COMBANK Level 2 CE - Accurate Answers To All
Questions
Tx Nursemaid's elbow (radial head subluxation). Correct Answer
- closed reduction with supination and elbow flexion then fully
flexing the elbow with pressure on the radial head
Rate HIV transmission after percutaneous needle stick with HIV
positive blood is ___%. Correct Answer - 0.3%
mucous membrane exposire 0.09%
Subendothelial deposits with marked thickening of capillary walls
which renal bx finding? Correct Answer - Lupus nephritis
- "wire loop"
- membranous or membranoproliferative nephropathy
Linear staining of the basement membrane which renal bx finding?
Correct Answer - Goodpasture syndrome
Mesangial deposits on electron microscopy in patients with asx
hematuria which renal bx finding? Correct Answer - IgA
nephroapthy (Berger's disease)
Expanded mesangium with cells and foreign proteinaceous material.
Diffuse foot process effacement and fusion of foot processes.
Correct Answer - Minimal change disease
The most common cause of secondary HTN. Correct Answer -
Renal artery stenosis
- arteriosclerosis and fibromuscular dysplasia
- dx with duplex doppler US of the kidney
,__ are contraindicated in cases of B/L renal artery stenosis as they
will accelerate renal failure by preventing sufficient renal perfusion
and decreasing GFR. Correct Answer - ACEi
The most accurate diagnostic test for Zollinger-Ellison. Correct
Answer - Secretin stimulation test
- fasting serum gastrin is best screening test and initial test
Tx Zollinger-Ellison syndrome Correct Answer - All patients
with sporadic Zollinger-Ellison w/o hepatic metastases or medical
contraindications to surgery are advised to have surgical resection
if mets give chemo, interferon, or octreotide
BP > 180/120 with end organ damage. dx. Correct Answer -
HTN EMERGENCY
- IV sodium nitroprusside
- pregnant use hydrazine
- pheochromocytoma phentolamine
__ considered first line tx angina with cardiac arrhythmias. Correct
Answer - BB
- sotalol (nonselective competitive beta blocker, class III anti
arrhythmic through inhibition K+ channels used in ventricular tach,
a. fib)
Goal BP in pt over 60 years old. Correct Answer - less than
150/90 mmHg
In black patients with evidence of proteinuria and CKD they should
be started on ___ to HTN. Correct Answer - ACEi or ARB
if CKD w/o proteinuria can use HCTZ
,Centor criteria Correct Answer -
Sore throat, hoarseness/muffled voice, stridor (audible inspiratory
sound), worse lying supine. Dx. Correct Answer - Epiglottitis
- fever
- thumb print sign lateral x-ray
- H. influenzae
Gold standard for dx an aortic dissection is ___. Correct Answer -
CT angiography
Debakey vs Stanford classification of Aortic dissection. Correct
Answer - Debakey type I - ascending and descending
type II - ascending
type III - descending
Stanford type A - ascending
Stanford type B - all others
Over 50
Proximal muscle pain and stiffness
Worse in the morning or after prolonged inactivity
Fever, wt loss, fatigue, depression Correct Answer -
Polymyalgia rheumatica
- tx corticosteroids low dose prednisone
Tx of choice active TB. Correct Answer - Rifampin, Isoniazid,
Pyrazinamide, Ethambutol for 2 months
Followed by Rifampin and Isoniazid only for 4 months
total 6 months treatment
, A lateral strain pattern has which axes. Correct Answer - 2
vertical axes
Grading of ankle ligamentous injury inversion ankle sprain.
Correct Answer - I - ATFL
II - ATFL + calcaneofibular
III - ATFL + CFL + posterior talofibular
Definitive dx of osteomyelitis is obtained by ___. Correct Answer -
Bone bx
Best imaging modality for osteomyelitis. Correct Answer - MRI
- INC signaling within the bone marrow with or without soft tissue
edema
Ataxia
Confusion
Ophthalmoplegia Correct Answer - Wenicke encephalopathy
- lateral rectus palsy or conjugate gaze palsy
Complex regional pain syndrome (CRPS) I versus II. Correct
Answer - I - no definable nerve lesion
II - defined nerve lesion
Complex regional pain syndrome (CRPS) disorder of extremities
that is characterized by pain, swelling, limited ROM, vasomotor
instability, skin changes, and patchy one demineralization
Tx bullous pemphigoid. Correct Answer - topical
corticosteroids and systemic anti-inflammatory therapy for 6-60
months
SE Ginko biloba Correct Answer - INC risk of bleeding (D/C
prior to sx)
Questions
Tx Nursemaid's elbow (radial head subluxation). Correct Answer
- closed reduction with supination and elbow flexion then fully
flexing the elbow with pressure on the radial head
Rate HIV transmission after percutaneous needle stick with HIV
positive blood is ___%. Correct Answer - 0.3%
mucous membrane exposire 0.09%
Subendothelial deposits with marked thickening of capillary walls
which renal bx finding? Correct Answer - Lupus nephritis
- "wire loop"
- membranous or membranoproliferative nephropathy
Linear staining of the basement membrane which renal bx finding?
