asap.
Gastritis (Cause/Symptoms/Diagnosis/Treatment) - ANSWER Causes: inflammation stomach lining, corticosteroid or NSAID use, excessive alcohol use.
Symptoms: abdominal pain, nausea/vomitting.
Diagnosis: symptomatic.
Treatment: antibiotics, antacids, antidiarrheals if needed.
GI Bleeding (Cause/Symptoms/Diagnosis/Treatment) - ANSWER Causes: Mallory-Weiss tear, cancer, NSAID use, history of GERD.
Symptoms: Abdominal discomfort, red bloody stools, asymptomatic.
Diagnosis: CBC, endoscope to confirm.
Treatment: Cause-based. Fluid replacement. Locating source.
Cirrhosis (Cause/Symptoms/Diagnosis/Treatment) - ANSWER Causes: Scar tissue replaces healthy liver tissue. Lipids stored in body cells instead.
Symptoms: Abdominal pain, drowsiness, weight loss. History of Hep C.
Diagnosis:
Treatment: Antivirals (with Hep C), diuretics, beta-blockers (if cardiac affect), Zinc supplement, liver transplant.
Foreign Bodies (Cause/Symptoms/Diagnosis/Treatment) - ANSWER Causes: Accidents. 2cm or bigger can cause blockage. Children, patients with dentures, and psych patients at risk.
Symptoms: Depends on location.
Diagnosis: Ultrasound, or X-ray, faster if d/t sharp object.
Treatment: Pro-motility medications if safe to pass, laparoscopic surgery if large/sharp/dangerous.
GI Obstruction (Cause/Symptoms/Diagnosis/Treatment) - ANSWER Causes: Body tissues causing blockage.
Symptoms: Pain, constipation, N/V/D.
Diagnosis: Endoscopy, X-ray.
Treatment: Antibiotics, colectomy, bowel rest, surgery if hemorrhage.
spine
Assess: numbness or paralysis, damage up to 48-72h after injury
Spinal Cord Injury (Forms of Care) - ANSWER General immobilization: lessen further damage.
Surgery: remove herniated discs, bone fragments, fractured vertebrae
Hypothermia: 24-48h stops cell death, support nerve regeneration
Rehabilitation: restore mobility
Medications: pain meds, restore bowel/bladder control
Hydrocephalus (Cause/Symptoms/Diagnosis/Treatment) - ANSWER Causes: excess CSF develops in ventricles, causing increased pressure, caused by blockage. Infants and elderly.
Symptoms: Larger head, vomitting, sleepiness (children); headache, fatigue, loss bladder control, memory loss (adults).
Diagnosis: ultrasound (most effective, see in utero), MRI, CT scan.
Treatment: shunt to relieve pressure. Monitor nausea, fever, headache, vision changes, abdominal pain.
Seizures (Diagnoses/Treatment) - ANSWER Diagnosed: on movement. EEG, MRI to rule-out tumors.
Treatment: antiepileptics, or phenytoin or benzodiazipine
Stroke (Cause/Symptoms/Types/Treatment) - ANSWER Causes: brain tissue dies due to injury
Symptoms: balance, eyes, face, arms, speech, time
Types: ischemic and hemorrhagic strokes
Treatment:
Ischemic Stroke (Causes/Mechanism/Forms/Risks/Treatment) - ANSWER Causes: more common, blood clot developing in the brain
Mechanism: blood clot depletes ATP stores, cytotoxic edema can occur
Forms: thrombotic (plaque causes thrombus and clot), embolic (clot in heart or elsewhere gets stuck in brain)
Risks: overweight, inactivity, ETOH, heroin/cocaine, HTN, cholesterol, heredity
Treatment: Alteplase, thrombectomy. Monitor hyperthermia, hypertension, cardiac arrest from shock
Hemorrhagic Stroke Causes/Mechanism/Forms/Dx/Risks/Treatment - ANSWER Causes: brain vessel leaks or ruptures (less common)
Mechanism:
Forms: intracerebral (in brain, caused by hypertension or anticoag's), subarachnoid (on/near brain surface bursts, cause headache
Diagnosis: CBC, coagulation test, CT, MRI
Risks:
Treatment: anti-HTN, ACE inhibitors (goal under 140mmHg), diuretics, elevate head, vitamin K (if taking warfarin)
Transient Ischemic Attack (Causes) - ANSWER Causes: transient loss of blood supply, lasts a few minutes. Due to narrowed artery or clot. At risk for stroke!
Transient Ischemic Attack (Treatment) - ANSWER Treatment: anticoagulants or antiplatelets, or thrombolytics. May need carotid endarterectomy or angioplasty
Temporal Arteritis (Causes) - ANSWER Causes: aka giant cell arteritis. Inflammatory damage in scalp arterial layers harms the area.
Abruptio Placenta (Causes) - ANSWER Cause: placenta separates from uterus, leading to severe intra-abdominal hemorrhage.
Vaginal Bleeding (Causes) - ANSWER Causes: genital ulcers, menopause, anticoagulants, trauma, malignancy
Ovarian Cyst-Causes ANSWER Causes: fluid or solid mass the develops on ovary surface, can rupture or cause torsion, loss of reproductive function.
