COMSAE COMPREHENSIVE QUESTIONS
AND COMPLETE SOLUTIONS TEST PAPER
●● 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
AND COMPLETE SOLUTIONS TEST PAPER
●● 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
