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NCCAOM BOARDS: BIOMEDICINE EXAM 2025 -
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VERTICAL ANATOMICAL LEVELS: iliac crest, umbilicus - ANSWERS_L Conduct impulses -- the "wiring" of the nervous system's information circuits - ANSWERS_neurons Contains nucleus, cytoplasm, and organelles - ANSWERS_soma (cell body) Branches from the cell bodies Receive stimuli that initiate nerve signals - ANSWERS_dendrites Conducts impulses away from cell body - ANSWERS_axon Peptide and transmitter of many central neurons (dorsal root ganglia and basal ganglia) Transmits pain - ANSWERS_Substance P Act like opiates to block pain - ANSWERS_endorphins, enkephalins
Alzheimer's Disease treatment A) cholinergic enhancers (aricept - donepezil), tricyclic antidepressants (remeron - mirtazapine), provigil, nsaids, memantine, gingko biloba B) levodopa, anticholinergics C) interferon, corticosteroids, plasmapheresis, lioresal - baclofen, tizanidine - zanaflex, benzodizepines, antidepressants, amantadine D) carbamazepine, phenytoin, amitriptyline E) corticosteroids - ANSWERS_A Parkinson's disease treatment A) cholinergic enhancers (aricept - donepezil), tricyclic antidepressants (remeron - mirtazapine), provigil, nsaids, memantine, gingko biloba B) levodopa, anticholinergics C) interferon, corticosteroids, plasmapheresis, lioresal - baclofen, tizanidine - zanaflex, benzodizepines, antidepressants, amantadine D) carbamazepine, phenytoin, amitriptyline E) corticosteroids - ANSWERS_B Multiple Sclerosis treatment A) cholinergic enhancers (aricept - donepezil), tricyclic antidepressants (remeron - mirtazapine), provigil, nsaids, memantine, gingko biloba B) levodopa, anticholinergics
Characterized by reddening of the skin Skin is unbroken and wound is superficial Like a sunburn Treatment consists of turning or alleviating pressure in some form or avoiding more exposure to the cause of injury - ANSWERS_ STAGE OF WOUNDS OF DECUBITUS ULCERS: Blister is either broken or unbroken Partial layer of skin is now injured Must cover, protect, and clean the area Quick attention is very important - ANSWERS_ STAGE OF WOUNDS OF DECUBITUS ULCERS: Wound extends through layers of the skin Primary site for serious infection to occur Treat same as previous stage Medial care necessary to promote healing and prevent infection - ANSWERS_ STAGE OF WOUNDS OF DECUBITUS ULCERS: Extends through skin and involves underlying muscle, tendons, and bone Tissue necrosis Diameter is not as important as the depth Very serious and may be life-threatening
Must have medical care Surgical removal of necrotic/decayed tissue is often used for large- diameter wounds - ANSWERS_ Chronic excretion of very large amounts of pale urine of low specific gravity Causes dehydration and extreme thirst Usually results from inadequate output of ADH - ANSWERS_diabetes insipidus Underactive thyroid gland during infancy and childhood - ANSWERS_cretinism Underactive GH during childhood - ANSWERS_dwarfism Oversecretion of GH in adulthood - ANSWERS_acromegaly Elevated levels of cholesterol and triglycerides Obesity Insulin resistance - ANSWERS_syndrome X Depigmented macules appear on face, hands, feet, and other regions
