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COMSAE EXAM QUESTIONS WITH COMPLETE SOLUTIONS
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COMSAE EXAM QUESTIONS WITH COMPLETE SOLUTIONS
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COMSAE EXAM QUESTIONS WITHCOMPLETE SOLUTIONS
3,500 kcal Correct Answers 1lb of body fat is equivalent to?
A 12 year old female is brought to the office with a 2 day history
of heavy menstual bleeding and fatigue. history includes
multiple episodes of purpura, epistaxis, and gingival bleeding
over the past year. Examination reveals pale conjunctivae.
laboratory studies reveal hemoglobin of 8.0g/dL (11.5-14.5
g/DL) and a hematocrit of 24 percent (33-43 percent). These
findings are consistent with a.cystic fibrosis b. deficiency of
factor IX c. inhibitor of factor VIII d.neoplastic liver disease
e.platelet membrane abnormalities Correct Answers The
findings described in the case are consistent with option E:
platelet membrane abnormalities. The patient's heavy menstrual
bleeding, fatigue, multiple episodes of purpura, epistaxis, and
gingival bleeding suggest a bleeding disorder.
The laboratory studies reveal a low hemoglobin level (8.0g/dL)
and hematocrit (24 percent), indicating anemia. This anemia is
likely a result of the heavy menstrual bleeding. The pale
conjunctivae further support the diagnosis of anemia.
Platelet membrane abnormalities can result in a bleeding
disorder known as von Willebrand disease (vWD). This
condition is characterized by defective platelet adhesion and
impaired clot formation. It often presents with mucocutaneous
bleeding, such as heavy menstrual bleeding, nosebleeds
(epistaxis), and gingival bleeding. The presence of purpura,
,which are small bleeding spots under the skin, is also indicative
of a platelet disorder.
The other options listed are not consistent with the given
scenario:
Cystic fibrosis (option A) is a genetic disorder that primarily
affects the respiratory and digestive systems. It does not
typically cause heavy menstrual bleeding or the bleeding
symptoms described.
Deficiency of factor IX (option B) is characteristic of
hemophilia B, but the bleeding symptoms described are not
consistent with a factor IX deficiency.
An inhibitor of factor VIII (option C) is seen in acquired
hemophilia, but this condition is rare in children and does not
typically present with heavy menstrual bleeding.
Neoplastic liver disease (option D) can lead to coagulopathy and
bleeding, but it is unlikely to be the cause in this case, as there
are no other signs or symptoms suggestive of liver disease.
Therefore, based on the information provided, the most likely
cause of the patient's symptoms is platelet membrane
abnormalities, which could be
a 17 year old male presents to the office with a 3-week history
of progressive right elbow pain. questioning reveals that the pain
is much worse when he plays tennis, which he does frequently
as a member of the high school team. examination reveals that
the right radial head is posterior and exquisitely tender. the
patient also has pain with resisted extension of the wrist. the
mechanism of this patient's conditon is a. capsulitis of the elbow
b. capsulitis of the glenohumeral joint c.inflammation of the
biceps d.inflammation of the origin of the wrist extensors e.
inflammation of the origin of the wrist flexors Correct Answers
, Based on the information provided, the most likely mechanism
of this patient's condition is option E: inflammation of the origin
of the wrist flexors. The history of progressive right elbow pain
exacerbated by playing tennis, specifically with pain during
resisted extension of the wrist, suggests a condition known as
"tennis elbow" or lateral epicondylitis.
Lateral epicondylitis is an overuse injury that involves
inflammation of the common extensor tendon, which originates
from the lateral epicondyle of the humerus. The extensor
tendons involved in wrist extension attach at this point. The pain
is typically felt on the outside of the elbow and can be worsened
with activities that involve repetitive gripping or wrist extension,
such as playing tennis.
The other options listed are not consistent with the given
scenario:
Capsulitis of the elbow (option A) refers to inflammation of the
joint capsule, but it does not explain the specific symptoms
described.
Capsulitis of the glenohumeral joint (option B) refers to
inflammation of the shoulder joint, which is not consistent with
the patient's symptoms.
Inflammation of the biceps (option C) would typically present
with pain in the front of the shoulder, not in the elbow.
Inflammation of the origin of the wrist extensors (option D)
would cause pain during resisted wrist extension, which is not
consistent with the patient's symptoms.
Therefore, based on the information provided, the most likely
mechanism of this patient's condition is inflammation of the
origin of the wrist flexors, known as lateral epicondylitis or
tennis elbow.
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