ALL THE COMSAE EXAMINATION PREP
STUDY GUIDE LATEST UPDATED PRACTICE
SOLUTION VERIFIED 100 PERCENT
◉ COCAINE intoxication. Answer: impaired judgement, pupil dilate,
hallucination (coke bugs) sudden cardiac death; paranoid ideations,
angina
Tx: alpha blockers/ benzos
caution B block bc can cause unopposed alpha
◉ Osteoporosis histo. Answer: trabecular and cortical bone lose mass
and interconnection despite normal bone mineralization
assoc w/ Colles fracture- distal radial fracture; fracture of femoral
neck
◉ Gilbert Syndrome. Answer: mild dec UDP glucuronosyltransferase
conjugation and impaired bilirubin uptake; asymptomatic or mild
jaundice>> inc unconjugated bilirubin w/o hemolysis; w/ fasting and
stress
◉ Crigler Najjar. Answer: ABSENT UDP glucuronsyltransferase;
early in life; die few years
,find: jaundice, kernicterus (in brain) inc unconjugated bilirubin;
tx: plasmapheresis and phototherapy; type II respond phenobarbital
◉ Dubin Johnson. Answer: Conjugated hyperbilirubinemia b/c
defective liver excretion;
grossly black liver
Benign
◉ Rotor syndrome. Answer: milder in presentation w/o black liver
impaired hepatic uptake and excretion
◉ wilson Disease. Answer: copper transporting ATPase; ATP7B on
Chromosome 13
s/s: before 40 yo, liver dz, neurodisease, psych dz, Kayser Fleischer
ring, hemolytic anemia, renal dz;
find: dec serum ceruloplasmin, inc urine copper
tx: chelation w/ penicillamine or Tridentine, oral zinc
◉ Hemochromatosis. Answer: recessive, HFE, chromosome 6;
abnormal iron sensing, increase intestinal absorb
,find: inc ferritin, inc iron, dec TIBC, inc transferrin saturation
identify w/ Prussian blue stain/ liver MRI
◉ Hemochromatosis finds. Answer: after age 40
>20 iron;
triad: cirrhosis, DM, skin pigmentation; dilated cardiomyopathy,
hypogonadism, arhtropathy; HCC is common cause death
◉ Treatment Hemochromatosis. Answer: repeat phlebotomy,
chelation deferasirox, deferoxamine, oral deferiprone
◉ Wolff Parkinson White Syndrome. Answer: MC ventricular pre
excitation syndrome
abnml fast atria to ventricle (bundle of Kent); bypasses AV node>>
ventricles begin partially depolarization earlier (NOTED BY DELTA
WAVE ON EKG) widened QRS and shortened PR
◉ Conduction pathway heart. Answer: SA node> atira> AV node>
bundle HIS, R and L bundle branches> purkinje fibers> ventricles
L branch anterior/posterior fascicles
◉ Edema. Answer: inc capillary pressure
dec plasma proteins (dec oncotic capillary pressure)
, inc capillary permeability
increase interstitial fluid colloid oncotic pressure
◉ Celiac Disease. Answer: setting: 14 mo kid losing weight eating
lots of foods;
histology: crypt abnormalities (hyperplasia); villous atrophy,
lymphocytic infiltration
presents as malabsorbtion (diarrhea etc in kids)
in adults= short stature, anemia delayed puberty
◉ Musculocutaneous nerve C5-C7. Answer: upper trunk compression
cause injury; loss forearm flexion/supination; loss sensation over
lateral forearm
◉ Axillary nerve C5-C6. Answer: flat deltoid; loss arm abduction,
loss sensation over deltoid and lateral arm
◉ Radial C5-T1. Answer: mid shaft fracture humerus, compression
axilla
find: dec grip, loss extension (wrist drop); loss sensation posterior
arm, dorsal hand
STUDY GUIDE LATEST UPDATED PRACTICE
SOLUTION VERIFIED 100 PERCENT
◉ COCAINE intoxication. Answer: impaired judgement, pupil dilate,
hallucination (coke bugs) sudden cardiac death; paranoid ideations,
angina
Tx: alpha blockers/ benzos
caution B block bc can cause unopposed alpha
◉ Osteoporosis histo. Answer: trabecular and cortical bone lose mass
and interconnection despite normal bone mineralization
assoc w/ Colles fracture- distal radial fracture; fracture of femoral
neck
◉ Gilbert Syndrome. Answer: mild dec UDP glucuronosyltransferase
conjugation and impaired bilirubin uptake; asymptomatic or mild
jaundice>> inc unconjugated bilirubin w/o hemolysis; w/ fasting and
stress
◉ Crigler Najjar. Answer: ABSENT UDP glucuronsyltransferase;
early in life; die few years
,find: jaundice, kernicterus (in brain) inc unconjugated bilirubin;
tx: plasmapheresis and phototherapy; type II respond phenobarbital
◉ Dubin Johnson. Answer: Conjugated hyperbilirubinemia b/c
defective liver excretion;
grossly black liver
Benign
◉ Rotor syndrome. Answer: milder in presentation w/o black liver
impaired hepatic uptake and excretion
◉ wilson Disease. Answer: copper transporting ATPase; ATP7B on
Chromosome 13
s/s: before 40 yo, liver dz, neurodisease, psych dz, Kayser Fleischer
ring, hemolytic anemia, renal dz;
find: dec serum ceruloplasmin, inc urine copper
tx: chelation w/ penicillamine or Tridentine, oral zinc
◉ Hemochromatosis. Answer: recessive, HFE, chromosome 6;
abnormal iron sensing, increase intestinal absorb
,find: inc ferritin, inc iron, dec TIBC, inc transferrin saturation
identify w/ Prussian blue stain/ liver MRI
◉ Hemochromatosis finds. Answer: after age 40
>20 iron;
triad: cirrhosis, DM, skin pigmentation; dilated cardiomyopathy,
hypogonadism, arhtropathy; HCC is common cause death
◉ Treatment Hemochromatosis. Answer: repeat phlebotomy,
chelation deferasirox, deferoxamine, oral deferiprone
◉ Wolff Parkinson White Syndrome. Answer: MC ventricular pre
excitation syndrome
abnml fast atria to ventricle (bundle of Kent); bypasses AV node>>
ventricles begin partially depolarization earlier (NOTED BY DELTA
WAVE ON EKG) widened QRS and shortened PR
◉ Conduction pathway heart. Answer: SA node> atira> AV node>
bundle HIS, R and L bundle branches> purkinje fibers> ventricles
L branch anterior/posterior fascicles
◉ Edema. Answer: inc capillary pressure
dec plasma proteins (dec oncotic capillary pressure)
, inc capillary permeability
increase interstitial fluid colloid oncotic pressure
◉ Celiac Disease. Answer: setting: 14 mo kid losing weight eating
lots of foods;
histology: crypt abnormalities (hyperplasia); villous atrophy,
lymphocytic infiltration
presents as malabsorbtion (diarrhea etc in kids)
in adults= short stature, anemia delayed puberty
◉ Musculocutaneous nerve C5-C7. Answer: upper trunk compression
cause injury; loss forearm flexion/supination; loss sensation over
lateral forearm
◉ Axillary nerve C5-C6. Answer: flat deltoid; loss arm abduction,
loss sensation over deltoid and lateral arm
◉ Radial C5-T1. Answer: mid shaft fracture humerus, compression
axilla
find: dec grip, loss extension (wrist drop); loss sensation posterior
arm, dorsal hand
