Comsae 110-with 100% verified solutions 2024-2025, Exams of Nursing

Download Comsae 110-with 100% verified solutions 2024-2025 and more Exams Nursing in PDF only on Docsity!

Comsae 110-with 100% verified solutions 2024-

Childhood vaccines: Birth Hep B *Birth = Hep B Childhood vaccines: 2mo Hep B DTaP PCV RV Polio Hib Childhood vaccines: 4mo DTaP PCV RV Polio Hib *same as 2mo except Hep B Childhood vaccines: 6mo Hep B DTaP PCV

RV

Polio Hib flu *same as 2mo Childhood vaccines: 12-18mo DTaP PCV Hib MMR Varicella Hep A flu Childhood vaccines: 4-6yo DTaP Polio MMR Varicella flu Dx of fibromyalgia Tenderness in at least 11/18 trigger points Dx of exclusion Which is the best predictor for good outcome? a. daily walking

b. smoking cessation b. smoking cessation Karyotype for complete mole 46 XX -enucleated egg + single sperm (double paternal DNA) Karyotype for partial mole 69 XXX -2 sperm + 1 egg -p57 positive Give 4 antihypertensives that are safe during pregnancy Hydralazine Methyldopa Labetalol Nifedipine Give 2 inflammatory processes of benign breast disease Fat necrosis Lactational mastitis Fat necrosis of the breast Painless lump due to trauma Calcified oil cyst on mammography

Lactational mastitis Breastfeeding S. aureus Give 3 benign breast tumors Fibroadenoma Intraductal papilloma Phyllodes tumor Fibroadenoma F < Small, mobile mass Made of fibrous tissue & glands Inc size & tenderness w/ estrogen Intraductal papilloma Fibroepithelial tumor in lactiferous ducts Usually beneath areola

Most common cause of nipple discharge (bloody or serous) Phyllodes tumor Large mass of CT w/ "leaflike" lobulated cysts 5th decade May become malignant Breast cancer is often due to overexpression of estrogen/progesterone receptors or HER -triple negative (ER, PR, & HER2 neg = more aggressive) Give 3 noninvasive breast carcinomas Ductal carcinoma in situ Paget disease Lobular carcinoma in situ Ductal carcinoma in situ:

gross morphology (2) micro morphology (2) penetrates the basement mem? subtype (1) Gross: fills duct lumen & engorged blood vessels Micro: ductal atypia & microcalcifications on mammography Does NOT penetrate basement membrane Subtype = comedocarcinoma Comedocarcinoma DCIS w/ central necrosis & dystrophic calcification Paget disease Extension of DCIS up lactiferous ducts & into skin of nipple -eczematous patches over nipple & areola -Paget cells = intraepithelial adenocarcinoma cells (large cells surrounded by clear halo) Lobular carcinoma in situ:

genetics mass & calcifications? risk of cancer? Genetics: dec E-cadherin No mass or calcifications (Incidental finding on biopsy) Inc risk of cancer Give 4 invasive breast carcinomas invasive ductal Invasive lobular Medullary Inflammatory Invasive ductal carcinoma: gross morphology micro morphology Most common invasive breast cancer Gross: firm, fibrous "rock hard" mass

Micro: glandular, ductlike cells in desmoplastic stroma Invasive lobular carcinoma: genetics micro morphology BL or UL Genetics: dec E-cadherin Micro: orderly row of cells, NO duct formation, lacks desmoplastic response BL *lines of cells = lobular Medullary carcinoma: micro morphology Micro: large, anaplastic cells in sheets w/ lymphocytes & plasma cells -well-circumscribed, can mimic fibroadenoma

Inflammatory carcinoma of the breast Dermal lymph invasion = breast pain, warmth, swelling, erythematous skin around hair follicles (peau d'orange) Poor prognosis Often mistaken for Paget or mastitis Lacks a palpable mass Testicular varicocele Dilated pampiniform plexus veins Most common cause of scrotal enlargement in adults L side "bag of worms" Does NOT transilluminate Congenital hydrocele

Common cause of scrotal swelling in infants Incomplete obliteration of processus vaginalis Spontaneously resolve Transilluminate Spermatocele Cyst due to dilated epididymal duct or rete testis Does NOT transilluminate Give 5 germ cell testicular tumors Seminoma Embryonal carcinoma Teratoma Yolk sac tumor Choriocarcinoma

Seminoma: malignant or benign? painless or painful? same as female ____ infancy or adulthood? micro elevated ____ prognosis Most common testicular tumor Malignant Painless Same as female ovarian dysgerminoma Adults Micro: large cells in lobules w/ watery cytoplasm & "fried egg" appearance Elevated placental ALP (PLAP) Good prognosis Embryonal carcinoma:

malignant or benign? painful or painless? gross morphology micro morphology elevated ____ Malignant Painful Gross: hemorrhagic mass w/ necrosis Micro: glandular/papillary morphology mixed w/ other tumor types Elevated BhCG Teratoma Mature = malignant in adult males Benign in children & females Yolk sac tumor Malignant Aggressive

Yellow, mucinous Schiller-Duval bodies resemble primitive glomeruli INCREASED AFP Most common in children <3yo *yolk SAC tumor = Schiller-Duval bodies, inc AFP & Children Choriocarcinoma: malignant or benign? disordered _____ tissue metastases? elevated ____ 2 other s/s Malignant Disordered trophoblastic tissue Mets to lung & brain Elevated BhCG Gynecomastia & hyperthyroidism

