Biomedicine Flashcards
(346 cards)
1
Q
Man with acute chest pain, resulted in myocardial infarction, which drug for initial treatment?
A
NTG - Nitroglycerin
2
Q
CAB in CPR
A
Compression, Airway, Breathing
3
Q
CPR in Adult: Compression to breaths
A
30:2
4
Q
Pericarditis-
Where’s the pain?
How can you alleviate it?
When does it get worse?
A
may travel to left shoulder and neck.
Sitting up and leaning forward can ease the pain
Often intensifies when you cough, lie down or inhale deeply.
5
Q
CPK levels indicate?
A
Creatine Kinase (CPK)
Heart damage
6
Q
Beta blockers are used for what?
A
Hyperthyroidism
Hypertension
Cardiovascular disease, prevent migraine headache
7
Q
What pharmaceuticals treats migraines?
A
Beta Blocker
8
Q
Beta blockers prevents
A
Headache
9
Q
Beta-adrenergic Blockers treat what?
A
Thyroid Storm
Hyperthyroidism
10
Q
Which drug can relax smooth muscle and lower vessel resistance
A
Alpha blocker cause vessel dilation: ACEI/ARB, CCB, direct vasodilator, nitrates
11
Q
Calcium channel blockers
- Purpose
- Side effect
A
Relax vessels
- for hypertension, arrthmia, angina
- side effect: hypotension, AV block
12
Q
Calcium Channel Blockers CCH) Toxicity
A
Rapid progression of hypotension, Brady dysrhythmia, cardiac arrest
13
Q
Diuretics can cause a loss of
A
Potassium
14
Q
Complication of ACE inhibitors?
A
early: cough
late: renal damage
Si Eff: dry cough, hyperkalemia (high Potassium)
15
Q
ACE inhibitors risk and uses
A
Hypertension, dry cough
16
Q
Renin-Angiotensin System (RAS)
A
regulates blood pressure and fluid balance
17
Q
Medicine for hypertension:
A
Beta Blockers, Thiazide, Diuretics, ACE In or CCB (Calcium Channel blockers)
18
Q
What is the primary cause for Hypertension?
A
too much salt intake
19
Q
Primary cause of secondary hypertension?
A
Renal and endocrine disease
20
Q
Which drug can treat high cholesterol?
A
HMG-CoA reductase inhibitor (-statin) & Niacin (B3)
- inhibits enzyme responsible for cholesterol biosynthesis
21
Q
Which category of drugs has muscle aches (myalgia) as a side effect?
A
HMG-CoA reductase inhibitor (-statin)
- lipitor
- may cause renal failure, muscle pain (most common) & fever & heart failure
22
Q
The generic name of medications that lower the cholesterol level often end in:
A
-statin
23
Q
What are the Fat Soluble vitamins?
A
D A K E
24
Q
What are the water soluble vitamins?
A
B C H (Biotin)
25
Q10 (Coenzyme Co10) function
Reduce Blood Pressure
- Congestive Heart Failure
- Parkinson's disease
- Statin- induce myopathy
- Migraines
- Raise energy
26
Which vitamins should Old people with rickets (osteomalacia) take?
Vitamin D
- bone fragility
- muscle weakening
- Dental problems
- Growth retardation
- Enlargement of LV/SP
27
When improving diet and increasing exercise, which LDL or HDL improves?
HDL
28
Which vitamin is used to raise HDL?
Niacin (B3)
29
Which vitamin deficiency will cause dementia, diarrhea, dermatitis and death (pallagra)
Niacin (B3)
Overdose: liver damage
Si Eff: flushing
30
A patient comes to you complaining of night blindness, which vitamin deficiency could she have:
vitamin A
31
Which vitamin is antioxidant?
A, C, E & Selenium
32
Which mineral is antioxidant?
Calcium
Iron
Magnesium
Selenium
Selenium
33
What are the side effects of overdosing on Vitamin E?
Nausea & Diarrhea
34
What causes elevated ketone bodies?
High fat/low carb diet (Atkins diet)
35
If a patient has Renal Failure, what diet should they have
Low protein, Low salt
36
Long term use of laxatives & mineral oil will cause a deficiency in which vitamins?
K, A, D, E
37
Orange colored palms indicateL
Carotenemia
38
The most common allergy
Peanut
39
Patients comes in for abdominal pain, diarrhea, abdominal bloating after eating Pizza. What is the cause?
Lactose
40
Celiac sprue or disease is hereditary digestive disorder that involves intolerance to?
Gluten - celiac disease : Vit B12 def -> RBC formation, Anemia
41
Elevated PSA (Prostate Specific Antigen), which supplement is bad?
American ginseng, siberian ginseng, gui zhi, ma huang, cordyceps
42
Mc. Burney's Sign
Tender point in Right Lower Abdomen of a patient with appendicitis
43
Patient with lower right quadrant abdominal pain
Appendicitis
44
Murphy's sign
Inspiratory arrest due to pain in right hypochondriac region, suggesting acute cholecystitis
45
Women with right upper quadrant pain, worse with eating greasy food.
cholecystitis
45
How to palpate splenomegaly
Start RLQ to LUQ
46
34 years old female complaints lower left quadrant pain, diarrhea, fever, fatigue, after you examination what is the possible disease?
Diverticulitis - LLQ (Answer)
Cholecystitis - RUQ
Appendicitis - RLQ
Pancreatitis - LUQ
47
Diverticulitis case study: which tests would you use to diagnose this?
CT Scan
48
Laparoscopy used to visualize what?
Abdominal and pelvic organs when a pathologic condition is suspected.
49
Exam for lower GI Tract (colon, rectum and small bowel - Entire colon from rectum to cecum and often portion of the terminal ileum
Colonoscopy
50
Barium enema visualizes (characteristics)
of the colon
51
Which lab exam to check patient who has abdominal pain?
Xray
52
Patient has abdominal pain (or low back pain) and is aggravated when defecating
Cystitis (Answer)
Urethritis
Aortic Aneurysm
Herniated Lumbar Disc
53
18 years old college student has acute onset of severe watery diarrhea, vomiting, nausea, abdominal cramping pain for 2 days after her camping trip. What pathogen possibly caused these symptoms?
