COMLEX Level 1 Exam |429 Q’s and A’s
cysteine stone - -- *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 - -most common cause of lower GI bleeding in pt's >60
- superior mesenteric artery - -supplies the lower portion of the duodenum,
jejunum, ileum, cecum, ascending colon, and transverse colon to the splenic
flexure
- pancreatic cancer - --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 - -Patients 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 - -malabsorption 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 - -after 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 - -In 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 - -where would you find a viserosomatic reflex resulting in
placatory changes of the pancreas?
- Deferoxamine (Desferal) - -iron chelating agent used in the treatment of
iron intoxication
- short leg syndrome - -when 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 - -Infarct 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 - -Infarct to what trunk of
the Left MCA results in Broca's aphasia?
- Osteosarcoma - -bone tumor that is present in young adult males that
involves the metaphysis of the long bones
- Ewing's sarcoma t(11;22) - -bone tumor that is present in young adult
males that involves the *diaphysis(mid-shaft)* of the long bones.
- fibrosarcoma - -malignant fibroblasts within a collagenous matrix
- chondrosarcoma - -osseous 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 - -PKU 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 - -where does the posterior scalene attach to?
- Paclitaxel - -used in the treatment of breast and ovarian cancer
MOA: hyper stabilization of polymerized microtubules--> prevents the
breakdown of the mitotic spindle
- restrictive barrier - -maximum distance a patient can actually move a
joint, can be pathologic
, - narcissistic personality disorder - -patterns 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 - -what does a carotid
massage do and how does it affect the AV node?
- Chronic myelogenous leukemia t(9;22)--> Philly chx - -a 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) - -germinal 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) - -second 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) - -PML/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 - -inhibits platelet aggregation by irreversibly blocking the
P2Y12 component of ADP receptors
- Bacillus anthracis, tendonopathy - -textile industry worker that develops a
low-grade fever, non-productive cough and substernal chest pain have what
bug? Treatment is with a fluroquinolone and why are frequently associated
with what ADR?
- G-6-PD deficiency - -X-linked recessive disorder present in AAs and
Mediterraneans that cause an inability to generate reduced glutathione and
lead to acute hemolysis when stress occurs. You will see bite cells and Heinz
bodies on peripheral blood smear.
- Itranuclear opthalmoplegia - -seen in those with MS, causes impaired
horizontal eye movement w/ weak adduction of the affected eye and
, abduction nystagmus of the contralateral eye. Due to a lesion in the MLF in
the dorsomedial brainstem tegmentum of wither the pons or the midbrain
- lead poisoning - -causes lethargy, seizures, or coma--> can also develop
distal motor neuropathies.
-leads to denaturation of the enzyme ribonuclease which causes ribosomes
to persist in the the RBCs and lead to basophilic stippling
- myofasical release, BLT, FPR, counterstain - -what are indirect OMM
techniques?
- Articulatory technique - -OMM technique classified as low velocity,
moderate to high amplitude
- pericarditis - -EKG presents with PR depression, ST segment elevation and
PR elevation in lead II. They also have sharp, midsternal, non-radiating chest
pain and mild lethargy. What do they have?
- Bottom rib in ISD/ Top rib in ESD - -BITE mnemonic is used for rib
dysfunction treatments, what is it?
- pectoralis minor muscle - -what muscle connects to ribs 3-5?
- rib dysfunctions are named by where they are stuck while rib restrictions
are named by which motion they do not experience! - -how are rib
dysfunctions named and how do they differ from rib restrictions?
- decreases due to decreased transport - -In Wilson's disease there is a
decrease in copper exportation which results in low biliary copper, what
happens to the transport protein ceruloplasmin?
- Digoxin - -positive inotrope for a failing heart
inhibits Na/K Atpase pumps and causes an increase in intracellular Ca2+
while also causing parasympathetic effects
ADR: has a narrow therapeutic window and can cause GI distress, visual
disturbances, AV Block and bradycardia
- Mercury poisoning - -Patient went on a seafood binge for a few days at a
shady restaurant and present to the hospital with neurotoxicity and acute
renal injury which presents as tremors or oliguria and elevated creatinine
- methanol poisoning - -* Symptoms: *Severe metabolic acidosis, retinal
damage (blindness).* Lab Values: ** Pathophysiology: *Toxicity via formic
acid. Severe acidosis, retinal damage.* Treatment: *Ethanol, dialysis,
fomepizole.
cysteine stone - -- *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 - -most common cause of lower GI bleeding in pt's >60
- superior mesenteric artery - -supplies the lower portion of the duodenum,
jejunum, ileum, cecum, ascending colon, and transverse colon to the splenic
flexure
- pancreatic cancer - --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 - -Patients 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 - -malabsorption 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 - -after 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 - -In 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 - -where would you find a viserosomatic reflex resulting in
placatory changes of the pancreas?
