Examl 2:l NU664B/l NUl 664Bl (Latestl
2025/l 2026l Update)l Primaryl Carel ofl Familyl Il Completel Guide|l Questionsl &l Answers|l Gradel A|l 100%l Correctl (Verifiedl Solutions)-l Regis
Q:l pancreatitis
Answer:
inflammationl ofl thel pancreas -mildl selfl limitingl tol lifel threateningl multil systemicl presentation risks:l ETOH,l gallstones/obstruction,l hyperglyceridemia,l preg,l HIV,l bluntl trauma mayl alsol bel infectious,l idiopathic,l orl relatedl tol medicationsl (manyl suchl asl Eluxadoline)
presentation:
-acutel onsetl persistentl severel epigastricl pain,l somel ptsl mayl bel inl RUQl pain,l rarelyl confinedl tol onlyl Ll side.l somel poorlyl localized,l sometimesl inl discomfortl forl daysl beforel comingl in -painl mayl radiatel tol chest,l back,l leftl shoulder,l flankl LLQ -mayl bel relievedl byl sittingl up,l bendingl forward -approproximatelyl 90%l willl havel N/V
Q:l physicall examl withl pancreatitis
Answer:
epigastric,l LUQl tenderness fever hypotension,l tachycardia,l hemodynamicl instabilityl andl CVl collapse **ecchymoticl discolorationl inl flankl areal (Greyl turner'sl sign) distention,l decreasedl bowell sounds
dx:
-CBC/diff -HCGl ifl indicated -U/A -seruml chemistryl (includingl LFTl andl BS) 1 / 4
***amylasel (risesl 6-12l hoursl afterl onsetl ofl symptoms)l butl doens'tl alwaysl becomel elevatedl especiallyl inl drinkers)l andl mayl returnl tol normall afterl 2-3l days ***lipasel (risesl 4-8l hoursl afterl onsetl ofl sxl speaksl atl 24l hrsl andl returnsl tol NLl inl 8- 14l days)l elevatedl inl drinksl andl non-drinkersl alike
Q:l dxl withl pancreatitis
Answer:
diagnosisl ofl acutel pancreatitisl requiresl thel presencel ofl twol ofl thel following: -acutel onsetl ofl persistent,l severe,l epigastricl painl oftenl radiatingl tol thel back -elevationl inl seruml lipasel orl amylasel orl threel timesl orl greaterl thanl thel ULN -characteristicl findingsl ofl acutel pancreatitisl onl imagingl (CT,l MRIl orl transabdominall US)
Q:l mortalityl r/tl pancreatitis
Answer:
remember...l initiall clinicall picturel isl notl al reliablel indicatorl ofl whatl isl tol come...l mildl presensationl mayl deterioratel rapidly,l particularlyl withl thosel >55....l Ransonl criteria treatmentsl varyl dependingl onl severity -fluidl replacement,l nutritionl eitherl entrall orl parental,l painl managment,l abxl neededl inl aprox.l 20%l duel extraparcreaticl infection
Q:l etiologyl ofl acutel pancreatitis
Answer:
mechanical:l gallstones,l biliaryl studge,l duodinall structurel orl obstructionl etc
toxic:l ethanol,l methanoll etc
metabolic:l hyperlipidemia,l hypercalcemia
drugs:l antifungal,l furosimide,l thiazide,l valproicl acid
infection:l viral
trauma:l bluntl orl pentratingl abdominall injury
Q:l ulcerativel colitis
Answer:
chronicl inflammatoryl bowell diseasel characterizedl byl recurringl episodesl ofl inflammationl limitedl tol thel mucosall layerl ofl thel colon.l itl commonlyl involvesl thel rectuml andl mayl extendl tol otherl partsl ofl thel colon clinicall presentation:l usuallyl presentl withl diarrhea...l possiblyl bloodl andl mucusl
associatedl symptoms:
-colickyl adbominall pain 2 / 4
-urgency -tenesmus -incontinence -erythemal nodosuml (redl nodulesl onl shins) -pryodermal gangrenosuml (earlyl lesionl inl pydermal gangrenosuml presentsl asl al pustularl plaque) -potentiall forl extral intestinall manifestations
Q:l ulcerativel colitis
Answer:
chronicl inflammaotryl bowell diseasel characterizedl byl recurringl episodesl ofl inflammationl limitedl tol thel mucosall layerl ofl thel colon.l commonlyl invovlesl thel rectuml andl mayl entendl tol otherl partsl ofl colon usuallyl presentl withl diarrheal andl orl mucus associatedl symptoms -colickyl abdominall pain -urgency -tenesmus -incontinence -potentiall forl extraintesitnall manifestations
Q:l extraintestinall manifestations
Answer:
aproxl 10%l havel thesel atl dx,l althoughl 25%l willl havel atl somel pointl inl theirl lifetime
musculoskeletal:l arthritis
eye:l uveitis,l episcleritis
derm:l erythemal nodosuml andl pyodermal gangrenosum
heptaobiliary:l NAFLD
hematology:l increasedl riskl ofl venousl andl arteriall thromboemolism
Q:l severityl ofl ulcerativel colitis
Answer:
mild:
=<4l stoolsl perl dayl withl orl withoutl blood -mildl cramping,l tenesmusl andl periodl constipation -l nol feverl orl s/sl ofl tox
moderate:
-frequentl loosel bloodyl stoolsl >4l dat 3 / 4
-mildl anemial notl requiringl bloodl transfusions -abdominall painl thatl isl notl severe -mayl havel lowl gradel templ
severe:
-frequentl >6l perl dayl loosel bloodyl stools -severel cramps -fever -tachycardial >90 -anemial orl elevatedl ESR -weightl loss complications -severel complications -fulminantl coloitisl andl toxicl megacolon -perforation -dysplasial andl colorectall cancer
Q:l ulcerativel colitisl physicall examl andl dx
Answer:
oftenl normall inl mildl disease,l asl severityl progressesl abdominall painl withl palpation,l hypotension,l tachycardial andl pallorl mayl bel seen.l inl severel disease,l musclel atrophy,l weightl lossl andl peripherall edemal mayl bel presentl andl reveall blood
labs:l CBC,l LFT,l CMP,l CRPl and/orl ESR
stooll studies -forl inflammation....l fecall calprotectin -forl infection-l cl diff -routinel stooll culturesl salmonella,l shingella,l campylobacter,l lookl forl paracites giardial stooll antigenl (rarel unlessl traveling)m
Q:l ulcerativel colitisl endoscopyl andl colonscopyl results
Answer:
endoscopicl findingsl inl thel ptl withl ucl arel nonl specific biopsiesl ofl thel colonl arel necessaryl tol establishl chronicityl ofl inflammationl tol r/ol otherl cuasesl ofl colitis findingsl include:l lossl ofl vascularl markingsl duel tol mucosal engorgement.l mucosal mayl exhibitl peteachiae,l edema,l exudates,l erosions,l spontagneousl bleeding
Q:l treatmentl forl ulcerativel colitis
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