Giardia (answer)
Borrelia
Rhinovirus
Trichomonas
54
Symptoms of abdominal pain, diarrhea - relieved with defecation
IBS (answer)
Crohn's disease
Ulcerative colitis
55
What are the symptoms of IBS
Colicky abdominal pain relieved by bowel movement, clear or white mucus and blood in stool.
56
Patient has diarrhea and constipation, stool shows mucus and blood. What is the diagnosis?
Ulcerative Colitis
57
Pus and blood w diarrhea for 6 months. What is the Diagnosis?
Ulcerative colitis`
58
Patient has lower left abdomen pain and has diarrhea with pus
Ulcerative colitis
59
Polyps removed from colon, what other signs would indicate colon cancer?
Painless bleeding
60
High level of Alpha-fetaprotein suggests
Liver cancer
61
Abdominal pain, worse by spicy food and alcohol, nausea, loose stool, no blood in sthool, anemia, amenorrhea, weight loss, no mention of stress or emotional problems.
Crohn's Disease (answer)
IBS (stress)
Gastritis
62
Patient long term use drug for pain, and has anemia symptoms. Which one is the reason that caused this problem?
Bleeding intestine (NSAID) (answer)
Hematemesis
Hematochezia
63
Side effects of ibuprofen (NSAID -non steroidal anti-inflammatory drug)
GI (peptic ulcer, stomach upset, GI track bleeding)
64
Which drug category will you select if you want to reduce gastric acid in the stomach?
Histamine blocker (answer)
Proton pump activator
antacids
65
What drug is used for acid reflux?
Antacid, proton pump inhibitors, anti-H2 receptors
66
What drug for peptic ulcer is used to decrease secretion of gastric acid
PPI, H2 blocker
67
If the patient has been taking antacids and there is no relief of heart burn. Which drug category:
Proton Pump Inhibitor
68
If the patient has GERD, which procedure would you use to evaluate the condition?
Endoscopy
69
What are the symptoms for GERD?
burning sensation in chest (HT burn)usually after eating, might be worse at night
Chest pain
Difficult swallowing
Regurgitationi of food or sour liquid
Sensation of a lump in your throat
70
Postmenopausal woman with uterine bleeding, soft abdomen not tender, what is the diagnosis?
Endometrial carcinoma
Ovarian carcinoma
chocolate cyst
Endometriosis
71
Right lower abdomen limited tender, female, young, regular period, abdomen pain
Ovary Cyst (answer)
Pancreatitis
Cholecystitis
PCOS
72
Female patient has symptoms of fatigue, dimpled skin (look like orange peel) in the breast area, no galactorrhea or other symptoms, also her skn near breast area is
Breast cancer
73
Unilateral/bilateral lactation in non lactating woman, lump changes size 5-7 days after menstruation. Upper outer quadrant pain.
Fibrocystic changes (Fibrocystic breast disease)
74
Endometrial polyps found by?
A. Transvaginal Ultrasound
B. Hysteroscopy
C. Curettage
D. Laparoscopy
Hysteroscopy
75
Endometrial Polyps
Grow in response to circulating estrogen
76
Primary dysmenorrhea is caused by?
Prostaglandin
77
What structure can be viewed with hysteroscopy to visualize the endometrial cavity, with an abnormal Pap smear dysfunctional uterine bleeding, or postmenopausal bleeding
Uterine Cavity (Endometrium)
78
What test is used to confirm diagnosis of endometriosis?
Laparoscopy
79
What test is performed after an abnormal pap smear
Colposcopy (for cervix & vagina)
80
Colposcopy is applied to visualize which structure(s)?
Vagina & Cervix
81
Pregnancy confirmed by
hCG hormone (human chorionic gonadotropin)
82
Ectopic Pregnancy Symptoms:
Abdominal pain, the absence of menstrual periods (amenorrhea) and vaginal bleeding or intermittent bleeding (spotting)
83
Pregnant women with hypertension and preeclampsia, what test should be done regularly?
Urine Protein
84
Leukemia may have an issue with what?
A. Hemophilia
B. Hemorrhage
C. Thrombus/Clot
D. Leukocytosis
Leukocytosis
85
Hodgkin's Lymphoma is
Cancer of the lymph nodes
86
Fatigue, night sweats, weight loss
Need R/O cancer
87
67 years old man with cachexia, what does it suggest?
Probably Cancer
88
Polycythemia
Increased RBCs
89
Abnormally increased large number of Red Blood Cells
Polycythemia
90
Reasons for EPO increase
A. Anemia
B. Diminished # of RBCs
C. Lower Oxygen levels
Lower Oxygen levels
91
Which hormone increases red blood cells production?
Erythopointin
92
14 year old girl with blood deficiency sign, what tests should be done?
CBC - Complete Blood Count
93
What is Pernicious Anemia?
A. Malabsorption of B12
B. Iron Deficiency
C. Folic acid deficiency
D. Deficiency of B12 from diet
Malabsorption of B12
94
Alcoholic need to be supplemented with
A. Vitamin C
B. Calcium
C. Vitamin B12
D. Potassium
C.Vitamin B12, excessive alcohol more than 2 weeks decrease vitamin B12 absorption from the gastrointestinal tract.
95
What is the problem with chronic Alcoholism?
A. Ketoacidosis
B. Macrocytic Anemia
C. Inflammatory Bowel Disease
B. Macrocytic Anemia (B12 def)
96
CAGE questions are:
Diagnose alcoholism
Cut down, Annoyed by criticism, Guilty feeling, Eye opener
97
Characteristics of Iron deficiency anemia:
A. Hct (low Hematocrit test)
B. Hg levels (low Hyperemesis gravidarum)
C. MCV small (mean corpuscular volume)
MCV small
Iron defiency Anemia (IDA)
98
Which vitamin helps Iron to be absorbed?
Vitamin C
99
S&S (Serious and Sudden) Iron overdose effects
A. GI upset, constipation/nausea
B. GI upset, constipation, weakness
C. GI upset, diarrhea, nausea/vomiting
GI upset, diarrhea, nausea, vomiting
100
Ingestion of Iron will cause?
A. Diarrhea
B. Acid Reflux
C. Vomiting/nausea
D. Constipation
Vomiting/nausea
101
Which tests are used to monitor the effects of iron therapy
Hemoglobin and reticulocyte levels
102
Which of the following iron related blood test is the most accurate indicator of iron deficiency?
