COMSAE EXAM QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS VERIFIED LATEST UPDATE
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
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
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).
HELLP syndrome
Preeclampsia with thrombotic microangiopathy of liver. Hemolysis, elevated liver
enzymes, low platelets. may occur in the absence of hypertension and proteinuria.
blood smear shows DIC (due to release of tissue factor from injured placenta)
treatment: immediate delivery
Brachioradilias Innervation
C6
3,500 kcal
1lb of body fat is equivalent to?
a 35 year old female is evaluated for mental status changes on day 4 of
hospitalization for status asthmaticus. she is being treated with albuterol,
predisone, and ipratropium. Social history is negative for substance use.
neurologic examination is nonfocal, but she shows impairment of attention,
concentration and recall. she has a minor resting hand tremor but no patholigc
reflexes. ECG and mri of the brain are both negaitve. this patient's mental status
change is most likely due?
Given the information provided, the most likely cause of the mental status changes in
this case would be option C: medication effect. The patient's symptoms, such as
impairment of attention, concentration, recall, and a minor resting hand tremor, are
consistent with the known side effects of medications like albuterol, prednisone, and
ipratropium, which she is currently receiving for the treatment of status asthmaticus.
COMPLETE SOLUTIONS VERIFIED LATEST UPDATE
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
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
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).
HELLP syndrome
Preeclampsia with thrombotic microangiopathy of liver. Hemolysis, elevated liver
enzymes, low platelets. may occur in the absence of hypertension and proteinuria.
blood smear shows DIC (due to release of tissue factor from injured placenta)
treatment: immediate delivery
Brachioradilias Innervation
C6
3,500 kcal
1lb of body fat is equivalent to?
a 35 year old female is evaluated for mental status changes on day 4 of
hospitalization for status asthmaticus. she is being treated with albuterol,
predisone, and ipratropium. Social history is negative for substance use.
neurologic examination is nonfocal, but she shows impairment of attention,
concentration and recall. she has a minor resting hand tremor but no patholigc
reflexes. ECG and mri of the brain are both negaitve. this patient's mental status
change is most likely due?
Given the information provided, the most likely cause of the mental status changes in
this case would be option C: medication effect. The patient's symptoms, such as
impairment of attention, concentration, recall, and a minor resting hand tremor, are
consistent with the known side effects of medications like albuterol, prednisone, and
ipratropium, which she is currently receiving for the treatment of status asthmaticus.
