COMSAE VIEW AHEAD EXAM QUESTIONS FULL SOLUTION GUIDE
Question:
Patient is retching, vomiting small amount of blood, history of AUD. Nonpentrating mucosal tear of
the posterior wall superior to the gastroesophageal junction that continues to the esophageal wall
compromises
Answer:
vagal trunk (runs posterior to the esophagus). Mallory-Weiss syndrome.
Question:
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
Answer:
Galphas mediated signaling. Pseudohypoparathyroidism type 1a (PHP1A).
Question:
Fever, dry cough, GI upset with COPD. Patchy opacities. Gram neg bacilli. They acquired the
bacteria via
Answer:
inhalation if environmental aerosols (usually HVAC person). Legionella pneumophila.
Question:
Sudden loss of consciousness that lasted for less than 1 minute. No tongue biting or urinary
incontinence. Most likely cause
Answer:
,idioventricular rhythm. sudden drop in cerebral perfusion due pacemaker failure.
Question:
50 yr old man presents for annual visit. FMH lung and bladder cancer. Drinks alcohol. PMH
hemorrhoids. Screening for him
Answer:
colonoscopy. Should be done starting at 45yrs old for everyone.
Question:
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
Answer:
spina bifida occulta.
Question:
68 yr old woman with T2DM, HTN, hyperlipidemia. Menopause at 52. DXA scan -2.1. Add
calcium, vitamin D and what med
Answer:
alendronate to prevent osteoporosis (Inhibits osteoclast activity, reducing bone resorption -
bisphosphonate)
Question:
What is the Pearson correlation value for this data set?
Answer:
correlation close to 0.00.
Question:
, 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
Answer:
Enterococcus faecalis.
Question:
75 yr old pruritic vulvar lesion which she first noticed 1 week. White, flaky, slightly roughened
lesion with focal areas of ecchymoses from scratching. Thinning of the squamous epithelium.
Hypocellular collagenous tissue. Dx
Answer:
lichen sclerosus et atrophicus.
Question:
37 yr old man presents with pruritus and bullae that are localized to sun exposed areas of the skin.
Urine sample is reddish brown in appearance and pink under fluorescent light. Elevated glucose,
alanine aminotransferase, aspartate aminotransferase. What would be elevated
Answer:
uroporphyrinogen III. Porphyria cutanea tarda (PCT).
Question:
Weakness and numbness in his right upper extremity following a shoulder injury. Reveals
anesthesia along the lateral aspect of the arm and forearm, including the thumb. Biceps ad
brachioradialis reflex are 0/4 on the right and 2/4 on the left. Which additional muscle is diminished
Answer:
abduction of the humerus. Axillary n. C5-C6 (from the brachial plexus).
Question:
62 yr old is slurring words, talking a lot but not making sense. Arthroscopic knee surgery 2 weeks
ago w/ upper respiratory tract recently. PMH is on psych drug. Mental status deteriorates and
Question:
Patient is retching, vomiting small amount of blood, history of AUD. Nonpentrating mucosal tear of
the posterior wall superior to the gastroesophageal junction that continues to the esophageal wall
compromises
Answer:
vagal trunk (runs posterior to the esophagus). Mallory-Weiss syndrome.
Question:
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
Answer:
Galphas mediated signaling. Pseudohypoparathyroidism type 1a (PHP1A).
Question:
Fever, dry cough, GI upset with COPD. Patchy opacities. Gram neg bacilli. They acquired the
bacteria via
Answer:
inhalation if environmental aerosols (usually HVAC person). Legionella pneumophila.
Question:
Sudden loss of consciousness that lasted for less than 1 minute. No tongue biting or urinary
incontinence. Most likely cause
Answer:
,idioventricular rhythm. sudden drop in cerebral perfusion due pacemaker failure.
Question:
50 yr old man presents for annual visit. FMH lung and bladder cancer. Drinks alcohol. PMH
hemorrhoids. Screening for him
Answer:
colonoscopy. Should be done starting at 45yrs old for everyone.
Question:
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
Answer:
spina bifida occulta.
Question:
68 yr old woman with T2DM, HTN, hyperlipidemia. Menopause at 52. DXA scan -2.1. Add
calcium, vitamin D and what med
Answer:
alendronate to prevent osteoporosis (Inhibits osteoclast activity, reducing bone resorption -
bisphosphonate)
Question:
What is the Pearson correlation value for this data set?
Answer:
correlation close to 0.00.
Question:
, 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
Answer:
Enterococcus faecalis.
Question:
75 yr old pruritic vulvar lesion which she first noticed 1 week. White, flaky, slightly roughened
lesion with focal areas of ecchymoses from scratching. Thinning of the squamous epithelium.
Hypocellular collagenous tissue. Dx
Answer:
lichen sclerosus et atrophicus.
Question:
37 yr old man presents with pruritus and bullae that are localized to sun exposed areas of the skin.
Urine sample is reddish brown in appearance and pink under fluorescent light. Elevated glucose,
alanine aminotransferase, aspartate aminotransferase. What would be elevated
Answer:
uroporphyrinogen III. Porphyria cutanea tarda (PCT).
Question:
Weakness and numbness in his right upper extremity following a shoulder injury. Reveals
anesthesia along the lateral aspect of the arm and forearm, including the thumb. Biceps ad
brachioradialis reflex are 0/4 on the right and 2/4 on the left. Which additional muscle is diminished
Answer:
abduction of the humerus. Axillary n. C5-C6 (from the brachial plexus).
Question:
62 yr old is slurring words, talking a lot but not making sense. Arthroscopic knee surgery 2 weeks
ago w/ upper respiratory tract recently. PMH is on psych drug. Mental status deteriorates and
