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COMSAE PRACTICE QUESTIONS WITH
CORRECT DETAILED ANSWERS A+ LATEST
VERSION 2025- 2026
DMARD drug for UC/Crohns/RA - ANSWERsulfasalazine pulmonary effects of CF - ANSWERchronic bronchitis and bronchiectasis osteoporosis affects what parts of bone? - ANSWER(spongy and ) trabecular bone mass loss imipramine - ANSWERTCA SE: Tri-Cs convulsions coma cardiotox antichol effects- confusion in elderly; (acute glaucoma and orthostatic hypotension- block alpha1) viscerosomatic - ANSWERvisceral disease --> somatic finding loratidine vs ranitidine - ANSWERloratidine: 2nd gen H1 blocker, doesnt cross BBB --> less sedating ranitidine: H2 receptor antagonist (like cimetidine) cells w RBCs inside - ANSWERentaemoba histolytica which type of pneumothorax causes tracheal deviation to the contra side? - ANSWERtension intracerebral hemorrhage adjacent to a lesion that contains a tangle of numerous tortuous vessels - ANSWERAVM arteriovenous malformation cavernous hemangioma - ANSWERbenign tumor of liver, A/W VHL
anti-HepB surface antibody is only present in what pop - ANSWERrecovered or immunized not in chronic or proctalgia fugax - ANSWERlevator ani syndrome fasciculus is UMN or LMN lesion? - ANSWERLMN ectopic gastric tissue - ANSWERmeckels diverticulum can also have ectopic pancreatic tissue remnant of vitelline duct antibodies in hashimotos attacks - ANSWERthyroid peroxidase or antithyroglobulin enlarged non tender thyroid 2 factors that influence starling curve - ANSWERx axis- preload (EDV) y axis- stroke volume or CO treatment for fibromyalgia - ANSWERTCA, SNRIs anticonvulsants what blocks NE reuptake? - ANSWERTCA or SNRIs possible complication of pagets bone disease - ANSWERosteocarcoma what does Hct tell you? - ANSWERratio of volume of RBCs compared to total blood volume probenecid - ANSWERinhibits reabsoprtion of uric acid in PCT
- also inhibits secretion of PCN
- can ppt uric acid calculi 2 causes of SCID - ANSWERADA deficiency (adenosine deaminase required for degradation of adenosim and deoxyadenosine
- in ADA deficiency, high levels of dATP --> toxicity in lymphocytes --> SCID
PTH inhibits reabsorption of phosphate where? increases calcium resorption where? - ANSWERPO4- proximal tubule ca- DCT anterior innominate rotation means tight hip flexors or extensors? - ANSWERextensor- hamstrings thoracic CS - ANSWERE SaRa most common cause of cellultis - ANSWERstaph aureus, strep pyogenes FPR- direct or indirect? active or passive? - ANSWERindirect- place them in position of diagnosis passive cant treat kid w tetracycline so what do you give? - ANSWERamoxicillin which Heps are there currently vaccines for? - ANSWERA and B (and so by virtue, also D) why does Hep D need Hep B? - ANSWERHep D utilizes the HBV surface antigen as its envelope? most common hepatitis A/W IVDA in the US - ANSWERhep c roseola - ANSWER4 day high fever then rash on the trunk (spares face) affects babies up to 2 years HHV6- affects CD4 helper cells and kills them off erythema infectiosum - ANSWERslapped cheek parvovirus B nonspecific fever/prodrome then slapp cheek rash 5 days later, then rash appears on arms and spreads to trunk/legs rash can worsen w fever and sun exposure
TORCH infxn so baby in womb that is exposed can lead to hydrops fetalis most common STD - ANSWERchlamydia sxs similar to STI plus discharge will have high neutrophil count dimorphic- butterflies - ANSWERcandida, histo, cocci, paracocci, blasto, sporothrix, butterflies huge pair of cocc catching stamp hip restricted in internal rotation dx? - ANSWERinnom outflare immune complex in glomerular mesangium 2 days after URI berger or PSGN? - ANSWERberger PSGN is 2 wks post URI kidney ureter viscerosomatic innervation - ANSWERT10- 11 college student w nonspecific symptoms nonproductive cough, sore throat CXR- diffuse infiltrates - ANSWERmyco PNA test for trichomonas - ANSWERnucleic acid amplification painless enlarging tumor in left testis 75 yo - ANSWERdiffuse large B cell lymphoma most common in 70-80s choriocarcinoma affecst what age group - ANSWER 15 - 35
