Biomed

Question 1

Patient reports an irresistable urge to move legs particularly at night. Also presents with sleep deprivation, fatigue, leg cramps, uncomfortable tingling, and burning sensation. This is most likely:

Answer 1

Restless Leg Syndrome

Question 2

What mineral deficiency is commonly associated with Restless Leg Syndrome?

Answer 2

Iron Deficiency

Question 3

Levodopa/ Carbidopa treats both Restless Leg Syndrome and what other disorder?

Answer 3

Parkinson’s

Question 4

It is recommended to start getting Pap Smears at what age?

Answer 4

21

Question 5

Bakody’s sign indicates _ at which vertebrae?

Answer 5

Cervical Radiculopathy

C4-C6

Question 6

What is the procedure of the Bakody’s sign and what indicates that it is positive?

Answer 6

Patient abducts the arm and places on top of the head

Positive if patient experiences relief or decrease of the patient’s symptoms

Question 7

What is the difference between radiculopathy and neuropathy?

Answer 7

Radiculopathy: “A pinched nerve.” A disease at the root of the nerve (AKA ‘A Fuse Box Problem’)

Neuropathy: “Peripheral nerve branch” issue leading to weakness, numbness, and pain from nerve damage usually distally (in hands or feet) (AKA ‘Problem with the outlet’)

Question 8

Which vitamins are antioxidants?

Answer 8

Vitamins
A, C, E

Question 9

Blood HbA1c are reflective of how well _ is controlled

Answer 9

Diabetes

Question 10

How often should Blood HbA1c be tested?

Answer 10

Every 3 months

Question 11

Healthy Blood HbA1c value is?

Answer 11

5.6 or below

Question 12

An HbA1c value of _ indicates Diabetes

Answer 12

6.5 or higher

Question 13

Name the five most common SSRIs

Answer 13

Escitalopram - Lexapro
Fluoxotine - Prozac
Sertraline - Zoloft
Paroxetine - Paxil
Citalopram - Celexa

EFFECTIVE - Escitalopram
FOR - Fluoxotine
SADNESS - Sertraline
PANIC - Paroxetine
COMPULSIONS - Citalopram

Question 14

What are three adverse effects that accompany SSRIs?

Answer 14

Stomach Upset
Sexual Dysfunction
Serotonin Syndrome

“S-S-S”

Question 15

What is the Triad (of Symptoms) of Serotonin Syndrome

Answer 15

1. Mental Changes - delirium, agitation
2. Autonomic Instability - BP/HR, tachycardia, diaphoresis, diarrhea
3. Neuromuscular Abnormality - Seizures, Myoclonus, Hyperreflexia

Question 16

What herbs/supplements should be avoided when taking SSRIs to prevent Serotonin Syndrome?

Answer 16

5-HTP
St. John’s Wort
SAMe
Tryptophan

Question 17

What is the standard of care for serotonin syndrome?

Answer 17

1. Stop offending medications/ herbs/ supplements
2. IV Fluids
3. Cyproheptadine to lower serotonin production
4. Benzodiazepines to lower muscle rigidity

Question 18

What foods should you avoid when taking MAOIs?

Answer 18

Tyramine-rich foods like pickled foods, cheese, wine

Question 19

What condition may occur if a patient is taking MAOIs concurrently with TCAs -OR- if a patient is taking MAOIs and has a lot of tyramine-rich foods in their diet?

Answer 19

MAOI-induced Hypertensive Crisis

Question 20

What hormone is tested to diagnose pregnancy?

Answer 20

beta-hCG (human chorionic gonadotropin)

Question 21

What confirms an intrauterine pregnancy?

Answer 21

Ultrasound

Question 22

A woman over the age of 50 reports right-sided headache with scalp pain, pain in the jaw, decreased visual acuity in the right eye, gentle pressure on the temple causes pain. What is the likely diagnoses?

