The total number of combinations for choosing 8 questions out of 10 is 45. This is calculated using the formula 10! / (8! * 2!), which accounts for the different ways to leave out 2 questions. Initially, there are 90 combinations when considering the order of selection, but this is adjusted by dividing by 2 to eliminate duplicates. The discussion highlights the use of combinatorial mathematics to solve such problems. Understanding this concept can be facilitated by using a calculator with combination functions.