Comlex: Kaplan : Qbank

Front 1

MOA of Amph B

Back 1

binding to ergosterol in the fungal membrane

Front 2

a little box is how long?
a big box?

Back 2

.04 sec

.2 sec

Front 3

Salter-Harris 2

Back 3

through the growth plate and knocks off piece of the growth plate

MOST COMMON

Front 4

tx for pre eclampsia?

Back 4

Magnesium Sulfate

Front 5

SH 3 fracture

Back 5

through growth plate and epiphysis, involves joint surface

Front 6

what is characterized by immune mediated widespread noncaseating granulomas? common in what pt population?

Back 6

Sarcoidosis

Black females

Front 7

what is the observational method of finding the HR?

Back 7

Pick an R-wave that peaks on a heavy line and count each dark line, they work as follows

300, 150, 100, 75, 60, 50, 43 37

Front 8

what clinically will have increased ACE activity, high serum calcium and bilateral hilar adenopathy on CXR?

Back 8

Sarcoidosis

Front 9

SH type IV?

Back 9

Fracture affects epiphysis, metaphysis and physis
Prone to chronic disability because of articular involvement

4 pieces of bone

Front 10

kid has retino blastoma that causes a lesion in the eye. What 2 other things could develop

Back 10

osteosarcoma

breast cancer

Front 11

Salter-Harris V

Back 11

Compression or crush injury of physeal plate
X-rays initially normal
Early closure of the growth plate
Poorer prognosis due to shortening and/or angulation

Front 12

Rate of this strip?

Back 12

100 bpm

Front 13

give the general breakdown of SH fractures

****SO IMPORTANT

Back 13

1 pulled apart
2 most common involves metapyhsis
3 involve epiphysis (3 pieces of bone)
4 involve epiphysis (4 pieces of bone
5 everything pulled apart, smash injury

Front 14

k cal in 1g fat?

Back 14

9

Front 15

Rate?

Back 15

40 BPM

Front 16

K cal in 1g carbs?

Back 16

4

Front 17

Kcal in 1g protein?

Back 17

4

Front 18

kcal in 1g alcohol?

Back 18

7

Front 19

pt has 1g of protein and 1g of carb, how many k cals is that

Back 19

8

(4+4)

Front 20

person has chest and back pain and is treated medically for dissecting ascending aorta. BP suddenly drops and she has tamponade. Which structure is likely the cause?

Back 20

Aortic valve

(less likely but possible is mitral)

Front 21

Man with afib started on warfarin. formation of what would be reduced in the pt?

Back 21

gamma-carboxyglutamate

formation of vitamin K dependent factors requires vitamin K dependent carboxylation of glutamic acid residues forming a mature clotting factor that contains gamma-carboxyglutamate and is capable of subsequent activation

Front 22

pt has pulmonary sx after being put on immunosupressive therapy for bone marrow transplant following her AML. Biopsy shows multiple thin septate hyphae with 45 degrees branching. Cause?

Back 22

Aspergillus

Front 23

how does the O2 curve shift when pH is lowered or you have increased 23PG? What does this mean?

Back 23

Right

hemoglobin dumps O2 more readily

Front 24

what is this

Back 24

normal sinus rhythm

Front 25

sympathetic innervation of the duodenum?

Back 25

T6-T8 on the right

Front 26

49 yo man with history of alcohol abuse present with ill defined upper abdominal discomfort and early satiety. On exam, he has a large epigastric mass deep within the abdomen that is hard to define. He was discharged from the hosptial 5 weeks ago after successful medical management for acute pancreatitis. He is afebrile and has a normal serum amylase. Diagnosis?

Back 26

Pancreatic pseudocyst

5 weeks elapsing btw damage to pancreae

this is a collection of fluid containing necrotic tissue, blood and pancreatic enzymes. Usually a complication of pancreatitis. 75% of masses in the pancreas

Use CT to asses

Front 27

what is this

Back 27

sinus bradycardia

Front 28

if a pt has and Adducted ulna, what will the carrying angle be like? medial/lateral glide? wrist ab/adduction?

Back 28

Lower carrying angle

restricted in medial glide

abducted wrist and hand

Front 29

what is this

Back 29

sinus tachycardia

Front 30

what are the findings of ABducted ulna?

Back 30

increased carrying angle

adducted wrist

restricted in lateral glide

Front 31

woman on drug for hyperlipdemia and gets rhabdomyolyis. What drug was she on? MOA?

Back 31

STATIN

HMG-CoA reductase inhibitor

Front 32

most common cause of bacterial meningitis in newborn?

Back 32

E coli (that was the answer in this but it should really be group b strep i recon)

Front 33

A normal, healthy 36-year-old woman who was found to have no somatic dysfunctions participates in a clinical study on the renal handling of sodium. The following data are collected from the woman:

GFR; 100mL/min
Plasma Na conc: 140mEq/L
Urine flow: 1mL/min
Urine Na conc: 100mEg/L

Back 33

The rate of filtration of a substance = glomerular filtration rate × plasma concentration.
For sodium, filtration = 0.1 L/min × 140 mEq/L = 14 mEq/min.

The rate of excretion = urine flow × urine sodium concentration = 0.001 L/min × 100 mEq/L = 0.1 mEq/min.

The rate of reabsorption = filtration rate – excretion rate = 14 – 0.1 = 13.9 mEq/min.

Sodium is not secreted by the renal tubules.

