COMBANK Level 2: Questions With Step-by-Step
Solutions
What is Kohler's disease? Correct Answer - Osteonecrosis of
the navicular bone
What is Freiburg's infarction? Correct Answer -
Osteochondrosis of the second metatarsal head
What is Panner's disease? Correct Answer - Osteochondrosis
of the capitellum in the elbow
Sever's disease? Correct Answer - Osteochondrosis of the
insertion of the growth plate at the Achille's tendon on the calcaneal
tuberosity
What can Gingko cause? Correct Answer - Bleeding, dizziness,
can be causing GI discomfort etc. D/C prior to surgery
What can Camelia Sinensis cause? Green and Black Tea Correct
Answer - Chemoprotective and antioxidant, green tea can
increase HDL and decrease LDL cholesterol levels
What is St. John's wort used for? Correct Answer - Often used
in depression
Can instigate mania in patients with Bipolar
Increased metabolism of P450 drugs
What is Echinacea used for? Correct Answer -
Immunostimulator used for overall immune function
,Nausea, dizziness, dyspnea, rash, dermatitis, pruritus, and
hepatotoxicity
What is Panax ginseng used in? Correct Answer - Also known
as ginseng root, known for aphrodisiac properties and used in the
treatment of sexual dysfunction and Type 2 diabetes mellitus
One of the side effects is inability to sleep
Paroxetine and Venlafaxine are 2 SSRIs with the greatest risk of
what? Correct Answer - Discontinuation syndrome
So you have to slowly taper them
What are the key differences b/w myasthenia gravis and lambert
eaton? Correct Answer - Lambert Eaton- Proximal muscle
weakness is progressive and symmetrical. Patients report
symptoms with gait difficulty or getting out of bed, chairs and/or
climbing stairs.
Extremity weakness is present in all patients with Lambert Eaton as
opposed to those with MG where weakness is ocular and
oropharyngeal.
Muscle weakness improves with Lambert Eaton but worsens with
MG
Lambert Eaton-hyporeflexia and lower extremity weakness
Symptoms for MG are worsened when? Correct Answer - At
the end of the day
Characteristics of MS? Correct Answer -
,Barrett's esophagus can lead to what? Correct Answer -
Esophageal adenocarcinoma
Best Tx is omeprazole and surveillance endoscopies
In OSA what do you see? Correct Answer - Desaturation with
decrease in blood flow
Salmeterol which is a long acting beta agonist should never be used
when? Correct Answer - Alone, it must be used with inhaled
glucocorticoids
So an alternative is Montelukast
What is the most common bleeding disorder? Correct Answer -
VWF
What are the lab values for VWF? Correct Answer - Normal
platelet count, normal PT, *prolonged PTT, prolonged bleeding
time*
What is the first line treatment in NSTEMI? Correct Answer -
Low molecular weight heparin (Enoxaparin) to prevent further
thrombus and reinafarction
When do you use ultrasound in thyroid nodule? Correct Answer -
To determine if it is solid or cystic
If you already know, then what do you do? Then you do FNA to rule
out malignancy or see how bad the nodule is
What is first line treatment for epistaxis? Correct Answer -
Continuous firm pressure on the cartilaginous portion of the nose
for up to 30 mins
, Then packing then cautery
Patient with recent travel history, blood in stool, flu like symptoms,
rose spots and splenomegaly is presenting with what? Correct
Answer - Typhoid fever from Salmonella
Spread through poor hygiene habits
Poultry and eggs is common source
E Coli 0157:H7 is usually associated with what? Correct Answer -
Undercooked beef, associated with HUS
Vibrio can cause bloody diarrhea and is associated with what?
Correct Answer - Ingestion of seafood
Shigella can cause what? Correct Answer - Bloody diarrhea
with reactive arthritis second most common to HUS
What is status epiliptecus? Correct Answer - Any seizure
lasting more than 5 minutes.
