1
COMSAE ALL EXAM ACTUAL QUESTIONS AND
CORRECT ANSWERS 100%.
COCAINE intoxication correct answers impaired judgement, pupil dilate, hallucination (coke
bugs) sudden cardiac death; paranoid ideations, angina
Tx: alpha blockers/ benzos
caution B block bc can cause unopposed alpha
Osteoporosis histo correct answers trabecular and cortical bone lose mass and interconnection
despite normal bone mineralization
assoc w/ Colles fracture- distal radial fracture; fracture of femoral neck
Gilbert Syndrome correct answers mild dec UDP glucuronosyltransferase conjugation and
impaired bilirubin uptake; asymptomatic or mild jaundice>> inc unconjugated bilirubin w/o
hemolysis; w/ fasting and stress
Crigler Najjar correct answers ABSENT UDP glucuronsyltransferase; early in life; die few years
find: jaundice, kernicterus (in brain) inc unconjugated bilirubin;
tx: plasmapheresis and phototherapy; type II respond phenobarbital
Dubin Johnson correct answers Conjugated hyperbilirubinemia b/c defective liver excretion;
grossly black liver
Benign
,2
Rotor syndrome correct answers milder in presentation w/o black liver
impaired hepatic uptake and excretion
wilson Disease correct answers copper transporting ATPase; ATP7B on Chromosome 13
s/s: before 40 yo, liver dz, neurodisease, psych dz, Kayser Fleischer ring, hemolytic anemia,
renal dz;
find: dec serum ceruloplasmin, inc urine copper
tx: chelation w/ penicillamine or Tridentine, oral zinc
Hemochromatosis correct answers recessive, HFE, chromosome 6; abnormal iron sensing,
increase intestinal absorb
find: inc ferritin, inc iron, dec TIBC, inc transferrin saturation
identify w/ Prussian blue stain/ liver MRI
Hemochromatosis finds correct answers after age 40
>20 iron;
triad: cirrhosis, DM, skin pigmentation; dilated cardiomyopathy, hypogonadism, arhtropathy;
HCC is common cause death
Treatment Hemochromatosis correct answers repeat phlebotomy, chelation deferasirox,
deferoxamine, oral deferiprone
Wolff Parkinson White Syndrome correct answers MC ventricular pre excitation syndrome
abnml fast atria to ventricle (bundle of Kent); bypasses AV node>> ventricles begin partially
depolarization earlier (NOTED BY DELTA WAVE ON EKG) widened QRS and shortened PR
,3
Conduction pathway heart correct answers SA node> atira> AV node> bundle HIS, R and L
bundle branches> purkinje fibers> ventricles
L branch anterior/posterior fascicles
Edema correct answers inc capillary pressure
dec plasma proteins (dec oncotic capillary pressure)
inc capillary permeability
increase interstitial fluid colloid oncotic pressure
Celiac Disease correct answers setting: 14 mo kid losing weight eating lots of foods;
histology: crypt abnormalities (hyperplasia); villous atrophy, lymphocytic infiltration
presents as malabsorbtion (diarrhea etc in kids)
in adults= short stature, anemia delayed puberty
Musculocutaneous nerve C5-C7 correct answers upper trunk compression cause injury; loss
forearm flexion/supination; loss sensation over lateral forearm
Axillary nerve C5-C6 correct answers flat deltoid; loss arm abduction, loss sensation over deltoid
and lateral arm
Radial C5-T1 correct answers mid shaft fracture humerus, compression axilla
find: dec grip, loss extension (wrist drop); loss sensation posterior arm, dorsal hand
, 4
Median C5-T1 correct answers supracondylar fracture humerus (proximal) CTS, wrist laceration
(distal)
ape hand pope's blessing
loss wrist flexion, flex of lateral fingers, thumb opposition, lumbricals 2nd and 3rd digit; loss
sensation over thenar eminence and dorsal and palmar aspects of lateral 3 1/2 fingers w/
proximal
Ulnar C8-T1 correct answers Fracture medial epicondyle humerus; fractured hook hamate (distal
lesion)
ulnar claw on extension; radial deception wrist upon flexion (proximal lesion)
loss wrist flex, flex of medial fingers, abduction and adduction fingers; medial 2 lumbricals;
loss sensation over 1 1/2 fingers including hypothenar eminence
Recurrent branch median nerve correct answers superficial laceration palm
ape hand; loss thenar muscles
no loss sensation
Treatment glaucoma: alpha agonists; epinephrine, brimonidine correct answers dec AH
synthesis> vasoconstriction; mydriasis alpha 1 (don't use in closed angle glaucoma) blurry
vision, ocular hyperemia, foreign body sensations ocular allergy, pruritis
Beta blockers: timolol, betaxolol, carteolol correct answers dec AH synthesis; no pupil/vision
changes
COMSAE ALL EXAM ACTUAL QUESTIONS AND
CORRECT ANSWERS 100%.