Front 34

pt has crepitus, anterior knee pain that gets worse climbing stairs...

Back 34

Patellofemoral syndrome

Front 35

what is this

Back 35

PVC

Front 36

Drug of choice for a kid who is wetting the bed without signs of physical problems? MOA?

Back 36

Imipramine

TCA antidepressant

causes contraction of the internal sphincter of the bladder and urinary retention

Front 37

what is this

Back 37

Pacemaker rhythm

Front 38

children with enuresis will have a history of what?

Back 38

enureisis in a family member of the same sex

Front 39

what is encopresis? if a kid has this with large diameter stool, no pain or urge to go, what should you suspect?

Back 39

pooping your pants despite having been previously toilet trained

Hirschsprung dz

Front 40

Pregnant woman with lesion in her mouth on the gingiva near a molar. It is found to have lobulated capillaries surrounded by fibrous tissue. What is this? Tx?

Back 40

Pyogenic granunloma

removal or just wait and it will go away

Front 41

what is this?

Back 41

Supraventricular tachy

Front 42

58 year old tailr has enlargment of the lateral aspect of the 5th metatarsal. What is this? What if it was one the 1st?

Back 42

5th: Bunionette

1st: Bunion

Front 43

Guy is in his car not wearing his seatbelt and gets into an accident. During it he hits the steering wheel and now has pain in the pelvis. What bone is most likely fractured?

Back 43

Pubic rami

Front 44

pt has urethrits with vaginal discharge. It is plated on Thayer-Martin media. What is it?

Back 44

Gonorrhea

Front 45

what is this

Back 45

atrial flutter

Front 46

Ratio of degrees of movement of the glenohumoeral joint to the scapulothoracic?

Back 46

2:1

Front 47

from most to least, list the zone in which a man is most likely to get prostate cancer

Back 47

1. Peripheral 70%
2. Central 20%
3. Transitional 10%

Front 48

Pain is located on the lateral side of the shoulder just below the acromion. Patients often complain of being awakened at night if they sleep on the affected shoulder. What is this?

Back 48

Subacromial bursitis

Front 49

What 3 things can a high dose dexamethasone test show you?

Back 49

1. Primary adrenal Cushing syndrome: ACTH is undetectable or low and cortisol is not suppressed by low or high doses of dexamethasone

2. Ectopic ACTH syndrome: ACTH is normal to elevated and cortisol is not suppressed by low or high doses of dexamethasone

3. Cushing disease: ACTH is normal to elevated and cortisol is NOT suppressed by low doses of deamthasone, but it is suppressed by high dose. Pituitary MRI should be ordered

Front 50

what is this

Back 50

atrial fibrilation

Front 51

Cushing Disease versus syndrome

Back 51

Cushing disease: ACTH is normal to elevated and cortisol is NOT suppressed by low doses of deamthasone, but it is suppressed by high dose. Pituitary MRI should be ordered

Primary adrenal Cushing syndrome: ACTH is undetectable or low and cortisol is not suppressed by low or high doses of dexamethasone

Front 52

A 34-year-old man who is receiving chemotherapy for Hodgkin disease presents with a headache, stiff neck, and fever that has been present for a week. Gram stain of the CSF reveals gram-positive rods. Whatis the most likely causative agent?

Back 52

Listeria monocytogenes

Front 53

what drug used for bipolar can cause diabetes insipidus?

Back 53

Lithium

more specifically it causes nephrogenic

Front 54

US of a baby shows intrauterine growth retardation. When it is born is has cataracts, hearing loss, pulmonary arterial hypoplasia, PDA, and hepatosplenomegaly. What sx would mom have had during pregnancy?

Back 54

maculopapular rash

this is congenital rubella

tends to happen when the mother is under 15

Front 55

what is this?

Back 55

Ventricular tachy

Front 56

prox attachment of the priformis?

distal?

movement? 3

Back 56

prox: anterior surface of the sacrum

distal: Superior surface of the greater trochanter

motion: Abduction, external rotation, and flexion

Front 57

71 yo alcoholic. Malaise, fatigue for last 3 weeks. Has rash consisting of confluent ecchymoses spreading out from around hair follicles on the limbs and trunk. Symp changes at T5-9. What is he deficient in?

Back 57

Vitamin C

can present with poor wound healing, bleeding gums, easy prusing, nosebleeds, joint pain, lack of energy, susceptibility to infection.

classic features: PERIFOLLICULAR HEMORRHAGE and BLEEDING GUMS

Front 58

what is this

Back 58

Polymorphic Ventricular Tachycardia

Front 59

what type of dysfunction does a standing flexion test show? what about a seated?

Back 59

standing: iliosacral

seated: sacroiliol

Front 60

newborn healthy looking child hasn't urinated in first 24 hours of life. Meatus is in the normal location, distended urinary bladder. Diagnosis?

Back 60

POSTERIOR urethral valves

Posterior urethral valves are the most common caue of bladder outlet obstuction

Front 61

a) traction apophysitis of tibial tubercle=?

b) traction apophysitis of the calcaneus at the attachment of the Achilles

Back 61

a=Osgood Schlatter

b=Sever disease

Front 62

what is this

Back 62

torsades de pointes

Front 63

man back from Costa rica. Complains of headache, fever, retro-orbital pain, backache in the lumbar area, leg and joint pains. Has black stool and epistaxis. Soft palate covered with vessicles and skin has scarlatiniform rash. Vector? Dz?