COMPONENTS OF BLOOD: most important cellular components in body's defenses - ANSWERS_leukocytes COMPONENTS OF BLOOD: cellular defense phagocytosis of small pathogenic microorganisms, bacterial infections, inflammation and stress responses - ANSWERS_neutrophils COMPONENTS OF BLOOD: lining of respiratory & digestive tracts; parasites & allergens - ANSWERS_eosinophils COMPONENTS OF BLOOD: contain histamine (anti-inflammatory) and heparin (anti-coagulant) - ANSWERS_basophils COMPONENTS OF BLOOD: smallest, T's directly attack infected or cancerous cells, viral infections - ANSWERS_lymphocytes COMPONENTS OF BLOOD: largest, phagocytosis of large bacterial organisms, chronic viral infections - ANSWERS_monocytes COMPONENTS OF BLOOD: "large eaters"; large and long-lived; capture foreign cells, digest and present protein fragments (peptides) from cells; present antigen to T-cells - ANSWERS_macrophages IMMUNE SYSTEM: first line of defense - ANSWERS_skin, mucus membranes
IMMUNE SYSTEM: second line of defense - ANSWERS_inflammation IMMUNE SYSTEM: third line of defense - ANSWERS_immune response IMMUNE SYSTEM: primary cell for immune response; originates in liver, spleen, and bone marrow of fetus - ANSWERS_lymphocytes IMMUNE SYSTEM: migrate through thymus gland to become T- lymphocytes (cell-mediated immunity) These cells leave marrow at an early age and travel to the thymus and mature Imprinted with critical information recognizing "self" and "non-self" substances - ANSWERS_T-lymphocytes IMMUNE SYSTEM: mature in bone marrow - ANSWERS_B- lymphocytes IMMUNE SYSTEM: filter lymph and phagocytes from harmful bacteria and microogranisms - ANSWERS_lymph nodes ANTIBODIES -- IMMUNOGLOBULIN: Synthesized by immature Beta cells Produced after initial contact w/ antigen Does NOT cross placenta
Ige antibody reaction occurs within 15 - 30 minutes of exposure, though sometimes 10-12 hours after exposure Anaphylaxis is most severe type of hypersensitivity Reactions in this group: allergic rhinitis, allergic conjunctivitis, allergic asthma, food allergies - ANSWERS_Type 1 HYPERSENSITIVITY REACTIONS: Igg and igm mediate cytotoxic reactions activate in the complement cascade Symptoms emerge within a few minutes to several hours after the antibody-antigen binding Hemolytic anemia, blood transfusions, and many drug allergies (pencillin) - ANSWERS_Type 2 HYPERSENSITIVITY REACTIONS: Igg and igm are immune complex reactions Reaction is usually within 3 - 10 hours after immune complex forms SLE, glomerulonephritis, polyarteritis, vasculitis and RA - ANSWERS_Type 3 HYPERSENSITIVITY REACTIONS: T-cell lymphocytes are also called delayed-type hypersensitivity reactions Usually take days or weeks to manifest Rashes like poison ivy, poison oak, poison sumac, bacteria or fungi that body is unable to completely eliminate - ANSWERS_Type 4
CHEMICALS OF INFECTION: allergic reactions - ANSWERS_histamine CHEMICALS OF INFECTION: mediates inflammation - ANSWERS_bradykinin CHEMICALS OF INFECTION: plays a role in inflammation - ANSWERS_serotonin Triad of fever, headache, and nuchal rigidity Develop over hours or days - ANSWERS_meningitis RED FLAG: chest muscles causing impaired respirations - ANSWERS_myasthenia gravis RED FLAG: fever, headache, photophobia w/ weakness and seizures; stiffness of neck; altered mental states; focal neurologic deficits - ANSWERS_encephalitis Disease caused by Bartonella bacteria - ANSWERS_cat scratch fever DUODENAL OR GASTRIC ULCER: Most common - ANSWERS_duodenal DUODENAL OR GASTRIC ULCER:
Inflammation of appendix Complications include: rupture, formation of abscess, peritonitis - ANSWERS_acute appendicitis Disorder of motility of entire GI tract Affects women more than men GI tract is sensitive to many stimuli: stress, diet, drugs, hormones - ANSWERS_IBS Chronic inflammation of intestinal wall or anywhere along digestive tract - ANSWERS_Crohn's disease Chronic inflammation and ulceration of LI Higher risk of colon cancer - ANSWERS_ulcerative colitis Inflammation or infection of one or more diverticula Can lead to fistulas between LI an dorgans - ANSWERS_diverticulitis Swollen and tender in mid- and left upper abdomen - ANSWERS_pancreatitis Quadrant affected: acute appendicitis - ANSWERS_RLQ Quadrant affected: Crohn's disease - ANSWERS_RLQ
