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COMSAE QUALIFIER 2024 QUESTIONS AND ANSWERS LATEST UPDATE
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COMSAE QUALIFIER 2024 QUESTIONS AND ANSWERS LATEST UPDATE
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COMSAE QUALIFIER 2024 QUESTIONSAND ANSWERS LATEST UPDATE
Sulfonylurea (exs, moa, SE) Answer: Exs:
-1st gen: tolbutamide, chlorpropamide
-2nd gen: glyburide, glipizide, glimepiride
MOA: close K channels in beta cell -> depol -> Ca influx -> incr insulin release
SE: weight gain, abn LFTs, disulfuram rxn (1st gen), hypoglycemia
Types of amyloidosis Answer: AL (primary): plasma cell dyscrasia (MM, Waldenstrom) w incr in light
chain -> deposit in liver, heart, kidney -> tx chemo + stem cell transplant
AA (secondary): systemic autoimmune/infex (RA, IBD) -> renal dysfunx (congo red) -> tx underlying
condition
Transthyretin
Panc adenocarcinoma (RF, location, dx, tx) Answer: RF: age >50, smoking, DM, chron panc
Location: head -> obstruct CBD
Dx: abd US -> CT
,Tx: surg + chemorad
Dermatomyositis (PE, dx, tx) Answer: PE: PROX muscle weak, gottron papules, heliotrope rash, V-
sign (eczematous rash on ant neck)
Dx: high CK, high aldolase -> muscle biopsy (PERImysial inflam, musc fiber necrosis, degen, atrophy)
anti-Jo, anti-Mi
Tx: sun protection -> HD steroids, HCQ -> MTX, azothioprine
Status epilepticus (criteria, mgmt) Answer: Sz >5mins or 2+ seizures without returning to normal in
between
Mgmt:
-ABC, BGL (<60 give B1 + D50W), CBC, CMP, Mg
-1st line: diazepam, lorazepam, IM midazolam (if don't work -> intubate w propofol)
-2nd line: phenytoin, fosphenytoin, valproate, levetir
-3rd line: pentobarb, propofol, midazolam (IV), thiopental
Acute bact prostatitis (etio, tx) Answer: Etio: 80% E coli (also Kleb, Pseudo, Enterobacter, Proteus)
-Usually spont
-Can be from Foley
Tx: TMP-SMX or fluoro
-Alternative: amp-gent
, Epididymitis (etio & tx by age) Answer: <35yo: Neis & gon -> ceftriaxone + doxy
>35yo: Ecoli, pseudo -> fluoro
Dx: US to r/o torsion, urethral swab, UA
Relapsing polychondritis (who, pres, sequelae, dx, mgmt) Answer: Who: 40-60yo
Pres: episodic bilat auricular inflam, vertigo, arthrlagia, saddle nose, Crohns
*Affects ears, nose, laryngotrach, joints -> hearing loss, cardiac, renal dz
Dx: HLA-DR4, biopsy
Mgmt: steroids, dapsone
Breast abscess (dx, tx) Answer: Dx: Clinical
*US if unknown cellulitis vs abscess
Tx:
-Drainage + abx
-Dicloxicllin, cefalexin
*MRSA: Bactrim or clinda
Raloxifene moa (agonist vs antagonist) and SE Answer: SERM
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