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COMSAE 2 Questions With Complete Solutions
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COMSAE 2 Questions With Complete Solutions
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COMSAE 2 Questions With Complete Solutions3 drugs known to improve Survival in CHF Correct Answers
Are ACE inhibitors, spironolactone, and metoprolol.
For those with prior CHF with a reduced left ventricular ejection
fraction, beta blocker therapy is implicated (carvedilol,
metoprolol, or bisoprolol).
5% Sheep Blood added to? Correct Answers Blood agar
usually contains 5% sheep blood and is used to determine
hemolysis patterns of Streptococcus
Abduction of fingers Correct Answers Is accomplished by the
dorsal interosseous muscles of the hand. These muscles are
innervated by the deep branch of the ulnar nerve, which arises
from the medial cord of the brachial plexus
Acetazolamide Correct Answers A carbonic anhydrase
inhibitor that is useful as a diuretic and for glaucoma. It prevents
the reabsorption of bicarbonate, causing excessive loss of
bicarbonate and sodium at the proximal tubules. Because of this,
there is a compensatory increase in sodium reabsorption in the
distal tubule. Chloride follows sodium as a pair in the distal
tubule reabsorption, causing hyperchloremia. Therefore a
hyperchloremic metabolic acidosis results. The elevated chloride
results in a normal anion gap.
ACL Injury Correct Answers The ACL is likely injured and
often occurs in athletes after a twisting or hyperextension injury.
It is common for the patient to report hearing a "pop." The ACL
,is important in restricting anterior translation of the tibia on the
femur. The ACL originates on the posterior aspect of the lateral
femoral condyle and inserts on the anterior and medial aspect of
the tibial plateau. The examination maneuver described above is
a positive anterior drawer test or Lachman test. These tests are
considered positive when the tibia translates forward on the
femur to a greater degree in the injured knee than the normal
knee. An ACL tear can be confirmed by MRI.
Adduction of the thumb Correct Answers Is accomplished by
the adductor pollicis muscle of the hand. This muscle is
innervated by the deep branch of the ulnar nerve, which arises
from the medial cord of the brachial plexus.
Alkpatonuria Correct Answers An AR disorder that results
from deficient activity of the enzyme homogentisic oxidase. It
results in elevated levels of homogentisic acid which forms a
pigment that is deposited in connective tissue and joints
throughout the body. It typically presents in the 3rd decade of
life, with initial pigmentation occurring in the ear cartilage and
sclera of the eyes. A dark pigment is also deposited in the large
joints and the lumbosacral spine. This leads to early onset
arthritis and can result in joint replacements at a younger age.
The disorder is characterized by urine that is of a normal color
initially, but turns a dark black color if left standing due to
oxidation of the homogentisic acid. The diagnosis is confirmed
by measurement of homogentisic acid in the urine. No effective
therapy is available for alkaptonuria.
Alpha-1-antitrypsin deficiency Correct Answers A codominant
inherited disorder that results in early onset panacinar
, emphysema as well as cirrhosis of the liver. Patients typically
present with signs and symptoms of COPD at an early age and
may not even have a history of smoking. The distension of the
abdomen along with the fluid wave points to signs of having
ascites secondary to cirrhosis. AAT is an acute phase reactant
that is synthesized in the liver and released from hepatocytes.
The genetic defect in α-1 antitrypsin (AAT) deficiency alters the
configuration of the AAT molecule, which prevents its release
from hepatocytes. AAT normally inhibits elastic fiber
breakdown around respiratory units caused by protease and
elastase enzymes. An overabundance of elastase and trypsin in
the lungs can result in the breakdown of alveolar surfactant
proteins, increasing alveolar compliance. Furthermore, the
inability of AAT to be released from hepatocytes results in an
abnormal intracellular accumulation of AAT within the
endoplasmic reticulum that leads to liver destruction. This
hepatic destruction can eventually lead to liver cirrhosis and
even hepatocellular carcinoma. AST, ALT, and bilirubin levels
elevate above normal when hepatocyte damage occurs and
bilirubin is backed up within the hepatic sinusoids. This can
eventually lead to a jaundiced appearance.
B-hCG Correct Answers A tumor marker for hydatidiform
moles, choriocarcinomas, and gestational trophoblastic tumors.
Bombesin Correct Answers A tumor marker for
neuroblastoma.
Bosentan & Ambrisentan MOA Correct Answers They treat
pulmonary hypertension by competitively antagonizing
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