Answer 22

Giant Cell Arteritis
AKA
Temporal Arteritis

Question 23

A woman over 50 reports right-sided facial pain. The pain comes suddenly and is “electric shock-like.” Simple actions such as combing or washing her hair may also cause episodes, what is the likely diagnosis?

Answer 23

Trigeminal Neuralgia

Question 24

Trigeminal Neuralgia is due to compression or inflammation of the _ , whereas Giant Cell Arteritis is inflammation of the _

Answer 24

Trigeminal Neuralgia - Trigeminal Nerve

Giant Cell Arteritis - Temporal Artery

Question 25

Standard of Care for Giant Cell Arteritis

Answer 25

High dose prednisone to prevent blindness

Question 26

Standard of Care for Trigeminal Neuralgia

Answer 26

Carbamazepine, Lamotrigine, or Gabapentin Failure of drugs to induce remission may be an indication that surgical intervention is required to relieve compression of the trigeminal nerve

Question 27

Define cachexia

Answer 27

Wasting of the body d/t significant chronic disease such as cancer, AIDS, celiac, COPD, RA, multiple sclerosis, CHF, TB, Crohn's disease, untreated/ severe DM-1, hormonal deficiency

Question 28

Severe deficiency of Vitamin B3/ Niacin is called

Answer 28

Pellagra

Question 29

Pellagra is characterized by what main symptoms?

Answer 29

Dermatitis Dementia Diarrhea

Question 30

High doses of niacin may lead to

Answer 30

Niacin Flush

Question 31

A positive Mulder's sign is associated with which condition?

Answer 31

Morton's Neuroma

Question 32

Morton's Neuroma is typically found between the _ & _ metatarsals

Answer 32

3rd and 4th

Question 33

What does CAGE screening help to identify?

Answer 33

Potential alcoholism

Question 34

What does CAGE stand for?

Answer 34

1. Have you ever felt you should **CUT** down on your drinking? 2. Have people **ANNOYED** you by criticizing your drinking? 3. Have you ever felt **GUILTY** about your drinking? 4. Have you ever had a drink first thing in the morning? **EYE-OPENER** question

Question 35

What is the most severe form of alcohol withdrawal?

Answer 35

Delirium Tremens

Question 36

What vitamin deficiency is associated with alcoholism?

Answer 36

Vitamin B1 - Thiamine

Question 37

Thiamine deficiency + alcoholism may lead to this syndrome

Answer 37

Wernicke-Korsakoff Syndrome

Question 38

Vitamin C aids the absorption of

Answer 38

Non-heme iron

Question 39

Condition that arises from Vitamin C deficiency is

Answer 39

Scurvy

Question 40

Nitrates cannot be mixed with which class of pharmaceuticals?

Answer 40

PDE5 Inhibitors (Sildenafil - Viagra, Tadalafil - Cialis) ## Footnote Leads to severe hypotension bc they're both vasodilators

Question 41

The C5 dermatome is where?

Answer 41

Bicep

Question 42

C6 dermatome is where?

Answer 42

Thumb and Index fingers

Question 43

C7 dermatome is where?

Answer 43

Middle and Ring Finger

Question 44

C8 Dermatome is where?

Answer 44

Little finger

Question 45

T4 dermatome is in the horizontal area level with the

Answer 45

Nipple

Question 46

The T10 dermatome is in the horizontal area level with the

Answer 46

Umbilicus

Question 47

The L5 dermatome is on the *blank* aspect of the foot

Answer 47

Dorsal

Question 48

The S1 dermatome is on the (MEDIAL/LATERAL) (SUPERIOR/INFERIOR) aspect of the foot

Answer 48

Lateral/ Inferior

Question 49

S2 - S4 Dermatomes are where?

Answer 49

Perineum

Question 50

What Vitamins are Water-Soluble?

Answer 50

Vitamins B, C

Question 51

What vitamins are Fat-Soluble?

Answer 51

Vitamins A, D, E, K

Question 52

What vitamin helps to clot blood and is deficient in newborns until they begin eating solid foods?

