COMSAE (ALL) Test with Questions and 100% Correct Verified Solutions Musculocutaneous nerve C5 -C7 - Answer upper trunk compr ession cause injury; loss forearm flexion/supination; loss sensation over lateral forearm Axillary nerve C5 -C6 - Answer flat deltoid; loss arm abduction, loss sensation over deltoid and lateral arm Radial C5 -T1 - Answer mid shaft fracture humerus, compre ssion axilla find: dec grip, loss extension (wrist drop); loss sensation posterior arm, dorsal hand Median C5 -T1 - Answer 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 d orsal and palmar aspects of lateral 3 1/2 fingers w/ proximal Ulnar C8 -T1 - Answer 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 - Answer superficial laceration palm ape hand; loss thenar muscles no loss sensati on Treatment glaucoma: alpha agonists; epinephrine, brimonidine - Answer dec AH synthesis> vasoconstriction; mydriasis alpha 1 (don't use in closed angle glaucoma) blurry vision, ocular hyperemia, foreign body sensations ocular allergy, pruritis Beta blo ckers: timolol, betaxolol, carteolol - Answer dec AH synthesis; no pupil/vision changes Diuretics; acetazolamide - Answer dec AH synthesis by inhibiting carbonic anhydrase; no vision/pupil change Cholinomimetics M3; direct pilocarpine carbachol; indirect physostigmine, echothiophate - Answer inc outflow of AH via contraction of ciliary muscle/open trabecular mesh; pilocarpine in ER --very effective open meshwork into Canal schlemm, lead to miosis --and cyclospasm Prostaglandin - bimatoprost, iatanoprost PGF2 alpha - Answer inc outflow AH; darken iris (brown); eyelash growth alpha agonists should be avoided in - Answer closed angle glaucoma pts M3 agonist= pilocarpine/carbachol (direct) - Answer contract the sphinc ter muscles allowing passage of fluid; pilocarpine emergencies pervasive development disorder - Answer what you think of when you consider autism spectrum: can't be touched, comforted, can't understand speech Mifepristone/ulipristal (mifetuspleasebegone) - Answer competitive inhibitor progestins at progesterone receptors; terminate pregnancy (mifepristone w/ misoprostol); ER contraception (ulipristal) antiprogestins AntiHistamines - Answer Reversible inhibitor of H1 histamine receptors 1st generation an tihistamines - Answer diphenhydramine, dimenhydrinate, chlorpheniramine "en/ine" or "en/ate" use: allergy motion sick, sleep aid AE: sedation, antimuscarinic, anti alpha adrenergic 2nd generation antihistimes - Answer loratadine, fexofenadine, desloratad ine, cetgirizine "adines" use: allergy; far less sedation than first gen bc dec entry into CNS Decompression disease/caisson dz) - Answer Air emboli --nitrogen bubbles precipitate in ascending divers> tx hyperbaric O2; can be iatrogenic due to invasive pro cedures Bronchiectasis - Answer chronic necrotizing infection bronchi>> perm dilated airways, purulent sputum, recurrent infecting, hemoptysis, digital clubbing; assoc: obstruction, poor ciliary motility (Kartagener syndrome, smoking) CF, allergic bronch opulmonary aspergillosis Kartagener Syndrome -- primary ciliary dyskinesia - Answer immotile cilia b/c dyne arm defect; male and female infertility, inc risk ectopic pregnancy; causes bronchiectasis, recurrent sinusitis, and situs inversus Myasthenia gravis - Answer Most C NMJ di sorder; autos to postsynaptic ACh receptor;; clinical -ptosis diplopia weakness, worsen w/ MUSCLE USE==WORSEEE Assoc: thymoma, thyme hyperplasia tx: pyridostigmine, edrophonium to diagnose==AChE inhibitor Lambert Eaton myasthenia syndrome - Answer uncommo n; autoabs to presynaptic Ca+2 channel>> dec ACh release proximal muscle weakness, autonomic sx, improve WITH MUSCLE USE= BETTER assoc: small cell lung cancer; AChE inhibitors don't help Visual Field defects: Right anopia - Answer Right optic nerve 2 bit emporal hemianopia - Answer optic chiasm, pituitary tumor