- Deferoxamine (Desferal) - -iron chelating agent used in the treatment of
iron intoxication
- short leg syndrome - -when 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 - -Infarct 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 - -Infarct to what trunk of
the Left MCA results in Broca's aphasia?
- Osteosarcoma - -bone tumor that is present in young adult males that
involves the metaphysis of the long bones
- Ewing's sarcoma t(11;22) - -bone tumor that is present in young adult
males that involves the *diaphysis(mid-shaft)* of the long bones.
- fibrosarcoma - -malignant fibroblasts within a collagenous matrix
- chondrosarcoma - -osseous 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 - -PKU 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 - -where does the posterior scalene attach to?
- Paclitaxel - -used in the treatment of breast and ovarian cancer
MOA: hyper stabilization of polymerized microtubules--> prevents the
breakdown of the mitotic spindle
- restrictive barrier - -maximum distance a patient can actually move a
joint, can be pathologic
, - narcissistic personality disorder - -patterns 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 - -what does a carotid
massage do and how does it affect the AV node?
- Chronic myelogenous leukemia t(9;22)--> Philly chx - -a 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) - -germinal 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) - -second 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) - -PML/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 - -inhibits platelet aggregation by irreversibly blocking the
P2Y12 component of ADP receptors
- Bacillus anthracis, tendonopathy - -textile industry worker that develops a
low-grade fever, non-productive cough and substernal chest pain have what
bug? Treatment is with a fluroquinolone and why are frequently associated
with what ADR?
- G-6-PD deficiency - -X-linked recessive disorder present in AAs and
Mediterraneans that cause an inability to generate reduced glutathione and
lead to acute hemolysis when stress occurs. You will see bite cells and Heinz
bodies on peripheral blood smear.
- Itranuclear opthalmoplegia - -seen in those with MS, causes impaired
horizontal eye movement w/ weak adduction of the affected eye and
, abduction nystagmus of the contralateral eye. Due to a lesion in the MLF in
the dorsomedial brainstem tegmentum of wither the pons or the midbrain
- lead poisoning - -causes lethargy, seizures, or coma--> can also develop
distal motor neuropathies.
-leads to denaturation of the enzyme ribonuclease which causes ribosomes
to persist in the the RBCs and lead to basophilic stippling
- myofasical release, BLT, FPR, counterstain - -what are indirect OMM
techniques?
- Articulatory technique - -OMM technique classified as low velocity,
moderate to high amplitude
- pericarditis - -EKG presents with PR depression, ST segment elevation and
PR elevation in lead II. They also have sharp, midsternal, non-radiating chest
pain and mild lethargy. What do they have?
- Bottom rib in ISD/ Top rib in ESD - -BITE mnemonic is used for rib
dysfunction treatments, what is it?
- pectoralis minor muscle - -what muscle connects to ribs 3-5?
- rib dysfunctions are named by where they are stuck while rib restrictions
are named by which motion they do not experience! - -how are rib
dysfunctions named and how do they differ from rib restrictions?
- decreases due to decreased transport - -In Wilson's disease there is a
decrease in copper exportation which results in low biliary copper, what
happens to the transport protein ceruloplasmin?
- Digoxin - -positive inotrope for a failing heart
inhibits Na/K Atpase pumps and causes an increase in intracellular Ca2+
while also causing parasympathetic effects
ADR: has a narrow therapeutic window and can cause GI distress, visual
disturbances, AV Block and bradycardia
- Mercury poisoning - -Patient went on a seafood binge for a few days at a
shady restaurant and present to the hospital with neurotoxicity and acute
renal injury which presents as tremors or oliguria and elevated creatinine
- methanol poisoning - -* Symptoms: *Severe metabolic acidosis, retinal
damage (blindness).* Lab Values: ** Pathophysiology: *Toxicity via formic
acid. Severe acidosis, retinal damage.* Treatment: *Ethanol, dialysis,
fomepizole.
