COMSAE ALL Questions with Correct Solutions
Question:
1. 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
Question:
2. 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
Question:
3. 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
Question:
4. 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
Question:
5. Dubin Johnson
Answer:
Conjugated hyperbilirubinemia b/c defective liver excretion; grossly black liver Benign
Question:
6. Rotor syndrome
Answer:
milder in presentation w/o black liver impaired hepatic uptake and excretion
,Question:
7. 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
Question:
8. 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
Question:
9. Hemochromatosis finds
Answer:
after age 40 >20 iron; triad: cirrhosis, DM, skin pigmentation; dilated cardiomyopathy,
hypogonadism, arhtropathy; HCC is common cause death
Question:
10. Treatment Hemochromatosis
Answer:
repeat phlebotomy, chelation deferasirox, deferoxamine, oral deferiprone
Question:
11. 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
Question:
12. Conduction pathway heart
Answer:
SA node> atira> AV node> bundle HIS, R and L bundle branches> purkinje fibers>
ventricles L branch anterior/posterior fascicles
, Question:
13. Edema
Answer:
inc capillary pressure dec plasma proteins (dec oncotic capillary pressure) inc capillary
permeability increase interstitial fluid colloid oncotic pressure
Question:
14. 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
Question:
15. Musculocutaneous nerve C5-C7
Answer:
upper trunk compression cause injury; loss forearm flexion/supination; loss sensation over
lateral forearm
Question:
16. Axillary nerve C5-C6
Answer:
flat deltoid; loss arm abduction, loss sensation over deltoid and lateral arm
Question:
17. Radial C5-T1
Answer:
mid shaft fracture humerus, compression axilla find: dec grip, loss extension (wrist drop); loss
sensation posterior arm, dorsal hand
Question:
18. Median C5-T1
Question:
1. 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
Question:
2. 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
Question:
3. 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
Question:
4. 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
Question:
5. Dubin Johnson
Answer:
Conjugated hyperbilirubinemia b/c defective liver excretion; grossly black liver Benign
Question:
6. Rotor syndrome
Answer:
milder in presentation w/o black liver impaired hepatic uptake and excretion
,Question:
7. 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
Question:
8. 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
Question:
9. Hemochromatosis finds
Answer:
after age 40 >20 iron; triad: cirrhosis, DM, skin pigmentation; dilated cardiomyopathy,
hypogonadism, arhtropathy; HCC is common cause death
Question:
10. Treatment Hemochromatosis
Answer:
repeat phlebotomy, chelation deferasirox, deferoxamine, oral deferiprone
Question:
11. 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
Question:
12. Conduction pathway heart
Answer:
SA node> atira> AV node> bundle HIS, R and L bundle branches> purkinje fibers>
ventricles L branch anterior/posterior fascicles
, Question:
13. Edema
Answer:
inc capillary pressure dec plasma proteins (dec oncotic capillary pressure) inc capillary
permeability increase interstitial fluid colloid oncotic pressure
Question:
14. 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
Question:
15. Musculocutaneous nerve C5-C7
Answer:
upper trunk compression cause injury; loss forearm flexion/supination; loss sensation over
lateral forearm
Question:
16. Axillary nerve C5-C6
Answer:
flat deltoid; loss arm abduction, loss sensation over deltoid and lateral arm
Question:
17. Radial C5-T1
Answer:
mid shaft fracture humerus, compression axilla find: dec grip, loss extension (wrist drop); loss
sensation posterior arm, dorsal hand
Question:
18. Median C5-T1
