Comlex 2

Question 1

Subclavian steal syndrome

Answer 1

due to retrograde flow of blood in the vertebral artery or the internal thoracic artery, caused by proximal stenosis or occlusion of the subclavian artery
Arm is supplied by blood flowing in a retrograde direction down the vertebral artery at teh expense of hte vertebrobasilar circulation
most common symptoms: presyncope, syncope, neurologic deficits, and BP differential between the arms
dx: doppler U/S, CT angiography, angiogram
Rx: stent/ balloon angioplasty adn endarterectomy

Question 2

signs of sarcoidosis

Answer 2

restrictive pulmonary functiontests
elevated ACE, hypercalcemia

erythema nodosum, bell palsy, bilateral hilar adenopathy

African american females

Question 3

drug to slow ALS

Answer 3

Riluzole

Question 4

increasing prevalence leads to

Answer 4

increased positive predictive value

Question 5

best treatment for fibromyalgia

Answer 5

counterstrain

Question 6

brain neurotransmitters during REM sleep

Answer 6

Ach increases, NE decreases

biochemical trigger for REM sleep

Question 7

vitamin needed for peripheral neuropathy in isoniazid rx

Answer 7

B6- Pyridoxine

Question 8

bilirubin in the urine–>

Answer 8

dark color and yellow foam (if a lot)

Question 9

blow to the temple goes with

Answer 9

epidural hematoma

Question 10

most needlestick injuries happen wheN?

Answer 10

while using the needle on the patient

Question 11

pyruvate carboxylase deficiency

Answer 11

autosomal recessive
–> elevated levels of alanine, ppyruvate, lactate, ketoacids

catalyzes the formation of oxaloacetate

Question 12

fasting timeline

Answer 12

16-24 hours- hepatic glycogenolysis

after that: gluconeogenesis

Question 13

lymphatic fluid on thoracentesis means

Answer 13

probably lymphoma or adjacent tumors

unless trauma

Question 14

pneumonia and cold agglutinins –>

Answer 14

Mycoplasma pneumoniae

use macrolides (azithromycin, clarithromycin)

Question 15

cyclosporine

Answer 15

immunosuppression by binding cyclophilin and inhibiting IL-1 and IL-2

–> nephrotoxicity, HTN, gingival hyperplasia, hyperlipidemia, hypergllycemia

Question 16

hodgkin lymphoma cell marker

Answer 16

reed sternberg owl’s eye cells with CD30 and CD 15

Question 17

test for bullous impetigo

Answer 17

golden-crusted lesions
usually staph aureus or group A strep

distinguish using catalase test

Question 18

pudendal nerve block- palpate what?

Answer 18

ischial spine

Question 19

trigeminal nerve foramen

Answer 19

SRO (standing room only)
V1- Superior orbital fissure
V2- Foramen Rotundum
V3- Foramen ovale

Question 20

lots of alchohol leads to what change in metabolic stuf??

Answer 20

increased conversion of pyruvate to lactate

Question 21

highest risk factor for gastric carcinoma?

Answer 21

H. Pylori

Question 22

what removes immune complexes from serum?

Answer 22

C3b, of the classical complement pathway

Question 23

primase

Answer 23

complex of proteins that synthesizes a short fragment of RNA. Required before the DNA can be synthesized

Question 24

patent ductus arteriosus arises from which branchial arch?

Answer 24

sixth branchial

and left sixth aortic

Question 25

pindolol and angina

Answer 25

Contraindicated
has intrinsic sympathomimetic activity and acts as a partial beta-1 agonist

maintains a high myocardial O2 consumption

Question 26

infant with gowth failure, cataracts, liver disease, aminoaciduria, and mental retardation

Answer 26

classical galactosemia

deficiency of galactose-1-phosphate

treat with strict dietary lactose restriction

Question 27

Down syndrome heart problems

Answer 27

endocardial cushian defects caused by failure of neural crest cells to migrate