Head/neck

Question 1

situs inversus, chronic sinusitis, and bronchiectasis

Answer 1

Kartagener syndrome

- primary ciliary dyskinesia, a disorder with a dynein arm defect causing immotile cilia

Question 2

what side effect do prostaglandin inhibitors have on the iris?
- bimatoprost, latanoprost

Answer 2

hyperpigmentation

- they alter the melanin content in the iris, leading to darkening in eye color

Question 3

ocular deposition of blood between the sclera and conjunctiva, sparing the area over the cornea

• resolves on its own
• not associated w/ vision changes or pain

Answer 3

subconjunctival hemorrhage

Question 4

what is the mCC of viral conjunctivitis?

Answer 4

adenovirus

Question 5

• Inflammation of the fibrous layer underling conjunctiva
• Progressive, boring pain; no pruritus or purulent drainage
• Vision changes including photophobia and blurriness
• Associated with autoimmune diseases and vasculitis

Answer 5

Scleritis

Question 6

protozoan that infects the nasal cavity and crosses the cribriform plate to infect the central nervous system

Answer 6

Naegleria fowleri

- causes primary amebic meningoencephalitis

Question 7

second-generation antihistamine that does not cross the blood-brain barrier and does not cause as much sedation as the first-generation drugs

Answer 7

loratidine aka claritin

- should always be first line tx, NOT diphenhydramine 9d/t sedation SA)

Question 8

organism that causes lockjaw, stiff neck, trouble swallowing, and paralyzed abdominal muscles

Answer 8

C. tetani

• gram positive, spore forming rod
• exotoxin, called tetanospasmin, causes decreased release of the inhibitory neurotransmitters GABA and glycine

Question 9

External rotation of paired bones (parietal, temporal, frontal), decreased anteroposterior (AP) diameter, eyes set further apart, counternutation of the sacrum

Answer 9

SBS Flexion

Question 10

Internal rotation of paired bones (parietal, temporal, frontal), increased AP diameter, eyes set closer together, nutation of the sacrum

Answer 10

SBS Extension

Question 11

t(14:18)?

Answer 11

DLBCL

- BCL2

Question 12

major side effect seen with sildenafil?

Answer 12

cyanopsia or blue vision

Question 13

counternutation?

Answer 13

sacral base moves posterior

- SBS flexion

Question 14

nutation?

Answer 14

sacral base moves anterior

- SBS extension

Question 15

vault hold finger placement

Answer 15

The index finger (2nd digit) is located on the greater wing of the sphenoid.
The middle finger (3rd digit) is located on the preauricular portion of the temporal bone.
The ring finger (4th digit) is located on the mastoid process.
The little finger (5th digit) is located on the squamous portion of the occiput.

Question 16

anti-SSA Abs?

Answer 16

anti-Ro, (SSB=La)

- sjogrens

Question 17

index fingers are moving superiorly and the fifth fingers are moving inferiorly while palpating the cranium with the vault hold

Answer 17

inferior vertical strain

Question 18

what are two common side effects of amytriptiline?

Answer 18

urinary retention and tachycardia

• blocks the reuptake of norepinephrine and serotonin
• has strong muscarinic blocking properties

Question 19

meningitis in HIV/AIDS?

Answer 19

cryptococcal meningitis

- tx: amphotericin B

Question 20

what is the MC affected sinus is children vs adults?

Answer 20

children: ethmoid
adults: maxillary

Question 21

lateral strabismus (eye drifts laterally), ptosis (drooping superior eyelid), and mydriasis (pupil dilation)
- loss of pupillary light reflex in affected eye

Answer 21

occulomotor nerve palsy

Question 22

Lesion of what nerve will cause medial strabismus (eye drifts medially)

Answer 22

abducens nerve

Question 23

lesion of what nerve will cause eye drift upwards

Answer 23

trochlear nerve

Question 24

painless loss of monocular vision with associated pale retina with a cherry-red macula seen on fundoscopic examination

Answer 24

retinal artery occlusion

Question 25

what is the leading cause of blindness in persons 25-74 years of age in the United States?

Answer 25

diabetic neuropathy - floaters, blurred vision, and gradual loss of visual acuity - presence of microaneurysms

Question 26

what is optin neuritis associated with?

Answer 26

MS

Question 27

Patients will initially complain of the sensation of a flashing light, floaters, or vision loss - vision loss may be filmy, cloudy, irregular, or **curtain-like**

Answer 27

retinal detachment | - Marfan's syndrome!!

Question 28

what is the differential diagnoses for a cherry-red macula?

Answer 28

Tay-Sachs disease, Niemann-Pick disease, and central retinal artery occlusion

Question 29

painless acute onset of blurred vision in one eye | - described as "cloudy vision" rather than an actual visual loss

Answer 29

central retinal vein occlusion

Question 30

ipsilateral genioglossus muscle is weak, and the protruded tongue deviates toward that weak side

Answer 30

hypoglossal (CN XII) nerve lesion

Question 31

provides somatosensation and taste for the posterior one third of the tongue

Answer 31

glossopharyngeal nerve (cranial nerve IX)

Question 32

provides somatosensation for the anterior two thirds of the tongue and innervates the muscles of mastication

Answer 32

trigeminal nerve (cranial nerve V)

Question 33

technique is used to enhance the amplitude of the Cranial Rhythmic Impulse (CRI)

Answer 33

CV4 - physician gently follows the motion of extension, while resisting the motion of flexion - induces parasympathetic activity/improves autonomics - reduces tension HA, anxiety

Question 34

what is the most appropriate osteopathic technique for treating isolated somatic dysfunctions at any cranial suture

Answer 34

V-spread technique

Question 35

antineoplastic that binds to tubulin and inhibits microtubule formation - disrupts the formation of the mitotic spindle, and causes the cell cycle to arrest at metaphase - specific for the M and S phases of the cell cycle

Answer 35

Vinblastine | - vinca alkaloid

Question 36

anthracycline that intercalates between DNA base pairs, impairs topoisomerase II function - inhibits replication and transcription - common side effect is cardiotoxicity

Answer 36

Doxorubicin

Question 37

tapeworm transmitted from eggs found in dog/sheep feces | - is responsible for large, locular cysts found in the liver, lungs, and brain

Answer 37

helminth Echinococcus granulosus

Question 38

what are the dural attachments?

Answer 38

foramen magnum, C2 (axis), C3, and S2

Question 39

what is the most common cause of bacterial meningitis in children under 5 years of age is Streptococcus pneumoniae? - what is the tx?

Answer 39

S. pneumo | - cephalosporin + vancomycin, both of which block the synthesis of peptidoglycan

Question 40

Dysfunctions of what cranial bone may cause strain on the vestibulocochlear nerve, resulting in tinnitus?

Answer 40

the temporal bone | - can also cause vertigo, motion sickness, nystagmus, and hearing loss

Question 41

adenosine deaminase (ADA) deficiency?

Answer 41

SCID