Back 63

Mosquito

Dengue fever

Front 64

Palmar fascia contracture with palpable tender nodules and decreased extension of the 4th and 5th digits. What is this? What could be seen in the history?

Back 64

Dupuyten contracture

Alcoholism

Front 65

Back 65

ventricular fib

Front 66

43 year old woman has rash on left breast. Sharply demarcated, centered on the nipple, bright red, oozing, crusting. Fails to respond to either antibiotics or steroids. What is the diagnosis?

Back 66

Paget's of the breast

Front 67

where is the counterstrain tenderpoint for an inhalation dysfunction rib? how long do you hold it

Back 67

Angle of the rib 2 minutes

Front 68

cold agluttins shows an infection with what? tx?

Back 68

Mycoplasma

Eryhtoromycin

can't ue something that targets cell wall because mycoplasm doesnt have one

Front 69

guy drives a nail into the pulp of his finger. Two days later he has throbbing pulp pain, fever and signs of an abscess withing the pulp of the affected finger. What is this? What makes it so risky?

Back 69

this is a felon (also known as a Whitlow)

infection of the fingertip pulp that presents as cellulitis or abscess

Surgical emergency: incision and drainage needed because septal compartments cannot distend easily and pressure can build up leading to necrosis

Front 70

what gram positive rod causes gas gangrene? What else does it cause?

Back 70

Clostridium perfringens

acute self limited gastritis

Front 71

Back 71

1st degree AV block

Front 72

person stabbed in chest. Tube drains 1550 mL of fluid. What is the cause (what was hit)

Back 72

Intercostal vessel

when blood recovered exceeds 1000 to 1500mL hemothorax was caused by injury of systemic vessel rather than that of lung parenchyma

Front 73

Back 73

Front 74

The following morning, the patient is asked how he is doing. He responds, “I am fine.” When asked where he lives, he responds, “I am fine.” All other questions are answered the same way. What type of behavior is this patient displaying?

Back 74

Preservation

Perseveration is persistence or repetition of a response after the cause of the stimulus has ceased. The patient typically answers correctly, but keeps giving the same response to each subsequent question. This is typically seen in organic brain lesions or schizophrenia.

Front 75

what is this

Back 75

Third Degree AV Block

Front 76

WHat is Subclavian steal syndrome?

Back 76

Perseveration is persistence or repetition of a response after the cause of the stimulus has ceased. The patient typically answers correctly, but keeps giving the same response to each subsequent question. This is typically seen in organic brain lesions or schizophrenia.

Front 77

Facilitated positional release uses what as the activating force.?

Back 77

torsion in the lumbar area

Front 78

what is this

Back 78

3rd degree AV Block

Front 79

mechanisms would explain the effectiveness of facilitated positional release?

Back 79

he mechanism of facilitated positional release is a decreased gain in the muscle spindle gamma loop.

Front 80

Back 80

3rd degree av block

Front 81

35 year old man, decreasing kidney function, elevated eosinophil count. Reports wheezing and need for bronchodialator. Diagnosis?

Back 81

Churg Strauss syndrome

eosinophilia+ashtma+renal failure

vasculitis that affects lung and kidneys

tx may require steroids

Front 82

What changes in ions can lead to constipation?

Back 82

Increased Ca or Decreased K

Front 83

if you have ruled out mechanical obstruction, what 2 dz states can lead to gastroparesis?

Back 83

Scleroderma

Diabetes mellitus (10+ years)

Front 84

During craniosacral flexion, the sacrum nutates.

what axis is this on?

Back 84

Inherent motion of the sacrum due to cranial rhythmic impulse occurs about the superior transverse axis.

Front 85

Back 85

Third-degree heart block

Front 86

During inhalation, the sacral base moves posterior.

what axis is this on?

Back 86

Normal physiologic motion of the sacrum during respiration occurs about the superior transverse axis.

Front 87

As a patient bends backward, the sacral base moves forward

on what axis?

Back 87

Postural motion (forward and backward bending) causes the sacrum to move about the middle transverse axis.

Front 88

Back 88

sinus tachy

Front 89

As a patient walks, weight bearing on the right leg while stepping forward with the left engages this axis...

Back 89

During normal ambulation, weight bearing on the right leg engages a right oblique axis due to sidebending created on that side as the right heel strikes the ground and weight is shifted to the right.

Front 90

Back 90

Second-degree heart block—type 1

WEINKEBACH

Front 91

pt with uncontrolled HTN presents to emergency dpt with severe headache nausea and vomiting. He has worsening neuro conditions and hemiparesis. What type of hemorrhage does he have?

Back 91

Intracerebral

Front 92

Back 92

Atrial flutter

Front 93

is rotavirus

naked/encapsulated?
segmented/nonsegmented?
DNA/RNA?

Back 93

naked icosahedron containing segmented RNA

Front 94

what nerve carries sensation for the anterior two thirds of the tongue?

Back 94

V

Front 95

besides burkitts lymphoma, what other carcinoma is EBV assoc with

Back 95

Nasopharyngeal

Front 96

cocaine use during pregnancy can lead to what

Back 96

abruptio placentae

Front 97

What is Gamekeeper thumb?

Back 97

tear of the ulnar collateral ligament of the thumb resulting in deviation btw the proximal phalanx and the first metacarpal bone

Front 98

where is the normal weight bearing line of L3 in releation to the sacrum?

