COMSAE Comprehensive Self-Assessment Exam Bundle 2026/2027 |
150 Verified Questions & Answers | NBOME Osteopathic Medical
Exam Prep | 4 Core Domains | Instant Download
1. M3 agonist= pilocarpine/carbachol (direct) - ANSWERS-contract the sphincter
muscles allowing passage of fluid; pilocarpine emergencies
2. Pervasive development disorder - ANSWERS-what you think of when you consider
autism spectrum: can't be touched, comforted, can't understand speech
3. Mifepristone/ulipristal (mifetuspleasebegone) - ANSWERS-competitive inhibitor
progestins at progesterone receptors;
Terminate pregnancy (mifepristone w/ misoprostol); ER contraception (ulipristal)
Antiprogestins
4. Antihistamines - ANSWERS-Reversible inhibitor of H1 histamine receptors
5. 1st generation antihistamines - ANSWERS-diphenhydramine, dimenhydrinate,
chlorpheniramine "en/ine" or "en/ate"
Use: allergy motion sick, sleep aid
AE: sedation, antimuscarinic, anti alpha adrenergic
6. 2nd generation antihistimes - ANSWERS-loratadine, fexofenadine, desloratadine,
cetgirizine "adines"
Use: allergy; far less sedation than first gen bc dec entry into CNS
7. Decompression disease/caisson dz) - ANSWERS-Air emboli--nitrogen bubbles
precipitate in ascending divers>
Tx hyperbaric O2; can be iatrogenic due to invasive procedures
8. Bronchiectasis - ANSWERS-chronic necrotizing infection bronchi>> perm dilated
airways, purulent sputum, recurrent infecting, hemoptysis, digital clubbing;
Assoc: obstruction, poor ciliary motility (Kartagener syndrome, smoking) CF,
allergic bronchopulmonary aspergillosis
9. Kartagener Syndrome -- primary ciliary dyskinesia - ANSWERS-immotile cilia b/c dyne
arm defect; male and female infertility, inc risk ectopic pregnancy; causes
bronchiectasis, recurrent sinusitis, and situs inversus
10. Myasthenia gravis - ANSWERS-Most C NMJ disorder;
Autos to postsynaptic ach receptor;;
Clinical-ptosis diplopia weakness, worsen w/ MUSCLE USE==WORSEEE
Assoc: thymoma, thyme hyperplasia
Tx: pyridostigmine, edrophonium to diagnose==ache inhibitor
11. Lambert Eaton myasthenia syndrome - ANSWERS-uncommon;
Autoabs to presynaptic Ca+2 channel>> dec ach release
, Proximal muscle weakness, autonomic sx, improve WITH MUSCLE USE= BETTER
Assoc: small cell lung cancer;
Ache inhibitors don't help
12. Visual Field defects: Right anopia - ANSWERS-Right optic nerve
13. 2 bitemporal hemianopia - ANSWERS-optic chiasm, pituitary tumor
14. Left homonymous hemianopia - ANSWERS-right optic tract
15. Left upper quadratic anopia - ANSWERS-right temporal lesion MCA, Meyer loop
16. Left Lower quadrantic anopia - ANSWERS-right parietal lesion MCA--dorsal optic
radiation
17. Left hemianopia w/ macular sparing - ANSWERS-PCA infarct
18. Central scotoma - ANSWERS-macular degeneration
19. Cranial nerve III damage - ANSWERS->> poss cause DM >> inc sorbitol; due dc
O2/nutrients
S/s: ptosis, down and out; diminished/absent pupillary light reflex, blown pupil
20. CN IV damage - ANSWERS-eye moves upward; esp C/l gaze, head tilt toward side
lesion; problems going downstairs; present w/ compensatory head tilt in app
direction
21. CNVI damage - ANSWERS-medially direct eye that cannot abduct
22. Eye nerves remember - ANSWERS-LR6, So4, R3
23. Acetaminophen - ANSWERS-moa: reversibly inhibit COX, mostly CNS;
AE: OD>> hepatic necrosis; NAPQI depletes glutathione>> toxic byproducts liver;
NAC= antidote>> regenerate glutathione
24. Vecuronium - ANSWERS-neuromuscular blocking drugs>> muscle paralysis in
surgery or mechanical ventilation; NONDEPOLARIZING (CUR'S)
Competitive antagonsits> compete ach for receptors
Reversal= neostigmine *given w/ atropine to avoid muscarinics such as bradycardia,
edrophonium and other cholinesterase inhibitors
25. Succinylcholine - ANSWERS-depolarizing neuromuscular blocking drug-- strong ach
receptor agonist>> produce sustained depot and prevent muscle contraction
Reversal blockade
Phase I: prolong depot- no antidote; block potentiated by cholinesterase
inhibitors
, Phase II: depolarized but blocked; ach receptors available but desensitized;
reversed with cholinesterase inhibitors
