2025/2026 COMSAE 114 LATEST EXAM VERSION | QUESTIONS AND
CORRECT ANSWERS AND STUDY GUIDE FOR GUARANTEED PASS
1. Mandibular fracture nerve that carries the pain sensation is the
○ A. Inferior alveolar N.
○ B. Lingual N.
○ C. Buccal N.
○ D. Mylohyoid N.
Answer: A. Inferior alveolar N.
Rationale: The inferior alveolar nerve provides sensory innervation to the
mandibular teeth and chin.
2. Patient is retching, vomiting small amount of blood, history of AUD.
Nonpenetrating mucosal tear of the posterior wall superior to the
gastroesophageal junction that continues to the esophageal wall
compromises
○ A. Vagal trunk (runs posterior to the esophagus).
○ B. Azygos vein.
○ C. Thoracic duct.
○ D. Left gastric artery.
Answer: A. Vagal trunk (runs posterior to the esophagus).
Rationale: Mallory-Weiss syndrome involves a mucosal tear at the
gastroesophageal junction, which can compromise the posterior vagal trunk.
3. PMH of calcium disorder which he ran out of supplements. BP is 110/70
and taking BP elicits carpal spasm. PT is short, stocky and shortened medial
digits (Albright Hereditary Osteodystrophy). Phosphate and cAMP don't
respond to IV PTH. The cause is decreased
,○ A. Gs alpha mediated signaling.
○ B. PTH receptor binding.
○ C. Vitamin D synthesis.
○ D. Renal tubular reabsorption.
Answer: A. Gs alpha mediated signaling.
Rationale: Pseudohypoparathyroidism type 1a is caused by a defect in the Gs
alpha subunit, leading to PTH resistance.
4. Fever, dry cough, GI upset with COPD. Patchy opacities. Gram neg bacilli.
They acquired the bacteria via
○ A. Inhalation of environmental aerosols (usually HVAC person).
○ B. Aspiration of oral flora.
○ C. Direct contact with infected individuals.
○ D. Contaminated water sources.
Answer: A. Inhalation of environmental aerosols (usually HVAC person).
Rationale: Legionella pneumophila is typically acquired through inhalation of
contaminated aerosols from environmental sources like HVAC systems.
5. Sudden loss of consciousness that lasted for less than 1 minute. No
tongue biting or urinary incontinence. Most likely cause
○ A. Idioventricular rhythm.
○ B. Ventricular fibrillation.
○ C. Third-degree heart block.
○ D. Sinus bradycardia.
Answer: A. Idioventricular rhythm.
,Rationale: An idioventricular rhythm can cause a sudden drop in cardiac
output, leading to syncope due to pacemaker failure.
6. 50 yr old man presents for annual visit. FMH lung and bladder cancer.
Drinks alcohol. PMH hemorrhoids. Screening for him
○ A. Colonoscopy.
○ B. Low-dose CT chest.
○ C. Cystoscopy.
○ D. PSA test.
Answer: A. Colonoscopy.
Rationale: Colorectal cancer screening with colonoscopy is recommended
starting at age 45 for all average-risk individuals.
7. Low grade lumbosacral achiness for as long as he can remember. Narrow
lucency down the middle of the L5 spinous process present. Patent sacroiliac
joints. Congenital abnormality
○ A. Spina bifida occulta.
○ B. Ankylosing spondylitis.
○ C. Lumbar disc herniation.
○ D. Spondylolisthesis.
Answer: A. Spina bifida occulta.
Rationale: Spina bifida occulta is a congenital defect characterized by a
narrow lucency in the spinous process, often asymptomatic.
8. 68 yr old woman with T2DM, HTN, hyperlipidemia. Menopause at 52. DXA
scan -2.1. Add calcium, vitamin D and what med
, ○ A. Alendronate to prevent osteoporosis (Inhibits osteoclast activity,
reducing bone resorption - bisphosphonate).
○ B. Raloxifene.
○ C. Teriparatide.
○ D. Denosumab.
Answer: A. Alendronate to prevent osteoporosis (Inhibits osteoclast activity,
reducing bone resorption - bisphosphonate).
Rationale: Bisphosphonates like alendronate are first-line therapy for
osteopenia (T-score -1.0 to -2.5) to prevent progression to osteoporosis.
9. What is the Pearson correlation value for this data set?
○ A. Correlation close to 0.00.
○ B. Correlation close to 1.00.
○ C. Correlation close to -1.00.
○ D. Correlation close to 0.50.
Answer: A. Correlation close to 0.00.
Rationale: A Pearson correlation value close to 0.00 indicates no linear
relationship between the variables.
10. 78 yr old presents to office with 1 week history of lower abdominal pain
and urinary hesitancy with interrupted flow. Enlarge, firm, tender prostate.
PSA is normal. Gram pos, catalase neg coccus. Etiological agent
○ A. Enterococcus faecalis.
○ B. Staphylococcus aureus.
○ C. Escherichia coli.
