COMSAE 2/ 104 Questions with Complete
Solutions.
Sheehan Syndrome
A rare condition that occurs secondary to pituitary ischemia and subsequent
infarction following significant postpartum bleeding. This occurs due to the
decreased perfusion of the pituitary during the final stages of pregnancy and labor
process. This can also occur due to significant blood loss during labor, leading to
hypoperfusion of the pituitary gland and subsequent infarction. This will in turn
cause a global decrease in the hormones that are produced in the anterior
pituitary.
The production of ADH and oxytocin is not affected because both hormones are
produced in the hypothalamus, and stored in the posterior pituitary gland.
Bosentan & Ambrisentan MOA
They treat pulmonary hypertension by competitively antagonizing endothelin-1
receptors, thus, decreasing pulmonary vascular resistance.
Page 1 of 24
,Inclusion Body Myositis
Characterized by inflammation and endomysial infiltrates of CD8+ T cells and
macrophages that focally surround and invade myofibrils. The presence
of rimmed vacuoles is a characteristic feature. It is more common in males over
the age of 50-years-old. It manifests as an insidious onset of proximal muscle
weakness, often with associated distal muscle weakness. The distribution of
weakness is variable, but unlike polymyositis and dermatomyositis, asymmetry is
common. Early involvement of the knee extensors, ankle dorsiflexors, and wrist
and finger flexors is characteristic. Weakness of the wrist and finger flexors is often
greater than their extensor counterparts. Hence, loss of finger dexterity and grip
strength may be a prominent symptom. It also commonly causes greater
weakness in knee extension when compared with the hip flexors. Deep tendon
reflexes may be impaired or absent if weakness is severe. Laboratory results reveal
a normal to slightly elevated level of serum creatine kinase. Muscle biopsy is the
gold standard for diagnosis.
Polymyalgia Rheumatica
A disease of the elderly that causes proximal myalgias of the hip and shoulder
girdles. The symptoms appear first in the shoulder girdle, and patients commonly
complain of stiffness after prolonged inactivity. The shoulder and hip girdles can
be painful and stiff, causing difficulty in rising from a chair or raising their arms
over their shoulder. Patients also have morning stiffness that typically lasts for
more than one hour. There is no muscle weakness, as compared to
dermatomyositis and polymyositis. It is commonly associated with giant cell
arteritis. Laboratory studies reveal an erythrocyte sedimentation rate (ESR) >
40 mm/h. Treatment is with prednisone.
What is the genetic transmission of Duchenne & Becker Muscular Dystrophy?
XLR
5% Sheep Blood added to?
Blood agar usually contains 5% sheep blood and is used to determine hemolysis
patterns of Streptococcus
Eosin-methylene blue is added to?
Page 2 of 24
, A staining agent used to visualize Escherichia coli that show up as a metallic
sheen.
Nystatin is added to help culture which organism?
Nystatin is a part of the VPN or Thayer-Martin agar designed to grow Neisseria
gonorrhoeae.
What 2 OMM techniques can be used to thin mucous secretions in a pt with
Asthma?
Asthma is the most common chronic disease in childhood and asthma symptoms
include wheezing, shortness of breath, chest tightness and cough. Asthma
involves hypersensitivity of the bronchi and lower airways to allergens, cold or
other irritants. This results in inflammation, bronchospasm and mucous
plugging. β-2-agonists help dilate the bronchioles but do not directly affect the
sympathetic nerves which regulate secretions. Persistent asthma can drive the
upper thoracic (particularly T1-T4) sympathetic nerves into a chronically active
state. One particularly significant physiologic response of this is proliferation of
goblet cells. These cells in the bronchial mucosa produce thick, tenacious
secretions which are difficult to clear. Rib raising is one method of normalizing (in
this case, decreasing) sympathetic tone to thin the secretions. Another useful
method is the thoracic pump, which can be particularly helpful in normalizing
lymphatic flow out of congested tissues.
