COMSAE Prep Verified Multiple Choice and
Conceptual Actual Emended Exam Questions
With Reviewed 100% Correct Detailed Answers
Guaranteed Pass!!Current Update
Q1. A patient struck the back of the head presents with headaches and difficulty
concentrating. OMM exam reveals restricted motion at the sphenobasilar
synchondrosis (SBS) with no flexion or extension. Most likely strain pattern?
A) Superior strain
B) Lateral strain
C) SBS compression
D) Torsion strain
Answer: C
Rationale: Direct trauma to the occiput often causes SBS compression → ↓cranial
rhythmic impulse.
Q2. After being hit under the chin, a patient develops headaches. OMM exam
shows one greater wing of the sphenoid superior while the opposite side of the
occiput is inferior. Diagnosis?
A) Torsion strain
B) Vertical strain
C) SBS compression
D) Lateral strain
Answer: A
Rationale: Blow under the chin on one side → torsion strain.
Q3. A blow to the side of the head produces cranial findings where both greater
wings of the sphenoid move anteriorly on one side and posteriorly on the other.
,What is this pattern?
A) Torsion strain
B) Lateral strain
C) Superior strain
D) Inferior strain
Answer: B
Rationale: Trauma to the side → lateral strain (sphenoid and occiput rotate in
same direction).
Q4. A newborn with meconium aspiration presents with wheezing. Which
viscerosomatic reflex level is most likely hypertonic?
A) T1–T4
B) T5–T9
C) T10–L2
D) S2–S4
Answer: A
Rationale: Pulmonary sympathetics → T1–T4.
Q5. A patient with peptic ulcer disease has viscerosomatic reflex changes at T5–
T9. Which nerve carries the parasympathetic innervation here?
A) Pelvic splanchnic nerves
B) Vagus nerve
C) Glossopharyngeal nerve
D) Hypogastric plexus
Answer: B
Rationale: Foregut (stomach/duodenum) parasympathetics → vagus.
,Q6. A pregnant woman at 30 weeks with preterm contractions is given ritodrine.
Mechanism of action?
A) α-1 agonist → vasoconstriction
B) β-2 agonist → uterine relaxation
C) Muscarinic antagonist
D) Oxytocin receptor agonist
Answer: B
Rationale: Ritodrine/Terbutaline → β-2 agonists → tocolysis.
Q7. A patient with postpartum hemorrhage not responding to oxytocin is given
methylergonovine. Contraindication?
A) Hypertension
B) Diabetes
C) Asthma
D) Hypothyroidism
Answer: A
Rationale: Methylergonovine causes vasoconstriction → avoid in HTN.
Q8. A patient being treated for chemotherapy-induced nausea develops
galactorrhea. Which drug is most likely responsible?
A) Ondansetron
B) Metoclopramide
C) Prochlorperazine
D) Meclizine
Answer: B
Rationale: Metoclopramide → D₂ antagonist → ↑prolactin.
Q9. A blue-green pigment with a fruity odor is found in a wound culture. Which
organism is responsible?
, A) Klebsiella pneumoniae
B) Pseudomonas aeruginosa
C) Staphylococcus aureus
D) Escherichia coli
Answer: B
Rationale: Pyocyanin → Pseudomonas hallmark.
Q10. A hospitalized patient develops pneumonia with currant jelly sputum. Which
organism is most likely?
A) Klebsiella pneumoniae
B) Streptococcus pneumoniae
C) Haemophilus influenzae
D) Moraxella catarrhalis
Answer: A
Rationale: Currant jelly sputum = Klebsiella pneumoniae.
Q11. A 26-year-old man presents with sudden chest pain and shortness of breath.
Exam: hyperresonant percussion note, ↓breath sounds on right, midline trachea.
Diagnosis?
A) Tension pneumothorax
B) Spontaneous pneumothorax
C) Pleural effusion
D) Pulmonary embolism
Answer: B
Rationale: Spontaneous PTX → hyperresonance + absent sounds, no tracheal
deviation.
Q12. A trauma patient with hypotension, distended neck veins, and absent breath
sounds on left. Next best step?