○ D. Pseudomonas aeruginosa.
CORRECT ANSWERS AND STUDY GUIDE FOR GUARANTEED PASS
1. Mandibular fracture nerve that carries the pain sensation is the
○ A. Inferior alveolar N.
○ B. Lingual N.
○ C. Buccal N.
○ D. Mylohyoid N.
Answer: A. Inferior alveolar N.
Rationale: The inferior alveolar nerve provides sensory innervation to the
mandibular teeth and chin.
2. Patient is retching, vomiting small amount of blood, history of AUD.
Nonpenetrating mucosal tear of the posterior wall superior to the
gastroesophageal junction that continues to the esophageal wall
compromises
○ A. Vagal trunk (runs posterior to the esophagus).
○ B. Azygos vein.
○ C. Thoracic duct.
○ D. Left gastric artery.
Answer: A. Vagal trunk (runs posterior to the esophagus).
Rationale: Mallory-Weiss syndrome involves a mucosal tear at the
gastroesophageal junction, which can compromise the posterior vagal trunk.
3. PMH of calcium disorder which he ran out of supplements. BP is 110/70
and taking BP elicits carpal spasm. PT is short, stocky and shortened medial
digits (Albright Hereditary Osteodystrophy). Phosphate and cAMP don't
respond to IV PTH. The cause is decreased
,○ A. Gs alpha mediated signaling.
○ B. PTH receptor binding.
○ C. Vitamin D synthesis.
○ D. Renal tubular reabsorption.
Answer: A. Gs alpha mediated signaling.
Rationale: Pseudohypoparathyroidism type 1a is caused by a defect in the Gs
alpha subunit, leading to PTH resistance.
4. Fever, dry cough, GI upset with COPD. Patchy opacities. Gram neg bacilli.
They acquired the bacteria via
○ A. Inhalation of environmental aerosols (usually HVAC person).
○ B. Aspiration of oral flora.
○ C. Direct contact with infected individuals.
○ D. Contaminated water sources.
Answer: A. Inhalation of environmental aerosols (usually HVAC person).
Rationale: Legionella pneumophila is typically acquired through inhalation of
contaminated aerosols from environmental sources like HVAC systems.
5. Sudden loss of consciousness that lasted for less than 1 minute. No
tongue biting or urinary incontinence. Most likely cause
○ A. Idioventricular rhythm.
○ B. Ventricular fibrillation.
○ C. Third-degree heart block.
○ D. Sinus bradycardia.
Answer: A. Idioventricular rhythm.
,Rationale: An idioventricular rhythm can cause a sudden drop in cardiac
output, leading to syncope due to pacemaker failure.
6. 50 yr old man presents for annual visit. FMH lung and bladder cancer.
Drinks alcohol. PMH hemorrhoids. Screening for him
○ A. Colonoscopy.
○ B. Low-dose CT chest.
○ C. Cystoscopy.
○ D. PSA test.
Answer: A. Colonoscopy.
Rationale: Colorectal cancer screening with colonoscopy is recommended
starting at age 45 for all average-risk individuals.
7. Low grade lumbosacral achiness for as long as he can remember. Narrow
lucency down the middle of the L5 spinous process present. Patent sacroiliac
joints. Congenital abnormality
○ A. Spina bifida occulta.
○ B. Ankylosing spondylitis.
○ C. Lumbar disc herniation.
○ D. Spondylolisthesis.
Answer: A. Spina bifida occulta.
Rationale: Spina bifida occulta is a congenital defect characterized by a
narrow lucency in the spinous process, often asymptomatic.
8. 68 yr old woman with T2DM, HTN, hyperlipidemia. Menopause at 52. DXA
scan -2.1. Add calcium, vitamin D and what med
, ○ A. Alendronate to prevent osteoporosis (Inhibits osteoclast activity,
reducing bone resorption - bisphosphonate).
○ B. Raloxifene.
○ C. Teriparatide.
○ D. Denosumab.
Answer: A. Alendronate to prevent osteoporosis (Inhibits osteoclast activity,
reducing bone resorption - bisphosphonate).
Rationale: Bisphosphonates like alendronate are first-line therapy for
osteopenia (T-score -1.0 to -2.5) to prevent progression to osteoporosis.
9. What is the Pearson correlation value for this data set?
○ A. Correlation close to 0.00.
○ B. Correlation close to 1.00.
○ C. Correlation close to -1.00.
○ D. Correlation close to 0.50.
Answer: A. Correlation close to 0.00.
Rationale: A Pearson correlation value close to 0.00 indicates no linear
relationship between the variables.
10. 78 yr old presents to office with 1 week history of lower abdominal pain
and urinary hesitancy with interrupted flow. Enlarge, firm, tender prostate.
PSA is normal. Gram pos, catalase neg coccus. Etiological agent
○ A. Enterococcus faecalis.
○ B. Staphylococcus aureus.
○ C. Escherichia coli.
○ D. Pseudomonas aeruginosa.