Hit under chin on same side - ANSWERTorsion Blow on side of head - ANSWERTorsion strain Hit on same side of head - ANSWERLateral strain Hit on forehead at top of head - ANSWERSuperior strain Hit at occiput - ANSWERInferior strain Touch, pain, temp sensation from ipsilateral face - ANSWERSpinal trigeminal nucleus Ritodrine/Terbutaline - ANSWERBeta 2 agonist that relzxes the uterus to reduce premature uterine cotnractions; tocolytic "Ritodrine allows the fetus to return to dreams" Ergonovine - ANSWERto facilitate delivery of the placenta and to prevent bleeding after childbirth by causing smooth muscle tissue in the blood vessel walls to narrow, thereby reducing blood flow; dx Prinzmental's angina Metoclopramide - ANSWERanti-emetic Pyocyanin pigment - ANSWERblue pigment - Pseudomonas Sensorineural hearing loss, tinnitus, paralysis of facial muscles, loss of corneal reflex - ANSWERCerebellopontine angle - b/w cerebellum and lateral pons; CNS 5, 7, 8 Hyperresonance - ANSWERpneumothorax, Large Q-waves - ANSWEROld infarcts Cachexia mediated by - ANSWERTNF-alpha, IFN-gamma, IL- 6 Tartrate resistant acid phosphatase positive in - ANSWERHairy Cell Leukemia Low leukocyte ALP - ANSWERCML Cytosolic steroid receptor - ANSWERVET CAP
Vitamin D, Estrogen, Testosterone, Cortisol, Aldosterone, Progesterone Nuclear steroid receptor - ANSWERT3/T Tetanus tx - ANSWERTetanus antitoxin and tetanus toxoid series Balantidium coli - ANSWERprotozoa found in pigs Sumatriptan - ANSWER 5 - HT 1B/1D agonist --> vasoconstsriction, inhibition of trigeminal activation and vasoactive peptide release Tx of S. pneumonia - ANSWERPenicillin Asthma drugs that cause tremors - ANSWERAlbuterol, Theophylline Theophylline MOA - ANSWERinhibits phosphodiesterease --> dec cAMP Xenograft - ANSWERfrom different species syngeneic graft - ANSWERfrom identical twin Cyclophosphamide - ANSWERalkylates DNA inferior vesical artery - ANSWERgoes to fundus of bladder corticobulbar tract of internal capsule - ANSWERcomposed of UMN of CNs, for muscles of face, head, and neck all CNs except III, IV, VI inhaled anthrax - ANSWERshows up as mediastinal widening on CXR vaginosis and pH - ANSWERpH of greater than 4.5 is likely bacterial insultation installers - ANSWERsusceptible to asbestos junctional rhythm - ANSWERpacemaker is the AV node. it usually presents without a P wave or with an inverted P wave. Retrograde P waves refers to the depolarization from the AV node back towards the SA node ova in stool - ANSWERmeans one of the following: giardiasis amebiasis
Cilostazol - ANSWERCilostazol is approved for the treatment of intermittent claudication Quadrigeminal cistern - ANSWERSuperior cistern or cistern of the great cerebral vein Duret haemorrhage - ANSWERDuret hemorrhages are small areas of bleeding in the ventral and paramedian parts of the upper brainstem, (midbrain and pons). They are secondary to raised intracranial pressure with formation of a transtentorial pressure cone involving the cerebral peduncles (crus cerebri) and other midbrain structures caused by raised pressure above the tentorium. Kernohan's notch is a groove in the cerebral peduncle that may be caused by this displacement of the brainstem against the incisura of the tentorium. The resulting ipsilateral hemiparesis is a false localising sign,[3] known as the Kernohan-Woltman syndrome.[4] This may succeed or accompany temporal lobe (uncal) herniation and subfalcian herniation secondary to a supratentorial mass 1mo development - ANSWERfocus on face, lifts head, moro reflex, turns to sound, turns head to sound 2mo development - ANSWERCoos, fixe and follow, grasps, smiles responsively, lifts head, turns head to sound 4mo development - ANSWERCoos/squeals/laughs, Bears weight, follow 180 degrees, Grasps, Holds head/chest up, holds small toy, no head lag, reaches, rolls front to back, turns to sound 6mo development - ANSWERBabbles, bears weight, laughs, pulls to sit, responds to name, rolls both ways, sits alone, transfers objects 9 mo development - ANSWERBabbles, claps/waves/peek-a-boo, creepts/crawls, cruises, sits up on own, says mama/dada, plays pat-a-cake, Pincer grasp, pulls to stand, stands with support 12mo development - ANSWERCruises, fills/empties containers, sits up on own, holds up and drinks, imitates words, pincer grasp, stands a lone, turns pages, says 1-2 words, walks alone