Back 98

anterior 3rd of the sacral base

Front 99

make a card about the rule of threes with respect to where spinous processes are compared to transverse

Back 99

green book

Front 100

What is pickwickian syndrome? what will change in their heart

Back 100

Obesity related hypoventilation

leads to resp acidosis

will have RVH due to hypoxia induced vasoconstriction of the pulmonary vascular bed

Front 101

Define a hammertoe

Back 101

hyperextension of the metatarsophalangeal and distal interphalangeal joint of the foot with flexion of the proximal interphalangeal joint

Front 102

dude has occiptial mastoid restriction...appropriate OMM tx

Back 102

v-spread

treats restricted sutures

Front 103

man has bilateral pain in butt, thigh, calves that worsens with standing, walking or climbing stairs. Gets better with sitting and with flexion of the back. What does he have

Back 103

spinal stenosis with bilateral radicular pain

Front 104

why do pts get acities with cirrhosis?

Back 104

decreased synthesis of albumin, leads to decreased serum oncotic pressure favoring systemic edema

Front 105

Q angle less than 10=?

Q angle greater than 12?

Back 105

<10 -->genu varum

>12-->genu valgum

Front 106

pt with large abdomen and splenomegaly with increased levels of Tartrate-resistant acid phosphatase (TRAP) =

Back 106

Hairy cell leukemia

Front 107

man from Laos on immunosuppresive therapy after a heart transplant gets fever and pulmonary infiltrates. There is a worm in him. What is it? tx?

Back 107

Strongyloides stercoralis

Thiabendazole

Front 108

what is a fluid filled cyst typically found on the dorson of the hand attached to extensor tendon surfaces?

Back 108

Ganglion cyst

Front 109

make a card on what bones are paired and which are not

Back 109

green book

Front 110

The inherent motion of the sacrum due to cranial rhythmic impulse occurs about what axis

Back 110

horizontal through S2

Front 111

what fungus causes tinea pedis? tx?

Back 111

trichophyton rubrum

terbinafin

Front 112

what electrolyte misbalance is associated with pancreatitis?

Back 112

decreased calcium

Front 113

Where is the most common location for hydrocephalus to occur?

Back 113

Aqueduct of Sylvius

(cerebral aqueduct)

connects 3rd and 4th

Front 114

what causes hyperacute organ rection?

acute?

Back 114

hyper: preformed Abs against graft in recipients serum

acute: cytotoxic T cell attack on foreign MHC

Front 115

hepatotoxicity in the young is a side-effect of what anti-epileptic

Back 115

valproic acid

Gingival hyperplasia seen in phenytoin use

Front 116

pt with black ear, degenerative joint dz and spondylitis has what?

What builds up?

lack what enzyme?

genetics of this dz?

Back 116

Alkaptonuria

homogentisic acid

deficient in homogentisic acid oxidase

AR

Front 117

what word is used to describe a spongy sensation of hypertonic muscles

Back 117

boggy

Front 118

in subluxation of the radial head, what motion is restricted?

how do you treat it

Back 118

supination

. Gentle passive supination with the arm in 90 degrees of flexion usually results in successful reduction and immediate pain relief for nursemaid elbow. If 90 degrees of flexion with supination is not successful, the maneuver can be attempted with supination and full flexion of the forearm.

Front 119

10 year old kid has his chest crushed. 10 cm diameter portion of his chest moves paradoxically when he moves. What chest disorder does he have?

Back 119

flail chest

due to vertebral fracture in numerous locations the chest wall moves freely with changes in intrathoracic pressure and will move in during inhalation and and push out during exhale

Front 120

pt with bronchiectasis has hemopysis. what vessel should be embolized to prevent further bleeding

Back 120

bronchial artery

Front 121

pt with fatigue. elevated Ca and low Phos. Parathyroid level is undetectible. Cause?

Back 121

Malignancy

(lung/kidney cancer could do this)-->produce parathyroid related protein (PTHrP)

Front 122

hypothyroidism, tremors, polyuria, and excessive weight gain are some of the more common side effects of what mood stabilizing drug?

what is a second line drug for mood stabilization?

Back 122

Lithium

valproic acid

Front 123

what is trucncus arteriosis

Back 123

pulmonary arteries arise from aorta rather than right ventricle

pt can have S1 ejection click, and murmurs all over the place with heart hypertrophy

Front 124

spinal level of the appendix?

What cells MUST you see to diagnose appendicitis?

Back 124

T9-T12 on the right

NEUTROPHILS

Front 125

high basophil count is unusual and suggests what hematologic problem?

Back 125

CML

Front 126

pt has a ball it the tip of his finger causing hyperflexion of his distal phalanx. He now longer can extend it...diagnosis?

Back 126

Mallet finger

permanent flexion due to distal phalanx of the finger resulting in rupture or avulsion of the extensor tendon

Front 127

12 year old with bitemporal hemianopsia. MRI shows calcified lesion above the sella. What does he have?

Back 127

Craniopharyngioma

typically calcified and presses on optic chiasma

Front 128

infant born with severe neurologic deficits has a tumor like lesion located in the lumbar spine. What would imaging studies reveal?

Back 128

herniation of the meninges and nerve roots through a defect in the lamina of lumbar vertebrae

meningomyelocele

Front 129

3 month old, trouble breathing but no cyanosis. Pansystolic heart mumur is heard that was not present at time of birth. CXR shows increased pulmonary vascular markings. Diagnosis?