Answer 52

Vitamin K

Question 53

What foods contains substantial Vitamin K?

Answer 53

Green Leafy Vegetables

Question 54

Vitamin K lowers the effectiveness of which pharmaceutical?

Answer 54

Warfarin

Question 55

DVT, Pulmonary Embolism, Atrial Fibrillation, Artificial Heart Valve are all indications for which class of medications?

Answer 55

Anti-coagulants

Question 56

What is the effective Therapeutic INR Range for people taking Warfarin?

Answer 56

2.0-3.0

Question 57

Dang Gui, Dan Shen, and Chuan Xiong can all (INCREASE/DECREASE) the effects of Warfarin

Answer 57

Increase

Question 58

In the context of Anti-thrombotics: * Anticoagulants _ of thrombus * Antiplatelets _ of thrombus * Thrombolytics _ formed thrombus

Answer 58

* Block growth/ prevent clots by interfering with blood-clotting proteins * Block formation/ thin blood by preventing platelets from sticking together * Dissolve/ "clot-buster"

Question 59

The majority of strokes/ cerebrovascular accidents are (ISCHEMIC/HEMORRHAGIC)?

Answer 59

Ischemic ## Footnote 80% - ischemic - blood supply to brain interrupted, preventing brain tissue fr. getting O2 and nutrients 20% - hemorrhagic - ruptured vessel causes brain bleeding

Question 60

Why isn't HRT the recommended first-line treatment for menopause symptoms?

Answer 60

HRT increases incidence of breast cancer

Question 61

A barium swallow aids the X-Ray examination of which areas of the GI?

Answer 61

Upper GI - Esophagus, Stomach, Duodenum (first part of small intestine)

Question 62

A barium enema aids the X-Ray examination of which areas of the GI?

Answer 62

Lower GI - colon/ large intestine

Question 63

This condition presents with abdominal pain, usually in the midepigastric region, that radiates to the back, and may be relieved when sitting forward. 70%-80% of cases are from a Hx of Gallstones or Alcohol Consumption

Answer 63

Acute Pancreatitis

Question 64

What is one way to differentiate between cholecystitis (GB inflammation) and acute pancreatitis?

Answer 64

Cholecystitis pn ~ in the RUQ and radiates upward to shoulder Acute Pancreatitis = midepigastric area and radiates to the back

Question 65

Acute pancreatitis will show and elevated values in these two enzymes

Answer 65

Lipase Amylase

Question 66

An elevated value in this hormone may signify menopause

Answer 66

FSH

Question 67

Yellowish crusts on the face, arms, legs with well-localized vesicles and honey-colored scabs found on the lesions are a classic presentation of what contagious skin disorder?

Answer 67

Impetigo

Question 68

Standard of care for impetigo is?

Answer 68

Topical Mupirocin Ointment

Question 69

An individual with a medical hx of diabetes and IV drug use presents with red, hot, swollen, tender skin. They have fever and chills. What is the likely diagnosis?

Answer 69

Cellulitis - need penicillin and/or antibiotics

Question 70

A person presents with raised, well-defined, tender, bright red rash on the face. What is the likely diagnosis?

Answer 70

Erysipelas

Question 71

Celiac disease is a long-term autoimmune disorder that primarily affects which part of the GI?

Answer 71

Small intestine

Question 72

Vitamin B12 (cobalamin) and B9 (folate) deficiency is associated with what kind of anemia?

Answer 72

Megaloblastic (a type of macrocytic anemia) B12 deficiency alone = pernicious anemia

Question 73

Aldosterone and Corticosteroid are produced and secreted from which endocrine gland?