15mo development - ANSWERClimbs furniture, Dances, jargon, rides toys, stacks 2 object tower, stands alone, scoops and recovers, throws ball, uses cup, uses spoon, says 4 words, walks well 18mo development - ANSWERsays 8 or more words, feeds self, follows simple directions, imitates housework, knows 2 or more body parts, names pictures, rides toys, runs, uses spoon/fork, walks backward, walks up & down stairs 24mo development - ANSWER 2 - word sentences, follows 2-step verbal command, gets along well with fam members, acts worried if parent is sad, helps dress self, holds cup in one hand, jumps with both feet, kicks a ball, removes clothes, runs, walks up/down stairs, scribbles, throws overhand 3 - yr developmental milestones - ANSWER 3 - 5 word sentences, balances on one foot, asks what? why? builds 10-block tower, copies circle and x, counts to 3, dresses self, knows name/age/gender, pedals tricyle, plays with other kids, recognizes 3 colors, toilet trained, walks upstairs alternating feet 4 - yr developmental milestones - ANSWER 4 - 5 word sentences, catches ball, cuts and pastes, draws people, dresses and undresses themselves, enjoy jokes, jumps/hops, names 4-5 colors, pedals tricycle, plays well with others, walks on tiptoes 5yr developmental milestones - ANSWERcounts to 10, draws people with 2- 5 body parts, follows directions, knows address/phone number, knows on/off, over/under, plays cooperatively, pretend play, prints name, rides bike, skips, speaks understandably, tells, imaginary stories Unpasteurized goat cheese - ANSWERBrucella Laxative abuse - ANSWERelectrolyte imbalance severe dehydration dependency stretched or "lazy" colon balantidium coli - ANSWERprotozoa that causes GI infection, ingest cysts thru infected water or food produces hyalonuridase and creates ulcers in mucosal walls Isospora belli - ANSWERdiarrhea, steatorrhea, malabsorption, non-bloody diarrhea
Lower GI - ANSWERT12-L What composes the lower GI - ANSWERDistal 1/3 transverse colon, descending colon, sigmoid colon, rectum Kidneys - ANSWERT11-L Upper ureters - ANSWERT10-L Lower ureters - ANSWERL1-L Urinary bladder and urethra - ANSWERT11-L Gonads - ANSWERT10-T Uterus and cervix - ANSWERT10-L Erectile penis or clit - ANSWERT11-L Arms - ANSWERT5-T Legs - ANSWERT10-T Parasympathetics to everything above lower GI tract, and Kidneys and upper ureters - ANSWERVagus nerve Parasympathetics to the Lower GI tract, Lower ureters, bladder, urethra, gonads, uterus, cervix, and penis/clit - ANSWERS2-S Common compensatory pattern rotation - ANSWEROA- Left Cervicothoracic- Right Thoracolumbar- Left Lumbosacral- Right Ankle ligament sprains - ANSWER1. ATF
- ATF and CF
- ATF, CF, and PTF C5 sensation - ANSWERLateral arm and lateral elbow
C5 motor - ANSWERDeltoid and biceps (also biceps reflex) C6 sensation - ANSWERLateral forearm and thumb C6 motor - ANSWERBiceps and wrist extensors C7 sensation - ANSWERMiddle finger C7 motor - ANSWERTriceps and wrist flexors C8 sensation - ANSWERLittle finger and middle forearm C8 motor - ANSWERWrist flexors and interossi T1 sensation - ANSWERMedial elbow and medial arm T1 motor - ANSWERInterossi Abduction of shoulder - ANSWERSupraspinatus and deltoid Adduction of shoulder - ANSWERPect major, lat dorsi Flexion of shoulder - ANSWERCoracobrachialis, anterior deltoid Extension of shoulder - ANSWERLat dorsi, teres major, post deltoid External rotation of shoulder - ANSWERInfraspinatus, teres minor Internal rotation of shoulder - ANSWERSubscapularis, pect major, teres major, lat dorsi Carrying angle of arm increases - ANSWERWhen wrist adducts and ulna abducts Innervation: Flexors of the wrist and hand besides flexor carpi ulnaris (ulnar nerve) - ANSWERMedian nerve Innervation: Extensors of wrist and hand - ANSWERRadial nerve Innervation: Primary supinators of forearm - ANSWERBiceps: musculocutaneous n
