COMBANK ASSESSMENT- Questions with Correct Answers Verified by Experts| Latest Update
ACHEIs are used to reverse NON-depolarizing neuro muscular blockers i.e. Rocuronium
Orphanophosphates
Physostigmine
Neostigmine
Galantamine
Caffiene
Donezepil
Edrophonium AchEIs
Wide S2 split Pulmonic stenosis or RBBB
Longer it takes to eject blood and the pulmonic valve to close
Fixed S2 split ASD
each time the heart beast, same amount of blood shunted thru the septal defect leading to a
fixed split
Paradoxical S2 split AS or LBBB
Longer it takes for aortic valve to close
PV closes before AV
Recent abx use and abd surgery
Diarrhea 1 week later, lasts for 10 weeks
Fe, crampy pain, watery diarrhea, high WBC
RF- bowel surgery, chemo, MOF C. difficle / Pseudomembranous colitis
,anaerobic GPR - makes 2 toxins both damage the colon mucosa
Dx - stool toxin assay
Tx - oral vancomycin + metronidazole
Weak atrophied hypothenar eminemce
Impaired add and abduction of 4th ad 5th fingers (weak PAB,DAB and abduct digiti minimi)
Guyon's canal syndrome / ulnar n entrapment
Deep br on ulnar n--> motor sx
entrapped by pisiform/hamate pishamate lig
Carpal tunnel Median n
entrapped @ flexor retinaculum
cannot oppose thumb and 2nd finger, atrophy of thenar eminance
Cubital tunnel syndrome Ulnar n entrappy @ level of elbow
Cannot flex 4th and 5th DIPs (ulnar p of FDP)
Cannot abd/add 4tha nd 5th
Radila n entrapment / Post interosseus syndrome Compressed radial n --> loss of finger
extension
entrapped pos iterosseas br of radial n at proximal edge of supinator
,30 yo F, severe n, abd pain, 3 days. after eating and brething. Hx- DM, HTN, HLD. 150/90, H90,
R20, O94, T 101.3
RUQ tenderness, +Murphys, invol gaurding
Mild jaundice
US- GB has 4 gallstones, pericholcystic fluid, thick wall, gas in GB, pain on sonography Acute
cholecystis
(Charcot) RUQ pain, Marked jaundice, Fever
Septic shock and AMS if systemic
Obstruction of the common bile duct (choledocolithiasis) Ascending cholangitis
Biliary colic, high ALKP, high total Bili Choledocolithiasis / stone in CBD
Signs of small bowel obstruciton
Pneumobilia on AbdXR Gallstone ileus / large gallstone in the bowel thru
cholecystoduodenla fistula
usu at the ileocecal valve
Cancer patient on chemo, bleedin gout rectum, and mucosa
Thrombocytopenia Give 6 units of pooled donor platelts
In bleeding setting when platelet dysfunction , not jsut decr platelts are issue
Aspirin, NSAID use
Liver dz, cardiopulmonary bypase, uremia Give Desmopression and pooled donor platelets
, 33 yo male. Pain on defecation. Avoids toilet. Chronic onstipatoin. Posterior anal tears. Anal
fissure
tx- fiber, stool softener, local anesthestic, Stiz bathes
if this fails... intral-anal nitroglycerin
need 3-4 weeks of failed Rx and crhonic fissures for sphincterectomy
68 yo scortal pain, swelling and tender Rt testicle, low grade fe, mild burn with iurination. no
sexual hx.
Testicle feels better when elevated (+Prehn sign)
+Cremasteric reflex Epididymitis
>35 yo ? E. coli
< 35 yo? C. trachomatis / N. gonorriehoeae
LEFT testicle dilation
Swelling goes awaly with lying down
no light goes thru (VENOUS)
Bag of worms
US is diagnostic Varicocele
Left teste --> left renal v
Right teste --> IVC
ACHEIs are used to reverse NON-depolarizing neuro muscular blockers i.e. Rocuronium
Orphanophosphates
Physostigmine
Neostigmine
Galantamine
Caffiene
Donezepil
Edrophonium AchEIs
Wide S2 split Pulmonic stenosis or RBBB
Longer it takes to eject blood and the pulmonic valve to close
Fixed S2 split ASD
each time the heart beast, same amount of blood shunted thru the septal defect leading to a
fixed split
Paradoxical S2 split AS or LBBB
Longer it takes for aortic valve to close
PV closes before AV
Recent abx use and abd surgery
Diarrhea 1 week later, lasts for 10 weeks
Fe, crampy pain, watery diarrhea, high WBC
RF- bowel surgery, chemo, MOF C. difficle / Pseudomembranous colitis
,anaerobic GPR - makes 2 toxins both damage the colon mucosa
Dx - stool toxin assay
Tx - oral vancomycin + metronidazole
Weak atrophied hypothenar eminemce
Impaired add and abduction of 4th ad 5th fingers (weak PAB,DAB and abduct digiti minimi)
Guyon's canal syndrome / ulnar n entrapment
Deep br on ulnar n--> motor sx
entrapped by pisiform/hamate pishamate lig
Carpal tunnel Median n
entrapped @ flexor retinaculum
cannot oppose thumb and 2nd finger, atrophy of thenar eminance
Cubital tunnel syndrome Ulnar n entrappy @ level of elbow
Cannot flex 4th and 5th DIPs (ulnar p of FDP)
Cannot abd/add 4tha nd 5th
Radila n entrapment / Post interosseus syndrome Compressed radial n --> loss of finger
extension
entrapped pos iterosseas br of radial n at proximal edge of supinator
,30 yo F, severe n, abd pain, 3 days. after eating and brething. Hx- DM, HTN, HLD. 150/90, H90,
R20, O94, T 101.3
RUQ tenderness, +Murphys, invol gaurding
Mild jaundice
US- GB has 4 gallstones, pericholcystic fluid, thick wall, gas in GB, pain on sonography Acute
cholecystis
(Charcot) RUQ pain, Marked jaundice, Fever
Septic shock and AMS if systemic
Obstruction of the common bile duct (choledocolithiasis) Ascending cholangitis
Biliary colic, high ALKP, high total Bili Choledocolithiasis / stone in CBD
Signs of small bowel obstruciton
Pneumobilia on AbdXR Gallstone ileus / large gallstone in the bowel thru
cholecystoduodenla fistula
usu at the ileocecal valve
Cancer patient on chemo, bleedin gout rectum, and mucosa
Thrombocytopenia Give 6 units of pooled donor platelts
In bleeding setting when platelet dysfunction , not jsut decr platelts are issue
Aspirin, NSAID use
Liver dz, cardiopulmonary bypase, uremia Give Desmopression and pooled donor platelets
, 33 yo male. Pain on defecation. Avoids toilet. Chronic onstipatoin. Posterior anal tears. Anal
fissure
tx- fiber, stool softener, local anesthestic, Stiz bathes
if this fails... intral-anal nitroglycerin
need 3-4 weeks of failed Rx and crhonic fissures for sphincterectomy
68 yo scortal pain, swelling and tender Rt testicle, low grade fe, mild burn with iurination. no
sexual hx.
Testicle feels better when elevated (+Prehn sign)
+Cremasteric reflex Epididymitis
>35 yo ? E. coli
< 35 yo? C. trachomatis / N. gonorriehoeae
LEFT testicle dilation
Swelling goes awaly with lying down
no light goes thru (VENOUS)
Bag of worms
US is diagnostic Varicocele
Left teste --> left renal v
Right teste --> IVC