First check ABCs, if stable, then first line is IV thiamine and dextrose
b/c hypoglycemia is reversible
If all fails, IV Lorazepam should be administered
Phenytoin is second line and phenobarb is 3rd
Batteries in the esophagus vs small bowel? Correct Answer - In
the esophagus should be removed right away, and in the small
bowel should be observed in a healthy stable patient
Solutions
What is Kohler's disease? Correct Answer - Osteonecrosis of
the navicular bone
What is Freiburg's infarction? Correct Answer -
Osteochondrosis of the second metatarsal head
What is Panner's disease? Correct Answer - Osteochondrosis
of the capitellum in the elbow
Sever's disease? Correct Answer - Osteochondrosis of the
insertion of the growth plate at the Achille's tendon on the calcaneal
tuberosity
What can Gingko cause? Correct Answer - Bleeding, dizziness,
can be causing GI discomfort etc. D/C prior to surgery
What can Camelia Sinensis cause? Green and Black Tea Correct
Answer - Chemoprotective and antioxidant, green tea can
increase HDL and decrease LDL cholesterol levels
What is St. John's wort used for? Correct Answer - Often used
in depression
Can instigate mania in patients with Bipolar
Increased metabolism of P450 drugs
What is Echinacea used for? Correct Answer -
Immunostimulator used for overall immune function
,Nausea, dizziness, dyspnea, rash, dermatitis, pruritus, and
hepatotoxicity
What is Panax ginseng used in? Correct Answer - Also known
as ginseng root, known for aphrodisiac properties and used in the
treatment of sexual dysfunction and Type 2 diabetes mellitus
One of the side effects is inability to sleep
Paroxetine and Venlafaxine are 2 SSRIs with the greatest risk of
what? Correct Answer - Discontinuation syndrome
So you have to slowly taper them
What are the key differences b/w myasthenia gravis and lambert
eaton? Correct Answer - Lambert Eaton- Proximal muscle
weakness is progressive and symmetrical. Patients report
symptoms with gait difficulty or getting out of bed, chairs and/or
climbing stairs.
Extremity weakness is present in all patients with Lambert Eaton as
opposed to those with MG where weakness is ocular and
oropharyngeal.
Muscle weakness improves with Lambert Eaton but worsens with
MG
Lambert Eaton-hyporeflexia and lower extremity weakness
Symptoms for MG are worsened when? Correct Answer - At
the end of the day
Characteristics of MS? Correct Answer -
,Barrett's esophagus can lead to what? Correct Answer -
Esophageal adenocarcinoma
Best Tx is omeprazole and surveillance endoscopies
In OSA what do you see? Correct Answer - Desaturation with
decrease in blood flow
Salmeterol which is a long acting beta agonist should never be used
when? Correct Answer - Alone, it must be used with inhaled
glucocorticoids
So an alternative is Montelukast
What is the most common bleeding disorder? Correct Answer -
VWF
What are the lab values for VWF? Correct Answer - Normal
platelet count, normal PT, *prolonged PTT, prolonged bleeding
time*
What is the first line treatment in NSTEMI? Correct Answer -
Low molecular weight heparin (Enoxaparin) to prevent further
thrombus and reinafarction
When do you use ultrasound in thyroid nodule? Correct Answer -
To determine if it is solid or cystic
If you already know, then what do you do? Then you do FNA to rule
out malignancy or see how bad the nodule is
What is first line treatment for epistaxis? Correct Answer -
Continuous firm pressure on the cartilaginous portion of the nose
for up to 30 mins
, Then packing then cautery
Patient with recent travel history, blood in stool, flu like symptoms,
rose spots and splenomegaly is presenting with what? Correct
Answer - Typhoid fever from Salmonella
Spread through poor hygiene habits
Poultry and eggs is common source
E Coli 0157:H7 is usually associated with what? Correct Answer -
Undercooked beef, associated with HUS
Vibrio can cause bloody diarrhea and is associated with what?
Correct Answer - Ingestion of seafood
Shigella can cause what? Correct Answer - Bloody diarrhea
with reactive arthritis second most common to HUS
What is status epiliptecus? Correct Answer - Any seizure
lasting more than 5 minutes.
First check ABCs, if stable, then first line is IV thiamine and dextrose
b/c hypoglycemia is reversible
If all fails, IV Lorazepam should be administered
Phenytoin is second line and phenobarb is 3rd
Batteries in the esophagus vs small bowel? Correct Answer - In
the esophagus should be removed right away, and in the small
bowel should be observed in a healthy stable patient