Answer 73

**Adrenals** Aldosterone: Regulates salt, water balance, and blood pressure Corticosteroid: Controls key functions in the body; acts as an anti-inflammatory; maintains blood sugar levels, blood pressure, and muscle strength; regulates salt and water balance

Question 74

ADH (Antidiuretic Hormone/ Vasopressin), ACTH ( Adrenocorticotropic Hormone), Growth Hormone, Luteinizing Hormone (LH), Follicle Stimulating Hormone (FSH), Oxytocin, Prolactin, Thyroid-Stimulating Hormone (TSH) are produced and secreted from which endocrine gland

Answer 74

**Pituitary Gland** ADH - Affects water retention in kidneys; controls blood pressure ACTH - Controls production of sex hormones (estrogen in women and testosterone in men) and the production of eggs in women and sperm in men. GH - Affects growth and development; stimulates protein production; affects fat distribution LH/ FSH - Controls production of sex hormones (estrogen in women and testosterone in men) and the production of eggs in women and sperm in men Oxytocin - aids in labor, delivery, "the cuddle hormone," stimulates contraction of uterus and milk ducts in breastfeeding Prolactin - Initiates and maintains milk production in breasts; impacts sex hormone levels TSH - Stimulates the production and secretion of thyroid hormones

Question 75

Renin, angiotensin, and erythropoietin are produced and secreted from which endocrine organ

Answer 75

**Kidneys** Renin/ Angiotensin - Controls blood pressure, both directly and also by regulating aldosterone production from the adrenal glands Erythropoietin - Affects red blood cell (RBC) production

Question 76

Glucagon and Insulin are produced and secreted from which endocrine gland/ organ?

Answer 76

**Pancreas** Glucagon - Raises blood sugar levels Insulin - Lowers blood sugar levels; stimulates metabolism of glucose, protein, and fat

Question 77

Estrogen and Progesterone are produced in and excreted by which female gonads?

Answer 77

**Ovaries** Estrogen - Affects development of female sexual characteristics and reproductive development, important for functioning of uterus and breasts; also protects bone health Progesterone - Stimulates the lining of the uterus for fertilization; prepares the breasts for milk production

Question 78

Parathyroid hormone (PTH), the most important regulator of blood calcium levels is produced in/ secreted by which endocrine gland?

Answer 78

**Parathyroid gland**

Question 79

Thyroid Hormone, which controls metabolism; also affects growth, maturation, nervous system activity, is produced in/ secreted by which endocrine gland?

Answer 79

**Thyroid**

Question 80

Epinephrine (Increases heart rate, oxygen intake, and blood flow) and Norepinephrine (Maintains blood pressure) are produced in and secreted from which endocrine gland?

Answer 80

**Adrenals**

Question 81

Testosterone is produced from which male gonads?

Answer 81

**Testicles**

Question 82

In AFABs, testosterone is produced where and what is its function in an AFAB?

Answer 82

Ovaries, Adrenal glands, Fat Cells, Skin Cells Bone health, breast health, fertility, sex drive, menstrual health, vaginal health; converting testosterone and other androgens into female sex hormones

Question 83

In AMABs, estrogen and progesterone are produced where and what are some of the functions in an AMAB?

Answer 83

Testes, Adrenal glands Men need progesterone to produce testosterone Estradiol (predominant form of estrogen) essential for modulating libido, erectile dysfxn, spermatogenesis

Question 84

Melatonin (released during night hours to help with sleep) is produced in and released from which endocrine gland?

Answer 84

Pineal gland

Question 85

Growth hormone releasing hormone (GHRH), Thyrotropin releasing hormone (TRH), Gonadotropin releasing hormone (GnRH), Corticotropin releasing hormone (CRH) are all produced in and excreted by which gland in the brain?

Answer 85

**Hypothalamus** GHRH - Regulates growth hormone release in the pituitary gland TRH - Regulates thyroid stimulating hormone release in the pituitary gland GnRH - Regulates LH/FSH production in the pituitary gland CRH - Regulates adrenocorticotropin release in the pituitary gland

Question 86

Humoral factors are hormones related to immune function and secreted by which endocrine gland?

Answer 86

Thymus