70 Questions
Which non-pharmacologic treatment option is recommended for simple nausea and vomiting?
Physical therapy
What is the recommended prophylactic treatment regimen for high emetic risk chemotherapy-induced nausea and vomiting?
Ondansetron
Which agent is considered the 'gold standard' for post-operative nausea and vomiting (PONV) prophylaxis?
Ondansetron
What is the appropriate treatment for breakthrough chemotherapy-induced nausea and vomiting (CINV)?
Administer a different medication with a different mechanism of action
Which type of nausea and vomiting is usually self-limiting and often treated with over-the-counter (OTC) options?
Simple nausea and vomiting
What is the primary goal of treatment for nausea and vomiting?
To prevent or eliminate nausea/vomiting
Which medication is useful in anticipatory nausea and vomiting?
Benzodiazepine
What type of agents are useful in simple nausea and vomiting related to reflux or gastroparesis?
Histamine-2 receptor antagonists
Which non-pharmacologic treatment option is recommended for pregnancy-induced nausea and vomiting?
Yoga
Which type of receptor antagonist is useful for acute simple, chemotherapy-induced, and post-operative nausea and vomiting?
5HT3 receptor antagonist
What is the most common type of prophylactic treatment for post-operative nausea and vomiting (PONV)?
Ondansetron
What is the primary goal of treatment for nausea and vomiting?
Prevent or eliminate nausea/vomiting
Which non-pharmacologic approach is recommended for simple nausea and vomiting?
Yoga
Which pharmacologic agent is useful for simple nausea and vomiting related to reflux?
Histamine-1 receptor antagonist
During which phase of chemotherapy does anticipatory CINV occur?
Before chemotherapy administration
What is considered the 'gold standard' for PONV prophylaxis?
Ondansetron
Which type of nausea and vomiting often resolves on its own and can be treated with OTC options?
Simple nausea/vomiting
What is the preferred treatment for pregnancy-induced nausea/vomiting?
Combination of pharmacologic and non-pharmacologic options
What medication is recommended for breakthrough CINV?
Repeat the drug given for prophylaxis
Which agent is useful in refractory CINV?
Cannabinoids
Which neurotransmitter receptor antagonist is useful in CINV and PONV?
NK1 receptor antagonist
What is the main factor determining the choice of antiemetic agent?
Etiology of the nausea/vomiting
What is a common cause of simple nausea and vomiting?
Motion sickness
What is the primary function of the pancreas?
To secrete enzymes for breaking down food
Which cells are of interest in the exocrine function of the pancreas?
Acinar cells
What is the average daily volume of alkaline fluid secreted by the pancreas?
2-4L
Which condition involves an acute inflammatory process of the pancreas?
Pancreatitis
What is the leading cause of GI hospitalizations in the US?
Pancreatitis
Which type of cells are involved in the exocrine function of the pancreas?
Acinar cells
What is the anatomical location of the pancreas?
Behind the stomach
What is the function of pancreatic juice?
To aid in digestion
Which medication is associated with medication-induced pancreatitis?
Valproic acid
What is the preferred imaging modality for finding stones in the pancreas?
Trans-abdominal ultrasound
What is the recommended initial fluid replacement rate for acute pancreatitis?
200-500 ml/hr
When are antibiotics routinely recommended for pancreatitis?
After 7-10 days with confirmed infection
Which procedure is indicated for patients with refractory symptoms of chronic pancreatitis?
Whipple procedure
What is the primary goal of nutritional support in severe acute pancreatitis?
Preventing necrosis and infection
Which of the following is NOT a side effect of pancreatic enzyme supplementation?
Constipation
What is the best initial approach to pain management in acute pancreatitis?
Multimodal approach
Which vital signs are consistent with acute pancreatitis?
High temperature, high blood pressure, low heart rate, and low respiratory rate
What do you think is the etiology of this patient’s acute pancreatitis?
All of the above
Can you diagnose the patient with acute pancreatitis. Why or why not?
Yes, because of the diffuse enlargement of the pancreas and hazy stranding of fat on the CT scan
What is the overall fatality rate for acute pancreatitis?
5%
What laboratory values should you order to diagnose this patient with acute pancreatitis?
Lipase, Amylase, and Triglycerides (TG)
What laboratory values should you order to determine the etiology of acute pancreatitis?
Serum alcohol level, Liver function tests (LFTs), and Serum triglycerides
Which of the following medications is NOT associated with medication-induced acute pancreatitis?
Metformin
What imaging do you want to order?
All of the above
In acute pancreatitis, which imaging modality is more useful in finding stones?
Trans-abdominal US
What is the recommended initial fluid replacement rate in the management of acute pancreatitis?
200-500 ml/hr
Which of the following is NOT a goal of therapy in chronic pancreatitis?
Induce pancreatic necrosis
Which antibiotic is NOT routinely recommended for prophylaxis in acute pancreatitis?
Gentamicin
Which treatment is specifically indicated for gallstone-induced acute pancreatitis?
Endoscopic retrograde cholangiopancreatography (ERCP)
What is the primary purpose of using pancreatic enzymes in chronic pancreatitis?
Help with malabsorption and steatorrhea
What is the primary function of the pancreas gland?
Producing digestive enzymes and bicarbonate
Which cells of the pancreas are responsible for secreting pancreatic juice?
Acinar cells
What is the approximate daily volume of alkaline fluid secreted by the pancreas?
1.5-3 liters
Which condition is characterized by an acute inflammatory process of the pancreas?
Pancreatitis
What is the leading cause of GI hospitalizations in the United States?
Pancreatitis
Which type of cells are of particular interest in the exocrine functions of the pancreas?
Acinar cells
What is the approximate number of enzymes present in the pancreatic juice?
~20 enzymes
What is the main product of pancreatic juice?
Water, electrolytes, and enzymes
Which vital signs are consistent with acute pancreatitis?
Temp 97˚F, BP 86/54 mmHg
What imaging do you want to order?
CT scan of the abdomen
Can you diagnose the patient with acute pancreatitis? Why or why not?
Yes, because the patient has elevated lipase levels and a history of heavy alcohol consumption.
What laboratory values should you order to diagnose this patient with acute pancreatitis?
Amylase and lipase levels
What laboratory values should you order to determine the etiology of acute pancreatitis?
Lipase levels and triglycerides
What do you think is the etiology of this patient’s acute pancreatitis?
Chronic heavy alcohol consumption
Which reported symptoms are consistent with acute pancreatitis?
Abdominal pain, nausea, vomiting
Which items from the physical exam are consistent with acute pancreatitis?
LUQ pain, distended abdomen, reduced bowel sounds
You are the hospital pharmacist in central pharmacy. You see the following orders come through. Are these correct to verify.
Meropenem 500 mg IV q6hr
This quiz covers treatment and prevention strategies for simple and pregnancy-induced nausea and vomiting, as well as recommendations for postoperative and chemotherapy-induced nausea and vomiting. It also includes constructing a monitoring plan for assessing the benefits, adverse effects, and toxicity of antiemetic drug therapy.
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