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COMSAE questions with correct answers graded A+
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COMSAE questions with correct answers graded A+
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COMSAEa 20-year-old female presents to the emergency department after she slipped on ice and hit her mouth on the sidewalk. Her medial maxillary incisors are fractured and she is intense pain. the nerve most likely
conveying this pain sensation is the?
a. anterior superior alveolar b. infraorbital c. middle superior alveolar d. nasopalatine e. posterior superior alveolar
The nerve most likely conveying the pain sensation in this scenario is the infraorbital nerve (option b).
The infraorbital nerve is a branch of the maxillary nerve, which is a division of the trigeminal nerve (cranial nerve V). The maxillary nerve provides sensory innervation to the maxillary teeth, maxillary sinus, upper gingiva, and the skin of the lower eyelid, lateral nose, and upper lip.
In the given case, the patient experienced a traumatic injury to her mouth, specifically fracturing her medial maxillary incisors. The intense pain she is feeling is likely transmitted through the sensory branches of the maxillary nerve, including the infraorbital nerve.
The infraorbital nerve travels through the infraorbital canal, emerges on the face through the infraorbital
foramen, and supplies sensation to the skin of the lower eyelid, lateral nose, and upper lip. The fractured
incisors would have damaged the associated nerve endings, leading to significant pain in those areas.
Therefore, the nerve most likely conveying the pain sensation in this patient's case is the infraorbital nerve (option b).
a 25 year old female presents to the office for evaluation of headaches, diplopia and loss of peripheral vision which have progressively worsened over the past week. she reports galactorrhea and amenorrhea. physical examination is unremarkable and Beta-HCG is negative for pregnancy. MRI of the brain is obtained. The secretory cells that are most likely causing this patient's conditions are? a.corticotrophs b.gonadotrophs c.lactotrophs d.somatotrophs e.thyrotrophs
Based on the provided information, the secretory cells most likely causing this patient's conditions are lactotrophs.
The symptoms of headaches, diplopia (double vision), and loss of peripheral vision along with galactorrhea (abnormal breast milk production) and amenorrhea (absence of menstrual periods) suggest
a hormonal imbalance. These symptoms are commonly associated with a condition known as hyperprolactinemia, which is characterized by high levels of prolactin hormone.
Lactotrophs are the cells in the anterior pituitary gland responsible for producing and secreting prolactin.
In this case, the lactotrophs are overactive, leading to an excessive secretion of prolactin. This excess prolactin production can result in the symptoms described by the patient. An MRI of the brain is obtained to assess the pituitary gland and rule out any structural abnormalities, such as a pituitary adenoma (a benign tumor). A pituitary adenoma involving the lactotrophs is a common cause of hyperprolactinemia.
Therefore, the most likely secretory cells causing this patient's conditions are lactotrophs (option c).
HELLP syndrome
Preeclampsia with thrombotic microangiopathy of liver. Hemolysis, elevated liver enzymes, low platelets.
may occur in the absence of hypertension and proteinuria. blood smear shows DIC (due to release of tissue factor from injured placenta)
treatment: immediate delivery
Brachioradilias Innervation
C6
3,500 kcal
1lb of body fat is equivalent to?
a 35 year old female is evaluated for mental status changes on day 4 of hospitalization for status asthmaticus. she is being treated with albuterol, predisone, and ipratropium. Social history is negative for substance use. neurologic examination is nonfocal, but she shows impairment of attention, concentration and recall. she has a minor resting hand tremor but no patholigc reflexes. ECG and mri of the brain are both negaitve. this patient's mental status change is most likely due?
Given the information provided, the most likely cause of the mental status changes in this case would be option C: medication effect. The patient's symptoms, such as impairment of attention, concentration, recall, and a minor resting hand tremor, are consistent with the known side effects of medications like albuterol, prednisone, and ipratropium, which she is currently receiving for the treatment of status asthmaticus. Alcohol withdrawal (option A) typically presents with a constellation of symptoms such as tremors, anxiety, agitation, hallucinations, and seizures, which are not described in the given scenario.
Hypercapnia (option B), which is an abnormally high level of carbon dioxide in the blood, can lead to altered mental status. However, it is less likely in this case since the patient's neurological examination is described as nonfocal and there is no mention of respiratory distress or other signs of severe respiratory compromise.
Seizures (option D) and stroke (option E) can both cause mental status changes, but there are no indications in the scenario to suggest these as the likely causes. The absence of pathological reflexes and negative MRI of the brain make these options less likely.
Therefore, based on the information provided, the most likely cause of the mental status changes is a medication effect from the medications being used to treat the patient's status asthmaticus. However, it is important to consult a healthcare professional for a comprehensive evaluation and definitive diagnosis.
a tracheostomy is performed. which of the following major structures should be retracted before incising
the trachea? a. epiglottis b. esophagus c.larynx d.parathyroid gland e. thyroid gland
Before incising the trachea during a tracheostomy, it is important to retract the major structure that lies anteriorly to the trachea. In this case, the structure that needs to be retracted is the thyroid gland. Therefore, the correct answer is option E: thyroid gland.
During a tracheostomy, the surgeon will make an incision in the midline of the neck, and the thyroid gland, which is located in the anterior neck, needs to be carefully retracted to expose the trachea for the procedure. The epiglottis (option A) is part of the larynx and is not directly involved in the tracheostomy procedure. The esophagus (option B) is located posteriorly to the trachea and does not require retraction during the tracheostomy. The parathyroid glands (option D) are small structures located near the thyroid gland, but they do not need to be retracted during a tracheostomy. The larynx (option C) is the structure being accessed through the tracheostomy, so it does not need to be retracted.
It is important to note that tracheostomy procedures should be performed by trained healthcare professionals with expertise in the technique to ensure patient safety and proper execution of the procedure.
imaging studies reveal hematosalpinx. the patient's examination findings most likely involve the.
paramesonephric ducts
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