We will start exactly 9:40 AM

1.A.
Melena- upper GI
*Bismuth subsalicylate- stool has a black appearance; black tongue (Pepyo- Bismol)
Imodium- Loperamide
Acidophilus- Lactobacillus acidophilus
Lonox- atropine
2.B.
Mahogany colored stool - lower GI
light colored/ clay colored stool
pencil thin stool- colorectal cancer
3.D.
PUD
Gastric ulcer- prolonged NSAID USE- aggravated by food intake
Duodenal ulcer/ pyloric ulcer- H. pylori- aggravated by empty stomach
stomach and duodenum- lat border of scapul pain referral
4.A.
Cholelithiasis- gallstones
Cholesterol stones
Pigment stones
(+) murphy's sign- cholecystitis
liver pain referral- R subscapular
5.B.
6.D.
Diverticulitis- bloody stool
Ulcerative colitis- bloody diarrhea
7.B.
ascending colon- liquid
transverse colon- soft/ loose stool with infrequent interval
descending colon- firm,irregular
sigmoid colon- hard,regular
8.A.
9.C.
PPI- interfer c calcium absorption
GERD- upright, L sidelying head elevated
Shaker headlifting exercise- strengthen UES
sleeping position- head elevated 6 in, L sidelying
10.D.
aluminum hydroxide- constipation
11.B.
IBD- corticosteriods, glucocorticoids
cRohns
uLcerative colitis
*rectum- inflamed- proctitis
IBS- no structural deformity or biomechanical abnormalities
12.D. rebound tenderness- blumberg sign
safest- pinch an inch test
Mcburney's point- halfway between ASIS and umbilicus; 1.5- 2' above ASIS
palpation of ilipsoas- 1/3 distance bet ASIS and umbilicus(90-90 position)
13.D.
L shoulder pain referral c pressure placed on the upper abdomen- kehr's sign
shoulder pain c inspiration- Danforth sign
14.B.
Psoas abcess- ill defined border, softer, lateral to femoral artery
15.B.
pancreatitis- leaning forwars, sitting up, or lying motionless on the L side in
fetal flexed position
-sidelying knee- chest position with pillow pressed against the abdomen, or
sitting with trunk flexed
16.D.
17.
DI-> dec ADH-> dehydrated-> NA in the blood is concentrated-> Hypernatremia-> dec
USG

SAIDH-> inc ADH-> water intoxication-> Na in the blood is diluted-> Hyponatremia->

inc USG
Na- 135-145 meq/L

N urine specific gravity- 1.015- 1.025

18.D.
19.B.
20.D.
Exopthalmos-hyperthyroidism- capillary dilation
21.C.
hypothyroidism-inc bone density
22.B.
trosseau sign- hypocalcemia
23.D.
24. C.
DKA- quadriceps
25. A.
Glycosylated hemoglobin0 most accurate for chronic glycemia
x anemia, diabetic pregnant, dialysis
Diabetic neuropathy- Cahrcot's joint- diabetic ulcer (+) hyperkeratosis
26.B.
27.D.
28.C.
Diabetic autonomic neuropathy- HRR %
29.C.
dec serum cortisol- hallmark of addison
30.B.
hyperfuncrion of adrenal gland- cushings and conns-> inc aldosterone (water
intoxication)-> K is dec-> Potassium sparing diuretic- aldactone-> spironolactone
31.C.
32.C.
CI addison- aquatic therapy
33.C.
34.B.
not more than 5 mins of supine- 1st trimester
35.D.
36.B.
pregnant- inc 300 cal per day
37.D.
Levator ani- not included in superficial mm of pelvic floor
38.A.
4-6 weeks gradual
cesarean- 8-10 wks c medical clearance
39.B.
Cervical cancer- HPV
40.C,
Freq hereditary syndromes of cancer- Breast, ovarian, colon cancer
41.D.
42.B.
Cancer- physical fxn decline- aerobic exercise, strengthening
43.B.
44.C.
cancer- RPE
first line of defense- skin
second line of defens- inflammation
third line of defense- immune response
45.C.
46.D.
don: Gow Mas Gog Glo
Doff: Gloves gown goggle, mask
47.B.
TB- Airborne
48.D.
C. difficile- drug induced diarreah
49.A.
50.D.
Scarlet fever- Droplet