The COMLEX-USA (Comprehensive Osteopathic Medical Licensing Examination of the United States) is a series of standardized medical board exams designed for osteopathic medical students and physicians. Administered by the National Board of Osteopathic Medical Examiners (NBOME), it evaluates candidate...
What causes Whipple Disease and what is its presentation? - Answers
Tropheryma whipplei (intracellular gram positive bacilli), arthralgias,
endoscopy shown pale yellow shaggy mucosa that alternates with
erythematous or friable mucosa. men > female bc possibly HLA B27
What is the presentation and diagnostic tests used for Small Intestinal
bacterial overgrowth (SIBO)? - Answers nonspecific increased
villous blunting, bloating, flatulence, abdominal pain. Hydrogen breath test
measures exhaled hydrogen, xylose breath test measures exhaled carbon
after ingested D-xylose.
What are the macroscopic findings of Celiac Disease? - Answers
scalloping of duodenal folds, decreased number of folds, submucosal
vascular pattern
Draw out the sensitivity/specificity table calculation - Answers PPV:
positive predictive value
NPV: Negative predictive value
TP: True Positive
FP: False Positive
, Q&A
TN: True Negative
FN: False Negative
Sensitivity: ability to detect the disease. High sensitivity means most people
have the disease test positive for it.
Specificity: tests ability to detect the absence of the disease. High
specificity means most people without the disease will test negative.
PPV: probability of positive test being true positive is great
NPV: probability of negative test result being true negative is great
What are mallory bodies and when/where can they be found? - Answers
accumulation of fat and cytokeratin intermediate filaments. Alcoholic
hepatitis, primary biliary cirrhosis, Wilson disease, chronic cholestatic
syndromes, hepatocellular tumors.
What are councilman bodies? - Answers form due to apoptosis of
hepatocytes infected with a virus.
What are Ferruginous bodies? - Answers hemosiderin-stained
bodies seen in asbestosis. Commonly found in the lungs, but not the liver.
What is lipofuscin and when/where can it be found? - Answers
pigment of undigested lipids derived from lipid peroxidation of cell
membranes. It is common in aging and usually asymptomatic.
What is toxic granulation and when/where can it be found? - Answers
associated with inclusions seen in neutrophils during a severe bacterial
infection.
, Q&A
What are some reasons for edema of the lower extremities? (Unilateral vs.
bilateral) - Answers Unilateral: lymphatic blockage leading to
increased interstitial colloid oncotic pressure -->non-pitting edema. Prior
surgery, radiation, tumors, parasites (lymphatic filariasis). Anything
obstructing the lymphatic system.
Bilateral: Cirrhosis of the liver due to decreased albumin production -->
decreased plasma colloid oncotic pressure
What will you find on biopsy for Crohn's disease and Ulcerative colitis? -
Answers Crohn's: noncaseating or non-necrotizing granulomas
Ulcerative Colitis: crypt abscesses/collections of neutrophils within crypts of
Leiberkuhn
A key feature of Crohn's disease is noncaseating granulomas, but what is
the key characteristic defining a granuloma? - Answers Epithelioid
histiocytes
Where does pain from the gallbladder and pancreas radiate? - Answers
Gallbladder: shoulder or scapula
Pancreas: back
Where is Virchow's node and what does it indicate? - Answers
Location: left supraclavicular fossa.
, Q&A
Supplied from lymph vessels in the abdominal cavity. A hard node is
Troisier's sign and is indicative of cancer in the abdomen
What is Courvoisier's sign? What is Murphy's sign? How do they differ? -
Answers Courvoisier's Sign: signals an enlarged, palpable painless
gallbladder. In the presence of jaundice is most commonly associated with
pancreatic cancer.
Murphy's sign: severe pain and inspiratory arrest with palpation of RUQ
during inspiration. Commonly associated with acute cholecystitis
What is Battle sign and what is it associated with? - Answers
Eccymosis behind the ear that is associated with basilar skull fracture.
What is Homan's sign and what is it associated with? - Answers Calf
pain on forcible dorsiflexion of the foot.
Associated with DVT
What is CA-19-9 and what is it used for? What about CA-125? - Answers
CA-19-9: It is a laboratory marker to monitor:
Pancreatic Adenocarcinoma
CA-125: associated with ovarian cancers
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