Complications: hypercalcemia, hyperc=kalemia, malignant hyperthermia
26. Tricyclic Antidepressants:imipramine - ANSWERS-amitryptiyline, nortryptiline
desipramine, clomipramine, doxepin, amoxapine
Moa: block reuptake NE and 5HT
AE: sedation, alpha 1 block effects>> postural hypotension and atropine like
(anticholinergic) side effects>> tachycardia, urinary retention, dry mouth,
GLAUCOMA LIKE, prolong QT
Tric's: Convulsions, Coma, Cardiotoxicity (arrhythmia due to NA channel inhibit)
27. Conduct disorder - ANSWERS-precursor to antisocial personality disorder=sociopath
Animal harm, illegal activity, destruction property, theft, aggression
28. Heroin - ANSWERS-miosis? Respiratory depression
Methadone or burpnorphine + naloxone treatment
29. Scalded skin syndrome - ANSWERS-Staphylococcal--
Exotoxin destroy attaches in stratum granulosum
Fever; general rash, sloughing upper layers epidermis heals completely; + Nkolsy;
newborns, children and adults w/ renal insufficiency
30. Placenta accrete/increta/percreta - ANSWERS--defective decidual layer>> abnormal
attach and separate after delivery (risk factor C section, inflammation, placenta
prevue_ 3 types:
31. Placenta accreta - ANSWERS-attaches myometrium; no penetration
32. Placenta increta - ANSWERS-placenta INTO myometrium
33. Placenta percreta - ANSWERS-perforates through myometrium into uterine serosa>
attachment placenta to rectum/bladder
34. Presentation of placenta accrete etc - ANSWERS-US prior delivery; no separation
after delivery>> post part bleeding can cause Sheehan syndrome
35. Placenta previa - ANSWERS-attach to lower uterine segment over (less 2 cm from)
cervical os; Risk factor prior C section; multiparity
Assoc w/ painless third TM bleeding
36. No lactation postpartum, absent mensturation, cold intolerance - ANSWERS-
Sheehan syndrome= pituitary infarction
37. Sheehan syndrome - ANSWERS-ischemic infarct pituitary follow post part bleeding;
pregnancy induced pit grow>> inc susceptible to hypoperfusion
Assoc: fail lactate, absent menstruation, cold intolerance
150 Verified Questions & Answers | NBOME Osteopathic Medical
Exam Prep | 4 Core Domains | Instant Download
1. M3 agonist= pilocarpine/carbachol (direct) - ANSWERS-contract the sphincter
muscles allowing passage of fluid; pilocarpine emergencies
2. Pervasive development disorder - ANSWERS-what you think of when you consider
autism spectrum: can't be touched, comforted, can't understand speech
3. Mifepristone/ulipristal (mifetuspleasebegone) - ANSWERS-competitive inhibitor
progestins at progesterone receptors;
Terminate pregnancy (mifepristone w/ misoprostol); ER contraception (ulipristal)
Antiprogestins
4. Antihistamines - ANSWERS-Reversible inhibitor of H1 histamine receptors
5. 1st generation antihistamines - ANSWERS-diphenhydramine, dimenhydrinate,
chlorpheniramine "en/ine" or "en/ate"
Use: allergy motion sick, sleep aid
AE: sedation, antimuscarinic, anti alpha adrenergic
6. 2nd generation antihistimes - ANSWERS-loratadine, fexofenadine, desloratadine,
cetgirizine "adines"
Use: allergy; far less sedation than first gen bc dec entry into CNS
7. Decompression disease/caisson dz) - ANSWERS-Air emboli--nitrogen bubbles
precipitate in ascending divers>
Tx hyperbaric O2; can be iatrogenic due to invasive procedures
8. Bronchiectasis - ANSWERS-chronic necrotizing infection bronchi>> perm dilated
airways, purulent sputum, recurrent infecting, hemoptysis, digital clubbing;
Assoc: obstruction, poor ciliary motility (Kartagener syndrome, smoking) CF,
allergic bronchopulmonary aspergillosis
9. Kartagener Syndrome -- primary ciliary dyskinesia - ANSWERS-immotile cilia b/c dyne
arm defect; male and female infertility, inc risk ectopic pregnancy; causes
bronchiectasis, recurrent sinusitis, and situs inversus
10. Myasthenia gravis - ANSWERS-Most C NMJ disorder;
Autos to postsynaptic ach receptor;;
Clinical-ptosis diplopia weakness, worsen w/ MUSCLE USE==WORSEEE
Assoc: thymoma, thyme hyperplasia
Tx: pyridostigmine, edrophonium to diagnose==ache inhibitor
11. Lambert Eaton myasthenia syndrome - ANSWERS-uncommon;
