COMSAE 2 Exam Questions And Correct Answers (Verified
Answers) 2026
1. Sheehan Syndrome: A rare condition that occurs secondary to pituitary ischemia and subsequent
infarction following significant postpartum bleeding. This occurs due to the decreased perfusion of the pituitary during
the final stages of pregnancy and labor process. This can also occur due to significant blood loss during labor, leading
to hypoperfusion of the pituitary gland and subsequent infarction. This will in turn cause a global decrease in the
hormones that are produced in the anterior pituitary.
The production of ADH and oxytocin is not attected because both hormones are produced in the hypothalamus, and stored
in the posterior pituitary gland.
2. Bosentan & Ambrisentan MOA: They treat pulmonary hypertension by competitively antagonizing
endothelin-1 receptors, thus, decreasing pulmonary vascular resistance.
3. Inclusion Body Myositis: Characterized by inflammation and endomysial infiltrates of CD8+ T cells and
macrophages that focally surround and invade myofibrils. The presence of rimmed vacuoles is a characteristic
feature. It is more common in males over the age of 50-years-old. It manifests as an insidious onset of proximal
muscle weakness, often with associated distal muscle weakness. The distribution of weakness is variable, but unlike
polymyositis and dermatomyositis, asymmetry is common. Early involvement of the knee extensors, ankle dorsiflexors, and
wrist and finger flexors is characteristic. Weakness of the wrist and finger flexors is often greater than their extensor
counterparts. Hence, loss of finger dexterity and grip strength may be a prominent symptom. It also commonly
causes greater weakness in knee extension when compared with the hip flexors. Deep tendon reflexes may be
impaired or absent if weakness is severe. Laboratory results reveal a normal to slightly elevated level of serum creatine
kinase. Muscle biopsy is the gold standard for diagnosis.
4. Polymyalgia Rheumatica: A disease of the elderly that causes proximal myalgias of the hip and
shoulder girdles. The symptoms appear first in the shoulder girdle, and patients commonly complain of stittness
after prolonged inactivity. The shoulder and hip girdles can be painful and stitt, causing diflculty in rising from a chair
or raising their arms over their shoulder. Patients also have morning stittness that typically lasts for more than one hour.
There is no muscle weakness, as compared to dermatomyositis and polymyositis. It is commonly associated with giant
cell arteritis. Laboratory studies reveal an erythrocyte sedimentation rate (ESR) > 40 mm/h. Treatment is with
prednisone.
5. What is the genetic transmission of Duchenne & Becker Muscular Dystro-
phy?: XLR
6. 5% Sheep Blood added to?: Blood agar usually contains 5% sheep blood and is used to determine
hemolysis patterns of Streptococcus
, COMSAE 2 Exam Questions And Correct Answers (Verified
Answers) 2026
7. Eosin-methylene blue is added to?: A staining agent used to visualize Escherichia coli that show
up as a metallic sheen.
8. Nystatin is added to help culture which organism?: Nystatin is a part of the VPN or
Thayer-Martin agar designed to grow Neisseria gonorrhoeae.
9. What 2 OMM techniques can be used to thin mucous secretions in a pt with
Asthma?: Asthma is the most common chronic disease in childhood and asthma symptoms include wheezing,
shortness of breath, chest tightness and cough. Asthma involves hypersensitivity of the bronchi and lower airways to
allergens, cold or other irritants. This results in inflammation, bronchospasm and mucous plugging. β-2-agonists help
dilate the bronchioles but do not directly attect the sympathetic nerves which regulate secretions. Persistent asthma can
drive the upper thoracic (particularly T1-T4) sympathetic nerves into a chronically active state. One particularly significant
physiologic response of this is proliferation of goblet cells. These cells in the bronchial mucosa produce thick, tenacious
secretions which are diflcult to clear. Rib raising is one method of normalizing (in this case, decreasing) sympathetic
tone to thin the secretions. Another useful method is the thoracic pump, which can be particularly helpful in
normalizing lymphatic flow out of congested tissues.
10. Sympathetic Vicerosomatics:
11. Isolated Tricuspid Stenosis MC from?: The most common causes are due to carcinoid heart
disease and right atrial myxoma.
12. What is the MOA of an Aspirin Overdose?: It causes the uncoupling of oxidative phosphoryla-
tion and thereby reduces the amount of ATP produced. Aspirin transports protons generated by the electron transport
chain back into the mitochondrial matrix. This decreases the amount of protons available for ATP synthase to use for
formation of ATP. As a result, there is an accumulation of carbon dioxide in the body. Which leads to a respiratory
alkolosis which is then followed by a Metabolic acidosis to recompensate (Mixed)
13. What is the Antidote for Cyanide Poisoning?: Amyl nitrite. Cyanide inhibits cytochrome
oxidase enzyme in the electron transport chain within mitochondria. This causes depletion of ATP. Patients with cyanide
poisoning present with elevated heart rates, drowsiness, and eventual coma and death.