Correct Answer - Goodpasture syndrome
Mesangial deposits on electron microscopy in patients with asx
hematuria which renal bx finding? Correct Answer - IgA
nephroapthy (Berger's disease)
Expanded mesangium with cells and foreign proteinaceous material.
Diffuse foot process effacement and fusion of foot processes.
Correct Answer - Minimal change disease
The most common cause of secondary HTN. Correct Answer -
Renal artery stenosis
- arteriosclerosis and fibromuscular dysplasia
- dx with duplex doppler US of the kidney
,__ are contraindicated in cases of B/L renal artery stenosis as they
will accelerate renal failure by preventing sufficient renal perfusion
and decreasing GFR. Correct Answer - ACEi
The most accurate diagnostic test for Zollinger-Ellison. Correct
Answer - Secretin stimulation test
- fasting serum gastrin is best screening test and initial test
Tx Zollinger-Ellison syndrome Correct Answer - All patients
with sporadic Zollinger-Ellison w/o hepatic metastases or medical
contraindications to surgery are advised to have surgical resection
if mets give chemo, interferon, or octreotide
BP > 180/120 with end organ damage. dx. Correct Answer -
HTN EMERGENCY
- IV sodium nitroprusside
- pregnant use hydrazine
- pheochromocytoma phentolamine
__ considered first line tx angina with cardiac arrhythmias. Correct
Answer - BB
- sotalol (nonselective competitive beta blocker, class III anti
arrhythmic through inhibition K+ channels used in ventricular tach,
a. fib)
Goal BP in pt over 60 years old. Correct Answer - less than
150/90 mmHg
In black patients with evidence of proteinuria and CKD they should
be started on ___ to HTN. Correct Answer - ACEi or ARB
if CKD w/o proteinuria can use HCTZ
,Centor criteria Correct Answer -
Sore throat, hoarseness/muffled voice, stridor (audible inspiratory
sound), worse lying supine. Dx. Correct Answer - Epiglottitis
- fever
- thumb print sign lateral x-ray
- H. influenzae
Gold standard for dx an aortic dissection is ___. Correct Answer -
CT angiography
Debakey vs Stanford classification of Aortic dissection. Correct
Answer - Debakey type I - ascending and descending
type II - ascending
type III - descending
Stanford type A - ascending
Stanford type B - all others
Over 50
Proximal muscle pain and stiffness
Worse in the morning or after prolonged inactivity
Fever, wt loss, fatigue, depression Correct Answer -
Polymyalgia rheumatica
- tx corticosteroids low dose prednisone
Tx of choice active TB. Correct Answer - Rifampin, Isoniazid,
Pyrazinamide, Ethambutol for 2 months
Followed by Rifampin and Isoniazid only for 4 months
total 6 months treatment
, A lateral strain pattern has which axes. Correct Answer - 2
vertical axes
Grading of ankle ligamentous injury inversion ankle sprain.
Correct Answer - I - ATFL
II - ATFL + calcaneofibular
III - ATFL + CFL + posterior talofibular
Definitive dx of osteomyelitis is obtained by ___. Correct Answer -
Bone bx
Best imaging modality for osteomyelitis. Correct Answer - MRI
- INC signaling within the bone marrow with or without soft tissue
edema
Ataxia
Confusion
Ophthalmoplegia Correct Answer - Wenicke encephalopathy
- lateral rectus palsy or conjugate gaze palsy
Complex regional pain syndrome (CRPS) I versus II. Correct
Answer - I - no definable nerve lesion
II - defined nerve lesion
Complex regional pain syndrome (CRPS) disorder of extremities
that is characterized by pain, swelling, limited ROM, vasomotor
instability, skin changes, and patchy one demineralization
Tx bullous pemphigoid. Correct Answer - topical
corticosteroids and systemic anti-inflammatory therapy for 6-60
months
SE Ginko biloba Correct Answer - INC risk of bleeding (D/C
prior to sx)
