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COMSAE ALL Questions and Complete Solutions Graded A+
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COMSAE ALL Questions and Complete Solutions Graded A+
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COMSAE ALLQuestions and
Complete Solutions
Graded A+
Denning [Date] [Course title]
,COCAINE intoxication - Answer: impaired judgement, pupil dilate, hallucination (coke bugs) sudden
cardiac death; paranoid ideations, angina
Tx: alpha blockers/ benzos
caution B block bc can cause unopposed alpha
Osteoporosis histo - Answer: 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 - Answer: 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 - Answer: 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 - Answer: Conjugated hyperbilirubinemia b/c defective liver excretion;
grossly black liver
Benign
Rotor syndrome - Answer: milder in presentation w/o black liver
impaired hepatic uptake and excretion
wilson Disease - Answer: 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 - Answer: 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 - Answer: after age 40
>20 iron;
triad: cirrhosis, DM, skin pigmentation; dilated cardiomyopathy, hypogonadism, arhtropathy; HCC is
common cause death
Treatment Hemochromatosis - Answer: repeat phlebotomy, chelation deferasirox, deferoxamine, oral
deferiprone
Wolff Parkinson White Syndrome - Answer: 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 - Answer: SA node> atira> AV node> bundle HIS, R and L bundle branches>
purkinje fibers> ventricles
L branch anterior/posterior fascicles
Edema - Answer: inc capillary pressure
, dec plasma proteins (dec oncotic capillary pressure)
inc capillary permeability
increase interstitial fluid colloid oncotic pressure
Celiac Disease - Answer: 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 - Answer: upper trunk compression 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, compression 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 dorsal and palmar aspects of lateral 3 1/2 fingers w/ proximal
Ulnar C8-T1 - Answer: Fracture medial epicondyle humerus; fractured hook hamate (distal lesion)
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