COMSAE
a 20 year old female presents to the emergency department after she slipped on ice and hit her
mouth on the sidewalk. Her medial maxillary incisors are fractured and she is intense pain. the
nerve most likely conveying this pain sensation is the?
a. anterior superior alveolar b. infraorbital c. middle superior alveolar d. nasopalatine e. posterior
superior alveolar
The nerve most likely conveying the pain sensation in this scenario is the infraorbital nerve
(option b).
The infraorbital nerve is a branch of the maxillary nerve, which is a division of the trigeminal
nerve (cranial nerve V). The maxillary nerve provides sensory innervation to the maxillary teeth,
maxillary sinus, upper gingiva, and the skin of the lower eyelid, lateral nose, and upper lip.
In the given case, the patient experienced a traumatic injury to her mouth, specifically fracturing
her medial maxillary incisors. The intense pain she is feeling is likely transmitted through the
sensory branches of the maxillary nerve, including the infraorbital nerve.
The infraorbital nerve travels through the infraorbital canal, emerges on the face through the
infraorbital foramen, and supplies sensation to the skin of the lower eyelid, lateral nose, and
upper lip. The fractured incisors would have damaged the associated nerve endings, leading to
significant pain in those areas.
Therefore, the nerve most likely conveying the pain sensation in this patient's case is the
infraorbital nerve (option b).
a 25 year old female presents to the office for evaluation of headaches, diplopia and loss of
peripheral vision which have progressively worsened over the past week. she reports
galactorrhea and amenorrhea. physical examination is unremarkable and Beta-HCG is negative
for pregnancy. MRI of the brain is obtained. The secretory cells that are most likely causing this
patient's conditions are? a.corticotrophs b.gonadotrophs c.lactotrophs d.somatotrophs
e.thyrotrophs
Based on the provided information, the secretory cells most likely causing this patient's
conditions are lactotrophs.
The symptoms of headaches, diplopia (double vision), and loss of peripheral vision along with
galactorrhea (abnormal breast milk production) and amenorrhea (absence of menstrual periods)
suggest a hormonal imbalance. These symptoms are commonly associated with a condition
known as hyperprolactinemia, which is characterized by high levels of prolactin hormone.
Lactotrophs are the cells in the anterior pituitary gland responsible for producing and secreting
prolactin. In this case, the lactotrophs are overactive, leading to an excessive secretion of
prolactin. This excess prolactin production can result in the symptoms described by the patient.
An MRI of the brain is obtained to assess the pituitary gland and rule out any structural
abnormalities, such as a pituitary adenoma (a benign tumor). A pituitary adenoma involving the
lactotrophs is a common cause of hyperprolactinemia.
, Therefore, the most likely secretory cells causing this patient's conditions are lactotrophs (option
c).
HELLP syndrome
Preeclampsia with thrombotic microangiopathy of liver. Hemolysis, elevated liver enzymes, low
platelets. may occur in the absence of hypertension and proteinuria. blood smear shows DIC
(due to release of tissue factor from injured placenta)
treatment: immediate delivery
Brachioradilias Innervation
C6
3,500 kcal
1lb of body fat is equivalent to?
a 35 year old female is evaluated for mental status changes on day 4 of hospitalization for
status asthmaticus. she is being treated with albuterol, predisone, and ipratropium. Social
history is negative for substance use. neurologic examination is nonfocal, but she shows
impairment of attention, concentration and recall. she has a minor resting hand tremor but no
patholigc reflexes. ECG and mri of the brain are both negaitve. this patient's mental status
change is most likely due?
Given the information provided, the most likely cause of the mental status changes in this case
would be option C: medication effect. The patient's symptoms, such as impairment of attention,
concentration, recall, and a minor resting hand tremor, are consistent with the known side
effects of medications like albuterol, prednisone, and ipratropium, which she is currently
receiving for the treatment of status asthmaticus.
Alcohol withdrawal (option A) typically presents with a constellation of symptoms such as
tremors, anxiety, agitation, hallucinations, and seizures, which are not described in the given
scenario.
Hypercapnia (option B), which is an abnormally high level of carbon dioxide in the blood, can
lead to altered mental status. However, it is less likely in this case since the patient's
neurological examination is described as nonfocal and there is no mention of respiratory
distress or other signs of severe respiratory compromise.
Seizures (option D) and stroke (option E) can both cause mental status changes, but there are
no indications in the scenario to suggest these as the likely causes. The absence of pathological
reflexes and negative MRI of the brain make these options less likely.
