COMLEX Level 1 Exam Study Guide.

COMLEX Level 1 Exam Study Guide. - *Hexagonal* stones - *Ground, glass appearance* - *(+) urinary cyanide nitroprusside test - Defect in renal transport of COLA: Cysteine, Ornithine, Lysine, Arginine - Does NOT respond to shock wave therapy - answercysteine stone most common cause of lower GI bleeding in pt's >60 - answerangiodysplasia supplies the lower portion of the duodenum, jejunum, ileum, cecum, ascending colon, and transverse colon to the splenic flexure - answersuperior mesenteric artery -usually arises in the *head* of the pancreas -is associated with *jaundice and pain* due to obstruction of the common bile duct - it is the *4th* most common cause of cancer -has a very poor prognosis - answerpancreatic cancer Patients with GERD normally have a dysfunction with LES sphincter tone that allows acid to reflux into the esophagus, thus drugs that affect sphincter tone would make GERD worse. What are the name of three drug categories that do this? - answer1. Calcium channel blockers--> specifically smooth muscle antagonists--> SM dilation 2. Alpha adrenergic receptor blockers --> cause dilation of vessels instead of constriction 3. Beta 2 agonists: causes dilation of smooth muscle vessels malabsorption syndrome caused by an immune reaction to gliadian protein in gluten -Tissue transglutaminase -results in villous atrophy of small intestine mucosa and causes steatorrhea, diarrhea, bloating and abdominal pain -*also associated with other autoimmune disorders like hashimotos thyroiditis* - answerceliac disease after a patient comes to the ER with sudden onset of pain and abdominal distention W/O peritoneal signs and after x-ray you diagnose her with a small bowel obstruction. What do you do next? - answermake NPO, Place on an NG tube and suction obstruction out--> this will usually resolve obstruction In a patient with liver cirrhosis what calcium levels would you expect to see? Would there be signs of hypocalcemia--> tetany, paresthesias, abdominal cramps? - answerLow total calcium due to low albumin levels from cirrhosis (95% of Ca2+ is bound to albumin) and normal ionized Ca2+ because PTH regulates free ionized Ca2+ independently--> that is why there are no signs go hypocalcemia where would you find a viserosomatic reflex resulting in placatory changes of the pancreas? - answerT5-T11 iron chelating agent used in the treatment of iron intoxication - answerDeferoxamine (Desferal) when a patient presents with a flexible scoliotic curve it is important to evaluate for... - answershort leg syndrome Infarct to what trunk of the Left MCA results in Wernicke's aphasia? - answerinferior trunk-- > encompasses broadmann areas 22,39,40 which are in the temporal region Infarct to what trunk of the Left MCA results in Broca's aphasia? - answerSuperior division-- > encompasses brooks area, frontal eye field, primary motor cortex and primary somatosensory cortex bone tumor that is present in young adult males that involves the metaphysis of the long bones - answerOsteosarcoma bone tumor that is present in young adult males that involves the *diaphysis(mid-shaft)* of the long bones. - answerEwing's sarcoma t(11;22) malignant fibroblasts within a collagenous matrix - answerfibrosarcoma osseous sarcomas that affect older patients and has a predilection for flat bones in the *shoulders and pelvis* - answerchondrosarcoma PKU presents as failure to thrive, mental retardation, gapped teeth, etc. What is the amino acid that needs to be supplemented due to a defect in what enzyme? - answertyrosine, due to a defect in phenylalanine hydroxylase where does the posterior scalene attach to? - answerRib 2 used in the treatment of breast and ovarian cancer MOA: hyper stabilization of polymerized microtubules--> prevents the breakdown of the mitotic spindle - answerPaclitaxel maximum distance a patient can actually move a joint, can be pathologic - answerrestrictive barrier patterns of grandiosity, need for admiration, lack of empathy for others - answernarcissistic personality disorder what does a carotid massage do and how does it affect the AV node? - answerA carotid massage causes an increase in stretch of the carotid baroreceptors which causes a reflexive PARASYM response which slows down the conduction velocity through the AV node this slowing down Heart Rate--> used in paroxysmal supra ventricular tachycardia a form of leukemia characterized by the accumulation of abnormal, mature granulocytes (granulocytes are a type of white blood cell), mild anemia, thrombocytosis and basophilia. What is the associated chromosomal translocation? - answerChronic myelogenous leukemia t(9;22)--> Philly chx germinal B celll lymphoma that is associated with a translocation between c-MYC and the Ig heavy chain on which two chromosomes? It is endemic in the continent of Africa which produces this - answerBurkitt's lymphoma t(8;14) second most common lymphoma in the US, arises from germinal center B-cells. Presents with painless peripheral lymphadenopathy w/ a history of lymph node enlargement . Positive for CD 10, CD 19 and CD 20 expression. Results in what chromosomal translocation evolving the BCL- 2 gene? - answerfollicular lymphoma t(14;18) PML/RARA fusion gene associated with DIC, characteristic folded, bilobed nuclei are found in these certain type of cells. Coarse azurorophilic granules and multiple Auer rods are also present on histo - answerAcute promyelocytic leukemia t(15;17) inhibits platelet aggregation by irreversibly blocking the P2Y12 component of ADP receptors - answerClopidogrel textile industry worker that develops a low-grade fever, non-productive cough and substernal chest pain have what bug? Treatment is with a fluroquinolone and why are frequently associated with what ADR? - answerBacillus anthracis, tendonopathy X-linked recessive disorder present in AAs and Mediterraneans that cause an inability to generate reduced glutathione and lead to acute hemolysis when stress occurs. You will see bite cells and Heinz bodies on peripheral blood smear. - answerG-6-PD deficiency seen in those with MS, causes impaired horizontal eye movement w/ weak adduction of the affected eye and abduction nystagmus of the contralateral eye. Due to a lesion in the MLF in the