COCAINE intoxication correct answers impaired judgement, pupil dilate, hallucination (coke
bugs) sudden cardiac death; paranoid ideations, angina
Tx: alpha blockers/ benzos
caution B block bc can cause unopposed alpha
Osteoporosis histo correct answers trabecular and cortical bone lose mass and interconnection
despite normal bone mineralization
assoc w/ Colles fracture- distal radial fracture; fracture of femoral neck
Gilbert Syndrome correct answers mild dec UDP glucuronosyltransferase conjugation and
impaired bilirubin uptake; asymptomatic or mild jaundice>> inc unconjugated bilirubin w/o
hemolysis; w/ fasting and stress
Crigler Najjar correct answers ABSENT UDP glucuronsyltransferase; early in life; die few years
find: jaundice, kernicterus (in brain) inc unconjugated bilirubin;
tx: plasmapheresis and phototherapy; type II respond phenobarbital
Dubin Johnson correct answers Conjugated hyperbilirubinemia b/c defective liver excretion;
grossly black liver
Benign
,2
Rotor syndrome correct answers milder in presentation w/o black liver
impaired hepatic uptake and excretion
wilson Disease correct answers copper transporting ATPase; ATP7B on Chromosome 13
s/s: before 40 yo, liver dz, neurodisease, psych dz, Kayser Fleischer ring, hemolytic anemia,
renal dz;
find: dec serum ceruloplasmin, inc urine copper
tx: chelation w/ penicillamine or Tridentine, oral zinc
Hemochromatosis correct answers recessive, HFE, chromosome 6; abnormal iron sensing,
increase intestinal absorb
find: inc ferritin, inc iron, dec TIBC, inc transferrin saturation
identify w/ Prussian blue stain/ liver MRI
Hemochromatosis finds correct answers after age 40
>20 iron;
triad: cirrhosis, DM, skin pigmentation; dilated cardiomyopathy, hypogonadism, arhtropathy;
HCC is common cause death
Treatment Hemochromatosis correct answers repeat phlebotomy, chelation deferasirox,
deferoxamine, oral deferiprone
Wolff Parkinson White Syndrome correct answers MC ventricular pre excitation syndrome
abnml fast atria to ventricle (bundle of Kent); bypasses AV node>> ventricles begin partially
depolarization earlier (NOTED BY DELTA WAVE ON EKG) widened QRS and shortened PR
,3
Conduction pathway heart correct answers SA node> atira> AV node> bundle HIS, R and L
bundle branches> purkinje fibers> ventricles
L branch anterior/posterior fascicles
Edema correct answers inc capillary pressure
dec plasma proteins (dec oncotic capillary pressure)
inc capillary permeability
increase interstitial fluid colloid oncotic pressure
Celiac Disease correct answers setting: 14 mo kid losing weight eating lots of foods;
histology: crypt abnormalities (hyperplasia); villous atrophy, lymphocytic infiltration
presents as malabsorbtion (diarrhea etc in kids)
in adults= short stature, anemia delayed puberty
Musculocutaneous nerve C5-C7 correct answers upper trunk compression cause injury; loss
forearm flexion/supination; loss sensation over lateral forearm
Axillary nerve C5-C6 correct answers flat deltoid; loss arm abduction, loss sensation over deltoid
and lateral arm
Radial C5-T1 correct answers mid shaft fracture humerus, compression axilla
find: dec grip, loss extension (wrist drop); loss sensation posterior arm, dorsal hand
, 4
Median C5-T1 correct answers supracondylar fracture humerus (proximal) CTS, wrist laceration
(distal)
ape hand pope's blessing
loss wrist flexion, flex of lateral fingers, thumb opposition, lumbricals 2nd and 3rd digit; loss
sensation over thenar eminence and dorsal and palmar aspects of lateral 3 1/2 fingers w/
proximal
Ulnar C8-T1 correct answers Fracture medial epicondyle humerus; fractured hook hamate (distal
lesion)
ulnar claw on extension; radial deception wrist upon flexion (proximal lesion)
loss wrist flex, flex of medial fingers, abduction and adduction fingers; medial 2 lumbricals;
loss sensation over 1 1/2 fingers including hypothenar eminence
Recurrent branch median nerve correct answers superficial laceration palm
ape hand; loss thenar muscles
no loss sensation
Treatment glaucoma: alpha agonists; epinephrine, brimonidine correct answers dec AH
synthesis> vasoconstriction; mydriasis alpha 1 (don't use in closed angle glaucoma) blurry
vision, ocular hyperemia, foreign body sensations ocular allergy, pruritis
Beta blockers: timolol, betaxolol, carteolol correct answers dec AH synthesis; no pupil/vision
changes