Autoabs to presynaptic Ca+2 channel>> dec ach release
, Proximal muscle weakness, autonomic sx, improve WITH MUSCLE USE= BETTER
Assoc: small cell lung cancer;
Ache inhibitors don't help
12. Visual Field defects: Right anopia - ANSWERS-Right optic nerve
13. 2 bitemporal hemianopia - ANSWERS-optic chiasm, pituitary tumor
14. Left homonymous hemianopia - ANSWERS-right optic tract
15. Left upper quadratic anopia - ANSWERS-right temporal lesion MCA, Meyer loop
16. Left Lower quadrantic anopia - ANSWERS-right parietal lesion MCA--dorsal optic
radiation
17. Left hemianopia w/ macular sparing - ANSWERS-PCA infarct
18. Central scotoma - ANSWERS-macular degeneration
19. Cranial nerve III damage - ANSWERS->> poss cause DM >> inc sorbitol; due dc
O2/nutrients
S/s: ptosis, down and out; diminished/absent pupillary light reflex, blown pupil
20. CN IV damage - ANSWERS-eye moves upward; esp C/l gaze, head tilt toward side
lesion; problems going downstairs; present w/ compensatory head tilt in app
direction
21. CNVI damage - ANSWERS-medially direct eye that cannot abduct
22. Eye nerves remember - ANSWERS-LR6, So4, R3
23. Acetaminophen - ANSWERS-moa: reversibly inhibit COX, mostly CNS;
AE: OD>> hepatic necrosis; NAPQI depletes glutathione>> toxic byproducts liver;
NAC= antidote>> regenerate glutathione
24. Vecuronium - ANSWERS-neuromuscular blocking drugs>> muscle paralysis in
surgery or mechanical ventilation; NONDEPOLARIZING (CUR'S)
Competitive antagonsits> compete ach for receptors
Reversal= neostigmine *given w/ atropine to avoid muscarinics such as bradycardia,
edrophonium and other cholinesterase inhibitors
25. Succinylcholine - ANSWERS-depolarizing neuromuscular blocking drug-- strong ach
receptor agonist>> produce sustained depot and prevent muscle contraction
Reversal blockade
Phase I: prolong depot- no antidote; block potentiated by cholinesterase
inhibitors
, Phase II: depolarized but blocked; ach receptors available but desensitized;
reversed with cholinesterase inhibitors
Complications: hypercalcemia, hyperc=kalemia, malignant hyperthermia
26. Tricyclic Antidepressants:imipramine - ANSWERS-amitryptiyline, nortryptiline
desipramine, clomipramine, doxepin, amoxapine
Moa: block reuptake NE and 5HT
AE: sedation, alpha 1 block effects>> postural hypotension and atropine like
(anticholinergic) side effects>> tachycardia, urinary retention, dry mouth,
GLAUCOMA LIKE, prolong QT
Tric's: Convulsions, Coma, Cardiotoxicity (arrhythmia due to NA channel inhibit)
27. Conduct disorder - ANSWERS-precursor to antisocial personality disorder=sociopath
Animal harm, illegal activity, destruction property, theft, aggression
28. Heroin - ANSWERS-miosis? Respiratory depression
Methadone or burpnorphine + naloxone treatment
29. Scalded skin syndrome - ANSWERS-Staphylococcal--
Exotoxin destroy attaches in stratum granulosum
Fever; general rash, sloughing upper layers epidermis heals completely; + Nkolsy;
newborns, children and adults w/ renal insufficiency
30. Placenta accrete/increta/percreta - ANSWERS--defective decidual layer>> abnormal
attach and separate after delivery (risk factor C section, inflammation, placenta
prevue_ 3 types:
31. Placenta accreta - ANSWERS-attaches myometrium; no penetration
32. Placenta increta - ANSWERS-placenta INTO myometrium
33. Placenta percreta - ANSWERS-perforates through myometrium into uterine serosa>
attachment placenta to rectum/bladder
34. Presentation of placenta accrete etc - ANSWERS-US prior delivery; no separation
after delivery>> post part bleeding can cause Sheehan syndrome
35. Placenta previa - ANSWERS-attach to lower uterine segment over (less 2 cm from)
cervical os; Risk factor prior C section; multiparity
Assoc w/ painless third TM bleeding
36. No lactation postpartum, absent mensturation, cold intolerance - ANSWERS-
Sheehan syndrome= pituitary infarction
37. Sheehan syndrome - ANSWERS-ischemic infarct pituitary follow post part bleeding;
pregnancy induced pit grow>> inc susceptible to hypoperfusion
Assoc: fail lactate, absent menstruation, cold intolerance