A) Intubation
Conceptual Actual Emended Exam Questions
With Reviewed 100% Correct Detailed Answers
Guaranteed Pass!!Current Update
Q1. A patient struck the back of the head presents with headaches and difficulty
concentrating. OMM exam reveals restricted motion at the sphenobasilar
synchondrosis (SBS) with no flexion or extension. Most likely strain pattern?
A) Superior strain
B) Lateral strain
C) SBS compression
D) Torsion strain
Answer: C
Rationale: Direct trauma to the occiput often causes SBS compression → ↓cranial
rhythmic impulse.
Q2. After being hit under the chin, a patient develops headaches. OMM exam
shows one greater wing of the sphenoid superior while the opposite side of the
occiput is inferior. Diagnosis?
A) Torsion strain
B) Vertical strain
C) SBS compression
D) Lateral strain
Answer: A
Rationale: Blow under the chin on one side → torsion strain.
Q3. A blow to the side of the head produces cranial findings where both greater
wings of the sphenoid move anteriorly on one side and posteriorly on the other.
,What is this pattern?
A) Torsion strain
B) Lateral strain
C) Superior strain
D) Inferior strain
Answer: B
Rationale: Trauma to the side → lateral strain (sphenoid and occiput rotate in
same direction).
Q4. A newborn with meconium aspiration presents with wheezing. Which
viscerosomatic reflex level is most likely hypertonic?
A) T1–T4
B) T5–T9
C) T10–L2
D) S2–S4
Answer: A
Rationale: Pulmonary sympathetics → T1–T4.
Q5. A patient with peptic ulcer disease has viscerosomatic reflex changes at T5–
T9. Which nerve carries the parasympathetic innervation here?
A) Pelvic splanchnic nerves
B) Vagus nerve
C) Glossopharyngeal nerve
D) Hypogastric plexus
Answer: B
Rationale: Foregut (stomach/duodenum) parasympathetics → vagus.
,Q6. A pregnant woman at 30 weeks with preterm contractions is given ritodrine.
Mechanism of action?
A) α-1 agonist → vasoconstriction
B) β-2 agonist → uterine relaxation
C) Muscarinic antagonist
D) Oxytocin receptor agonist
Answer: B
Rationale: Ritodrine/Terbutaline → β-2 agonists → tocolysis.
Q7. A patient with postpartum hemorrhage not responding to oxytocin is given
methylergonovine. Contraindication?
A) Hypertension
B) Diabetes
C) Asthma
D) Hypothyroidism
Answer: A
Rationale: Methylergonovine causes vasoconstriction → avoid in HTN.
Q8. A patient being treated for chemotherapy-induced nausea develops
galactorrhea. Which drug is most likely responsible?
A) Ondansetron
B) Metoclopramide
C) Prochlorperazine
D) Meclizine
Answer: B
Rationale: Metoclopramide → D₂ antagonist → ↑prolactin.
Q9. A blue-green pigment with a fruity odor is found in a wound culture. Which
organism is responsible?
, A) Klebsiella pneumoniae
B) Pseudomonas aeruginosa
C) Staphylococcus aureus
D) Escherichia coli
Answer: B
Rationale: Pyocyanin → Pseudomonas hallmark.
Q10. A hospitalized patient develops pneumonia with currant jelly sputum. Which
organism is most likely?
A) Klebsiella pneumoniae
B) Streptococcus pneumoniae
C) Haemophilus influenzae
D) Moraxella catarrhalis
Answer: A
Rationale: Currant jelly sputum = Klebsiella pneumoniae.
Q11. A 26-year-old man presents with sudden chest pain and shortness of breath.
Exam: hyperresonant percussion note, ↓breath sounds on right, midline trachea.
Diagnosis?
A) Tension pneumothorax
B) Spontaneous pneumothorax
C) Pleural effusion
D) Pulmonary embolism
Answer: B
Rationale: Spontaneous PTX → hyperresonance + absent sounds, no tracheal
deviation.
Q12. A trauma patient with hypotension, distended neck veins, and absent breath
sounds on left. Next best step?
A) Intubation
