COMLEX Level 1 EXAM REVIEW WITH 100% CORRECT ANSWERS.

cysteine stone - correct answer️️- *Hexagonal* stones - *Ground, glass appearance* - *(+) urinary cyanide nitroprusside test - Defect in renal transport of COLA: Cysteine, Ornithine, Lysine, Arginine - Does NOT respond to shock wave therapy angiodysplasia - correct answer️️most common cause of lower GI bleeding in pt's 60 superior mesenteric artery - correct answer️️supplies the lower portion of the duodenum, jejunum, ileum, cecum, ascending colon, and transverse colon to the splenic flexure pancreatic cancer - correct answer️️-usually arises in the *head* of the pancreas -is associated with *jaundice and pain* due to obstruction of the common bile duct - it is the *4th* most common cause of cancer -has a very poor prognosis 1. Calcium channel blockers-- specifically smooth muscle antagonists-- SM dilation 2. Alpha adrenergic receptor blockers -- cause dilation of vessels instead of constriction 3. Beta 2 agonists: causes dilation of smooth muscle vessels - correct answer️️Patients with GERD normally have a dysfunction with LES sphincter tone that allows acid to reflux into the esophagus, thus drugs that affect sphincter tone would make GERD worse. What are the name of three drug categories that do this? celiac disease - correct answer️️malabsorption syndrome caused by an immune reaction to gliadian protein in gluten -Tissue transglutaminase -results in villous atrophy of small intestine mucosa and causes steatorrhea, diarrhea, bloating and abdominal pain -*also associated with other autoimmune disorders like hashimotos thyroiditis* make NPO, Place on an NG tube and suction obstruction out-- this will usually resolve obstruction - correct answer️️after a patient comes to the ER with sudden onset of pain and abdominal distention W/O peritoneal signs and after x-ray you diagnose her with a small bowel obstruction. What do you do next? Low total calcium due to low albumin levels from cirrhosis (95% of Ca2+ is bound to albumin) and normal ionized Ca2+ because PTH regulates free ionized Ca2+ independently-- that is why there are no signs go hypocalcemia - correct answer️️In a patient with liver cirrhosis what calcium levels would you expect to see? Would there be signs of hypocalcemia-- tetany, paresthesias, abdominal cramps? T5-T11 - correct answer️️where would you find a viserosomatic reflex resulting in placatory changes of the pancreas? Deferoxamine (Desferal) - correct answer️️iron chelating agent used in the treatment of iron intoxication short leg syndrome - correct answer️️when a patient presents with a flexible scoliotic curve it is important to evaluate for... inferior trunk-- encompasses broadmann areas 22,39,40 which are in the temporal region - correct answer️️Infarct to what trunk of the Left MCA results in Wernicke's aphasia? Superior division-- encompasses brooks area, frontal eye field, primary motor cortex and primary somatosensory cortex - correct answer️️Infarct to what trunk of the Left MCA results in Broca's aphasia? Osteosarcoma - correct answer️️bone tumor that is present in young adult males that involves the metaphysis of the long bones Ewing's sarcoma t(11;22) - correct answer️️bone tumor that is present in young adult males that involves the *diaphysis(mid-shaft)* of the long bones. fibrosarcoma - correct answer️️malignant fibroblasts within a collagenous matrix chondrosarcoma - correct answer️️osseous sarcomas that affect older patients and has a predilection for flat bones in the *shoulders and pelvis* tyrosine, due to a defect in phenylalanine hydroxylase - correct answer️️PKU presents as failure to thrive, mental retardation, gapped teeth, etc. What is the amino acid that needs to be supplemented due to a defect in what enzyme? Rib 2 - correct answer️️where does the posterior scalene attach to? Paclitaxel - correct answer️️used in the treatment of breast and ovarian cancer MOA: hyper stabilization of polymerized microtubules-- prevents the breakdown of the mitotic spindle restrictive barrier - correct answer️️maximum distance a patient can actually move a joint, can be pathologic narcissistic personality disorder - correct answer️️patterns of grandiosity, need for admiration, lack of empathy for others A carotid massage causes an increase in stretch of the carotid baroreceptors which causes a reflexive PARASYM response which slows down the conduction velocity through the AV node this slowing down Heart Rate-- used in paroxysmal supra ventricular tachycardia - correct answer️️what does a carotid massage do and how does it affect the AV node? Chronic myelogenous leukemia t(9;22)-- Philly chx - correct answer️️a form of leukemia characterized by the accumulation of abnormal, mature granulocytes (granulocytes are a type of white blood cell), mild anemia, thrombocytosis and basophilia. What is the associated chromosomal translocation? Burkitt's lymphoma t(8;14) - correct answer️️germinal B celll lymphoma that is associated with a translocation between c-MYC and the Ig heavy chain on which two chromosomes? It is endemic in the continent of Africa which produces this follicular lymphoma t(14;18) - correct answer️️second most common lymphoma in the US, arises from germinal center B-cells. Presents with painless peripheral lymphadenopathy w/ a history of lymph node enlargement . Positive for CD 10, CD 19 and CD 20 expression. Results in what chromosomal translocation evolving the BCL-2 gene? Acute promyelocytic leukemia t(15;17) - correct answer️️PML/RARA fusion gene associated with DIC, characteristic folded, bilobed nuclei are found in these certain type of cells. Coarse azurorophilic granules and multiple Auer rods are also present on histo Clopidogrel - correct answer️️inhibits platelet aggregation by irreversibly blocking the P2Y12 component of ADP receptors