Page 1 of 114
COMSAE | ALL COMSAE STUDY GUIDE EXAM QUESTIONS
WITH 100% CORRECT ANSWERS | NEW UPDATE 2026/2027
| GRADED A+ | GUARANTEED SUCCESS.
Gilbert Syndrome -- ANSWER--mild dec UDP glucuronosyltransferase conjugation and
impaired bilirubin uptake; asymptomatic or mild jaundice>> inc unconjugated bilirubin w/o
hemolysis; w/ fasting and stress
Osteoporosis histo -- ANSWER--trabecular and cortical bone lose mass and interconnection
despite normal bone mineralization
assoc w/ Colles fracture- distal radial fracture; fracture of femoral neck
Crigler Najjar -- ANSWER--ABSENT UDP glucuronsyltransferase; early in life; die few
years
find: jaundice, kernicterus (in brain) inc unconjugated bilirubin;
tx: plasmapheresis and phototherapy; type II respond phenobarbital
COCAINE intoxication -- ANSWER--impaired judgement, pupil dilate, hallucination (coke
bugs) sudden cardiac death; paranoid ideations, angina
Tx: alpha blockers/ benzos caution B block bc
can cause unopposed alpha
Dubin Johnson -- ANSWER--Conjugated hyperbilirubinemia b/c defective liver excretion;
grossly black liver
Benign
, Page 2 of 114
Rotor syndrome -- ANSWER--milder in presentation w/o black liver
impaired hepatic uptake and excretion
Hemochromatosis finds -- ANSWER--after age 40
>20 iron; triad: cirrhosis, DM, skin pigmentation; dilated cardiomyopathy, hypogonadism,
arhtropathy; HCC is common cause death
Treatment Hemochromatosis -- ANSWER--repeat phlebotomy, chelation deferasirox,
deferoxamine, oral deferiprone
Wolff Parkinson White Syndrome -- ANSWER--MC 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 -- ANSWER--SA node> atira> AV node> bundle HIS, R and L
bundle branches> purkinje fibers> ventricles
L branch anterior/posterior fascicles
Edema -- ANSWER--inc capillary pressure dec
plasma proteins (dec oncotic capillary pressure) inc
capillary permeability increase interstitial fluid
colloid oncotic pressure
Celiac Disease -- ANSWER--setting: 14 mo kid losing weight eating lots of foods;
histology: crypt abnormalities (hyperplasia); villous atrophy, lymphocytic infiltration
, Page 3 of 114
presents as malabsorbtion (diarrhea etc in kids) in
adults= short stature, anemia delayed puberty
Musculocutaneous nerve C5-C7 -- ANSWER--upper trunk compression cause injury; loss
forearm flexion/supination; loss sensation over lateral forearm
wilson Disease -- ANSWER--copper 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 -- ANSWER--recessive, 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
Axillary nerve C5-C6 -- ANSWER--flat deltoid; loss arm abduction, loss sensation over
deltoid and lateral arm
Radial C5-T1 -- ANSWER--mid shaft fracture humerus, compression axilla
find: dec grip, loss extension (wrist drop); loss sensation posterior arm, dorsal hand
Median C5-T1 -- ANSWER--supracondylar fracture humerus (proximal) CTS, wrist
laceration (distal)
ape hand pope's blessing
, Page 4 of 114
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
Treatment glaucoma: alpha agonists; epinephrine, brimonidine -- ANSWER--dec 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 -- ANSWER--dec AH synthesis; no pupil/vision
changes
Diuretics; acetazolamide -- ANSWER--dec AH synthesis by inhibiting carbonic anhydrase;
no vision/pupil change
Cholinomimetics M3; direct pilocarpine carbachol; indirect physostigmine, echothiophate --
ANSWER--inc outflow of AH via contraction of ciliary muscle/open trabecular mesh;
pilocarpine in ER--very effective open meshwork into Canal schlemm,
lead to miosis--and cyclospasm
Prostaglandin- bimatoprost, iatanoprost PGF2 alpha -- ANSWER--inc outflow AH; darken
iris (brown); eyelash growth
alpha agonists should be avoided in -- ANSWER--closed angle glaucoma pts
M3 agonist= pilocarpine/carbachol (direct) -- ANSWER--contract the sphincter muscles
allowing passage of fluid; pilocarpine emergencies
pervasive development disorder -- ANSWER--what you think of when you consider autism
spectrum: can't be touched, comforted, can't understand speech
COMSAE | ALL COMSAE STUDY GUIDE EXAM QUESTIONS
WITH 100% CORRECT ANSWERS | NEW UPDATE 2026/2027
| GRADED A+ | GUARANTEED SUCCESS.
