COMSAE ALL (Already Graded
100% Correct)2025
COCAINE intoxication - Correct answerimpaired 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 answertrabecular 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 answermild 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 answerABSENT 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 answerConjugated hyperbilirubinemia b/c defective liver
excretion;
grossly black liver
Benign
Rotor syndrome - Correct answermilder in presentation w/o black liver
impaired hepatic uptake and excretion
wilson Disease - Correct answercopper 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 answerrecessive, 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 answerafter age 40
>20 iron;
triad: cirrhosis, DM, skin pigmentation; dilated cardiomyopathy, hypogonadism,
arhtropathy; HCC is common cause death
Treatment Hemochromatosis - Correct answerrepeat phlebotomy, chelation
deferasirox, deferoxamine, oral deferiprone
Wolff Parkinson White Syndrome - Correct answerMC 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
Conduction pathway heart - Correct answerSA node> atira> AV node> bundle
HIS, R and L bundle branches> purkinje fibers> ventricles
L branch anterior/posterior fascicles
Edema - Correct answerinc capillary pressure
dec plasma proteins (dec oncotic capillary pressure)
inc capillary permeability
increase interstitial fluid colloid oncotic pressure
Celiac Disease - Correct answersetting: 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 answerupper trunk compression cause
injury; loss forearm flexion/supination; loss sensation over lateral forearm
, Axillary nerve C5-C6 - Correct answerflat deltoid; loss arm abduction, loss
sensation over deltoid and lateral arm
Radial C5-T1 - Correct answermid shaft fracture humerus, compression axilla
find: dec grip, loss extension (wrist drop); loss sensation posterior arm, dorsal hand
Median C5-T1 - Correct answersupracondylar 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 answerFracture 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 answersuperficial laceration palm
ape hand; loss thenar muscles
no loss sensation
Treatment glaucoma: alpha agonists; epinephrine, brimonidine - Correct
answerdec 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 answerdec AH synthesis; no
pupil/vision changes
Diuretics; acetazolamide - Correct answerdec AH synthesis by inhibiting carbonic
anhydrase; no vision/pupil change
100% Correct)2025
COCAINE intoxication - Correct answerimpaired 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 answertrabecular 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 answermild 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 answerABSENT 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 answerConjugated hyperbilirubinemia b/c defective liver
excretion;
grossly black liver
Benign
Rotor syndrome - Correct answermilder in presentation w/o black liver
impaired hepatic uptake and excretion
wilson Disease - Correct answercopper 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 answerrecessive, 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 answerafter age 40
>20 iron;
triad: cirrhosis, DM, skin pigmentation; dilated cardiomyopathy, hypogonadism,
arhtropathy; HCC is common cause death
Treatment Hemochromatosis - Correct answerrepeat phlebotomy, chelation
deferasirox, deferoxamine, oral deferiprone
Wolff Parkinson White Syndrome - Correct answerMC 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
Conduction pathway heart - Correct answerSA node> atira> AV node> bundle
HIS, R and L bundle branches> purkinje fibers> ventricles
L branch anterior/posterior fascicles
Edema - Correct answerinc capillary pressure
dec plasma proteins (dec oncotic capillary pressure)
inc capillary permeability
increase interstitial fluid colloid oncotic pressure
Celiac Disease - Correct answersetting: 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 answerupper trunk compression cause
injury; loss forearm flexion/supination; loss sensation over lateral forearm
, Axillary nerve C5-C6 - Correct answerflat deltoid; loss arm abduction, loss
sensation over deltoid and lateral arm
Radial C5-T1 - Correct answermid shaft fracture humerus, compression axilla
find: dec grip, loss extension (wrist drop); loss sensation posterior arm, dorsal hand
Median C5-T1 - Correct answersupracondylar 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 answerFracture 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 answersuperficial laceration palm
ape hand; loss thenar muscles
no loss sensation
Treatment glaucoma: alpha agonists; epinephrine, brimonidine - Correct
answerdec 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 answerdec AH synthesis; no
pupil/vision changes
Diuretics; acetazolamide - Correct answerdec AH synthesis by inhibiting carbonic
anhydrase; no vision/pupil change