Ferritin - blood cell protein that contains iron, and shows the amount of iron stored in body
103
Sickle cell anemia causes:
A. Nutrition deficiency
B. Vitamin B12 deficiency
C. Hemolytic Anemia
D. Aplastic anemia
Hemolytic Anemia - sickle cell disease causes a chronic hemolytic anemia, caused by homozygous inheritance of HBs
104
Which one of these is a risk factor blood clots?
A. Alcoholism
B. Pregnancy
C. Renal Failure
D. Hemophilia
E. Leukemia
B. Pregnancy
105
Taking Coumadin (blood thinner) and B12 is bad because
might increase risk of clotting
106
Vitamin D deficiency can result in what?
A. Anemia
B. Hemorrhage
C. Hemophilia
B. Hemorrhage
107
Coumadin (Warfarin) with B12 & K (deficiency bleeding) may cause?
Clotting
108
Coumadin (Warfarin) with Vitamin E (deficiency: Anemia)
Bleeding
109
If taking anticoagulant, avoid which supplement?
Vitamin K
110
Vitamin K is produced by
Large Intestinal Bacteria (& Liver)
111
A patient has blood clotting problem, the disease?
Thrombopenia or thrombocytopenia
112
Cephalosporins are antibiotics that
Inhibit bacterial cell wall synthesis
113
One of the most common first signs of infectious mononucleosis is
Severe sore throat
114
A young teen with swollen lymph nodes, fever, sore throat and fatigue, what is the disease?
A. Infectious mononucleosis
B. Leukemia
Infectious mononucleosis
115
20 yo college student presents with fever, sore throat, and faitgue. Upon examination enlarged lymph nodes are found in the poster lateral neck. What is the most likely medical diagnosis?
A. Palatine tonsillitis
B. Cervical tuberculosis
C. Infectious mononucleosis
D. Streptococcal pharyngitis
C. Infectious mononucleosis
116
Mononucleosis presents with what?
Spleanomegally - Anorexia - Fever
117
Most common STD in the US:
Chlamydia
118
Case: 17 yo girl with fever, amenorrhea, clear discharge, burning sensation during urination. probably:
A. Chlamydia
B. Bacteria Virginitis
Chlamydia
119
Most common pathogen for PID (Pelvic inflammatory Disease)
Chlamydia and Gonorrhea
120
Chlamydia/gonorrhea co infected rate is
50%
- 50% of People with gonorrhea have chlamydia
121
Case: woman with infertility issues and blocked fallopian tubes:
Post chlamydia infection
122
Patient comes in with cryptosporidiosis and esophageal candida. What is most likely cause?
A. Immune deficiency (HIV and AIDS)
B. Syphilis
C. Herpes
D. Thrush
A. Immune deficiency
123
How is HIV/AIDS diagnosed?
Gum Swab (& Blood test)
124
What is the risk of getting HIV from needle stick with contaminated blood?
0.3%
125
What is the % that an infected hypodermic needle stick will transmit HIV?
0.3%
126
Which are the primary mode of transmission for hepatitis B
Blood, sex and syringes
127
What is the risk of getting Hepatitis B from needle stick with contaminated blood?
30%
128
What is higher % transfer of infected needle?
A. HIV
B. HAV (Hep A)
C. HBV (Hep B)
D. HCV (Hep C)
HBV
129
Which of these statements about Hep is true?
A. Hep A is blood borne
B. Hep B Oral-Fecal
C. Hep C is the most common cause of Liver Cancer
Hep C - most common liver Cancer
130
Wearing a mask in the waiting room prevents
HAV, Chicken pox, Polio
131
Exposure to HBV will show what symptoms?
A. 2-6 months, fatigue, fever, flu-like symptoms
B. 4-6 months, flu like symptoms
C. 1 month flu-like symptoms
D. Within 2-3 months, flu-like symptoms
A. 2-6 months, fatigue, fever, flu-like symptoms
132
A patient has just returned from Mexico and has nausea and vomit. What should you ask?
Does he have a Hep A vaccine?
133
Which vaccination is highly recommended for acupuncturists?
Flu shots
134
OSHA - Hep B shot should be offered after the worker has received the required bloodborne pathogen training and within how many days of initial assignment to a job with occupational exposure.
10 days
135
CNT main focus on what?
A. Clean field
B. Hand washing
C. Disposable needles
D. Sharps container
all are correct, however the most important is hand washing to prevent cross-infection
136
CNT procedure: hand washing time?
15-20 seconds
CDC: 20sec
137
What best defines CNT?
A. Sterile procedure
B. Aseptic procedure
C. Clean procedures
C. Clean procedures
138
How full can sharpts container be?
3/4 full
139
The regulation for sharps container:
A. Big enough to put the long needles
B. Has to be labeled with the universal biohazard symbol and the word "biohazard" or be color-coded red
C. Made from a variety of products from cardboard to plastic
A. Big enough to put the long needles.
doesn't have to be red
made from plastic, not cardboard
140
Catching disease from contaminated object in environment, ex: treatment table is
A. Indirect contact transmission
B. Direct contact transmission
Indirect contact transmission
141
Who must be given bloodborne pathogen training and universal precaution training?
A. All emplyees with occupational exposure to bloodborne pathogens
142
CNT: Universal Precautions should be taught to:
All emplyees with occupational exposure, including part-time and temporary employees
143
During treatment, you accidentally cut your finger, what should you do next?
A. Wear gloves
B. Wash and dress the cut with bandage
C. Cancel treatment
B. Wash and dress the cut with bandage
144
A single cotton swab can be used to clean more than one point on the same patient if:
A. A single cotton swab can only be used to prepare a single point
B. The points are in the same general area
C. The points are in different areas and there are no signs of inflammation, disease or broken skin
D. 90% isopropyl alcohol is used to prepare the patient's skin
B. The points are in the same general area
145
All of the following tatments about the use of needle guide tubes are true EXCEPT:
A. Guide tubes should be sterile at the beginning of each treatment on each patient
B. When using bundled needles, it is considered acceptable to use the guide tube more than once on the same patient as long as it's unsoiled and uncontaminated.
