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COMSAE ALL:- Questions With Complete A+ Solutions
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COMSAE ALL:- Questions With Complete A+ Solutions
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COMSAE ALL:- Quetsions With Complete A+ Solutions COCAINE intoxication Correct Ans - impaired judgement, pupil dilate, hallucination (coke bugs) sudden cardiac death; paranoid ideations, anginaTx: alpha blockers/ benzos
caution B block bc can cause unopposed alpha
Osteoporosis histo Correct Ans - trabecular and cortical bone lose mass and interconnection despite normal bone mineralization
assoc w/ Colles fracture- distal radial fracture; fracture of femoral neck
Gilbert Syndrome Correct Ans - mild dec UDP glucuronosyltransferase conjugation and impaired bilirubin uptake; asymptomatic or mild jaundice>> inc unconjugated bilirubin w/o hemolysis; w/ fasting and stress
Crigler Najjar Correct Ans - ABSENT UDP glucuronsyltransferase; early in life; die few years
find: jaundice, kernicterus (in brain) inc unconjugated bilirubin;
tx: plasmapheresis and phototherapy; type II respond phenobarbital
Dubin Johnson Correct Ans - Conjugated hyperbilirubinemia b/c defective liver excretion;
grossly black liver
Benign
Rotor syndrome Correct Ans - milder in presentation w/o black liver
impaired hepatic uptake and excretion
wilson Disease Correct Ans - copper transporting ATPase; ATP7B on Chromosome 13
s/s: before 40 yo, liver dz, neurodisease, psych dz, Kayser Fleischer ring, hemolytic anemia, renal dz;
find: dec serum ceruloplasmin, inc urine copper tx: chelation w/ penicillamine or Tridentine, oral zinc
Hemochromatosis Correct Ans - recessive, HFE, chromosome 6; abnormal iron sensing, increase intestinal absorb
find: inc ferritin, inc iron, dec TIBC, inc transferrin saturation
identify w/ Prussian blue stain/ liver MRI
Hemochromatosis finds Correct Ans - after age 40
>20 iron;
triad: cirrhosis, DM, skin pigmentation; dilated cardiomyopathy, hypogonadism, arhtropathy; HCC is common cause death
Treatment Hemochromatosis Correct Ans - repeat phlebotomy, chelation deferasirox, deferoxamine, oral deferiprone
Wolff Parkinson White Syndrome Correct Ans - MC ventricular pre excitation syndrome
abnml fast atria to ventricle (bundle of Kent); bypasses AV node>> ventricles begin partially depolarization earlier (NOTED BY DELTA WAVE ON EKG) widened QRS and shortened PR
Conduction pathway heart Correct Ans - SA node> atira> AV node> bundle HIS, R and L bundle branches> purkinje fibers> ventricles
L branch anterior/posterior fascicles
Edema Correct Ans - inc capillary pressure
dec plasma proteins (dec oncotic capillary pressure)
inc capillary permeability
increase interstitial fluid colloid oncotic pressure
Celiac Disease Correct Ans - setting: 14 mo kid losing weight eating lots of foods;
histology: crypt abnormalities (hyperplasia); villous atrophy, lymphocytic infiltration presents as malabsorbtion (diarrhea etc in kids)
in adults= short stature, anemia delayed puberty
Musculocutaneous nerve C5-C7 Correct Ans - upper trunk compression cause injury; loss forearm flexion/supination; loss sensation over lateral forearm
Axillary nerve C5-C6 Correct Ans - flat deltoid; loss arm abduction, loss sensation over deltoid and lateral arm
Radial C5-T1 Correct Ans - mid shaft fracture humerus, compression axilla
find: dec grip, loss extension (wrist drop); loss sensation posterior arm, dorsal
hand
Median C5-T1 Correct Ans - supracondylar fracture humerus (proximal) CTS, wrist laceration (distal)
ape hand pope's blessing
loss wrist flexion, flex of lateral fingers, thumb opposition, lumbricals 2nd and 3rd digit; loss sensation over thenar eminence and dorsal and palmar aspects of lateral 3 1/2 fingers w/ proximal
Ulnar C8-T1 Correct Ans - Fracture medial epicondyle humerus; fractured hook hamate (distal lesion)
ulnar claw on extension; radial deception wrist upon flexion (proximal lesion)
loss wrist flex, flex of medial fingers, abduction and adduction fingers; medial 2 lumbricals;
loss sensation over 1 1/2 fingers including hypothenar eminence
Recurrent branch median nerve Correct Ans - superficial laceration palm
ape hand; loss thenar muscles
no loss sensation
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