Back 129

VSD

high flow murmor that is pan systolic

L-->R (no cyanosis)

didn't hear at birth b/c high pulmonary resistance minimizes the shunt

Front 130

18 Male comes in with fatigue, pruritis and jaundice, with elevated serum alkaline phosphatase. Direct cholangiography shows multiple short strictures and saccular dilations of the intrahepatic and extrahepatic biliary ducts which gives the biliary tree a beaded appearance.

Diagnosis?

Autoantibodies are directed against?

if the pt had tissue texture changes at T9-L2 what additional dz would this pt have?

Back 130

Primary sclerosing cholangitis

p-ANCA

Ulcerative colitis (PSC is strongly associated with IBD, and is linked more strongly to UC than CD)

Front 131

child has to use inhaler 3 times an hour for the last 2 weeks. Dysfunction at T2-T8. Inhaler had a B2 agonist.

OD would lead to what problem?

appropriate osteopathic adjunctive tx?

Back 131

Bronchoconstriction: prolonged use leads to down regulation of receptors causing paradoxic bronchoconstriction

rib raising

Front 132

What is the word for hyperextension of the knee? (bilateral backward bowing of the knees)

Back 132

Genu recurvatum

Front 133

posterior chapman point for the kidney?

Back 133

L1

Front 134

woman has episodes of severe pounding headaches with palpitations and pallor but by the time she gets to the office she is completely normal. Dysfunction at T10-11.

What lab test would help tell you what she has?

Back 134

Urine metanephrine and vanilymandelic acid (VMA) in 24 hour specimen-->PHEO

Front 135

pt with fever, chronic tissue texture change at T12-L2. He has high white count. Suffered a small shallow stab wound in his back a few months ago. Suspected retroperitoneal abdominal infection. What is most likely affected?

Back 135

Descending colon

retroperitoneal organ and assoc with tissue texture change

Front 136

a double-stranded DNA virus that is definitively diagnosed by the presence of intranuclear inclusion bodies or multinucleated giant cells would be what?

what is the mechanism of action of the drug that treats this?

Back 136

HERPES

inhibits DNA polymerase via phosphorylated thymidine kinase (acyclovir)

Front 137

What drug is used to tx ALS?

where is neuron loss?

Back 137

Riluzole

doesn't cure but extents survival

decrease Na channels presynaptically to prevent glutamate release

neuron loss in the anterior horns of the spinal cord

Front 138

What is the tx for narcolepsy?

Back 138

Amphetamine

or

modafinil

Front 139

what is the nacoleptic tetrad?

What stage of sleep is responsible for these sx?

Back 139

daytime somnolence, cataplexy, hypnagogic hallucinations (vivid hallucinatory dream imagery at the onset of sleep), and sleep paralysis

REM: should occur in 90 min but in narcolepsy onset is 10 minutes

Front 140

where do you give light touch on a patient in order to test C5 on an ASIA test?

Back 140

lateral elbow

Front 141

where do you give light touch on a patient in order to test C6 on an ASIA test?

Back 141

dorsal thumb

Front 142

where do you give light touch on a patient in order to test C7 on an ASIA test?

Back 142

dorsal distal middle finger

Front 143

where do you give light touch on a patient in order to test C8 on an ASIA test?

Back 143

Dorsal 5th finger

Front 144

where do you give light touch on a patient in order to test T1 on an ASIA test?

Back 144

medial elbow

Front 145

where do you give light touch on a patient in order to test L2 on an ASIA test?

Back 145

medial mid thigh

Front 146

what classification is used for fractures in children? What does a higher class show?

Back 146

Salter Harris Fractures

I-V

Higher the class, the greater the risk of growth arrest at the physis

Front 147

where do you give light touch on a patient in order to test L3 on an ASIA test?

Back 147

medial knee cap

Front 148

where do you give light touch on a patient in order to test L4 on an ASIA test?

Back 148

medial ankle (malleolous)

Front 149

Please describe a Salter-Harris type one fracture

Back 149

in children

Fracture across the physis with no metaphysial or epiphysial injury

Front 150

where do you give light touch on a patient in order to test L5 on an ASIA test?

Back 150

dorsal medial foot

Front 151

please describe a Salter-Harris Type II fracture

Back 151

seen in children

fracture across the physis which extends into the metaphysis

Front 152

where do you give light touch on a patient in order to test S1 on an ASIA test?

Back 152

posterior lateral heel

Front 153

Describe a Salter-Harris type III fracture

Back 153

fracture across the physis which extends into the epiphysis

Front 154

please describe a Salter Harris type IV

Back 154

Fracture through the metaphysis, physis, and epiphysis

Front 155

please describe a Salter-Harris Type V fracture

Back 155

in children

crush injury to the physis

Front 156

inheritance of Marfans?

Back 156

AD

Front 157

high steppage gate (trying to avoid foot drop) + intermittent weakness and facial paralysis=

Back 157

multiple sclerosis

Front 158

56 yo man with horners and paralysis of the wrist and hand.

What palsy does he have?

location of nerve root injury?

Back 158

Klumpke: is a brachial plexus injury that usually occurs during childbirth by way of traumatic vaginal delivery. It can also occur in adults, however, through brachial plexus traumatic injuries, falls, or a Pancoast tumor.