Give 3 non-germ cell testicular tumors Leydig cell tumor Sertoli cell tumor Primary testicular lymphoma Leydig cell tumor: malignant or benign? micro morphology? other s/s Benign Golden brown color + Reinke crystals (eosinophilic cytoplasmic inclusions) Inc androgens & estrogen = precocious puberty Sertoli cell tumor Androblastoma (from sex cord stroma) Benign

Primary testicular lymphoma: malignant or benign? aka UL or BL Most common testicular cancer in males >60yo Malignant & aggressive Diffuse large B-cell lymphoma BL Direction of thrust for HVLA of the OA: a. opposite shoulder b. mandible c. ear d. axilla c. ear OMT in a pregnant pt w/ placental abruption is CI bc it may cause Uterine contractions

C3 translates easier to the L & more symmetrically in extension. What is the dx? C3 E RrSr C2 has increased translation to the R which is more asymmetric in flexion. What is the dx? C2 E RlSl Pt presents w/ exhalation dysfn of ribs 6-10. What muscles are primarily used to correct this? a. serratus anterior b. external intercostals a. serratus anterior A Native American asks for a ritual in the hospital that includes dancing & chanting. Can you honor the request? a. honor it as long as there is no harm to the patient b. not honor the request bc it may be disruptive to other hospital pts a. honor it as long as there is no harm to the patient

A pt w/ Alzheimer's presents w/ recent hx of starting new mediation, UTI & delirium. What is the cause of his delirium? UTI What 2 muscles does Zenker's diverticulum protrude through Killian's dehiscence Cricopharyngeus (upper sphincter m) -not a true diverticulum Guillan-Barre Auto-immune disease that destroys Schwann cells (PNS myelin) Symmetric ascending muscle weakness beginning in lower limbs. What do the lenticulostriate arteries supply? What are they a br off of? Br. from MCA Supply basal ganglia

Gene duplication that causes Charcot-Marie-Tooth PMP -foot probs BL vestibular Schwannomas are associated w/ Neurofibromatosis 2 Oligodendroglioma Frontal lobe Dystrophic calcification "Fried egg" cell appearance Highly vascularized ("chicken wire") Adjustment disorder vs Major Depressive Disorder timeline AD = w/in 3mo of identifiable psychosocial stressor lasting <6mo MDD = >2wks of s/s

Dorsal column-medial lemniscus modalities Vibration Fine touch Pressure Conscious proprioception Spinothalamic tract modalities Pain Temp Crude touch Pressure Corticospinal tract modailities Voluntary motor Wernicke aphasia

Fluent aphasia -impaired comprehension & repetition -word salad -superior temporal gyrus -Brodmann area 22 -MCA Broca aphasia Non-fluent aphasia -can repeat & comprehend -inferior frontal gyrus -Brodmann areas 44 & 45 -MCA Conduction aphasia Can't repeat

-are fluent & can comprehend -arcuate fasciculus (supramarginal gyrus) -MCA Global aphasia Can't speak, comprehend or repeat -Mainstem MCA Gastric ulcers: pain H. pylori mechanism other causes risk of carcinoma Pain greater w/ meals = weight loss

H. pylori common Mech = dec mucosal protection against gastric acid Other causes = NSAIDs Risk of carcinoma increases Duodenal ulcer: pain H. pylori mechanism other causes risk of carcinoma Pain lesser w/ meals = weight gain No H. pylori Mech = dec mucosal protection/increased gastric acid

Other causes = Zollinger-Ellison Risk of carcinoma no Krukenberg tumor Gastric adenocarcinoma that mets to ovary -abundant mucin-secreting signet ring cells Chron disease: Location Gross morphology Micro morphology Complications (3) Diarrhea ExtraGI manifestations (4) Tx (4) Location = all GI, terminal ileum & colon, skip lesions, rectal sparing

Gross morphology = transmural, fistulas, cobblestone mucosa, creeping fat, string sign, linear ulcers & fissures Micro morphology = noncaseating granulomas Complications (3) = malabsorption, fistulas, & strictures Diarrhea = may NOT be bloody ExtraGI manifestations (4) = rash, oral ulcers, Ca2+ oxalate stones, & anti-Saccharomyces cervisiae Abs (ASCA) Tx = glucocorticoids, AZA, Abx (cipro & metronidazole) biologics (infliximab, adalimumab) Ulcerative colitis: Location Gross morphology Micro morphology Complications (3) Diarrhea

ExtraGI manifestations (4) Tx (4) Location = colon, continuous, involves rectum Gross morphology = mucosal & submucosal only, friable, loss of haustra (lead pipe) appearance Micro morphology = crypt abscesses, bleeding Complications (3) = malabsorption, toxic megacolon, & perforation Diarrhea = bloody ExtraGI manifestations (4) = rash, oral ulcers, primary sclerosing cholangitis, & MPO-ANCA/p-ANCA Tx (4) = 5-aminosalicylic acid prep (mesalamine), 6-MP, infliximab, & colectomy Alpha hemolytic optochin sensitive strep Strep pneumo Strep pneumo VF (1) & common infections (4) VF = IgA protease