COMSAE PHASE 2 FORM 114
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A 25-year-old female presents with primary amenorrhea. Physical exam reveals a short
stature, webbed neck, and a wide-spaced nipple appearance. What is the most likely
karyotype?
A. 46, XX
B. 45, X
C. 47, XXY
D. 47, XXX
Answer: B
Conceptual Explanation: Turner syndrome (45, X) is characterized by short stature,
webbed neck, and primary amenorrhea due to streak ovaries.
2. A 65-year-old male presents with resting tremor, bradykinesia, and postural instability.
Which of the following is the most likely pathological finding in the brain?
A. Amyloid plaques
B. Neurofibrillary tangles
,C. Lewy bodies
D. Negri bodies
Answer: C
Conceptual Explanation: Parkinson’s disease is characterized by the loss of dopaminergic
neurons in the substantia nigra and the presence of Lewy bodies (alpha-synuclein).
3. A patient is diagnosed with a L on L sacral torsion. Which of the following findings is
expected during the physical examination?
A. L5 is rotated right
B. Left sulcus is deep
C. Right sacral base is posterior
D. Negative seated flexion test
Answer: B
Conceptual Explanation: In a Left on Left torsion, the sacrum rotates left on a left oblique
axis, making the left sulcus deep and the right inferior lateral angle posterior.
4. A 4-year-old boy presents with a ‘barking’ cough and inspiratory stridor. X-ray shows
subglottic narrowing (steeple sign). What is the most likely causative agent?
A. Haemophilus influenzae type b
B. Respiratory syncytial virus
C. Parainfluenza virus
, D. Bordetella pertussis
Answer: C
Conceptual Explanation: Croup (laryngotracheobronchitis) is most commonly caused by
Parainfluenza virus and presents with a barking cough and steeple sign.
5. A 55-year-old smoker presents with weight loss and hemoptysis. Chest X-ray shows a
central mass. Labs show hypercalcemia. What is the most likely histological type of lung
cancer?
A. Adenocarcinoma
B. Small cell carcinoma
C. Squamous cell carcinoma
D. Large cell carcinoma
Answer: C
Conceptual Explanation: Squamous cell carcinoma of the lung is typically central and is
associated with paraneoplastic hypercalcemia due to PTHrP secretion.
6. A 30-year-old pregnant woman at 32 weeks gestation presents with sudden onset of
severe abdominal pain and dark vaginal bleeding. Her uterus is firm and tender. What is the
most likely diagnosis?
A. Placenta previa
B. Uterine rupture
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A 25-year-old female presents with primary amenorrhea. Physical exam reveals a short
stature, webbed neck, and a wide-spaced nipple appearance. What is the most likely
karyotype?
A. 46, XX
B. 45, X
C. 47, XXY
D. 47, XXX
Answer: B
Conceptual Explanation: Turner syndrome (45, X) is characterized by short stature,
webbed neck, and primary amenorrhea due to streak ovaries.
2. A 65-year-old male presents with resting tremor, bradykinesia, and postural instability.
Which of the following is the most likely pathological finding in the brain?
A. Amyloid plaques
B. Neurofibrillary tangles
,C. Lewy bodies
D. Negri bodies
Answer: C
Conceptual Explanation: Parkinson’s disease is characterized by the loss of dopaminergic
neurons in the substantia nigra and the presence of Lewy bodies (alpha-synuclein).
3. A patient is diagnosed with a L on L sacral torsion. Which of the following findings is
expected during the physical examination?
A. L5 is rotated right
B. Left sulcus is deep
C. Right sacral base is posterior
D. Negative seated flexion test
Answer: B
Conceptual Explanation: In a Left on Left torsion, the sacrum rotates left on a left oblique
axis, making the left sulcus deep and the right inferior lateral angle posterior.
4. A 4-year-old boy presents with a ‘barking’ cough and inspiratory stridor. X-ray shows
subglottic narrowing (steeple sign). What is the most likely causative agent?
A. Haemophilus influenzae type b
B. Respiratory syncytial virus
C. Parainfluenza virus
, D. Bordetella pertussis
Answer: C
Conceptual Explanation: Croup (laryngotracheobronchitis) is most commonly caused by
Parainfluenza virus and presents with a barking cough and steeple sign.
5. A 55-year-old smoker presents with weight loss and hemoptysis. Chest X-ray shows a
central mass. Labs show hypercalcemia. What is the most likely histological type of lung
cancer?
A. Adenocarcinoma
B. Small cell carcinoma
C. Squamous cell carcinoma
D. Large cell carcinoma
Answer: C
Conceptual Explanation: Squamous cell carcinoma of the lung is typically central and is
associated with paraneoplastic hypercalcemia due to PTHrP secretion.
6. A 30-year-old pregnant woman at 32 weeks gestation presents with sudden onset of
severe abdominal pain and dark vaginal bleeding. Her uterus is firm and tender. What is the
most likely diagnosis?
A. Placenta previa
B. Uterine rupture