C8-T1

Front 159

what is the tx for pts with Guillain Barre?

Back 159

IVIG

Front 160

increased BUN, Cr, and angII. Pt given an ACE and gets worse. Diagnosis?

ACE inhibitor will increase the levels of what?

Back 160

Renal artery stenosis

renin

Front 161

Glomerular filtration rate (GFR) decreases following treatment with the ACE inhibitor because of a decrease in
A. Bowman capsule pressure
B. glomerular capillary pressure
C. glomerular filtration coefficient
D. peritubular capillary pressure
E. plasma oncotic pressure

Back 161

B. glomerular capillary pressure

The decrease in blood pressure caused by ACE inhibition (especially the dilation of the efferent arterioles) lowers glomerular capillary pressure, thus reducing GFR. A decrease in Bowman capsule pressure (choice A) or plasma oncotic pressure (choice E) would tend to increase GFR. Decreasing the glomerular filtration coefficient (choice C) could theoretically decrease GFR; however, there is no reason to assume a decrease in filtration coefficient with ACE inhibition. Peritubular capillary pressure (choice D) does not have a direct effect on GFR.

Front 162

15 yo old girl with wanting to drink lots of liquid. Urine dipstick +4 glucose. Abs will be directed against what?

Back 162

Islet ells (islet of Langerhans)

this is type 1 diabetes

Front 163

the juxtaglomerular apparatus (JG) cells are found in the

A. tunica intima of the afferent arteriole
B. tunica media of the afferent arteriole
C. wall of the collecting duct
D. wall of the distal convoluted tubule adjacent to the afferent arteriole
E. wall of the proximal convoluted tubule adjacent to the afferent arteriole

Back 163

The correct answer is B. JG (juxtaglomerular) cells are specialized smooth muscle cells of the tunica media of the afferent arteriole (and sometimes also of the efferent arteriole) in the juxtaglomerular apparatus of the kidney. The juxtaglomerular apparatus, which monitors and controls blood pressure by way of the renin-angiotensin system, consists of the JG cells, the macula densa (specialized cells in the wall of the distal tubule adjacent to the afferent and efferent arteriole), and the extraglomerular mesangial (polar cushion) cells. Neither the collecting ducts nor the proximal tubules contain cells that are part of this system.

Front 164

Draw out the true pos false pos box

Back 164

Tp. Fp

Fn. Tn

Front 165

What is the equation for sensitivity? Does it rule in our out?

Back 165

Tp/(tp+fn)

Rules out.

Used for screening

Front 166

What is the equation for specificity? Does it rule in or out?

Back 166

Tn/(tn+fp)

Rules in

Used as confirmatory after positive screening test

Front 167

in a left lateral strain how do the spehnoid and occiput move and on what axis?

Back 167

Clockwise about 2 vertical axes

Front 168

ring shaped structures in RBCs is a sign of what?

Back 168

malaria

Front 169

In military-bearing posture describe the following:

ankles (plantar/dorsi)
head tilt (ant/post)
knees (flex/extended)
lumbar lordosis (increased or decreased)

Back 169

ankles (plantar
head tilt post)
knees (extended)
lumbar lordosis (increased)

Front 170

where does thyroid cancer met to?

what others do this?

Back 170

Bone

breast, lung, multiple myeloma,,
renal cell, prostate, testicular

Front 171

where is a melanoma known to spread to?

Back 171

brain

Front 172

what is Cushings disease versus syndrome

Back 172

Dz: pituitatry tumor (high ACTH)

Syndrome: adrenal tumor (low ACTH)

Front 173

What does G6 P3-2-1-4 mean?

Back 173

G=gravada (number of pregnancies) so six

Full term = born at 37 weeks or later
premature = less than 37 weeks

FPAL

Full term/premature/abortion/living

Front 174

Because the patient was found to have somatic dysfunction at T10-L2, he undergoes an ultrasound evaluation of the pelvis, and the bladder is noted to be full. Which of the following will be noted on the ultrasound?
A. Hydronephrosis
B. Hydrocele
C. Hernia
D. Papillary necrosis
E. Renal cyst

Laboratory tests determine that the man is in acute renal failure. Which of the following is most likely increased in this patient?
A. Bicarbonate
B. Creatinine
C. Chloride
D. Potassium
E. Sodium

Back 174

A. This patient has post-obstructive renal insufficiency. As a result of the mechanical obstruction of the urethra, the urine will back up into the bladder and ureters, and result in enlargment of the renal collecting duct, leading to hydronephrosis.

B. Serum creatinine is the most effective marker for following renal function. It will increase before any of the other parameters. In more advanced renal disease, all the electrolytes would be affected.

Front 175

32 year oldman complains of headache followining a recent blow to the top of the head midline and just anterior to the coronal suture. What is the most likely cranioscaral stain pattern?

Back 175

Vertical

this occurs when the sphenoid deviated superiorly or inferiorly as compared with the occiput

Front 176

octurnal anal pruritus; eggs demonstrable by cellulose tape test.
A. Ancylostoma braziliense
B. Ascaris lumbricoides
C. Enterobius vermicularis
D. Necator americanus
E. Strongyloides stercoralis
F. Toxocara canis or Toxocara cati
G. Trichinella spiralis
H. Trichuris trichiura

Back 176

C. Enterobius vermicularis, also known as pinworms, is common worldwide. Humans are the only host. The disease is characterized by nocturnal perianal and vulvar pruritus, and the eggs are visible on a cellulose tape that has been applied perianally and examined under a microscope.

