ALL THE COMSAE | ACTUAL EXAM 2025/2026 LATEST UPDATED |
COMPLETE QUESTIONS WITH 100% RATED CORRECT ANSWERS PLUS
WELL DETAILED AND ELABORATE RATIONALES | GET IT A+
Question 1
A patient who recently went camping and drank unfiltered stream water presents with foul-
smelling, fatty stools (steatorrhea), abdominal cramping, and bloating. A stool O&P test reveals
flagellated, pear-shaped trophozoites. What is the first-line treatment for this infection?
A) Albendazole
B) Praziquantel
C) Tinidazole or nitazoxanide
D) Paromomycin
E) Iodoquinol
Correct Answer: C) Tinidazole or nitazoxanide
Rationale: The presentation is classic for Giardiasis, caused by Giardia lamblia. While
metronidazole is an alternative, tinidazole and nitazoxanide are often considered first-line due
to better efficacy and shorter treatment courses. They are effective against this protozoan
parasite.
Question 2
A traveler returns from a trip to Mexico with a two-week history of bloody diarrhea (dysentery)
and right upper quadrant pain. An ultrasound reveals a liver abscess. What is the appropriate
two-step treatment for this condition?
A) Metronidazole, followed by albendazole
B) Metronidazole or tinidazole, followed by paromomycin or iodoquinol
C) Praziquantel, followed by nitazoxanide
D) Albendazole, followed by pyrantel pamoate
E) Trimethoprim-sulfamethoxazole, followed by tinidazole
Correct Answer: B) Metronidazole or tinidazole, followed by paromomycin or iodoquinol
Rationale: This is the classic presentation of amebiasis with a liver abscess, caused
by Entamoeba histolytica. Treatment requires a tissue agent to kill the invasive trophozoites
,(metronidazole or tinidazole) followed by a luminal agent (paromomycin or iodoquinol) to
eradicate the cysts in the colon and prevent relapse.
Question 3
A child from a rural area presents with vague abdominal pain and malnutrition. A large
roundworm is seen passing in the stool. What is the drug of choice for this infection, caused
by Ascaris lumbricoides?
A) Praziquantel
B) Ivermectin
C) Albendazole or mebendazole
D) Metronidazole
E) Niclosamide
Correct Answer: C) Albendazole or mebendazole
Rationale: Ascariasis is the most common helminthic infection worldwide. The treatment of
choice is a benzimidazole, such as albendazole or mebendazole, which works by inhibiting
microtubule synthesis in the worm, leading to its paralysis and expulsion.
Question 4
A patient who often walks barefoot in a rural area of the southeastern United States develops a
pruritic rash on their feet, followed by a cough, and now presents with iron deficiency anemia. A
stool sample reveals hookworm eggs. What is the appropriate treatment for this infection
caused by Necator americanus?
A) Praziquantel
B) Ivermectin
C) Albendazole
D) Doxycycline
E) Tinidazole
Correct Answer: C) Albendazole
Rationale: Hookworm infection (Necator americanus or Ancylostoma duodenale) causes
,chronic blood loss from the intestine, leading to iron deficiency anemia. The treatment of
choice is albendazole (or mebendazole as an alternative) to eliminate the adult worms.
Question 5
A patient develops fever, myalgias, periorbital edema, and eosinophilia one week after
consuming undercooked pork. A muscle biopsy reveals encysted larvae. What is the
recommended treatment for this patient with trichinellosis?
A) Mebendazole only
B) Praziquantel only
C) Albendazole + prednisone
D) Ivermectin + doxycycline
E) Metronidazole only
Correct Answer: C) Albendazole + prednisone
Rationale: The patient has Trichinosis, caused by Trichinella spiralis. Treatment is aimed at
both the parasite and the inflammation it causes. Albendazole or mebendazole is used to kill
the adult worms and migrating larvae. Corticosteroids like prednisone are added to control
the severe inflammatory response to the dying larvae, especially in cases with cardiac or CNS
involvement.
Question 6
A mother brings her 5-year-old child to the clinic, complaining that the child has been irritable
and scratching their anal area, especially at night. A "tape test" is positive for eggs. What is the
drug of choice for this common infection?
A) Albendazole
B) Ivermectin
C) Praziquantel
D) Mebendazole
E) Metronidazole
Correct Answer: D) Mebendazole
Rationale: The presentation of perianal pruritus, especially at night, is classic for pinworm
, infection, caused by Enterobius vermicularis. Mebendazole (or albendazole) is the treatment
of choice. It's important to treat the entire family to prevent reinfection.
Question 7
A patient who swam in freshwater lakes in Africa develops hematuria and is found to have
calcifications on the bladder wall. Urine microscopy reveals eggs with a terminal spine. What is
the drug of choice for this infection?
A) Albendazole
B) Ivermectin
C) Praziquantel
D) Mebendazole
E) Tinidazole
Correct Answer: C) Praziquantel
Rationale: This is urinary schistosomiasis, caused by the trematode Schistosoma
haematobium. Praziquantel is the drug of choice for all Schistosoma species. It increases
calcium permeability of the worm's cell membrane, causing paralysis and death.
Question 8
A patient who regularly consumes raw freshwater fish presents with megaloblastic anemia due
to vitamin B12 deficiency. A stool analysis reveals proglottids and eggs. What is the first-line
treatment for this tapeworm infection?
A) Albendazole
B) Mebendazole
C) Ivermectin
D) Praziquantel
E) Metronidazole
Correct Answer: D) Praziquantel
Rationale: The patient is infected with the fish tapeworm, Diphyllobothrium latum, which is
unique in its ability to cause vitamin B12 deficiency. The treatment of choice for most
tapeworm infections, including this one, is praziquantel. Niclosamide is an alternative.