Sympathetic Vicerosomatics
Page 3 of 24
Solutions.
Sheehan Syndrome
A rare condition that occurs secondary to pituitary ischemia and subsequent
infarction following significant postpartum bleeding. This occurs due to the
decreased perfusion of the pituitary during the final stages of pregnancy and labor
process. This can also occur due to significant blood loss during labor, leading to
hypoperfusion of the pituitary gland and subsequent infarction. This will in turn
cause a global decrease in the hormones that are produced in the anterior
pituitary.
The production of ADH and oxytocin is not affected because both hormones are
produced in the hypothalamus, and stored in the posterior pituitary gland.
Bosentan & Ambrisentan MOA
They treat pulmonary hypertension by competitively antagonizing endothelin-1
receptors, thus, decreasing pulmonary vascular resistance.
Page 1 of 24
,Inclusion Body Myositis
Characterized by inflammation and endomysial infiltrates of CD8+ T cells and
macrophages that focally surround and invade myofibrils. The presence
of rimmed vacuoles is a characteristic feature. It is more common in males over
the age of 50-years-old. It manifests as an insidious onset of proximal muscle
weakness, often with associated distal muscle weakness. The distribution of
weakness is variable, but unlike polymyositis and dermatomyositis, asymmetry is
common. Early involvement of the knee extensors, ankle dorsiflexors, and wrist
and finger flexors is characteristic. Weakness of the wrist and finger flexors is often
greater than their extensor counterparts. Hence, loss of finger dexterity and grip
strength may be a prominent symptom. It also commonly causes greater
weakness in knee extension when compared with the hip flexors. Deep tendon
reflexes may be impaired or absent if weakness is severe. Laboratory results reveal
a normal to slightly elevated level of serum creatine kinase. Muscle biopsy is the
gold standard for diagnosis.
Polymyalgia Rheumatica
A disease of the elderly that causes proximal myalgias of the hip and shoulder
girdles. The symptoms appear first in the shoulder girdle, and patients commonly
complain of stiffness after prolonged inactivity. The shoulder and hip girdles can
be painful and stiff, causing difficulty in rising from a chair or raising their arms
over their shoulder. Patients also have morning stiffness that typically lasts for
more than one hour. There is no muscle weakness, as compared to
dermatomyositis and polymyositis. It is commonly associated with giant cell
arteritis. Laboratory studies reveal an erythrocyte sedimentation rate (ESR) >
40 mm/h. Treatment is with prednisone.
What is the genetic transmission of Duchenne & Becker Muscular Dystrophy?
XLR
5% Sheep Blood added to?
Blood agar usually contains 5% sheep blood and is used to determine hemolysis
patterns of Streptococcus
Eosin-methylene blue is added to?
Page 2 of 24
, A staining agent used to visualize Escherichia coli that show up as a metallic
sheen.
Nystatin is added to help culture which organism?
Nystatin is a part of the VPN or Thayer-Martin agar designed to grow Neisseria
gonorrhoeae.
What 2 OMM techniques can be used to thin mucous secretions in a pt with
Asthma?
Asthma is the most common chronic disease in childhood and asthma symptoms
include wheezing, shortness of breath, chest tightness and cough. Asthma
involves hypersensitivity of the bronchi and lower airways to allergens, cold or
other irritants. This results in inflammation, bronchospasm and mucous
plugging. β-2-agonists help dilate the bronchioles but do not directly affect the
sympathetic nerves which regulate secretions. Persistent asthma can drive the
upper thoracic (particularly T1-T4) sympathetic nerves into a chronically active
state. One particularly significant physiologic response of this is proliferation of
goblet cells. These cells in the bronchial mucosa produce thick, tenacious
secretions which are difficult to clear. Rib raising is one method of normalizing (in
this case, decreasing) sympathetic tone to thin the secretions. Another useful
method is the thoracic pump, which can be particularly helpful in normalizing
lymphatic flow out of congested tissues.
Sympathetic Vicerosomatics
Page 3 of 24
