COMLEX practice questions help!

[spongiebob]

Hey all:
i'm having trouble with these questions from the COMLEX practice test.
Can someone clarify these for me? thank you very much!

1) pt got in a fight, has a Deviated septum, bleeding nose, pressure on medial lip/septum does not alleviate bleeding. Blood runs to back of his throat. Which septal branch of which artery responsible? ..answers include the post ethmoidal artery,palatine,anterior ethmoidal.

2) pt has a grade 2 concussion. Which premorbid trait will increase risk of headaches?? choices included HTN, migraines, etc,

3) pt has R side of face paralyzed, also no direct response to pupillary constriction of right eye, but normal consensual response. where Is location of injury?

4) After a fall, medial clavicle elevated, lateral clavicle depressed. Elevation of medial end of clavicle is due to which muscle?

5)8 month old w/ atymia has AB's against bacteria. Which ones? is it IgG or IgM,etc

6)what 's the pathophysiology behind the fact that long term laxative use causes constipation

7) person in a car w/ motor running found in a coma. Never regains consciousness. Neuronal damage is most likely in which of the following locations???>>red nucles, VPL,globus pallidus, or amygdala.

8)pt has Horner's in right eye w/ decreased facial sensation. Also left lower body loss of sensation and dysmetria of right arm? Which vessel? (choices included l/r carotid,vertebral,etc, i thought vertebral cause of PICA?)

more coming up..........thank you!!!!

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[dbcuse23]

Hey all:
i'm having trouble with these questions from the COMLEX practice test.
Can someone clarify these for me? thank you very much!

1) pt got in a fight, has a Deviated septum, bleeding nose, pressure on medial lip/septum does not alleviate bleeding. Blood runs to back of his throat. Which septal branch of which artery responsible? ..answers include the post ethmoidal artery,palatine,anterior ethmoidal.

2) pt has a grade 2 concussion. Which premorbid trait will increase risk of headaches?? choices included HTN, migraines, etc,

3) pt has R side of face paralyzed, also no direct response to pupillary constriction of right eye, but normal consensual response. where Is location of injury?

4) After a fall, medial clavicle elevated, lateral clavicle depressed. Elevation of medial end of clavicle is due to which muscle?
MEDIAL HEAD OF STERNOCLEIDOMASTOID PULLS MEDIAL CLAVICLE SUPERIORLY - CLAVICLE IS LIKE A SEESAW SO LATERAL END WILL DEPRESS

5)8 month old w/ atymia has AB's against bacteria. Which ones? is it IgG or IgM,etc

6)what 's the pathophysiology behind the fact that long term laxative use causes constipation
IF YOU FREQUENTLY USE LAXATIVES OVER A PERIOD OF WEEKS OR MONTHS, THEY CAN DECREASE YOUR COLON'S NATURAL ABILITY TO CONTRACT AND ACTUALLY WORSEN CONSTIPATION. IN SEVERE CASES, OVERUSE OF LAXATIVES CAN DAMAGE NERVES, MUSCLES, AND TISSUE OF THE LARGE INTESTINE


7) person in a car w/ motor running found in a coma. Never regains consciousness. Neuronal damage is most likely in which of the following locations???>>red nucles, VPL,globus pallidus, or amygdala.
GLOBUS PALLIDUS (PART OF BASAL GANGLIA)
ORDER OF CARBON MONOXIDE ANOXIC DAMAGE TO BRAIN: HIPPOCAMPUS > PURKINJE FIBERS OF CEREBELLUM > BASAL GANGLIA

8)pt has Horner's in right eye w/ decreased facial sensation. Also left lower body loss of sensation and dysmetria of right arm? Which vessel? (choices included l/r carotid,vertebral,etc, i thought vertebral cause of PICA?)
VERTEBRAL ARTERY --> PICA --> WALLENBERG SYNDROME
-HORNER'S SYNDROME IN THIS CASE IS DUE TO DESCENDING HYPOTHALAMIC TRACT DAMAGE WHICH IS RIGHT NEXT TO THE SPINOTHALAMIC TRACT IN THE MEDULLA

 

[doctorperez]

What's the source of these questions?

 

[spongiebob]

the COMLEx practice test from the NBOME. Thank you thank you thank you!!!!!!! keep them coming

also , couldn't it also be damage to AICA and basilar??i guess that wasn't one of the answer choices though.
8)pt has Horner's in right eye w/ decreased facial sensation. Also left lower body loss of sensation and dysmetria of right arm? Which vessel? (choices included l/r carotid,vertebral,etc, i thought vertebral cause of PICA?)
VERTEBRAL ARTERY --> PICA --> WALLENBERG SYNDROME
-HORNER'S SYNDROME IN THIS CASE IS DUE TO DESCENDING HYPOTHALAMIC TRACT DAMAGE WHICH IS RIGHT NEXT TO THE SPINOTHALAMIC TRACT IN THE MEDULLA

another question, how do we tell a carotid vs a vertebral artery occlusion?