COMPLETE QUESTIONS WITH 100% RATED CORRECT ANSWERS PLUS
WELL DETAILED AND ELABORATE RATIONALES | GET IT A+
Question 1
A patient who recently went camping and drank unfiltered stream water presents with foul-
smelling, fatty stools (steatorrhea), abdominal cramping, and bloating. A stool O&P test reveals
flagellated, pear-shaped trophozoites. What is the first-line treatment for this infection?
A) Albendazole
B) Praziquantel
C) Tinidazole or nitazoxanide
D) Paromomycin
E) Iodoquinol
Correct Answer: C) Tinidazole or nitazoxanide
Rationale: The presentation is classic for Giardiasis, caused by Giardia lamblia. While
metronidazole is an alternative, tinidazole and nitazoxanide are often considered first-line due
to better efficacy and shorter treatment courses. They are effective against this protozoan
parasite.
Question 2
A traveler returns from a trip to Mexico with a two-week history of bloody diarrhea (dysentery)
and right upper quadrant pain. An ultrasound reveals a liver abscess. What is the appropriate
two-step treatment for this condition?
A) Metronidazole, followed by albendazole
B) Metronidazole or tinidazole, followed by paromomycin or iodoquinol
C) Praziquantel, followed by nitazoxanide
D) Albendazole, followed by pyrantel pamoate
E) Trimethoprim-sulfamethoxazole, followed by tinidazole
Correct Answer: B) Metronidazole or tinidazole, followed by paromomycin or iodoquinol
Rationale: This is the classic presentation of amebiasis with a liver abscess, caused
by Entamoeba histolytica. Treatment requires a tissue agent to kill the invasive trophozoites
,(metronidazole or tinidazole) followed by a luminal agent (paromomycin or iodoquinol) to
eradicate the cysts in the colon and prevent relapse.
Question 3
A child from a rural area presents with vague abdominal pain and malnutrition. A large
roundworm is seen passing in the stool. What is the drug of choice for this infection, caused
by Ascaris lumbricoides?
A) Praziquantel
B) Ivermectin
C) Albendazole or mebendazole
D) Metronidazole
E) Niclosamide
Correct Answer: C) Albendazole or mebendazole
Rationale: Ascariasis is the most common helminthic infection worldwide. The treatment of
choice is a benzimidazole, such as albendazole or mebendazole, which works by inhibiting
microtubule synthesis in the worm, leading to its paralysis and expulsion.
Question 4
A patient who often walks barefoot in a rural area of the southeastern United States develops a
pruritic rash on their feet, followed by a cough, and now presents with iron deficiency anemia. A
stool sample reveals hookworm eggs. What is the appropriate treatment for this infection
caused by Necator americanus?
A) Praziquantel
B) Ivermectin
C) Albendazole
D) Doxycycline
E) Tinidazole
Correct Answer: C) Albendazole
Rationale: Hookworm infection (Necator americanus or Ancylostoma duodenale) causes
,chronic blood loss from the intestine, leading to iron deficiency anemia. The treatment of
choice is albendazole (or mebendazole as an alternative) to eliminate the adult worms.
Question 5
A patient develops fever, myalgias, periorbital edema, and eosinophilia one week after
consuming undercooked pork. A muscle biopsy reveals encysted larvae. What is the
recommended treatment for this patient with trichinellosis?
A) Mebendazole only
B) Praziquantel only
C) Albendazole + prednisone
D) Ivermectin + doxycycline
E) Metronidazole only
Correct Answer: C) Albendazole + prednisone
Rationale: The patient has Trichinosis, caused by Trichinella spiralis. Treatment is aimed at
both the parasite and the inflammation it causes. Albendazole or mebendazole is used to kill
the adult worms and migrating larvae. Corticosteroids like prednisone are added to control
the severe inflammatory response to the dying larvae, especially in cases with cardiac or CNS
involvement.
Question 6
A mother brings her 5-year-old child to the clinic, complaining that the child has been irritable
and scratching their anal area, especially at night. A "tape test" is positive for eggs. What is the
drug of choice for this common infection?
A) Albendazole
B) Ivermectin
C) Praziquantel
D) Mebendazole
E) Metronidazole
Correct Answer: D) Mebendazole
Rationale: The presentation of perianal pruritus, especially at night, is classic for pinworm
, infection, caused by Enterobius vermicularis. Mebendazole (or albendazole) is the treatment
of choice. It's important to treat the entire family to prevent reinfection.
Question 7
A patient who swam in freshwater lakes in Africa develops hematuria and is found to have
calcifications on the bladder wall. Urine microscopy reveals eggs with a terminal spine. What is
the drug of choice for this infection?
A) Albendazole
B) Ivermectin
C) Praziquantel
D) Mebendazole
E) Tinidazole
Correct Answer: C) Praziquantel
Rationale: This is urinary schistosomiasis, caused by the trematode Schistosoma
haematobium. Praziquantel is the drug of choice for all Schistosoma species. It increases
calcium permeability of the worm's cell membrane, causing paralysis and death.
Question 8
A patient who regularly consumes raw freshwater fish presents with megaloblastic anemia due
to vitamin B12 deficiency. A stool analysis reveals proglottids and eggs. What is the first-line
treatment for this tapeworm infection?
A) Albendazole
B) Mebendazole
C) Ivermectin
D) Praziquantel
E) Metronidazole
Correct Answer: D) Praziquantel
Rationale: The patient is infected with the fish tapeworm, Diphyllobothrium latum, which is
unique in its ability to cause vitamin B12 deficiency. The treatment of choice for most
tapeworm infections, including this one, is praziquantel. Niclosamide is an alternative.