C. If a guide tube is used for more than one needle, it's better to drop the needle into the tub handle-end first rather than point-end first
D. If guide tube are used, they should not be placed on the clean field between uses, since they are no longer sterile.
D. If guide tube are used, they should not be placed on the clean field between uses, since they are no longer sterile.
146
Needles can be used on the same patient from different parts of the body if
A. It is kept in the clean field
B. Immediately put into cotton swab
C. No because bacteria transfer/different areas with different immunities.
C. No because bacteria transfer/different areas with different immunities.
147
Change bed sheets between patient's treatment. How should they be washed?
Launder with hot water & detergent. Add hypochlorite (bleach) solution to the wash provides an extra margin of safety
148
Excessive production of growth hormone
is caused by which gland? Which hormones?
Caused by pituitary adenoma
GH up: child - gigantism, adult -acromegaly
ACTH: Cushing disease
149
Patient comes in with Type1 Diabetes (side effect) for 10 years. What is a reasonable expectation of reatment?
A. Reduce dependency on insulin
B. treat diabetic circulatory problems
B. treat diabetic circulatory problems
150
Diabetes mellitus 20 years, mot serious complication?
Peripheral neuropathy (B12)
151
Chronic diabetic patient testing to check blood sugar level
A. HbA1C hemoglobin
B. FBS (fasting sugar)
C. Oral glucose tolerance test
A. HbA1C hemoglobin
152
Which hormone when high can cause hypercalcenia?
A. Calcitonin
B. Parathyroid hormone
C. Thyroid stimulating
D. Pitocin
B. Parathyroid hormone
153
What hormone helps absorb calcium in intestines?
PTH
154
Calcitonin is a hormone involved in the regulation of calcium metabolism, is secreted by the?
A. Pineal Gland
B. Thymus Gland
C. Thyroid Gland
D. Parathyroid Gland
C. Thyroid Gland
155
Goiter is caused by
A. Iodine deficiency
156
Older women 60s, fatigue, pale and puffy, dry skin and hair. What disease?
A. Grave's
B. Myxedema (hypothyroidism)
C. Hashimoto's
B. Myxedema (hypothyroidism)
157
Potassium deficiencies with high BP
Aldosterone is too high because of Adrenal cortex tumor (Adenoma)
Conn's Syndrome
158
What and where does Aldosterone come from?
Raises blood pressure, released by adrenal cortex
159
DHEA - natural steroid hormonoe produced from cholesterol in which organs?
Adrenal glands, gonads and brain
160
What medicine is a risk for osteoporosis?
Steroids
161
What is Addison's disease?
Adrenal insufficiency
Aldosterone: hypotension, metabolic acidosis
Cortisol fatigue, low blood sugar
162
A young female patient, who has suffered from an autoimmune disease, and is being treated with a glucocorticoid, shows the appearance of a moon shape face, buffalo hump, truncal obesity.
A. Graves Disease
B. Addison's Disease
C. Turner's Syndrome
D. Cushing's Syndrome
D. Cushing's Syndrome
163
Oral contraceptive Pills (OCP) feeback
Inhibition on LH and FSH
- regulates production of estrogen and progesterone
- release in the anterior pituitary
- FSH: stimulates follicle development in ovaries, stimulates sperm formation
LH: triggers ovulation in females, stimulates testosterone production in males
164
What hormone spikes during ovulation?
LH
165
What hormone is elevated in menopause?
FSH
166
50 yo woman present with irregular menstrual period, hot flashes, night sweats, mood swings and insomnia. A preliminary diagnosis of perimenopausal syndrome is made. Which hormones are expected to have an elevated level?
LH and FSH
(estrogen and progesterone decreased)
167
Progesterone is released from where after ovulation?
Corpus Luteum
168
What should you look for in a women taking estrogen therapy?
Shortness of breath
169
Patient has PCOS, infertility, she is overweight, w/irregular periods what other symptoms
A. Dysmenorrhea
B. Dyspareunia
C. PID
D. Insulin Resistance
D. Insulin Resistance
170
Which hormone level is high in PCOS?
Testosterone
171
Female patient 28, hysteria pain, increased testosterone. Probably has:
A. PCOS
B. Pituitary lesion
C. Adrenal lesion
A. PCOS
172
43 years old female patient has symptoms of high level of adrogen, irregular menses and ovarian polyps, what test should be done to confirm the diagnosis (PCOS)
A. hysteroscopy
B. Ultrasound
C. X-Ray
B. Ultrasound
173
Patient injured his calf, it's red, swollen. What do you do?
Apply ice, let it rest
174
Which disorder is most likely to cause sleep disturbances?
A. MS
B. Lupus
C. Amyloidosis
D. Fibromyalgia
D. Fibromyalgia
175
Motor part enters muscle fiber, most electrically excitable part of muscle?
A. Trigger point
B. Reflect Point
C. Motor Point
D. Sensory Point
C. Motor Point
176
Ankylosing spondylitis is linked to which specific HLA Antigen
HLA-B27 (Human Leukocyte Antigen)
177
Restless leg syndrome symptoms
A. Pain, sting and worsen after long time standing
B. Cramping, needling pain worsen in the evening
C. Tingling, numbness and worsen after long time standing
D. Anxiety, shaking leg and worsen in the evening.
D. Anxiety, shaking leg and worsen in the evening.
U - Urge to move
R - rest induced
G - get better with activity
E - Evening and night gets worse
Willis-Ekbom Disease (WED)
Urge to move, usually due to uncomfortable sensation, worsening of symptoms by relaxation, worse in evening
178
MRI can confirm
A. Avascular Necrosis
B. Soft Tissue injury
A. Avascular Necrosis
B. Soft Tissue injury
Soft tissue, spinal cord, cancer, muscle, ligament
179
What does DEXA (Dual Energy Xray)
Bone scan, bone density osteoporosis
180
What is the cause for avascular necrosis at the head of the femoral?
Trauma, blood clots, inflammation, alcohol or steroid use
181
What does CT scan do?
Brain bleeding, organ bleeding, rupture, tumor
182
What does Xray confirm?
bone fracture, penumonia, initial survey
183
A patient has a skate board accident, possible skull fracture and subarachnoid hemorrhage: Diagnostic test used:
A Head CT (efficienty)
or MRI (slower bu accurate and costly)
184
Patient has abdominal pain (my test said low back pain) and is aggravated when defecating?