 

[SOUNDMAN]

7) person in a car w/ motor running found in a coma. Never regains consciousness. Neuronal damage is most likely in which of the following locations???>>red nucles, VPL,globus pallidus, or amygdala.
GLOBUS PALLIDUS (PART OF BASAL GANGLIA)
ORDER OF CARBON MONOXIDE ANOXIC DAMAGE TO BRAIN: HIPPOCAMPUS > PURKINJE FIBERS OF CEREBELLUM > BASAL GANGLIA

If the hippocampus is most likely to receive damage in anoxia why isn't the amygdala your choice? I think that is the correct answer not globus pallidus.

 

[dbcuse23]

If the hippocampus is most likely to receive damage in anoxia why isn't the amygdala your choice? I think that is the correct answer not globus pallidus.

agreed..mistake on my part

 

[djnels01]

Hey all:
i'm having trouble with these questions from the COMLEX practice test.
Can someone clarify these for me? thank you very much!

1) pt got in a fight, has a Deviated septum, bleeding nose, pressure on medial lip/septum does not alleviate bleeding. Blood runs to back of his throat. Which septal branch of which artery responsible? ..answers include the post ethmoidal artery,palatine,anterior ethmoidal.

2) pt has a grade 2 concussion. Which premorbid trait will increase risk of headaches?? choices included HTN, migraines, etc,

3) pt has R side of face paralyzed, also no direct response to pupillary constriction of right eye, but normal consensual response. where Is location of injury?

4) After a fall, medial clavicle elevated, lateral clavicle depressed. Elevation of medial end of clavicle is due to which muscle?

5)8 month old w/ atymia has AB's against bacteria. Which ones? is it IgG or IgM,etc

6)what 's the pathophysiology behind the fact that long term laxative use causes constipation

7) person in a car w/ motor running found in a coma. Never regains consciousness. Neuronal damage is most likely in which of the following locations???>>red nucles, VPL,globus pallidus, or amygdala.

8)pt has Horner's in right eye w/ decreased facial sensation. Also left lower body loss of sensation and dysmetria of right arm? Which vessel? (choices included l/r carotid,vertebral,etc, i thought vertebral cause of PICA?)

more coming up..........thank you!!!!

I think the answer to #5 is IgM. An athymic baby could produce IgM but no other anti-bodies in response to an infex (no Th cells = no isotype switching to different Ig's).

 

[cyclohexanol]

7) person in a car w/ motor running found in a coma. Never regains consciousness. Neuronal damage is most likely in which of the following locations???>>red nucles, VPL,globus pallidus, or amygdala.

I thought this was a stupid question, since neuronal damage would be seen in many areas.

However, carbon monoxide poisoning seems to damage the globus pallidus (bilaterally) most specifically which can result in parkinsonian symptoms (from Harrisons).

http://www.learningradiology.com/archives06/COW 232-CO Poisoning/copoisoningcorrect.html

and

http://www.emedicine.com/EMERG/topic817.htm

 

[FutureDO2016]

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[FutureDO2016]

bump....anyone figure out those questions?

 

[FutureDO2016]

Bump

 

[Harvey260]

#1-posterior ethmoidal
#2-migraines?...no idea on this one. obviously if you have a history of migraines, you are more at risk of having more migraines...maybe the grade 2 concussion is a distractor in this case? then again, i can see how a sudden increase in BP (pheochromocytoma) could also cause headaches...need more information from this question.
#3-sounds like something affecting LMN of CN VII as well as the right optic nerve...maybe a huge tumor?
#4-two muscles that i can think of attach to medial clavicle: SCM and pectoralis major. a tightening of the SCM would elevate clavicle; loss of tonicity in pectoralis major would elevate clavicle. maybe the deltoid muscle's lateral attachment has a role in this, too.
#5-IgM; no thymus --> no T-cells --> no class switching with B-cells; the baby is also 8 months old and IgG from mother/placenta are usually absent after 6 months.
#6-i should know this...but i don't...maybe some kind of receptor down regulation?
#7-globus pallidus
#8-sounds like a defect in right CNIII and CNV and right motor columns-->hypoxia in the anterior, superior pons. maybe right pontine arteries?

these are just my guesses. i'm only 2 weeks into board prep, so take my suggestions for what they are worth.

 

[FutureDO2016]

Thanks that helped!