COMSAE Exam
Questions and
Complete Solutions
Graded A+
Denning [Date] [Course title]
, a 20 year old female presents to the emergency department after she slipped on ice and hit her mouth
on the sidewalk. Her medial maxillary incisors are fractured and she is intense pain. the nerve most likely
conveying this pain sensation is the?
a. anterior superior alveolar b. infraorbital c. middle superior alveolar d. nasopalatine e. posterior
superior alveolar - Answer: The nerve most likely conveying the pain sensation in this scenario is the
infraorbital nerve (option b).
The infraorbital nerve is a branch of the maxillary nerve, which is a division of the trigeminal nerve
(cranial nerve V). The maxillary nerve provides sensory innervation to the maxillary teeth, maxillary
sinus, upper gingiva, and the skin of the lower eyelid, lateral nose, and upper lip.
In the given case, the patient experienced a traumatic injury to her mouth, specifically fracturing her
medial maxillary incisors. The intense pain she is feeling is likely transmitted through the sensory
branches of the maxillary nerve, including the infraorbital nerve.
The infraorbital nerve travels through the infraorbital canal, emerges on the face through the
infraorbital foramen, and supplies sensation to the skin of the lower eyelid, lateral nose, and upper lip.
The fractured incisors would have damaged the associated nerve endings, leading to significant pain in
those areas.
Therefore, the nerve most likely conveying the pain sensation in this patient's case is the infraorbital
nerve (option b).
a 25 year old female presents to the office for evaluation of headaches, diplopia and loss of peripheral
vision which have progressively worsened over the past week. she reports galactorrhea and
amenorrhea. physical examination is unremarkable and Beta-HCG is negative for pregnancy. MRI of the
brain is obtained. The secretory cells that are most likely causing this patient's conditions are?
a.corticotrophs b.gonadotrophs c.lactotrophs d.somatotrophs e.thyrotrophs - Answer: Based on the
provided information, the secretory cells most likely causing this patient's conditions are lactotrophs.
The symptoms of headaches, diplopia (double vision), and loss of peripheral vision along with
galactorrhea (abnormal breast milk production) and amenorrhea (absence of menstrual periods) suggest
a hormonal imbalance. These symptoms are commonly associated with a condition known as
hyperprolactinemia, which is characterized by high levels of prolactin hormone.
Lactotrophs are the cells in the anterior pituitary gland responsible for producing and secreting
prolactin. In this case, the lactotrophs are overactive, leading to an excessive secretion of prolactin. This
excess prolactin production can result in the symptoms described by the patient.
An MRI of the brain is obtained to assess the pituitary gland and rule out any structural abnormalities,
such as a pituitary adenoma (a benign tumor). A pituitary adenoma involving the lactotrophs is a
common cause of hyperprolactinemia.
Therefore, the most likely secretory cells causing this patient's conditions are lactotrophs (option c).
Questions and
Complete Solutions
Graded A+
Denning [Date] [Course title]
, a 20 year old female presents to the emergency department after she slipped on ice and hit her mouth
on the sidewalk. Her medial maxillary incisors are fractured and she is intense pain. the nerve most likely
conveying this pain sensation is the?
a. anterior superior alveolar b. infraorbital c. middle superior alveolar d. nasopalatine e. posterior
superior alveolar - Answer: The nerve most likely conveying the pain sensation in this scenario is the
infraorbital nerve (option b).
The infraorbital nerve is a branch of the maxillary nerve, which is a division of the trigeminal nerve
(cranial nerve V). The maxillary nerve provides sensory innervation to the maxillary teeth, maxillary
sinus, upper gingiva, and the skin of the lower eyelid, lateral nose, and upper lip.
In the given case, the patient experienced a traumatic injury to her mouth, specifically fracturing her
medial maxillary incisors. The intense pain she is feeling is likely transmitted through the sensory
branches of the maxillary nerve, including the infraorbital nerve.
The infraorbital nerve travels through the infraorbital canal, emerges on the face through the
infraorbital foramen, and supplies sensation to the skin of the lower eyelid, lateral nose, and upper lip.
The fractured incisors would have damaged the associated nerve endings, leading to significant pain in
those areas.
Therefore, the nerve most likely conveying the pain sensation in this patient's case is the infraorbital
nerve (option b).
a 25 year old female presents to the office for evaluation of headaches, diplopia and loss of peripheral
vision which have progressively worsened over the past week. she reports galactorrhea and
amenorrhea. physical examination is unremarkable and Beta-HCG is negative for pregnancy. MRI of the
brain is obtained. The secretory cells that are most likely causing this patient's conditions are?
a.corticotrophs b.gonadotrophs c.lactotrophs d.somatotrophs e.thyrotrophs - Answer: Based on the
provided information, the secretory cells most likely causing this patient's conditions are lactotrophs.
The symptoms of headaches, diplopia (double vision), and loss of peripheral vision along with
galactorrhea (abnormal breast milk production) and amenorrhea (absence of menstrual periods) suggest
a hormonal imbalance. These symptoms are commonly associated with a condition known as
hyperprolactinemia, which is characterized by high levels of prolactin hormone.
Lactotrophs are the cells in the anterior pituitary gland responsible for producing and secreting
prolactin. In this case, the lactotrophs are overactive, leading to an excessive secretion of prolactin. This
excess prolactin production can result in the symptoms described by the patient.
An MRI of the brain is obtained to assess the pituitary gland and rule out any structural abnormalities,
such as a pituitary adenoma (a benign tumor). A pituitary adenoma involving the lactotrophs is a
common cause of hyperprolactinemia.
Therefore, the most likely secretory cells causing this patient's conditions are lactotrophs (option c).