A. Cystitis
B. Urethritis
C. Aortic aneurysm (pulsating sensation near umbilicus)
D. Herniated Lumbar Disc
D. Herniated Lumbar Disc
185
Patient felt pain when doing straight leg test. What is the diagnosis?
Intervertebral disc herniation
186
What is Lasegue's sign?
low back pain wht underlying herniated disc (L5)
187
Patient has lower back pain, positive raising leg sign. What would be the 'initial' imaging test to do?
A. CT
B. MRI
C. Xray
D. PET
C. Xray
188
Patient with pain in his back but all the tests for nerve damage are negative. What do you do?
Refer for MRI
189
Patient is referred to you for lower back pain, abduction and lateral rotation, recreate/irritate pain, flex hip to 45 degrees and gets pain. What does it mean?
A. herniated disc
B. Referred pain
C. Radiculopathy
D. Sacroiliac Joint Dysfunction
Patrick's Test (FABER test)
D. Sacroiliac Joint Dysfunction
190
Positive Trendelenburg's sign (seen in patients with weak or paralyzed hip abductor muscles) indicates what muscles are affected?
Hip abductors - gluteus medius and gluteus minimus
191
20 years old boy played some game, stand a lot and rotated his food a lot yesterday. He showed up symptoms like can't bear his weight, fatigue, fever, pain on legs. What problem does he have?
A. Collateral ligament injury
B. Anterior cruciate ligament Injury
C. Medial Meniscus Tear
D. Patella Muscle rupture
C. Medial Meniscus Tear
192
The abduction (Valgus) stress test checks for:
Medial collateral ligament injury
193
Adduction (Varus) stress test checks for:
Lateral Collateral Ligament Injury
194
The Apley's test checks for:
Meniscus Tear (similar to McMurray's)
195
What are the McMurray and Apley tests for?
Check meniscus injury (medial & lateral)
196
What knee joint exams check meniscus (medial and lateral) injury?
Mc Murray & Apley's test
197
Case: Patient has ski week and complains of knee pain, positive Apley test.
Meniscus injury
198
What are the 3 ACL test?
Lachman's Test
Anterior Drawer Test
Lateral Pivot Shift Test
199
What are the Meniscus Test?
Apley Compression Test
McMurray Test
200
Lady went on vacation and hiked 40 miles. Pain in the lateral forefoot, swelling, no bruising
A. Morton's neuroma
B. Stress Fracture
C. Plantar Fasciitis
B. Stress Fracture
Hairline fracture, fatigue-induced fracture of the bone caused by repeated stress over time
201
Painful arc 60-120 deg abducting arm, painful when washing hair, which muscle or tendon is most affected?
Supraspinatus, the most common muscle affected in Rotator Cuff Syndrome
202
An acute supraspinatus tendinitis (rotator cuff) movement are usually not limited but there is painful arc between.
60-120degree of abduction of the arm
203
Shoulder joint pain palpated on Deltoid, Teres minor area and subscapularis, supraspinatus, infraspinatus area and patient did repetitive motion of a sports activity, What is the diagnosis?
A. Rotator cuff syndrome
B. Frozen Shoulder (adhesive capulitis)
A. Rotator cuff syndrome
SITS: Supraspinatus, Infraspinatus, Teres Minor, Subscapularis
204
Winged Scapula, which muscles are injured?
A. Serratus anterior (boxer's muscle)
B. Teres major
C. Supraspinatus
A. Serratus anterior (boxer's muscle)
Long Thoracic nerve innervates the serratus anterior
205
Winged scapula is a condition in which the shoulder blade protrudes from a person's back in an abnormal position. The most common cause is the serratus anterior muscle paralysis due to an injury to the?
A. Axillary nerve
B. Long Thoracic nerve
C. Dorsal scapular nerve
D. Spinal accessory nerve
B. Long Thoracic nerve
206
Case: Practitioner raised patient's arm and can't feel the radial pulse, and patient has neck, shoulder and arm pain, numbness or impaired circulation to the affected areas, what is the problem?
A. Thoracic outlet syndrome
B. Angina
A. Thoracic outlet syndrome
- wright's test- hyperabducting the arms over the head with some extension
loss or radial pulse
- pain does not happen or increase when walking while the pain of angina
207
woman who is 7 months pregnant comes into clinic with a left side headache and right arm paresthesia and neck pain. What is the condition?
A. Heart attack
B. Preclampsia
C. Gestational Diabetes
D. Cervical Radiculopathy (pinched nerve)
D. Cervical Radiculopathy (pinched nerve)
cause: repetitive & excessive load on the spine
- incluce heavy manual labor requiring lifting of more than 25 lbs, smoking and driving
208
Bony nodules called Bouchard's nodes (middle joint) or Heberden's nodes (fingertip)
Osteoarthritis
Bouchard - PIP
Heberden's (DIP)
209
A patient has both hand pain when constantly typing on the keyboard, what is the disorder?
A. Osteoporosis
B. Osteoarthritis
C. Rheumatoid Arthritis
D. Osteomyelitis
B. Osteoarthritis
210
How to differentiate between rheumatoid arthritis and osteoarthritis?
RA - Joints are painful, swollen and stiff
- Morning stiffness, lasts longer than 1 hour
Frequent fatigue
- Relatively rapid over weeks to month
OS
- Slow progression
- Joints ache and may be tender but have little or no swelling
- Stiffness returns at end of day, or period of activity
- not whole body
211
To evaluate joint range or motion, what's the correct order?
Active ROM -> passive ROM -> resistant isometrics
212
The initial step in joint examination is to evaluate
A. Isotonic muscle contraction
B. Isometric muscle contraction
C. Active range of motion (ROM)
D. Passive range of motion
C. Active range of motion (ROM)
213
Passive ROM is used for what:
A. Muscles
B. Joints
C. Bursa
D. Nerves
B. Joints
214
Difference between Isotonic and Isometric muscles?
Isotonic: same tension; changing length
Isometric: Same length, changing tension
215
Parasympathetic response?
