Comlex

Question 1

first reason inversion ankle sprains

Answer 1

The anterior talofibular (ATF) ligament is the ligament most often sprained in this type of injury (ATF = always tears first). It is located on the anterolateral ankle between the talus and fibula. When the ankle inverts too far, this ligament is stretched, causing an ankle sprain.

Question 2

second reason inversion ankle sprain

Answer 2

the calcaneofibular. It is located on the lateral aspect of the ankle, connecting the calcaneous to the fibula

Question 3

eversion ankle sprain

Answer 3

deltoid ligament

Question 4

how does phenytoin cause osteoporsis

Answer 4

It has a direct inhibitory effect on the intestinal absorption of calcium, a direct stimulatory effect on osteoclastic bone resorption, and inhibitions the proliferation of human osteoblastic-like cells. Phenytoin also induces the P450 enzyme system which accelerates catabolism of vitamin D. A deficiency of calcium and phosphate may be associated. Therefore, osteomalacia due to vitamin D deficiency is another possible long-term side effect

Question 5

what drugs can cause Vit D deficiency

Answer 5

aromatase inhibitors, proton pump inhibitors, SSRI’s, anticonvulsants (phenytoin), thiazolidinediones, and androgen deprivation agents

Question 6

long term effects of phenytoin

Answer 6

hirsutism, gingival hyperplasia, peripheral neuropathies, and osteomalac

Question 7

A 45-year-old female presents to the office with the complaint of burning pain in her right leg. History reveals the pain has been refractory to conventional pain management. She also experiences joint stiffness in the right knee and ankle, and regular muscle spasms. Physical examination of the extremity reveals mild edema and the region is sensitive to touch. There is increased hair growth over the affected area of skin. An MRI of the lumbar spine is normal

Answer 7

complex regional pain syndrome, type 1

Question 8

Describe complex regional pain syndrome type 1

Answer 8

characterized by severe, burning pain at the site of injury. Muscle spasm, joint stiffness, restricted mobility, rapid hair and nail growth, and vasospasm causing edema and skin changes can also occur. There is NO evidence of nerve damage in type 1 injuries

Question 9

Describe complex regional pain syndrome type 2

Answer 9

associated nerve injury. Edema is typically widespread, hair growth diminishes, nails become cracked and brittle, osteoporosis becomes severe and diffuse, joints thicken, and muscle atrophy occurs.

Question 10

Describe Cauda Equina syndrome

Answer 10

bowel and bladder dysfunction or saddle anesthesia

Question 11

what is sarcoid associated with?

Answer 11

noncaseating granulomas in the interstitium and hilar lymph nodes. Patients with this disorder have erythema nodosum, eye problems, and commonly hypercalcemia as a result of hypervitaminosis D. It has both obstructive and restrictive lung disease hallmarks.

Question 12

first line agent for strep throat (group A strep or strep pyogenes)

Answer 12

penicillin

Question 13

ependymomas

Answer 13

perivascular pseudorosette pattern of cells with rod-shaped blepharoblasts, or cilary bodies, near the nuclei of each cell. This tumor is the third most common primary brain tumor in children, and it can most often be found near the fourth ventricle, which can lead to hydrocephalus

Question 14

medullablastoma

Answer 14

Solid sheets of basophilic cells surrounding eosinophilic, circular zones devoid of cells. rosette pattern; PNET

Question 15

schwannnomas

Answer 15

consist of alternating areas of high cellular (Antoni A) and low cellular (Antoni B) structures. This condition is the third most common primary brain tumor in adults, and it is often associated with neurofibromatosis type 2. These tumors originate from the Schwann cells, often of cranial nerve VIII (vestibulocochlear) found in the cerebellopontine angle of the brain.

Question 16

Craniopharyngioma

Answer 16

cystic masses filled with cholesterol crystals and viscous fluid. Calcifications may be present in this tumor. They are the most common childhood supratentorial tumors, and are benign. Craniopharyngiomas are derived from remnants of Rathke’s pouch and can often be confused with pituitary adenomas, which also cause bitemporal hemianopsia.

Question 17

Glioblastoma multiforme

Answer 17

pseudopalisading, pleomorphic cells that border central areas of necrosis and hemorrhage. This is the most common primary brain tumor in adults, typically found in the cerebral hemispheres, and it has the worst prognosis. It is the highest grade (grade IV) astrocytoma and is derived from ectoderm

Question 18

Meningiomas Histo

Answer 18

comprised of densely packed cells in sheets with no distinct cytoplasmic borders. Nuclei have intranuclear vacuoles. Some types of meningiomas have more spindle cells than other types, interlacing among an intercellular stroma made of reticulin and collagen. Psammoma bodies, or whorled calcifications, are present throughout.

Question 19

drugs that cause lupus-like shits

Answer 19

hydralazine, isoniazid, procainamide, and phenytoin

Question 20

hemodynamic criteria for constrictive pericarditis

Answer 20

right ventricular systolic pressure less than 55 mm Hg; elevated left and right ventricular diastolic pressures equalized within 5 mm Hg; mean right arterial pressure greater than 15 mm Hg; right ventricular end-diastolic pressure greater than one third of the right ventricular systolic pressure, which means the patient has a narrow pulse pressure.

Question 21

restrictive pericarditis

Answer 21

right atrial pressure tracings will show an exaggerated x descent and a steep y descent, forming what is known as the “W” sign