COMSAE 115 EXAMINATION TEST
COMPLETE QUESTIONS AND SOLUTIONS
●● Yergason test
Answer: determines whether head of biceps is stable in the bicipital
groove- pt fully flexes elbow while examiner grasps elbow and wrist- pt
resists motion while examiner simultaneously extends elbow and
externally rotates the arm.
pain or snapping sensation in the bicipital groove
●● Speed test
Answer: forearm supinated, palm up. stresses the long head of the
biceps.
●● alloimmunization causing fetal anemia
Answer: common causes of sinusoidal fetal heart tracing:
- Rh alloimmunization
- fetomaternal hemorrhage
- twin to twin transfusion
- severe fetal hypoxia (less common)
●● button battery ingestion = GI emergency
Answer: 🔋 Button battery
,Mechanism of injury
Electrical current → hydroxide ions → alkali burn → liquefactive
necrosis
Complications
Esophageal ulcer
Esophageal perforation
Tracheoesophageal fistula
Mediastinitis
Aortoesophageal fistula (can cause fatal hemorrhage)
Management
Battery in esophagus: Emergent endoscopic removal
Battery beyond the esophagus + asymptomatic: Observe with serial
imaging and monitor for passage (management depends on battery size,
patient age, symptoms, and location).
●● massive transfusion can lead to coagulopathy
Answer: massive transfusion:
greater than 10 units PRBCs within 24 hours, or replacement of an entire
blood volume
dilution coagulopathy (packed RBCs contain very few platelets, very
little clotting factors)
,platelets become diluted --> thrombocytopenia
clotting factors become diluted --> prolonged PT/PTT
increases risk of postoperative bleeding, so coagulation studies and
platelet
●● hr and rr
Answer: Newborn: 100-160 HR, 30-60 RR
Infant: 100-160 HR, 30-50 RR
Adult: 60-100 HR, 12-20 RR
●● upper lobe consolidation --> obstructing bronchogenic carcinoma
causing post obstructive pneumonia
Answer: Smoker + persistent upper lobe infiltrate → Bronchogenic
carcinoma
Nonresolving pneumonia after antibiotics → CT chest
Post-obstructive pneumonia is a classic presentation of lung cancer.
●● coal workers' pneumoconiosis
Answer: Carbon dust, seen in coal miners. Massive exposure leads to
diffuse fibrosis('black lung')
measure functional pulmonary impairment with spirometry
, ●● CI for lymphatic pump techniques
Answer: High-yield contraindications for lymphatic techniques (Pedal
pump, Thoracic pump)
Think of anything where increasing lymphatic/venous return could be
harmful:
Acute decompensated CHF
Pulmonary edema
Untreated DVT (risk of embolization)
Acute fracture
Open wounds/burns over treatment area
Metastatic cancer involving the area (relative)
●● Ottawa ankle rules
Answer: Ottawa Ankle Rules:
Order an ankle X-ray if the patient has pain in the malleolar zone AND
one of the following:
1. Bone tenderness over the posterior edge or tip of the lateral malleolus
(distal 6 cm)
2. Bone tenderness over the posterior edge or tip of the medial malleolus
3. Unable to bear weight for 4 steps immediately after the injury AND in
the ED/clinic
COMPLETE QUESTIONS AND SOLUTIONS
●● Yergason test
Answer: determines whether head of biceps is stable in the bicipital
groove- pt fully flexes elbow while examiner grasps elbow and wrist- pt
resists motion while examiner simultaneously extends elbow and
externally rotates the arm.
pain or snapping sensation in the bicipital groove
●● Speed test
Answer: forearm supinated, palm up. stresses the long head of the
biceps.
●● alloimmunization causing fetal anemia
Answer: common causes of sinusoidal fetal heart tracing:
- Rh alloimmunization
- fetomaternal hemorrhage
- twin to twin transfusion
- severe fetal hypoxia (less common)
●● button battery ingestion = GI emergency
Answer: 🔋 Button battery
,Mechanism of injury
Electrical current → hydroxide ions → alkali burn → liquefactive
necrosis
Complications
Esophageal ulcer
Esophageal perforation
Tracheoesophageal fistula
Mediastinitis
Aortoesophageal fistula (can cause fatal hemorrhage)
Management
Battery in esophagus: Emergent endoscopic removal
Battery beyond the esophagus + asymptomatic: Observe with serial
imaging and monitor for passage (management depends on battery size,
patient age, symptoms, and location).
●● massive transfusion can lead to coagulopathy
Answer: massive transfusion:
greater than 10 units PRBCs within 24 hours, or replacement of an entire
blood volume
dilution coagulopathy (packed RBCs contain very few platelets, very
little clotting factors)
,platelets become diluted --> thrombocytopenia
clotting factors become diluted --> prolonged PT/PTT
increases risk of postoperative bleeding, so coagulation studies and
platelet
●● hr and rr
Answer: Newborn: 100-160 HR, 30-60 RR
Infant: 100-160 HR, 30-50 RR
Adult: 60-100 HR, 12-20 RR
●● upper lobe consolidation --> obstructing bronchogenic carcinoma
causing post obstructive pneumonia
Answer: Smoker + persistent upper lobe infiltrate → Bronchogenic
carcinoma
Nonresolving pneumonia after antibiotics → CT chest
Post-obstructive pneumonia is a classic presentation of lung cancer.
●● coal workers' pneumoconiosis
Answer: Carbon dust, seen in coal miners. Massive exposure leads to
diffuse fibrosis('black lung')
measure functional pulmonary impairment with spirometry
, ●● CI for lymphatic pump techniques
Answer: High-yield contraindications for lymphatic techniques (Pedal
pump, Thoracic pump)
Think of anything where increasing lymphatic/venous return could be
harmful:
Acute decompensated CHF
Pulmonary edema
Untreated DVT (risk of embolization)
Acute fracture
Open wounds/burns over treatment area
Metastatic cancer involving the area (relative)
●● Ottawa ankle rules
Answer: Ottawa Ankle Rules:
Order an ankle X-ray if the patient has pain in the malleolar zone AND
one of the following:
1. Bone tenderness over the posterior edge or tip of the lateral malleolus
(distal 6 cm)
2. Bone tenderness over the posterior edge or tip of the medial malleolus
3. Unable to bear weight for 4 steps immediately after the injury AND in
the ED/clinic