A. Pupil constriction (miosis)
B. Bronchioles dilates
C. Heart rate increases
A. Pupil constriction (miosis)
- heartbeat slows
- Constricts bronchi
- contracts bladder
216
Sympathetic nervous system B receptors cause all of the following except the following physiological response
Pupil constriction
Accelerate heartbeat
Convert glycogen to glucose
Inhibits peristalsis and secretion in digestion
Inhibits saliva flow
217
Early Signs of Opiate withdrawal
- Anxiety
- Dehydration
- Fatigue
- Hot/cold flashes
- Sweating
- muscle aches
218
Late signs of Opiate withdrawal
Late symptoms
- Dilated pupils
- Goosebumps
- Nausea
- Vomiting
219
A young man has anxiety, nausea/vomiting, "goose bump" with dilated pupils. What substanes(s) did the patient use?
A. Alcohol
B. Opiates
C. Cocaine
B. Opiates
220
Patient came to the clinic, agitated with dilated pupils what substanes did the patient use?
A. Cocaine
B. Alcohol
C. Opioid
D. Heroin
E. Amphetamine
A. Cocaine
E. Amphetamine
221
Beta Endorphins, enkephalins, dynorphins, which drug binds to these receptors?
A. Opioids
B. Antidepressants
A. Opioids
222
26 yo mad with headache, nausea and PHOTOSENSITIVITY. Most likely type of headache:
Migraine (vascular)
223
A patient comes in with a headache that is very painful and has lacrimation and runny nose, what type of headache is this?
A. Classic migraine
B. Common migraine
C. Cluster headache
D. Neuromyalgia headache
C. Cluster headache
224
What is cachexia?
weakness and wasting of the body due to chronic illness
225
Complete blood count include?
platelet count, RBC count, WBC count, hemoglobin, hematocrit
226
What is the Phalen test?
Putting top of hands together in opposite prayer hands. Testing the carpal tunnel syndrome, median nerve.
227
What is Leukopenia and what is associated with it?
Decreased WBC count associated with bone marrow failure, radiation therapy, drug toxicity, autoimmune, steroids, chemotherapy
228
What are the worse cancer in terms of death, top 4
pancreatic, breast, colon and finally worse: lungs
229
How is HIV/AIDS diagnosed?
Gum Swab
230
What is the risk of getting HIV from needle stick with contamincated blood?
0.3%
231
What is % that an infected hypodermic needle stick wtill transmit HIV?
0.3%
232
Which are the primary mode of transmission for hepatitis B?
Blood, sex, Syringe
233
What is risk of getting Hep B from needle stick with contaminated blood?
30%
234
What is higher % transfer of infected needle?
HBV
235
Which of these statements about Hep is true?
Hep A is bloodborne
Hep B Oral-Fecal
Hep C is the most common cause of Liver cancer
Hep C is the most common cause of Liver cancer
236
Expsosure to HBV will show what symptoms?
2-6 months, fatigue, fever, flu-like symptoms
4-6 months, flu-like symptoms
1 month, flu-like symptoms
within 2-3 months, flu-like symptoms
2-6 months, fatigue, fever, flu-like symptoms
237
A patient has just returned from Mexico and has nausea and vomit what should you ask?
Does he have a Hep A vaccine?
238
Which vaccination is highly recommended for acupuncturist?
Flu Shot (HBV shot was NOT an option)
239
OSHA - Hep B shot should be offered after the worker has received the required bloodborne pathogens raining and within XX days of initial assignment to a job with occupational exposure.
10 days
240
CNT main focus on waht?
Clean Field
Hand Washing
Disposable needles
Sharps container
Hand Washing
241
CNT procedure: hand washing time?
15-20 sec to prevent cross infection
242
What best defines CNT?
Sterile procedure
Aseptic procedure
Clean procedure
Clean procedure - Aseptic technique
243
How full can sharps container be?
3/4 full
244
The regulation for sharps container
-Big enough to put the long needles
-Has to be labeled with the universal biohazard symbol and the word "biohazard" or be color-coded red
- Made from a variety of products from cardboard to plastic
Big enough to put the long needles
245
Catching disease from contaminated object in environemnt, ex.treatment table is:
- Indirect contact transmission
- Direct cotnact transmission
- Indirect contact transmission
246
Who must be given bloodborne pathogen training and universal precaution training?
ALL employees
247
CNT: Universal Precautions should be taught to:
All employees
248
During treatment, you accidentally cut your finger, what should you do next?
- Wear gloves
- Wash and dress the cut with a bandage
- Cancel treatment
Wash and dress the cut with a bandage
249
Single cotton swab can be used to clean more than one point onthe same patient if:
- A single cotton swab can only be used to prepare a single point
- The points are in the same general area
- The points are in different areas and there are no signs of inflammation, disease or broken skin
- 90% isopropryl alcohol is used to preapare the patient's skin
- The points are in the same general area
250
All of the following statements about the use of needle guide tubes are true EXCEPT:
- Guide tubes should be sterile at the begining of each treatment on each patient
- When using bundled needles, it is considered acceptable to use the guide tube more than once on the same patient, as long as it's unsoiled and uncontaminated
- If a guide tube is used for more than one needle, it's better to drop the needle into the tube handle-end first rather than point-end first.
- If guide tube are used, they should not be placed on the clean field between uses, since they are no longer sterile
If guide tube are used, they should not be placed on the clean field between uses, since they are no longer sterile
251
Needles can be used on the same patient from different parts of the body if
- it is kept in the clean field
- Immediately put into cotton swab
- No because bacteria transfer/different areas with different immunities
No because bacteria transfer/different areas with different immunities
252
Change bed sheets between patient's reatment. How should they be washed?
Launder with hot water and detergent, add hypochlorite(bleach) solution to the wash provides an extra margin of safety.
253
What is hyperpituitarism?
Excessive production of growth hormone (acromegaly or gigantism)
GH up (acromegaly)
PRL up (infertility)
ACTH up (cushing)
254
Patient comes in with Type 1 Diabetes (side effect) for 10 years. What is a reasonable expectation of treatment?
- Reduce dependency on sinsulin
- Treat diabetic circulatory problems
- Treat diabetic circulatory problems
255
Diabetes mellitus 20 years, most serious complication?