Quadrant affected: diverticulosis - ANSWERS_LLQ Quadrant affected: diverticulitis - ANSWERS_LLQ Rebound pain at mcburney's point Pain worse w/ leg lift Pain could be dull - ANSWERS_acute appendicitis Bloating, gas, nausea, headaches, fatigue, depression, anxiety, difficulty concentrating Often exacerbated by emotional conflict - ANSWERS_IBS Chronic diarrhea, loss of appetite, weight loss, vomiting Can lead to fistulas and abscess that cause fever and pain Bleeding from rectum is not common thin stools - ANSWERS_Crohn's disease Begins gradually w/ mild cramps in lower abdomen Abdominal pain and peritonitis Inflammation is continuous in affected areas - ANSWERS_ulcerative colitis Possible episodes of lower abdominal pain - ANSWERS_diverticulosis
Bleeding and constipation Tender w/ inflammation - ANSWERS_diverticulitis Worse after eating Nausea, vomiting, increased heart rate and BP Labs: increased amylase, lipase, WBC DX: ultrasound or CT scan - ANSWERS_pancreatitis Skip lesions: Crohn's or ulcerative colitis - ANSWERS_Crohn's Continuous lesions: Crohn's or ulcerative colitis - ANSWERS_ulcerative colitis Persistent low-grade fever A) acute appendicitis B) Crohn's disease C) ulcerative colitis D) diverticulitis E) pancreatitis - ANSWERS_A Fever A) acute appendicitis B) Crohn's disease C) ulcerative colitis
D) diverticulitis E) pancreatitis - ANSWERS_B, D, E High fever A) acute appendicitis B) Crohn's disease C) ulcerative colitis D) diverticulitis E) pancreatitis - ANSWERS_C Adson's test - ANSWERS_thoracic outlet syndrome Brudzinski sign - ANSWERS_meningitis Kernig test - ANSWERS_meningitis Yergason test - ANSWERS_biceps tendon injury Examiner palpates radial pulse while moving upper extremity in abduction, extension, and external rotation Patient is then asked to rotate head toward affected side while taking a deep breath and holding it +: diminished or absent radial pulse - ANSWERS_Adson's test
Raise one leg - knee absolutely straight - until pain is experienced in thigh, buttock, and calf - ANSWERS_straight leg test Braggard's test - ANSWERS_nerve root lesion, disc herniation, sciatica Straight leg test + passively dorsiflex ankle by pushing up on ball of foot - ANSWERS_Braggard's test Apley Compression test - ANSWERS_meniscus injury Patient placed prone on exam table w/ knee flexed to 90 degrees Gently kneel on back of thigh to stabilize while leaning hard on heel to compress medial and lateral menisci between tibia and femur Rotate tibia internally and externally on femur as you maintain compression - ANSWERS_Apley Compression test Apley Distraction test - ANSWERS_ligament damage Same position as Apley Compression test Apply traction to leg while rotating internally and externally on femur - ANSWERS_Apley Distraction test Mcmurray test - ANSWERS_meniscus tear
With patient supine, grasp knee, place one hand over top o fknee with thumb over one joint line and index and middle finger over opposite joint line Begin with knee in full flexion and then medially and laterally rotate tibial while paying attention for audible click Then laterally rotate tibia and extend knee beyond 90 degrees Audible click: torn medial meniscus - ANSWERS_mcmurray test Anterior Drawer test - ANSWERS_ACL injury Posterior drawer test - ANSWERS_PCL injury Romberg's test - ANSWERS_cerebellum (balance) KNEE INJURIES: fall directly on knee, sudden flexion A) patella B) ACL C) PCL D) meniscus - ANSWERS_A KNEE INJURIES: running fast then stopping quickly, stopping when going forward A) patella B) ACL