Therefore, based on the information provided, the most likely cause of the mental status
changes is a medication effect from the medications being used to treat the patient's status
asthmaticus. However, it is important to consult a healthcare professional for a comprehensive
evaluation and definitive diagnosis.
a 20 year old female presents to the emergency department after she slipped on ice and hit her
mouth on the sidewalk. Her medial maxillary incisors are fractured and she is intense pain. the
nerve most likely conveying this pain sensation is the?
a. anterior superior alveolar b. infraorbital c. middle superior alveolar d. nasopalatine e. posterior
superior alveolar
The nerve most likely conveying the pain sensation in this scenario is the infraorbital nerve
(option b).
The infraorbital nerve is a branch of the maxillary nerve, which is a division of the trigeminal
nerve (cranial nerve V). The maxillary nerve provides sensory innervation to the maxillary teeth,
maxillary sinus, upper gingiva, and the skin of the lower eyelid, lateral nose, and upper lip.
In the given case, the patient experienced a traumatic injury to her mouth, specifically fracturing
her medial maxillary incisors. The intense pain she is feeling is likely transmitted through the
sensory branches of the maxillary nerve, including the infraorbital nerve.
The infraorbital nerve travels through the infraorbital canal, emerges on the face through the
infraorbital foramen, and supplies sensation to the skin of the lower eyelid, lateral nose, and
upper lip. The fractured incisors would have damaged the associated nerve endings, leading to
significant pain in those areas.
Therefore, the nerve most likely conveying the pain sensation in this patient's case is the
infraorbital nerve (option b).
a 25 year old female presents to the office for evaluation of headaches, diplopia and loss of
peripheral vision which have progressively worsened over the past week. she reports
galactorrhea and amenorrhea. physical examination is unremarkable and Beta-HCG is negative
for pregnancy. MRI of the brain is obtained. The secretory cells that are most likely causing this
patient's conditions are? a.corticotrophs b.gonadotrophs c.lactotrophs d.somatotrophs
e.thyrotrophs
Based on the provided information, the secretory cells most likely causing this patient's
conditions are lactotrophs.
The symptoms of headaches, diplopia (double vision), and loss of peripheral vision along with
galactorrhea (abnormal breast milk production) and amenorrhea (absence of menstrual periods)
suggest a hormonal imbalance. These symptoms are commonly associated with a condition
known as hyperprolactinemia, which is characterized by high levels of prolactin hormone.
Lactotrophs are the cells in the anterior pituitary gland responsible for producing and secreting
prolactin. In this case, the lactotrophs are overactive, leading to an excessive secretion of
prolactin. This excess prolactin production can result in the symptoms described by the patient.
An MRI of the brain is obtained to assess the pituitary gland and rule out any structural
abnormalities, such as a pituitary adenoma (a benign tumor). A pituitary adenoma involving the
lactotrophs is a common cause of hyperprolactinemia.
, Therefore, the most likely secretory cells causing this patient's conditions are lactotrophs (option
c).
HELLP syndrome
Preeclampsia with thrombotic microangiopathy of liver. Hemolysis, elevated liver enzymes, low
platelets. may occur in the absence of hypertension and proteinuria. blood smear shows DIC
(due to release of tissue factor from injured placenta)
treatment: immediate delivery
Brachioradilias Innervation
C6
3,500 kcal
1lb of body fat is equivalent to?
a 35 year old female is evaluated for mental status changes on day 4 of hospitalization for
status asthmaticus. she is being treated with albuterol, predisone, and ipratropium. Social
history is negative for substance use. neurologic examination is nonfocal, but she shows
impairment of attention, concentration and recall. she has a minor resting hand tremor but no
patholigc reflexes. ECG and mri of the brain are both negaitve. this patient's mental status
change is most likely due?
Given the information provided, the most likely cause of the mental status changes in this case
would be option C: medication effect. The patient's symptoms, such as impairment of attention,
concentration, recall, and a minor resting hand tremor, are consistent with the known side
effects of medications like albuterol, prednisone, and ipratropium, which she is currently
receiving for the treatment of status asthmaticus.
Alcohol withdrawal (option A) typically presents with a constellation of symptoms such as
tremors, anxiety, agitation, hallucinations, and seizures, which are not described in the given
scenario.
Hypercapnia (option B), which is an abnormally high level of carbon dioxide in the blood, can
lead to altered mental status. However, it is less likely in this case since the patient's
neurological examination is described as nonfocal and there is no mention of respiratory
distress or other signs of severe respiratory compromise.
Seizures (option D) and stroke (option E) can both cause mental status changes, but there are
no indications in the scenario to suggest these as the likely causes. The absence of pathological
reflexes and negative MRI of the brain make these options less likely.
Therefore, based on the information provided, the most likely cause of the mental status
changes is a medication effect from the medications being used to treat the patient's status
asthmaticus. However, it is important to consult a healthcare professional for a comprehensive
evaluation and definitive diagnosis.
