COMSAE PHASE 2 STYLE PRACTICE
EXAM (FORM 112 SIMULATION) Exam
Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant download Pdf
1. A 67-year-old man presents with crushing chest pain radiating to the left arm.
ECG shows ST elevation in leads II, III, and aVF. Which artery is MOST likely
occluded?
A. Left anterior descending artery
B. Right coronary artery
C. Circumflex artery
D. Left main coronary artery
Answer: B. Right coronary artery
Rationale: Inferior wall MI is most commonly due to RCA occlusion.
2. A patient with COPD develops worsening dyspnea and elevated PaCO₂. What
is the BEST initial management?
A. High-flow oxygen only
B. Noninvasive positive pressure ventilation
C. Immediate intubation for all patients
D. Diuretics
,Answer: B. Noninvasive positive pressure ventilation
Rationale: BiPAP reduces CO₂ retention and work of breathing.
3. A 24-year-old woman presents with tremor, weight loss, and heat
intolerance. Labs show low TSH and elevated T4. What is the MOST likely
diagnosis?
A. Hashimoto thyroiditis
B. Graves disease
C. Thyroid cancer
D. Subacute thyroiditis only
Answer: B. Graves disease
Rationale: Autoimmune hyperthyroidism causes elevated T4 and suppressed TSH.
4. A newborn fails to pass meconium within 48 hours. Which condition is MOST
likely?
A. Hirschsprung disease
B. Pyloric stenosis
C. Intussusception
D. Necrotizing enterocolitis
Answer: A. Hirschsprung disease
Rationale: Aganglionic colon leads to obstruction.
5. A 45-year-old man has painless hematuria. Most appropriate next diagnostic
step?
A. Urinalysis only
B. Cystoscopy
C. Empiric antibiotics
D. KUB X-ray
Answer: B. Cystoscopy
Rationale: Hematuria in adults requires bladder cancer evaluation.
,6. A patient presents with fever, neck stiffness, and photophobia. CSF shows
neutrophils, low glucose, high protein. Diagnosis?
A. Viral meningitis
B. Bacterial meningitis
C. Fungal meningitis
D. TB meningitis
Answer: B. Bacterial meningitis
Rationale: Neutrophils + low glucose indicate bacterial infection.
7. A 60-year-old smoker has weight loss and cough. CXR shows hilar mass. Most
likely cancer type?
A. Small cell carcinoma
B. Adenocarcinoma
C. Mesothelioma
D. Hamartoma
Answer: A. Small cell carcinoma
Rationale: Strongly associated with smoking and central tumors.
8. A child presents with “steeple sign” on neck X-ray. Diagnosis?
A. Epiglottitis
B. Croup
C. Asthma
D. Bronchiolitis
Answer: B. Croup
Rationale: Subglottic narrowing = parainfluenza infection.
9. A patient on heparin develops thrombocytopenia. Most likely diagnosis?
, A. ITP
B. HIT
C. TTP
D. DIC
Answer: B. HIT
Rationale: Heparin-induced thrombocytopenia is immune-mediated.
10. A pregnant woman at 34 weeks has painless vaginal bleeding. Diagnosis?
A. Placenta previa
B. Placental abruption
C. Uterine rupture
D. Cervical cancer
Answer: A. Placenta previa
Rationale: Painless third-trimester bleeding is classic.
11. A patient has elevated AST/ALT ratio >2 and chronic alcohol use. Diagnosis?
A. NAFLD
B. Alcoholic hepatitis
C. Hepatitis B
D. Autoimmune hepatitis
Answer: B. Alcoholic hepatitis
Rationale: AST predominance is characteristic.
12. A child has nocturnal cough, wheezing, and allergic rhinitis. Diagnosis?
A. Cystic fibrosis
B. Asthma
C. Pneumonia
D. Bronchiectasis
EXAM (FORM 112 SIMULATION) Exam
Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant download Pdf
1. A 67-year-old man presents with crushing chest pain radiating to the left arm.
ECG shows ST elevation in leads II, III, and aVF. Which artery is MOST likely
occluded?
A. Left anterior descending artery
B. Right coronary artery
C. Circumflex artery
D. Left main coronary artery
Answer: B. Right coronary artery
Rationale: Inferior wall MI is most commonly due to RCA occlusion.
2. A patient with COPD develops worsening dyspnea and elevated PaCO₂. What
is the BEST initial management?
A. High-flow oxygen only
B. Noninvasive positive pressure ventilation
C. Immediate intubation for all patients
D. Diuretics
,Answer: B. Noninvasive positive pressure ventilation
Rationale: BiPAP reduces CO₂ retention and work of breathing.
3. A 24-year-old woman presents with tremor, weight loss, and heat
intolerance. Labs show low TSH and elevated T4. What is the MOST likely
diagnosis?
A. Hashimoto thyroiditis
B. Graves disease
C. Thyroid cancer
D. Subacute thyroiditis only
Answer: B. Graves disease
Rationale: Autoimmune hyperthyroidism causes elevated T4 and suppressed TSH.
4. A newborn fails to pass meconium within 48 hours. Which condition is MOST
likely?
A. Hirschsprung disease
B. Pyloric stenosis
C. Intussusception
D. Necrotizing enterocolitis
Answer: A. Hirschsprung disease
Rationale: Aganglionic colon leads to obstruction.
5. A 45-year-old man has painless hematuria. Most appropriate next diagnostic
step?
A. Urinalysis only
B. Cystoscopy
C. Empiric antibiotics
D. KUB X-ray
Answer: B. Cystoscopy
Rationale: Hematuria in adults requires bladder cancer evaluation.
,6. A patient presents with fever, neck stiffness, and photophobia. CSF shows
neutrophils, low glucose, high protein. Diagnosis?
A. Viral meningitis
B. Bacterial meningitis
C. Fungal meningitis
D. TB meningitis
Answer: B. Bacterial meningitis
Rationale: Neutrophils + low glucose indicate bacterial infection.
7. A 60-year-old smoker has weight loss and cough. CXR shows hilar mass. Most
likely cancer type?
A. Small cell carcinoma
B. Adenocarcinoma
C. Mesothelioma
D. Hamartoma
Answer: A. Small cell carcinoma
Rationale: Strongly associated with smoking and central tumors.
8. A child presents with “steeple sign” on neck X-ray. Diagnosis?
A. Epiglottitis
B. Croup
C. Asthma
D. Bronchiolitis
Answer: B. Croup
Rationale: Subglottic narrowing = parainfluenza infection.
9. A patient on heparin develops thrombocytopenia. Most likely diagnosis?
, A. ITP
B. HIT
C. TTP
D. DIC
Answer: B. HIT
Rationale: Heparin-induced thrombocytopenia is immune-mediated.
10. A pregnant woman at 34 weeks has painless vaginal bleeding. Diagnosis?
A. Placenta previa
B. Placental abruption
C. Uterine rupture
D. Cervical cancer
Answer: A. Placenta previa
Rationale: Painless third-trimester bleeding is classic.
11. A patient has elevated AST/ALT ratio >2 and chronic alcohol use. Diagnosis?
A. NAFLD
B. Alcoholic hepatitis
C. Hepatitis B
D. Autoimmune hepatitis
Answer: B. Alcoholic hepatitis
Rationale: AST predominance is characteristic.
12. A child has nocturnal cough, wheezing, and allergic rhinitis. Diagnosis?
A. Cystic fibrosis
B. Asthma
C. Pneumonia
D. Bronchiectasis