Peripheral neuropathy (B12)
256
Chronic diabetic patient testing to check blood sugar level:
- HbA1C hemoglobin
- FBS (fasting sugar)
- long term monitor blood sugar
- Oral glucose tolerance test
- HbA1C hemoglobin
257
Which hormone when high can cause hypercalcemia
- calcitonin
- parathyroid hormone
- thyroid stimulating
- pitocin
- parathyroid hormone
258
What hormone helps absorb calcium in intestines?
PTH
259
Calcitonin, a hormone involved in the regulation of calcium metabolism, is secreted by the?
- Pineal gland
- Thymus gland
- Thyroid Gland
- Parathyroid Gland
- Thyroid Gland
260
If Ca2+ levels are too HIGH, which gland releases hormone to manage Ca2+?
Thyroid releases calcitonin, which increases Ca2+ deposits in bones, decrease uptake in intestines, decrease reabsorption from urine
261
If Ca2+ levels are too LOW, which gland releases hormone to manage Ca2+?
Parathyroid releases PTH, which decreases Ca2+ deposits in bones, increase uptake in intestines, increase reabsorption from urine
262
Goiter is caused by?
Iodine deficiency
(hyper - graves), hypo - hashimoto
263
Older woman 60's, fatigue, pale and puffy, dry skin and hair. What disease?
- Grave's
- Myxedema (hypothyroidism)
- Hashimoto's
- Myxedema (hypothyroidism)
264
Potassium deficiencies with high BP
Aldosterone is too high because of adrenal cortex tumor (adenoma)
265
What does aldosterone and where does it come from?
Raises blood pressure; released by adrenal cortex
266
DHEA - natural steroid hormone produced from cholesterol in which organs?
Adrenal glands, gonads and brain
267
What medicine is a risk for osteoporosis?
Steroids
268
What id Addison's disease
Adrenal insufficiency
aldosterone (down) hypotension
Cortosol (down) fatigue
ACTH (up)-hyperpigmentation
269
Young female patient, who has suffered from an autoimmune disease, and is being treated with a glucocorticoid, shows the appearance of a moon shape face, buffalo hump, and truncal obesity. This is typical case of?
-Graves disease
-Addison's Disease
-Turners Syndrome
-Cushing's syndrome
-Cushing's syndrome
270
Oral contraceptive Pills (OCP) feedback
Inhibition on LH and FSH
271
What hormone spikes during ovulation
LH - basal body temp up
272
What hormone is elevated in monopause?
FSH
273
50 year old woman present with irregular menstrual period, hot flashes, night sweats, mood swings, and insomnia. A preliminary diagnosis of perimenopausal syndrome is made. Which hormones are expected to have an elevated level?
LH and FSH (estrogen and progesterone decrease)
274
Progesterone is released from where after ovulation?
Corpus Luteum
275
What should you look for in a women taking estrogen therapy?
Headache, Nausea, breast tenderness
276
Patient has PCOS, infertility, she is overweight, w/ irregular periods what other symptoms
- Dysmenorrhea
-Dyspareunia
-PID
-Insulin Resistance
-Insulin Resistance
277
Which hormone level is high in PCOS?
Testosterone
278
patient 28, hysteria, pain, increased testosterone. Probably has:
- PCOS
-Pituitary lesion
-Adrenal lesion
- PCOS
279
43 years old female patient has symptoms of high level of androgen, irregular menses, and ovarian polyps, what test should be done to confirm the diagnosis (PCOS)?
- hysteroscopy
-ultrasound
-Xray
-ultrasound
280
Patient thinks he injured his calf, theyare red, swollen. What do you do?
Let it rest
Apply Ice
281
Which disorder is most likely to cause sleep disturbances?
MS
Lupus
Amuloidosis
Fibromyalgia
Fibromyalgia
282
Motor part enters muscle fiber, most electrically excitable part of muscle?
Trigger point
Reflex point
Motor point
Sensory point
Motor point
283
Ankylosing spondylitis is linked to which specific HLA (human leukocyte antigen)
HLA - B27
284
Restless leg syndrome symptoms:
pain, sting & worsen after long time standing
cramping, needling pain worsen in he evening
Tingling, numbness and worsen in the evening.
285
MRI is used to confirm
Soft Tissue injury
Avascular necrosis
286
DEXA (DUal Energy Xray Absorptionmetry)
Osteoporosis
287
A patient has skate board accident, possible skull fracture & subarachnoid hemorrhage: diagnostic test used:
Head CT (efficient) or MRI (slower but accurate and costly)
288
Patient has abdominal pain and is aggravated when defecating?
Herniated Lumbar Disc
289
Patient felt pain when doing straight leg test. What is the diagnosis?
Intervertebral disc herniation
290
Patient has lower back pain, positive raising leg sign. What would be the initial imaging test to do?
Xray
291
Patient with pain in his back but all the tests for nerve damage are negative, what do you do?
Refer for MRI
292
Patient is referred to you for lower back pain, abduction and lateral rotation, recreate/irritate, flex hip to 45 def and gets pain what does this mean? (FABER test)
Sacroiliac Joint Dysfunction
293
Positive Trendelenburg's sign indicates what muscles affected?
Hip abductors - gluteus medius and gluteus minimus
294
20 yrs old played some game, stand a lot and rotated his foot alot yesterday, he showed up with symptoms like can't bear his weight, fatigue, fever, pain on legs. what problem does he have?
Collateral ligament injury
295
The abduction (Valgus) stress test test for
Medial Collateral Ligament Injury (MCL)
296
The Adduction (Varus) Stress Test test for :
Lateral Collateral Ligament Injury (LCL)
297
The Apley's Test test for:
Meniscus Tear (MCL)
298
What are McMurray and Apley tests used for?
Meniscus injury, (medial and lateral)
299
What knee joint exams check meniscus injury?
McMurray & Apley's test
300
Patient has ski week and complains of knee pain, positive Apley test. Your diagnosis:
Meniscus injury
301
Lady went on vacation and hiked 40miles. Pain in the lateral forefoot, swelling, no bruising
Stress Fracture (hairline fracture)
302
Painful arc 60-120deg abducting arm, painful when washing hair, which muscle or tendon is most affected?
Supraspinatus - most common muscle affected in Rotator Cuff Syndrome
303
An acute supraspinatus tendinitis, movement are usually not limited but there is painful arc between?
60-120 deg of abduction of the arm
304
Shoulder joint pain palpated on Deltoid, Teres minor area and supraspinatus, infraspinatus area, and patient did repetitive motion of a sports activity what is the diagnosis?
