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QBank Qs > COMBANK Random 2 > Flashcards

COMBANK Random 2 Flashcards

1
Q

Which part of Medicare covers inpatient hospital care, skilled nursing, hospice, and home health care?

A

Medicare part A

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2
Q

Which part of Medicare covers outpatient care, doctor’s services, physical therapy, and occupational therapy?

A

Medicare part B

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3
Q

What part of Medicare is called Medicare advantage plan and what is it combined of?

A

Medicare part C - combination of A and B

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4
Q

What part of Medicare is for prescription drug coverage?

A

Medicare part D

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5
Q

What are neoplastic polyps known as

A

adenomas

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6
Q

What are 3 characteristics that increase cancer risk in adenomas?

A
  1. greater than 1 cm
  2. contain substantial villous component
  3. high-grade dysplasia
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7
Q

What shape/structure of polyp is more likely to be cancerous?

A

sessile polyps with broad-based attachments are more likely to be malignant than pedunculated polyps attached to a stem

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8
Q

What are the 3 histologic types of colon adenomas?

A

tubular, villous, and tubulovillous

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9
Q

Which histologic type of adenoma is most likely to be associated with cancer and where are they commonly located?

A

Villous adenoma - located in sigmoid/rectal region

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10
Q

What is the appearance of a villous adenoma?

A

larger and flatter with a velvety, cauliflower-like appearance

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11
Q

What is the most common type of polyp?

A

Tubular adenoma

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12
Q

What is the appearance of a tubular adenoma?

A

small, pedunculated, and carry little risk for malignant transformation (can have malignant foci, esp in larger tubular polyps)

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13
Q

What is the appearance of a tubulovillous adenoma?

A

Most resemble tubular adenomas but have surface covered in villi - malignancy is greater than tubular but less than villous

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14
Q

Where is the most common location for colorectal cancer to metastasize and why?

A

Liver d/t dual blood supply via hepatic artery and portal vein allowing for hematologic spread as well as liver’s ability to filter blood
-~60-70% people with colorectal cancer will develop a liver tumor

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15
Q

Other than colon, what are 7 other cancers that commonly metastasize to the liver?

A
  1. breast
  2. esophagus
  3. stomach
  4. pancreas
  5. lungs
  6. kidneys
  7. skin (melanoma
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16
Q

What are 3 cancers that commonly metastasize to bone?

A

prostate, breast, and lung

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17
Q

What are 3 common cancers that metastasize to the brain?

A

lung, breast, and genitourinary

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18
Q

What are 6 cancers that metastasize to the lungs?

A

breast, colon, prostate, bladder, neuroblastoma, and sarcomas

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19
Q

What nonspecific marker can be increased in pancreatic cancer, gastric cancer, breast cancer, thyroid medullary carcinoma, ulcerative colitis, pancreatitis, cirrhosis, COPD, Crohn, and chronic smokers?

A

CEA - found in adenocarcinomas

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20
Q

What does AFP serve as a tumor marker for?

A

hepatocellular carcinoma, germ cell tumors, and metastatic cancers of the liver

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21
Q

What do pts with FAP have an autosomal dominant mutation in?

A

APC - tumor suppressor gene on chromosome 5

22
Q

What diseases is ALP elevated in?

A

metastatic bone disease, biliary disease, and Paget disease of the bone

23
Q

What is a nonspecific tumor marker that can confirm the Dx of colorectal cancer, monitor for tumor recurrence, and monitor response to therapy?

A

CEA

24
Q

Which bleeding disorder is commonly associated with easy bruising, skin bleeding, prolonged bleeding from mucosal surfaces, trivial wounds, and excessive menstrual bleeding?

A

von Willebrand Disease

25
Q

What are the lab values of vWD and why?

A

normal platelet count, increased bleeding time, normal PT, and slightly increased PTT
-vWF normally protects factor VIII from degradation; low levels of vWF correspond to low levels of factor VIII

26
Q

What assay is diagnostic for vWD?

A

ristocetin-induced platelet agglutination (RIPA)

27
Q

What platelet disorder is caused by a deficiency of GpIb leading to decreased platelet count and normal PT/PTT?

