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COMSAE 2 EXAM STUDY GUIDE
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COMSAE 2 EXAM STUDY GUIDE
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COMSAE 2 EXAM STUDY GUIDESheehan 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.
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?
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
Isolated Tricuspid Stenosis MC from?
The most common causes are due to carcinoid heart disease and right atrial
myxoma.
, What is the MOA of an Aspirin Overdose?
It causes the uncoupling of oxidative phosphorylation and thereby reduces the
amount of ATP produced. Aspirin transports protons generated by the electron transport
chain back into the mitochondrial matrix. This decreases the amount of protons
available for ATP synthase to use for formation of ATP. As a result, there is
an accumulation of carbon dioxide in the body. Which leads to a respiratory
alkolosis which is then followed by a Metabolic acidosis to recompensate (Mixed)
What is the Antidote for Cyanide Poisoning?
Amyl nitrite. Cyanide inhibits cytochrome oxidase enzyme in the electron transport
chain within mitochondria. This causes depletion of ATP. Patients with cyanide
poisoning present with elevated heart rates, drowsiness, and eventual coma and death.
Alkpatonuria
An AR disorder that results from deficient activity of the enzyme homogentisic
oxidase. It results in elevated levels of homogentisic acid which forms a pigment that
is deposited in connective tissue and joints throughout the body. It typically presents in
the 3rd decade of life, with initial pigmentation occurring in the ear cartilage and sclera
of the eyes. A dark pigment is also deposited in the large joints and the lumbosacral
spine. This leads to early onset arthritis and can result in joint replacements at a
younger age. The disorder is characterized by urine that is of a normal color initially,
but turns a dark black color if left standing due to oxidation of the homogentisic acid.
The diagnosis is confirmed by measurement of homogentisic acid in the urine. No
effective therapy is available for alkaptonuria.
Metachromatic Leukodystrophy
An AR lysosomal storage disease that causes progressive demyelination of the
central and peripheral nervous system. It is due to a deficiency in Arylsulfatase A.
Common manifestations include regression of motor skills, gait abnormalities, ataxia,
hypotonia, upper motor neuron signs, and peripheral neuropathy. The diagnosis is
established by demonstrating deficient arylsulfatase A activity in leukocytes or
elevated sulfatides
McArdle Disease
An AR glycogen storage disease due to a deficiency in the
enzyme myophosphorylase. Myophosphorylase is involved in the breakdown
of glycogen to glucose in the muscles. McArdle disease usually presents
in adolescence or early adulthood with fatigue, myalgias, muscle cramps,
weakness, exercise intolerance, and myoglobinuria. These symptoms are brought on
by exercise. An ischemic muscle forearm test would reveal a failure of the lactate
levels to rise in venous blood after ischemic exercise.
Some AD diseases
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