14. Alkpatonuria: An AR disorder that results from deficient activity of the enzyme homogentisic oxidase. It
results in elevated levels of homogentisic acid which forms a pigment that is deposited in connective tissue and joints
throughout the body. It typically presents in the 3rd decade of life, with initial pigmentation occurring in the ear
, COMSAE 2 Exam Questions And Correct Answers (Verified
Answers) 2026
cartilage and sclera of the eyes. A dark pigment is also deposited in the large joints and the lumbosacral spine. This
leads to early onset arthritis and can result in joint replacements at a younger age. The disorder is characterized by
urine that is of a normal color initially, but turns a dark black color if left standing due to oxidation of the homogentisic acid.
The diagnosis is confirmed by measurement of homogentisic acid in the urine. No ettective therapy is available for
alkaptonuria.
15. Metachromatic Leukodystrophy: An AR lysosomal storage disease that causes progressive
de- myelination of the central and peripheral nervous system. It is due to a deficiency in Arylsulfatase A. Common
man- ifestations include regression of motor skills, gait abnormalities, ataxia, hypotonia, upper motor neuron signs, and
peripheral neuropathy. The diagnosis is established by demonstrating deficient arylsulfatase A activity in leukocytes or
elevated sulfatides
16. McArdle Disease: An AR glycogen storage disease due to a deficiency in the enzyme myophosphorylase.
Myophosphorylase is involved in the breakdown of glycogen to glucose in the muscles. McArdle disease usually
presents in adolescence or early adulthood with fatigue, myalgias, muscle cramps, weakness, exercise intolerance, and
myoglobinuria. These symptoms are brought on by exercise. An ischemic muscle forearm test would reveal a failure
of the lactate levels to rise in venous blood after ischemic exercise.
17. Some AD diseases: Tuberous
Sclerosis achondroplasia
Huntington disease
Marfan syndrome
neurofibromatosis.
18. Some AR diseases: cystic fibrosis
sickle cell anemia
hemochromatosis
glycogen storage diseases
thalassemias
albinism
infantile polycystic kidney disease (ARPKD)
19. XLR diseases: Bruton's agammaglobulinemia
Wiskott-Aldrich
G6PD deficiency
Lesch-Nyhan syndrome
Answers) 2026
1. Sheehan Syndrome: A rare condition that occurs secondary to pituitary ischemia and subsequent
infarction following significant postpartum bleeding. This occurs due to the decreased perfusion of the pituitary during
the final stages of pregnancy and labor process. This can also occur due to significant blood loss during labor, leading
to hypoperfusion of the pituitary gland and subsequent infarction. This will in turn cause a global decrease in the
hormones that are produced in the anterior pituitary.
The production of ADH and oxytocin is not attected because both hormones are produced in the hypothalamus, and stored
in the posterior pituitary gland.
2. Bosentan & Ambrisentan MOA: They treat pulmonary hypertension by competitively antagonizing
endothelin-1 receptors, thus, decreasing pulmonary vascular resistance.
3. Inclusion Body Myositis: Characterized by inflammation and endomysial infiltrates of CD8+ T cells and
macrophages that focally surround and invade myofibrils. The presence of rimmed vacuoles is a characteristic
feature. It is more common in males over the age of 50-years-old. It manifests as an insidious onset of proximal
muscle weakness, often with associated distal muscle weakness. The distribution of weakness is variable, but unlike
polymyositis and dermatomyositis, asymmetry is common. Early involvement of the knee extensors, ankle dorsiflexors, and
wrist and finger flexors is characteristic. Weakness of the wrist and finger flexors is often greater than their extensor
counterparts. Hence, loss of finger dexterity and grip strength may be a prominent symptom. It also commonly
causes greater weakness in knee extension when compared with the hip flexors. Deep tendon reflexes may be
impaired or absent if weakness is severe. Laboratory results reveal a normal to slightly elevated level of serum creatine
kinase. Muscle biopsy is the gold standard for diagnosis.
4. Polymyalgia Rheumatica: A disease of the elderly that causes proximal myalgias of the hip and
shoulder girdles. The symptoms appear first in the shoulder girdle, and patients commonly complain of stittness
after prolonged inactivity. The shoulder and hip girdles can be painful and stitt, causing diflculty in rising from a chair
or raising their arms over their shoulder. Patients also have morning stittness that typically lasts for more than one hour.
There is no muscle weakness, as compared to dermatomyositis and polymyositis. It is commonly associated with giant
cell arteritis. Laboratory studies reveal an erythrocyte sedimentation rate (ESR) > 40 mm/h. Treatment is with
prednisone.