6 - 9: Serratus anterior 10 - 12: Lat dorsi HVLA contraindications - ANSWERAbsolute: Osteoporosis, osteomyelitis, fractures in area of thrust (spondys), bone metastasis, severe RA, Down's syndrome (cervicals) Relative: Acute whiplash, pregnancy, post surgery, herniated disc, pts on anti- coags, vertebral artery ischemia (cervical) Psoas syndrome findings - ANSWERBackward sacral torsion Nonneutral L Ipsilateral psoas spasm Contralateral pelvic shift and piriformis spasm Exaggerated lumbar lordosis when supine Positive thomas test Ribs - ANSWERAtypical: 1, 2, 11, 12 Typical: 3- 10 True: 1- 7 False: 8- 12 Pump: 1- 5 Bucket: 6- 10 Caliper: 11- 12 Axis vs plane - ANSWERAxis is like the pole that the bone rotates across, plane is the field where the bone is moving in Disc herniation - ANSWERAffects the nerve of the lower spinal segment, unless above C7 (affects top segment) Scoliosis affects - ANSWERDextro: Right convexity; left sidebending and left restricted translation Levo: Left convexity: right sidebending and right restricted translation GI ganglion - ANSWERCeliac: T5- 9 Superior mesenteric: T10- 11 Inferior mesenteric: T12-L Vertical strain movement - ANSWER2 parallel transverse axes with sphenoid and occiput in same direction
Torticolis - ANSWERSidebent to affected side, rotated to opposite side CV4 technique - ANSWERCompression of 4th ventricle: thenar eminences on each hand on occipital bone and drawing back during craniosacral flexion, until still point is reached Arrangement of facet orientation for cervicals, thoracics, lumbars - ANSWERBUM, BUL, BUM Scoliosis classifications - ANSWER<20 is mild, 20-45 is moderate, >45 is severe. Mild and moderate tx with OMT or bracing, severe requires surgery. Resp compromise > Cardiac compromise > Myokymia that progresses downward - ANSWERDue to internally rotated temporal bone of same side Craniosacral motion - ANSWEROccurs at superior transverse axis, or the respiratory axis at level of S2. During CS flexion, sacrum counternutates and AP diameter shortens Nerve impingements - ANSWERC5: Numbness at lateral elbow and diminished biceps reflex C6: Numbness at lateral forearm, thumb, wrist extensors, and diminished brachioradialis C7: Numbness of middle finger, weakness of finger and elbow extensors, diminished triceps reflex Vault hold - ANSWERIndex on greater wings of sphenoid Middle on zygomatic process of temporal bone (ant to ear) Ring on mastoid process of temporal bone (post to ear) Little finger on occiput Thumbs over sagittal suture Spencer's technique - ANSWER1. Extend shoulder
- Flexion of shoulder with elbow extension
- Circumduction w/ compression
- Circumduction w/ extraction
- Abduct shoulder
- Internal and external rotation
Pharynx - ANSWERC2 spinous process
Tongue - ANSWERC2 spinous process Larynx - ANSWERC2 spinous process Sinuses - ANSWERC2 spinous process
- Esophagus - ANSWERT Arms - ANSWERC2 spinous process
- Bronchus - ANSWERT
- Thyroid - ANSWERT
- Upper lung and myocardium - ANSWERT
- Lower lung - ANSWERT
- Acidity of stomach - ANSWERLeft T
- Liver - ANSWERRight T5-T
- Gallbladder - ANSWERRight T
- Spleen - ANSWERLeft T
- Pancreas - ANSWERRight T
- Small intestines - ANSWERT8-T
- Adrenals - ANSWERT
- Kidneys - ANSWERL
- Bladder and abdomen - ANSWERL
- Prostate/ broad ligament - ANSWERS
- Ovaries - ANSWERT
Middle ear - ANSWERSuperior clavicle Tonsils - ANSWER1st ICS near manubrium Kidneys (adrenals are 2" superior, 1" lateral) - ANSWER1" superior and 1" lateral to umbilicus Nasal sinuses - ANSWERInferior clavicle Lung dz - ANSWERSternum at 4th ICS Bladder - ANSWERUmbilicus Stomach acidity - ANSWERLeft 5th ICS (right is peristalsis) Liver - ANSWERRight 5th and 6th ICS Gallbladder - ANSWERRight 6th ICS Spleen - ANSWERLeft 7th ICS Pancreas - ANSWERRight 7th ICS Thyroid gland - ANSWERSternum at 2nd ICS Esophagus - ANSWERSternum at 2nd ICS Myocardium - ANSWERSternum at 2nd ICS Bronchi - ANSWERSternum at 2nd ICS Pharynx - ANSWERRib 1 Eye - ANSWERLateral humerus Cerebellum - ANSWERCoracoid process Colon - ANSWERUpside down over IT band of thighs Ovaries - ANSWERSuperior to pubic tubercle
