COMSAE PHASE 2 FORM 114
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A 45-year-old male presents with acute onset of severe epigastric pain radiating to the
back. Physical exam reveals periumbilical ecchymosis. What is the most likely diagnosis?
A. Acute Appendicitis
B. Acute Pancreatitis
C. Peptic Ulcer Perforation
D. Choledocholithiasis
Answer: B
Conceptual Explanation: Cullen’s sign (periumbilical ecchymosis) is indicative of severe
acute pancreatitis with retroperitoneal hemorrhage.
2. In a patient with a suspected right on left sacral torsion, what would be the expected
finding on L5?
A. L5 rotated left, sidebent left
B. L5 rotated right, sidebent right
C. L5 rotated left, sidebent right
,D. L5 rotated right, sidebent left
Answer: C
Conceptual Explanation: According to Fryette’s laws and sacral mechanics, L5 rotates in
the opposite direction of the sacral rotation in a torsion (Neutral mechanics).
3. A 65-year-old female presents with sudden vision loss in her right eye, described as a
‘curtain coming down.’ She has a history of giant cell arteritis. What is the immediate
treatment?
A. High-dose intravenous corticosteroids
B. Aspirin
C. Topical timolol
D. Laser photocoagulation
Answer: A
Conceptual Explanation: Giant cell arteritis causing vision loss is an emergency requiring
high-dose steroids to prevent permanent blindness and involvement of the other eye.
4. Which Chapman point is located on the lateral aspect of the humerus, near the surgical
neck?
A. Thyroid
B. Heart
C. Eye
, D. Sinuses
Answer: C
Conceptual Explanation: The Chapman reflex point for the eye is located on the lateral
humerus at the level of the surgical neck.
5. A 28-year-old female at 32 weeks gestation presents with a BP of 165/110 mmHg and 3+
proteinuria. She complains of a severe headache. What is the next step in management?
A. Labetalol and discharge
B. Magnesium sulfate and stabilization for delivery
C. Immediate Cesarean section
D. Bed rest and weekly follow-up
Answer: B
Conceptual Explanation: Severe preeclampsia (BP >160/110 and symptoms) requires
magnesium sulfate for seizure prophylaxis and planned delivery.
6. A 3-year-old boy presents with high fever, barking cough, and inspiratory stridor. X-ray
shows subglottic narrowing. What is the causative agent?
A. Respiratory Syncytial Virus
B. Haemophilus influenzae type b
C. Parainfluenza virus
D. Staphylococcus aureus
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A 45-year-old male presents with acute onset of severe epigastric pain radiating to the
back. Physical exam reveals periumbilical ecchymosis. What is the most likely diagnosis?
A. Acute Appendicitis
B. Acute Pancreatitis
C. Peptic Ulcer Perforation
D. Choledocholithiasis
Answer: B
Conceptual Explanation: Cullen’s sign (periumbilical ecchymosis) is indicative of severe
acute pancreatitis with retroperitoneal hemorrhage.
2. In a patient with a suspected right on left sacral torsion, what would be the expected
finding on L5?
A. L5 rotated left, sidebent left
B. L5 rotated right, sidebent right
C. L5 rotated left, sidebent right
,D. L5 rotated right, sidebent left
Answer: C
Conceptual Explanation: According to Fryette’s laws and sacral mechanics, L5 rotates in
the opposite direction of the sacral rotation in a torsion (Neutral mechanics).
3. A 65-year-old female presents with sudden vision loss in her right eye, described as a
‘curtain coming down.’ She has a history of giant cell arteritis. What is the immediate
treatment?
A. High-dose intravenous corticosteroids
B. Aspirin
C. Topical timolol
D. Laser photocoagulation
Answer: A
Conceptual Explanation: Giant cell arteritis causing vision loss is an emergency requiring
high-dose steroids to prevent permanent blindness and involvement of the other eye.
4. Which Chapman point is located on the lateral aspect of the humerus, near the surgical
neck?
A. Thyroid
B. Heart
C. Eye
, D. Sinuses
Answer: C
Conceptual Explanation: The Chapman reflex point for the eye is located on the lateral
humerus at the level of the surgical neck.
5. A 28-year-old female at 32 weeks gestation presents with a BP of 165/110 mmHg and 3+
proteinuria. She complains of a severe headache. What is the next step in management?
A. Labetalol and discharge
B. Magnesium sulfate and stabilization for delivery
C. Immediate Cesarean section
D. Bed rest and weekly follow-up
Answer: B
Conceptual Explanation: Severe preeclampsia (BP >160/110 and symptoms) requires
magnesium sulfate for seizure prophylaxis and planned delivery.
6. A 3-year-old boy presents with high fever, barking cough, and inspiratory stridor. X-ray
shows subglottic narrowing. What is the causative agent?
A. Respiratory Syncytial Virus
B. Haemophilus influenzae type b
C. Parainfluenza virus
D. Staphylococcus aureus