Gilbert Syndrome -- ANSWER--mild dec UDP glucuronosyltransferase conjugation and
impaired bilirubin uptake; asymptomatic or mild jaundice>> inc unconjugated bilirubin w/o
hemolysis; w/ fasting and stress
Osteoporosis histo -- ANSWER--trabecular and cortical bone lose mass and interconnection
despite normal bone mineralization
assoc w/ Colles fracture- distal radial fracture; fracture of femoral neck
Crigler Najjar -- ANSWER--ABSENT UDP glucuronsyltransferase; early in life; die few
years
find: jaundice, kernicterus (in brain) inc unconjugated bilirubin;
tx: plasmapheresis and phototherapy; type II respond phenobarbital
COCAINE intoxication -- ANSWER--impaired judgement, pupil dilate, hallucination (coke
bugs) sudden cardiac death; paranoid ideations, angina
Tx: alpha blockers/ benzos caution B block bc
can cause unopposed alpha
Dubin Johnson -- ANSWER--Conjugated hyperbilirubinemia b/c defective liver excretion;
grossly black liver
Benign
, Page 2 of 114
Rotor syndrome -- ANSWER--milder in presentation w/o black liver
impaired hepatic uptake and excretion
Hemochromatosis finds -- ANSWER--after age 40
>20 iron; triad: cirrhosis, DM, skin pigmentation; dilated cardiomyopathy, hypogonadism,
arhtropathy; HCC is common cause death
Treatment Hemochromatosis -- ANSWER--repeat phlebotomy, chelation deferasirox,
deferoxamine, oral deferiprone
Wolff Parkinson White Syndrome -- ANSWER--MC 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 -- ANSWER--SA node> atira> AV node> bundle HIS, R and L
bundle branches> purkinje fibers> ventricles
L branch anterior/posterior fascicles
Edema -- ANSWER--inc capillary pressure dec
plasma proteins (dec oncotic capillary pressure) inc
capillary permeability increase interstitial fluid
colloid oncotic pressure
Celiac Disease -- ANSWER--setting: 14 mo kid losing weight eating lots of foods;
histology: crypt abnormalities (hyperplasia); villous atrophy, lymphocytic infiltration
, Page 3 of 114
presents as malabsorbtion (diarrhea etc in kids) in
adults= short stature, anemia delayed puberty
Musculocutaneous nerve C5-C7 -- ANSWER--upper trunk compression cause injury; loss
forearm flexion/supination; loss sensation over lateral forearm
wilson Disease -- ANSWER--copper 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 -- ANSWER--recessive, 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
Axillary nerve C5-C6 -- ANSWER--flat deltoid; loss arm abduction, loss sensation over
deltoid and lateral arm
Radial C5-T1 -- ANSWER--mid shaft fracture humerus, compression axilla
find: dec grip, loss extension (wrist drop); loss sensation posterior arm, dorsal hand
Median C5-T1 -- ANSWER--supracondylar fracture humerus (proximal) CTS, wrist
laceration (distal)
ape hand pope's blessing
, Page 4 of 114
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
Treatment glaucoma: alpha agonists; epinephrine, brimonidine -- ANSWER--dec 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 -- ANSWER--dec AH synthesis; no pupil/vision
changes
Diuretics; acetazolamide -- ANSWER--dec AH synthesis by inhibiting carbonic anhydrase;
no vision/pupil change
Cholinomimetics M3; direct pilocarpine carbachol; indirect physostigmine, echothiophate --
ANSWER--inc outflow of AH via contraction of ciliary muscle/open trabecular mesh;
pilocarpine in ER--very effective open meshwork into Canal schlemm,
lead to miosis--and cyclospasm
Prostaglandin- bimatoprost, iatanoprost PGF2 alpha -- ANSWER--inc outflow AH; darken
iris (brown); eyelash growth
alpha agonists should be avoided in -- ANSWER--closed angle glaucoma pts
M3 agonist= pilocarpine/carbachol (direct) -- ANSWER--contract the sphincter muscles
allowing passage of fluid; pilocarpine emergencies
pervasive development disorder -- ANSWER--what you think of when you consider autism
spectrum: can't be touched, comforted, can't understand speech