Ovarian Cyst-Diagnosis ANSWER Pelvic exam identify dermoid/ cystadenomas/endometriomas, pregnancy test
Ovarian Cyst (Treatment) - ANSWER Treatment: oral contraceptives, laporoscopy
Sexual Assault (Treatment) - ANSWER Treating injuries, test for STDs, psychological assessment, interview patient
Placental Abruption (Risks) - ANSWER Risks: occurs during third trimester, hypertension, falling, being over 40,
Placental Abruption (Symptoms) - ANSWER Sudden-onset vaginal bleeding, abdominal pain, frequent uterine contractions, anemia
Placental Abruption (Treatment) - ANSWER Transfusion, delivering baby asap after 34 weeks, c-section possibly.
Ectopic Pregnancy (Causes) - ANSWER Fertilized ovum appears in fallopian tube or other location outside uterus. Ovum will not receive nutrients or develop.
Ectopic Pregnancy (Risks) - ANSWER Risks: use of IUD, smoking, fallopian tube malformation
Ectopic Pregnancy (Symptoms) - ANSWER Symptoms: vaginal bleeding, severe pelvic pain, excessive weakness or fatigue
Ectopic Pregnancy (Diagnosis) - ANSWER CBC, BHCG, LFT's, CMP (to check if
methotrexate is OK to give)
Ectopic Pregnancy (Treatment) - ANSWER Methotrexate IM (to stop pregnancy), laparoscopy
Hyperemesis Gravidarum (Diagnosis/Treatment) - ANSWER Diagnosis: UA for acid-base balance, LFT to rule-out hepatitis, Ultrasound to check fetal health.
Treatment: IVF, electrolytes.
APGAR Testing (2/1/0) - ANSWER Appearance (Pink/Bluish/Blue)
Pulse (>100BPM/<100BPM/None)
Grimace (Cries/Minimal/None)
Activity (Flexing/Weak/None)
Respiration (Breathing/Gasping/None)
Hemorrhage Pregnancy (Causes/Treatment) - ANSWER Causes: loss of >500mL blood vaginal, 1000mL C-section.
Treatment: surgery, blood transfusion (prepare 6 units)
Temporal Arteritis (Diagnosis) - ANSWER Diagnosis: CRP test, scalp ultrasound.
Temporal Arteritis (Treatment)-ANSWER Treatment: prednisone, other corticosteroids, advise healthy diet/exercise to lower blood pressure
Temporal Arteritis (Symptoms)-ANSWER Symptoms: headache radiating to jaw, neck; vision changes; scalp veins bulging; blindness (permanent if >2 wks)
Migraine Headache (Stages)-ANSWER Prodrome (increased thirst, mood change, constipation [( few days)])
Can cause brain damage, seizures, kidney failure
Meningitis (Diagnosis) - ANSWER Procedure: lumbar puncture sample can assess for infection.
Meningitis (Treatment) - ANSWER Vaccine: MCV 4 has reduced occurence
Medication: IV antibiotics, IV fluids
Procedure: sinus draining
Other: rehabilitation to recover from CNS damage
Dementia (Causes/Risk) - ANSWER Causes: ongoing destruction of neurological tissue
Risk: strokes, head injuries
Dementia (Diagnosis) - ANSWER Cognitive/physical exam
CT or MRI assess brain function
Alzheimer's Disease (Causes) - ANSWER Causes: plaques or tangles caused by tau proteins in brain, cell die off due to lack of support, brain shrinks.
Alzheimer's Disease (Diagnosis) - ANSWER Test: thyroid or vitamin D deficiency
Imaging: MRI or CT to rule out tumors
Alheimer's Disease (Treatment) - ANSWER None, but memantine will slow progression
Myesthenia Gravis (Causes) - ANSWER Causes: failure of nerve-muscle communication, could be antibodies attack ACh receptors, thymus gland tumor may disrupt hormones.
Infection may cause a relapse.
Myesthenia Gravis (Symptoms) - ANSWER Drooping eyelids, double vision, difficulty moving facial muscless
Myesthenia Gravis (Diagnosis) - ANSWER Exam: checking reflexes, muscle strength, tone, coordination
Tests: checking antibody counts, MRI for thymus tumors
Myesthenia Gravis (Treatment) - ANSWER Medication: immunosuppressants, corticosteroids, cholinesterase inhibitors
Procedure: thymectomy
Guillain-Barre Syndrome (Causes) - ANSWER Causes: Immune system attack nerves, causing numbness/tingling, then weakness, then paralysis in extremities
Guillain-Barre Syndrome (Symptoms) - ANSWER Stomach flu or respiratory infection at first, then weakness, then loss of bowel/bladder control
Guillain-Barre Syndrome (Diagnosis) - ANSWER Test: spinal tap for antibody counts, nerve conduction test
Guillain-Barre Syndrome (Treatment) - ANSWER No cure.
Plasma exchange replaces antibodies
Medications: immunoglobulin therapy, anticoagulants (due to immobilization)
Multiple Sclerosis (Causes) - ANS Causes: destruction of myelin sheath around CNS cells, plaque build-up, T-cells will attack the nerve cells.
Multiple Sclerosis (Symptoms) - ANS Symptoms - tingling, numbness, loss of balance, weakness, blurred or double vision
Commonly relapsing-remitting, can be progressive slowly
