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COMSAE 110 2024/2025 Questions and Answers Rated A+
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COMSAE 110 2024/2025 Questions and Answers Rated A+
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COMSAE 110 2024/2025 Questions andAnswers Rated A+
68 yo M brought into ED for eval of sudden-onset L side numbness of the face &
extremities. PMHx significant for HTN & T2DM. These symptoms most likely represent
a lacunar infarct of the:
a. basis pontis
b. central midbrain
c. posterior limb of internal capsule
d. subthalamic nucleus
e. ventroposterior thalamus - ANSWER-e. ventroposterior thalamus
A 24yo F presents w/ 1mo hx of extreme fatigue, weakness & 8lb weight loss. Vital
signs reveal BP 100/50 mmHg & HR 115/min. Lab studies reveal hyponatremia,
hyperkalemia & elevated Cr. Patient's fatigue & weakness is most likely due to:
a. adrenocortical insufficiency
b. anemia
c. DM
d. hypothyroidism - ANSWER-a. adrenocortical insufficiency
A 36 yo F w/ 3mo hx of fatigue presents w/ multiple aches & pains all over her body.
She hasn't been sleeping well & doesn't feel like doing anything. PE reveals multiple
TPs on both sides of the body & above & below the diaphragm. Plain film radiographs
reveal no abnormalities, & rheumatological blood tests are negative. Most appropriate
method of dx:
a. dx of exclusion
b. electromyography
c. MRI of brain
d. m biopsy
e. serum protein electrophoresis - ANSWER-a. dx of exclusion
-pt has fibromyalgia
A 54yo F presents w/ difficulty walking. ROS reveals flu-like s/s 2wks ago. Pt reports
weakness began in feet days ago & now involves her legs. PE reveals symmetric
decreased strength in both lower limbs & absent patellar & Achilles reflexes BL.
Sensation is intact. Nerve conduction studies reveal decreased conduction velocity in
the lower limbs. The most likely pathogenesis is:
a. auto-immune-mediated demyelination
b. inherited deficiency of dystrophin
c. metabolic disease of the m
,d. spinal cord compression from a tumor
e. viral infection of dorsal roots - ANSWER-a. auto-immune-mediated demyelination
-pt has GB
A Native American asks for a ritual in the hospital that includes dancing & chanting. Can
you honor the request?
a. honor it as long as there is no harm to the patient
b. not honor the request bc it may be disruptive to other hospital pts - ANSWER-a.
honor it as long as there is no harm to the patient
A pt w/ Alzheimer's presents w/ recent hx of starting new mediation, UTI & delirium.
What is the cause of his delirium? - ANSWER-UTI
Adjustment disorder vs Major Depressive Disorder timeline - ANSWER-AD = w/in 3mo
of identifiable psychosocial stressor lasting <6mo
MDD = >2wks of s/s
Alpha hemolytic optochin resistant strep - ANSWER-Viridans
-mutans, sanguinis
Alpha hemolytic optochin sensitive strep - ANSWER-Strep pneumo
B hemolytic bacitracin resistant strep - ANSWER-Strep agalactiae (group B)
B hemolytic bacitracin sensitive strep - ANSWER-Strep pyo (group A)
Bacillus anthracis VFs (3) & shape/stain - ANSWER-Gram positive, box-car, spore-
forming
Lethal toxin
Edema toxin
Poly-D-glutamic capsule
Bacillus cereus :
transmission
gram stain
s/s - ANSWER-Rice
Gram positive rod
Watery diarrhea, food poisoning
BL vestibular Schwannomas are associated w/ - ANSWER-Neurofibromatosis 2
Bordetella pertussis:
toxin (Gi, Gs, or Gq)
, s/s (2)
tx - ANSWER-Pertussis toxin (Gi)
Catarrhal (coryza & low-grade fever) & whooping cough
Tx = macrolides (TMP-SMX if allergic)
Borrelia burgdorferi:
stain
shape
transmission
tx
co-infection w/ - ANSWER-Giemsa stain
Spirochete
Transmission = Ixodes deer tick
Tx = doxycycline
Co-infection w/ Babesia microti (Maltese cross)
Breast cancer is often due to overexpression of - ANSWER-estrogen/progesterone
receptors or HER2
-triple negative (ER, PR, & HER2 neg = more aggressive)
Broca aphasia - ANSWER-Non-fluent aphasia
-can repeat & comprehend
-inferior frontal gyrus
-Brodmann areas 44 & 45
-MCA
Brucella:
transmission
hides in what cell type?
s/s (4)
tx (2) - ANSWER-Unpasteurized dairy
Hide in macrophages
S/S = noncaseating granulomas, undulant fever, night sweats, arthralgia
Tx = doxy + rifampin or streptomycin
Burkholderia cepacia - ANSWER-Cystic fibrosis pts pneumonia
C. botulinum 5 D's - ANSWER-Diplopia
Dysarthria
Dysphagia
Dyspnea
Descending flaccid paralysis
C. jejuni can precede what 2 conditions - ANSWER-GB & reactive arthritis
C. perfringens VF - ANSWER-Lecithinase (alpha toxin)
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