Front 177

Filariform larva penetrates intact skin of bare feet, pneumonitis.
A. Ancylostoma braziliense
B. Ascaris lumbricoides
C. Enterobius vermicularis
D. Necator americanus
E. Strongyloides stercoralis
F. Toxocara canis or Toxocara cati
G. Trichinella spiralis
H. Trichuris trichiura

Back 177

D. Necator americanus, commonly known as hookworm, causes a disorder in which filariform larvae penetrate the intact skin of bare feet, from which the larvae migrate to the lungs, causing a dry cough, low-grade fever, and pneumonitis.

Front 178

Ingestion of inadequately cooked pork results in diarrhea, cramps, and malaise.
A. Ancylostoma braziliense
B. Ascaris lumbricoides
C. Enterobius vermicularis
D. Necator americanus
E. Strongyloides stercoralis
F. Toxocara canis or Toxocara cati
G. Trichinella spiralis
H. Trichuris trichiura

Back 178

G. Trichinella spiralis, the cause of trichinosis, is present wherever pork is eaten but is a major problem in temperate areas. Typically, the pork is either raw or inadequately cooked; and within the first week after ingestion the patient presents with diarrhea, cramps, and malaise.

Front 179

Eggs of the etiologic agent are ingested, resulting in appendicitis and rectal prolapse.
A. Ancylostoma braziliense
B. Ascaris lumbricoides
C. Enterobius vermicularis
D. Necator americanus
E. Strongyloides stercoralis
F. Toxocara canis or Toxocara cati
G. Trichinella spiralis
H. Trichuris trichiura

Back 179

H. Trichuris trichiura is a whipworm that, once its eggs are ingested, likes to inhabit the cecum, causing appendicitis and rectal prolapse.

Front 180

Eggs of the etiologic agent are ingested by pica or from handling puppies, resulting in hepatosplenomegaly.
A. Ancylostoma braziliense
B. Ascaris lumbricoides
C. Enterobius vermicularis
D. Necator americanus
E. Strongyloides stercoralis
F. Toxocara canis or Toxocara cati
G. Trichinella spiralis
H. Trichuris trichiura

Back 180

F. Toxocara canis or Toxocara cati, also known as visceral larva migrans, is a latent infection of female dogs that is transmitted from mother to puppies. The eggs can be ingested by humans after handling puppies or by eating dirt, and the larvae tend to attack visceral organs, causing hepatosplenomegaly.

Front 181

Intense skin itching; serpiginous eruptions.
A. Ancylostoma braziliense
B. Ascaris lumbricoides
C. Enterobius vermicularis
D. Necator americanus
E. Strongyloides stercoralis
F. Toxocara canis or Toxocara cati
G. Trichinella spiralis
H. Trichuris trichiura

Back 181

A. Ancylostoma braziliense is caused by the larvae of dog and cat hookworms, and results in intense itching and the classic serpiginous lesion of the skin.

Front 182

Filariform larva penetrates the intact skin of bare feet, producing pneumonitis, malabsorption, and autoinfection.
A. Ancylostoma braziliense
B. Ascaris lumbricoides
C. Enterobius vermicularis
D. Necator americanus
E. Strongyloides stercoralis
F. Toxocara canis or Toxocara cati
G. Trichinella spiralis
H. Trichuris trichiura

Back 182

E. Strongyloides stercoralis is a threadworm that is uniquely capable of maintaining its life cycle in a human host or the soil. Its filariform larvae penetrate the intact skin of bare feet, migrate to the lungs up the glottis, and are swallowed. Internal autoinfection occurs in the lower bowel of human hosts, leading to indefinite infections unless treated with thiabendazole.

Front 183

person falls and breaks their scaphoid, what is a complication of this

Back 183

The most serious complication of a scaphoid fracture is the nonunion healing of the bone, resulting in an avascular necrosis of the displaced fragment. Typically, this is treated with a thumb spica cast, and if union does not occur, surgical removal of the fragment may be necessary.

Front 184

Go over apgar scoring

Back 184

yeah

Front 185

Had this child had an Apgar score of 2, which of the following would have been the most appropriate management?
A. Assess airway, breathing, and circulation
B. Continue stimulation by rubbing the feet
C. Make sure newborn is dry and warm
D. No further assistance is required
E. Reassess Apgar score in 5 minutes

Back 185

A. An Apgar score of 0-3 is a neonate who requires immediate and major assistance. Always remember the ABCs and carefully and quickly assess airway, breathing, and circulation. Reassessing the Apgar in 5 minutes (choice E) is therefore incorrect and dangerous.

Rubbing the feet (choice B) and making sure the newborn is dry and warm (choice C) is the correct management of infants who have an Apgar score of 4-6.

A neonate who requires no further assistance (choice D) would be true if the Apgar score was 7 or greater.

Front 186

what cranial dysfunction is assoc with low-pitched innitus? include the axis

Back 186

external rotation of the temporal bone about a vertical axis

Front 187

microglia in the brain are the equivalent of what cell found in the blood

Back 187

monocyte

Front 188

Diethylstibestrol use in mom can lead to predisposition to what in baby

Back 188

clear cell adenocarcinoma of the vagina

Front 189

what enzyme is effected in lead poisoning?