Rotator Cuff Syndrome
305
Winged scapula - which muscle has injury
Serratus anterior (boxer's muscle)
306
Winged scapula is a condition in which the shoulder blade protrudes from a person's back in an abnormal position. The most common cause is the serratus anterior muscle paralysis due to an injury to the?
Long Thoracic Nerve
307
Case STudy: Practitioner raised patient's arm and can't feel the radial pulse, and patient has neck, shoulder, and arm pain, numbness or impaired circulation to the affected area, what is the problem?
Thoracic Outlet Syndrome (wright's test)
308
A woman who is 7 months pregnant comes into clinic with a left side headache and right arm paresthesia and neck pain, what is the condition?
Cervical Radiculopathy
309
Swan neck in fingers, boutonniere deformity
Rheumatoid Arthritis
310
Bony nodules called Bouchard's nodes (middle joint) or Heberden's nodes (fingertip) seen in:
Osteoarthritis
311
A patient has both hand pain when constantly typing on the keyboard, what is the disorder?
Osteoarthritis
312
How to differentiate between rheumatoid arthritis and osteoarthritis?
RA - joint are painful, swollen and stiff. Symmetrical on both joints, morning stiffness > 1hr
Osteo - Joints may ache, but no swelling, morning stiffness lasts less than 1 hour
313
To evaluate joint range of motion, what's the correct order"
Active ROM -> passive ROM -> resistant isometrics
314
The initial step in the joint examination is to evaluate
Active range of Motion
315
Passive ROM is used for what?
Joints
316
Parasympathetic response?
Pupil constriction (miosis)
317
Sympathetic nervous system B receptors?
Opiod
318
Signs of Opiate withdrawal:
Early :
Anxiety, Dehydration, Fatigue, Sweating
Late:
Dilated pupils, goosebumps
319
A young man has anxiety, nausea/vomiting "goosebump" with "dilated pupils", what substances did the patient used?
Opiates
320
Patient came to the clinic, agitated, with dilated pupils, what substances did the patient use?
Amphetamine, Cocaine
321
Beta Endorphin, enkephalins, dynorphins, which drug binds to these receptors?
Opiods
322
26 year old man with headache, drunk, nausea, and photosensitivity. Most likely type of headache:
Migraine
323
A patient comes in with a headache that is very painful and has lacrimation and runny nose, what type of headache is thi?
Cluster Headache
324
What are differences with the following headaches:
Migraine
Tension-type headache
Cluster headache
Migraine - Duration: hours. Nausea, photophobia, phonophobia + eye redness/tearing runny nose
Tension Type HA - Location - top of head - Duration for weeks
Clsuter HA - Side of face and eyes. ONly eye redness, sharp pain, last a few mins
325
Patient who is 78 years old has a hitory of hypertension and comes in today complaining of excruciating headache, he has never had a headache of this type. Which type of headache does this patient have?
- Cluster
- Sinus
- Migraine
- Hormonoal
- Thunderclap
Thunderclap HA - grabbing your attention like a clap of thunder.
326
On one side limbs are weak with slurred speech. Where is the stroke?
On opposite side and in cerebral cortex (not cerebellum)
327
Patient got stroke 2 weeks ago, what should you closely pat attention?
Blood pressure
328
Patient has right hemisphere cerebral vascular accident (CVA), which area is affected?
- Right face / right body
- Right face / left body
- Left Face / Left body
Left Face / Right Body
Left face /left body
329
Discriminative nerve findings: Left arm 1 + right 2+ left arm muscle weakness (during discrimination point find 2 better discrimination points on R arm) which side is lesion on:
- Right cerebral cortex
- Left cerebral cortex
- Right Cerebellum
- Left Cerebellum
Right Cerebral cortex
330
Restless LEg Syndrome (RLS) is associated with:
- Iron deficiency
- Vitamin D
- Magnesium deficiency
Iron Deficiency
331
A pap smear is recommenede at what age?
21
332
Dr may recommend a colposcopy if this test is abnormal
- urinalysis
- pap smear
- IQ test
- Testicular test
Pap smear
333
Describe symptoms and the positive signs to Bakody's sign.
Patient abduct the artm and place on the head. A positive sign gives relief of symptoms.
Cervical radiculopathy at the C4-C6
334
What are the antioxidant vitamins and their corresponding minerals?
A - Lutein
C - Lycopene
E - Selenium
335
What is HbA1c used for?
Hemoglobin that carries oxygen. This one is specifically reflective of Blood Sugar (Diabetes)
336
How often should a patient be tested with an HbA1C?
about once every 3 months
337
What is the pre-diabetic range for A1C?
5.7 - 6.4 (6 is the middle +- 0.4)
338
Name the SSRI drugs?
E(ffective) : Escitalo-pram
F(or) : Fluoxetin
S(adness) : Sertraline
P(anic) : Paroxetine
C(ompulsion) : Citalo-pram
339
What are the adverse effects of SSRI?
Stomach Upset
Sexual Dysfunction
Serotonin Syndrome
340
Causes for Serotonin Syndrome?
Commonly placed with other pharmaceuticals:
SSRI + SSRI
SSRI + MAOI
SSRI + SNRI (venlafaxine)
341
What are the symptoms of Serotonin Syndrome?
delirium, agitation, tachycardia, diaphoresis, diarrhea, seizures
342
Treatment for Serotonin Syndrome?
STop the offending medications, IV fluids, Cyproheptadine (serotonin production down)
Benzodiazepine (muscle rigidity down)
343
What foods should you avoid with the following drugs:
- MAOI
- Gout
MAOI - Tyraminie-rich (cheese, pickled foods, wine)
Gout: Purine-rich foods (anchovies, sardines, alcohold)
344
What are the overdose symptoms for the following psychotics?
- LIthium
- Antipsychotics
- SSRI
- MAOI
Litium - Lithium Toxicity
Antipsychotics - Neuroleptic Malignant Syndrome (NMS)
SSRI - Serotonin Syndrome
MAOI -induced Hypertensive Crisis
345
Causes of high ESR
N (eoplasia)
A (nemia, autoimmune)
P regnancy
K idney disease
I infection, inflammation
N eoplasm
