COMLEX Stuff 3 2015

ruhland1's version from 2015-06-21 18:53

Section 1

Question Answer
Sarcoid PFT patternrestrictive, normal FEV1/FVC dn TLC
laminated calium concretions found wheresarcoid cxr
afla toxin sourceaspergillus
afla toxin dzdn p53 so up HCCx
aspergillus allergy txsteroid, itraconazole
Invasive aspergillos txvoriconazole, ampho B, capsofungin
angioinvasive asper cxrhalo sign
tinea veriscolor txmiconazole selenium slufide
ringworm tximidazole
sporotrichosis txitraconazole
All Non-oppurtunistic Systemic mycoses tx Fluconazole and Ampho B
Cypto Neof TxAmpho B and Flucytosine
Aspergillus txitraconazole and ampho B
oppurtunistic mycosescandida, crypt neo, aspergi, mucor, rhizopus, PCP
Mucor txAmp B
rhizopus txamp B
PCP tx (same as ppx)TMP-SMX
PCP causesdiffuse interstital pneumonia

Section 2

Question Answer
bruise over mastoid process(you have to ___ a mastadon)battle sign
battle sign indicatesfrx of middle cranial fossa
raccon eyes indicatesbasilar skull injury
courversiers signpalpable gb
isolytic contractioncontract as another extends forcing muscle to lengthen

Section 3

Question Answer
PKU enzyme defphenylalanine hydroxylase
PKU labup phenyl, dn tyrosine
mousy odor urinepku
MSUD defbranched chain keto acid dehydrog
MSUD cant break downValine Leucin Isoleucine (branched AA)
MSUD presentneonate letharg, dn lb, delta tonia, retard, *didnt give classic*
alkaptonuria (ALKP) def homogentisate oxidase (inabiltiy to break down homogen acid)
ALKP ochronosisarthritis of homogenic accum
Hartnup defdef neutral AA tranported cant absorb Trp
hartnuo sxpellegra
Homocystinuria (HCU) defmethionine degrade pathway (cant break down it)
vit def in b6 b12 and folate can producemild homocytinuria
HCU presentationsimilar to marfan

Section 4

Question Answer
albinism enzyme def moadn tyrosinase, melanocyte number normal, just dn active
albinism embryo moafailue of neural crest melanocyte mig
foamy histiocytesNieman Pick (NP)
NPick defsphingomyleniase (lysosomal storage d/o = LS d/o)
Fabry enzy defa-galactosidase
Fabry accumceramide
Fabry sxhand/feet PNP(periph neuropathy), angio kertomas
angiokeratomassmall purple blemishes
Krabbe (K) defB-galactocerebrosidase
Krabbe sxup DTR, optic atrophy, dumb as a ___ , blind as a ____ , as reflexive as a _____
Gaucher enz def"G"lucocerebrosidase
Gaucher cellstissue paper dendritic cells (GACHOO!)
Gaucher sxHS-meg, aseptic necrosis of long bones (femur)
GM2 ganglioside accumtay saych (hexoaminodase def)
metachromic leukodystrophy defarylsulfatase A
metachromic leukodystrophy accumcerebroside sulfate
metachromic leukodystrophy sx demyleination dn CNS dn PNS
Hurler defl iduronidase
Hurler accumheparan/dermantan sulfate
Hunter defiduronate
Hunter accumheparan/dermantan sulfate (less severe)

Section 5

Question Answer
skeletal abnormal, high level of lysosomal enz, dn joint mvmt, COARSE facieI-cell disease I=inclusion (lysosomal enzymes sec out of cell instead of targeted into lysosome)
Chediak Higashi moaprimary lysosomes of wbc cannot fuse into phagosomes
CHAINCH Albinism Immunodysf Neuropathy(PNP)
cyclosporine moadn IL-2 expression (binds calcineurin so things cant act on it) dn IL-2 so dn T-cell prolif
tacrlimus=FK-binding protein (FK506)
tacrolimus moainhibit IL-2 secretion
daclizumabbinds IL-2 rec (CD25) on T cells causing it to not be able to be activated
sirolimus moabinds MTOR so down T-cell prolif
phyisological binding MTOR causesTcell prolif in response to IL-2
sirolimus useafter kidney transplant w cyclospor and steroid
6-MP precursor immnosuppressorazathrioprine (up BM suppression)
Mycophenolate Mofetil moadn de novo guanine synth dn lymphocyte production
kills T cellscyclophos

Section 6

Question Answer
Thal (T) ventral posterior LATERAL nucleusrecieves bodily sensation
T ventral posterior MEDIAL nucleusface sensation
T arteryMCA
Thalamus strokepure sensory
MCA T arterieslenticulostriate vessels
subthalmic stroke causescontra hemiballismus
tranylcypromine isMAOI
isocarboxizid isMAOI
how does smooth m allow to relax enzymemyosin light chain phosphatase
Nitric oxide producescGMP
cGMP activatesProtein kinase G
Protein Kinase G activatesMyosin Light Chain Phosphatase

Section 7

Question Answer
raw meattoxo
neo=neonate toxo sxchorioretinitis, H S meg, brain calcifications
neo rubella sxPDA, cataract, deaf, small eyes, small head
neo rubella skin"blueberry muffin"
Heterophile + (monospot)EBV
Heterophile -CMV to r/o
cotton wool eye examCMV retinitis
neo CMV sxjaun,HS meg, deaf, Thrombocytic Purpura, sz
neo HIV sxthrush, pneum, rrhea
neo HIV brain histomicroglial nodules with multinucleated giant cells
neo HSV sxencephalitis and skin lz
neo Syph sxsaddle nose, saber shin, hutchinson teeth, deaf
Syph tx if allergytetracycline/doxycycline