Hepatic encephalopathy is a clinical syndrome seen in patients with chronic liver disease;

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Hepatic encephalopathy is a clinical syndrome seen in patients with chronic liver disease; its presentation may

range from mild personality changes, to psychosis, to coma. The primary chemical mediators of hepatic encephalopathy include all of the following except:

A.Gamma-aminobutyric acid (GABA)

B. Ammonia

C.False neurotransmitters

D.Serotonin

 
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Justin F. is seen in the emergency department with an 8-cm jagged laceration

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Justin F. is seen in the emergency department with an 8-cm jagged laceration on the dorsal surface of his right

forearm. He says he was working with his brother-in-law yesterday morning building a deck on the back of his home. A pile of wooden planks fell on top of him, and he sustained a variety of cuts and superficial injuries. He cleaned the wound with soap and water but didn’t want to go to the emergency room because he didn’t want to risk being in the waiting room for hours. He wrapped up his arm and went back to work, and then took a normal shower and went to bed last night. This morning the cut on his arm was still flapping open, and he realized he needed sutures. The appropriate management of this patient includes:

A. Proper cleansing and covering of the laceration, along with antibiotic therapy

B. Local anesthesia, cleansing, and wound exploration for foreign bodies

C. Local anesthesia, cleansing, and suture repair

D. Cleansing, covering, antibiotic therapy, and tetanus prophylaxis

 
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T. O. is a 44-year-old female patient who presents for evaluation of sudden,

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T. O. is a 44-year-old female patient who presents for evaluation of sudden, severe upper abdominal pain. She is

clear about the onset, which was profound and occurred approximately one hour ago. She denies that the onset had any relationship to food or eating, and she denies nausea or vomiting. On examination, she is lying on her right side with her hips and knees flexed to draw her knees to her chest. Vital signs are stable, but examination reveals involuntary guarding. The abdomen is painful and tympanic to percussion in all quadrants. CBC reveals a white blood cell count of 15,600/µL. The AGACNP suspects:

A. Dissecting aortic aneurysm

B. Acute pancreatitis

C. Perforated peptic ulcer

D. Mallory-Weiss tear

 
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C. V. is a 70-year-old African American male patient who presents for surgical consultation.

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C. V. is a 70-year-old African American male patient who presents for surgical consultation. His history includes

4 months of severe hypertension that has been poorly responsive to medication. He also complains of intermittent pounding headaches, palpitations, and a vague sense of anxiety with tremors. A 24-hour urine demonstrated elevated metanephrines. The AGACNP recognizes that this patient has a:

A. Malignant hyperthyroidism

B. Catecholamine-secreting tumor

C. Pituitary adenoma

D. Hyperaldosteronism

 
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