Back 189

ferrochelatase

Front 190

Pannus formation, which is characteristic of _______, is a proliferation of the synovium and granulation tissue over the articular cartilage

Back 190

rheumatoid arthritis

Front 191

20 yo female with sore throat and bilateral ankle pain. She has painful patchy erythema on the lower third of her anterior shins and ankles. ESR is elevated, mild leukocytosis..diagnosis?

Back 191

Erythema nodosum

nodules w/o ulceration on anterior aspect of lower extremities. Seen in women and assoc with infections (syphillis) or drug sensitivity

Front 192

pt with lesion on the nose, elevated tissue with ulcerated center. Tiny blood vessels are visible. Palisading of nuclei is a prominent feature of the biopsy report. What is this?

Back 192

Basal cell carcinoma

Talengectasia and palisading are the 2 keys here

Front 193

pt has right psoas muscle spasm. Which of the following is assoc?

Contralateral piriformis spasm
forward sacral torsion
pelvic shift ipsilaterally
ipsilateral radiculopathy to the knee
T2 FRSR

Back 193

contralateral piriformis spasm

pt will have backward sacral torsion, and dysfunction is found at L1/2, contralateral pelvic shift will be seen

Front 194

hemotympanum (blood behind the ear drum) is assoc with what?

Back 194

basilar skull fracture

Front 195

What are the following gaits associated with?

Shuffling:
Antalgic:
Ataxic:
Waddling:

Back 195

Shuffling: Parkinsons

Antalgic: characterized by a short stance phase and a rapidly executed swing phase. The patient is trying to avoid standing on a painful extremity.

Ataxic:reeling, unsteady gait with a wide base and a tendency to fall toward the side of the lesion. This gait is found in cerebellar disease and multiple sclerosis.

Waddling:can be described as a rolling from side to side (penguin walk). This gait is associated with the muscular weakness seen in muscular dystrophy.

Front 196

Hallux valgus =

Back 196

Bunion

Front 197

10 month old kid with pruritic skin lesion w/ chronic fluctuating course. Exam has erythematous, papulovesicular and exudative lesions. Kid scratches them making it worse. Corticostaroids applied with moderated resolution. Where will this rash be and what is it?

Back 197

Face (cheeks) and extensor surfaces

Atopic dermatitis

Front 198

pt with cellulitis after getting her eyebrow pierced. What will lead to her death?

Back 198

cavernous sinus thrombosis

Front 199

What is contained in the carotid sheath?

Back 199

internal jugular vein
common carotid artery
vagus nerve

(damage to vagus here causes hoarse voice)

Front 200

12 year old girl with heart murmur. Pulmonary flow systolic murmur and fixed split-second heart sound. The rest of the physical examination is unremarkable. On direct questioning a history of frequent colds and upper respiratory infections is elicited. Dx?

Back 200

Atrial septal defect

Fixed split second heart sound is pathognomonic

Front 201

pt with myoglobinemia and rhabdomyolysis in lower extermities. Starts getting acute tubular necrosis and kidney failure. Most appropriate tx?

Back 201

Vigorous hydration with normal saline and alkalinization of the urine

mannitol will augment urine output

Front 202

bicornuate uterus causes infertility and is due to?

Back 202

Incomplete fusion of the paramesonephric ducts

Front 203

man has aortic stenosis. Please describe the following:

Aortic pressure compared to femoral artery pressure (why?)

aortic pressure compared to Left ventricle pressure

Back 203

aortic pressure will be LESS than femoral a. pressure-->femoral a undergoes pressure augmentation across the vascular bed, making the pressure greater (not gonna lie I don't really get this)

aortic pressure will be less than that of the LV, you can't get blood out!

Front 204

What does ankle/brachial systolic pressure ratio show

Back 204

it is a doppler recorded measurement of pressures in the lower and upper extremities

differences in this ratio (normal being .9-1.5) can show arteriosclerosis and peripheral artery occlusion

look for erectile dysfunction, leg pain on walking (claudication)

Front 205

woman with difficulty swallowing and dizziness. Loss of pain/temp on left side of face and entire right side of body. Ptosis and miosis present on left. What artery is affected? What is this called?

Back 205

Left posterior inferior cerebellar artery (PICA)

Wallenberg syndrome

Front 206

woman presents with spiking fever, chills, and a king size elevation of her alkaline phosphatse. She has tenderness and guarding in her RUQ. What does she have

Back 206

acute ascending cholangitis

Front 207

what muscle attaches to the base of the 5h metatarsal and is associated with supination injuries of the ankle

Back 207

Peroneus brevis

Front 208

what muscles insert on the lateral aspect of the mid shaft of the radius?

proximal radius?

Back 208

what muscles insert on the lateral aspect of the mid shaft of the radius: Pronators (teres and quadratus)

proximal radius: supinators

Front 209

where would a pt have pain if it were associated with the ethmoid, frontal, maxillary, and sphenoid sinus respectively

Back 209

ethmoid: behind the eyes

frontal: forehead

maxillary: zygomatic bone (cheek)

sphenoid: deep in the skull

Front 210

pt has tamponade, what will happen to systolic pressure?

Back 210

decreased

when pt inspires the RV fills and the seputm moves into the left ventricle. Thus the LV fill less and the systolic BP decreases

Front 211

newly diagnosed cancer pt hasn't gotten staged yet. What OMT can you do on them

Back 211

NONE until they are staged

especially not lymphatic or HVLA