A

Bernard-Soulier syndrome

28
Q

Why is Hemophilia B unlikely to be in females?

A

It is a an X-linked recessive disorder

29
Q

What clotting factors is Vitamin K important for the synthesis for?

A

intrinsic and extrinsic: II, VII, IX, and X

30
Q

What is the Tx for mild vWD and what is the MOA?

A

desmopression acetate - increases pt’s own levels of vWF by increasing its release from Weibel-Palade bodies in endothelial cells

31
Q

Which populations are at risk for Vitamin K deficiency?

A

newborn infants, bulimics, and pts on Warfarin

32
Q

What antibiotic can increase PT levels in a pt on warfarin therapy?

A

Sulfonamides - displace warfarin in plasma proteins so more warfarin circulates in the blood and decreases hepatic synthesis of factor II, VII, IX, and X via vitamin K antagonism

33
Q

What is the MOA of Vitamin K?

A

activates clotting facotrs II, VII, IX, and X by adding carboxyl groups to key glutamic acid residues within the proteins’ structure

34
Q

What is the most common Sx of Dupuytren contracture?

A

inability to extend 4th and 5th digits as the fascia loses its elasticity

35
Q

What is the drug of choice (and its MOA) for PTSD

A

SSRI - blocks presynaptic serotonin receptors which increases availability of serotonin in synaptic cleft

36
Q

What type of drug is a reuptake inhibitor of serotonin and norepinephrine?

A

TCA (amitryptiline and clomipramine)

37
Q

What is the MOA of haloperidol? What can it be used as a non-first line therapy for?

A

blocks postsynaptic D1 adn D2 receptors and depresses teh release of hypothalamic and hypophyseal hormones

  • can be used to suppress tics of Tourette
  • can also be used for psychosis, delirium, postop nausea and vomiting, and tranquilization of severely agitated pts
38
Q

What are firsr-line pharm Txs for Tourette disorder?

A

dopamine receptor antagonists: fluphenazine, pimozide, and tetrabenazine - they depress the reticular activating system

39
Q

What does scaly thickened skin on anterior legs in a pt’s with hyperthyroidism indicate and what condition is it exclusive for?

A

pretibial myxedema - exclusive for Graves’ disease

40
Q

What causes pretibial myxedema?

A

infiltration of lymphocytes and glycosaminoglycans (especially hyaluronic acid) into dermis

41
Q

What is the drug of choice for pregnant women with hyperthyroidism in pregnancy?

A

PTU

42
Q

Where is the Chapman point for sigmoid colon?

A

lateral though within the IT band close to the greater trochanter

43
Q

What UE lesion can occur in a newborn during delivery wiht traction on the neck in attempt to free a trapped shoulder during shoulder dystocia and how does it present?

A

Erb-Duchenne palsy: adducted, medially rotated, and pronated

44
Q

What neoplasisa are associated with MEN1/Werner syndrome?

A
  • associated wtih genes on chromosome 11
  • pituitary adenomas, parathyroid adenomas, and non-beta islet cell tumors of the pancreas
    (i. e. prolactinoma, PUD d/t gastrinoma, insulinoma, kidney stones)
45
Q

What neoplasias are associated with MEN Type 3 (2B)?

A

pheochromocytoma, thyroid medullary carcinoma, mucosal neuromas, and marfanoid physical features

46
Q

What neoplasias are assocaited with Men-2A/Sipple syndrome?

A
  • chromosome 10

- pheochromocytoma, thyroid medullary carcinoma, and parathyroid adenomas

47
Q

What is the difference between complex regional pain syndrome-1 and complex regional pain syndrome-2?

A

there is no evidence of nerve damage in type 1 and there is nerve damage in type 2

48
Q

What are the characteristics of CRPS-1?

A

severe, burning pain at site of injury, muscle spasm, joint stiffness, restricted mobility, rapid hair and nail growth, and vasospasm causing edema and skin changes

49
Q

What are the characteristics of CRPS-2?

A

widespread edema, diminished hair growth, cracked and brittle nails, severe and diffuse osteoporosis, and muscle atrophy

50
Q

What is the MOA of metoclopramide and what are SE?

A

It stimulates peristalsis by antagonizing D2 receptors; SE include parkinsonism and dystonia

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