5. What is the genetic transmission of Duchenne & Becker Muscular Dystro-
phy?: XLR
6. 5% Sheep Blood added to?: Blood agar usually contains 5% sheep blood and is used to determine
hemolysis patterns of Streptococcus
, COMSAE 2 Exam Questions And Correct Answers (Verified
Answers) 2026
7. Eosin-methylene blue is added to?: A staining agent used to visualize Escherichia coli that show
up as a metallic sheen.
8. Nystatin is added to help culture which organism?: Nystatin is a part of the VPN or
Thayer-Martin agar designed to grow Neisseria gonorrhoeae.
9. What 2 OMM techniques can be used to thin mucous secretions in a pt with
Asthma?: Asthma is the most common chronic disease in childhood and asthma symptoms include wheezing,
shortness of breath, chest tightness and cough. Asthma involves hypersensitivity of the bronchi and lower airways to
allergens, cold or other irritants. This results in inflammation, bronchospasm and mucous plugging. β-2-agonists help
dilate the bronchioles but do not directly attect the sympathetic nerves which regulate secretions. Persistent asthma can
drive the upper thoracic (particularly T1-T4) sympathetic nerves into a chronically active state. One particularly significant
physiologic response of this is proliferation of goblet cells. These cells in the bronchial mucosa produce thick, tenacious
secretions which are diflcult to clear. Rib raising is one method of normalizing (in this case, decreasing) sympathetic
tone to thin the secretions. Another useful method is the thoracic pump, which can be particularly helpful in
normalizing lymphatic flow out of congested tissues.
10. Sympathetic Vicerosomatics:
11. Isolated Tricuspid Stenosis MC from?: The most common causes are due to carcinoid heart
disease and right atrial myxoma.
12. What is the MOA of an Aspirin Overdose?: It causes the uncoupling of oxidative phosphoryla-
tion and thereby reduces the amount of ATP produced. Aspirin transports protons generated by the electron transport
chain back into the mitochondrial matrix. This decreases the amount of protons available for ATP synthase to use for
formation of ATP. As a result, there is an accumulation of carbon dioxide in the body. Which leads to a respiratory
alkolosis which is then followed by a Metabolic acidosis to recompensate (Mixed)
13. What is the Antidote for Cyanide Poisoning?: Amyl nitrite. Cyanide inhibits cytochrome
oxidase enzyme in the electron transport chain within mitochondria. This causes depletion of ATP. Patients with cyanide
poisoning present with elevated heart rates, drowsiness, and eventual coma and death.
14. Alkpatonuria: An AR disorder that results from deficient activity of the enzyme homogentisic oxidase. It
results in elevated levels of homogentisic acid which forms a pigment that is deposited in connective tissue and joints
throughout the body. It typically presents in the 3rd decade of life, with initial pigmentation occurring in the ear
, COMSAE 2 Exam Questions And Correct Answers (Verified
Answers) 2026
cartilage and sclera of the eyes. A dark pigment is also deposited in the large joints and the lumbosacral spine. This
leads to early onset arthritis and can result in joint replacements at a younger age. The disorder is characterized by
urine that is of a normal color initially, but turns a dark black color if left standing due to oxidation of the homogentisic acid.
The diagnosis is confirmed by measurement of homogentisic acid in the urine. No ettective therapy is available for
alkaptonuria.
15. Metachromatic Leukodystrophy: An AR lysosomal storage disease that causes progressive
de- myelination of the central and peripheral nervous system. It is due to a deficiency in Arylsulfatase A. Common
man- ifestations include regression of motor skills, gait abnormalities, ataxia, hypotonia, upper motor neuron signs, and
peripheral neuropathy. The diagnosis is established by demonstrating deficient arylsulfatase A activity in leukocytes or
elevated sulfatides
16. McArdle Disease: An AR glycogen storage disease due to a deficiency in the enzyme myophosphorylase.
Myophosphorylase is involved in the breakdown of glycogen to glucose in the muscles. McArdle disease usually
presents in adolescence or early adulthood with fatigue, myalgias, muscle cramps, weakness, exercise intolerance, and
myoglobinuria. These symptoms are brought on by exercise. An ischemic muscle forearm test would reveal a failure
of the lactate levels to rise in venous blood after ischemic exercise.
17. Some AD diseases: Tuberous
Sclerosis achondroplasia
Huntington disease
Marfan syndrome
neurofibromatosis.
18. Some AR diseases: cystic fibrosis
sickle cell anemia
hemochromatosis
glycogen storage diseases
thalassemias
albinism
infantile polycystic kidney disease (ARPKD)
19. XLR diseases: Bruton's agammaglobulinemia
Wiskott-Aldrich
G6PD deficiency
Lesch-Nyhan syndrome
