COMSAE Phase 2 – Form 109 Exam
Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant download Pdf
1.
A 68-year-old man presents with chest pain radiating to the left arm, diaphoresis,
and nausea. 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. Left circumflex artery
D. Left main coronary artery
Answer: B. Right coronary artery
Rationale: Inferior wall MI (II, III, aVF) is most commonly due to RCA occlusion.
2.
A patient with COPD has chronic CO₂ retention. What is the PRIMARY renal
compensation?
A. Increased bicarbonate excretion
B. Increased bicarbonate retention
C. Increased hydrogen excretion only
D. Decreased sodium reabsorption
Answer: B. Increased bicarbonate retention
Rationale: Kidneys compensate respiratory acidosis by retaining HCO₃⁻.
,3.
A newborn has a holosystolic murmur at the left lower sternal border and failure
to thrive. Most likely diagnosis?
A. Atrial septal defect
B. Ventricular septal defect
C. Patent ductus arteriosus
D. Tetralogy of Fallot
Answer: B. Ventricular septal defect
Rationale: VSD causes holosystolic murmur and CHF symptoms in infants.
4.
A patient present with tremor, heat intolerance, and weight loss. Labs show low
TSH and high T3/T4. Likely diagnosis?
A. Hashimoto thyroiditis
B. Graves’ disease
C. Thyroid cancer
D. Secondary hypothyroidism
Answer: B. Graves’ disease
Rationale: Autoimmune TSH receptor stimulation causes hyperthyroidism.
5.
A 25-year-old has fever, flank pain, and costovertebral angle tenderness. Most
likely diagnosis?
A. Cystitis
B. Pyelonephritis
C. Glomerulonephritis
D. Kidney stone
,Answer: B. Pyelonephritis
Rationale: Systemic symptoms + CVA tenderness indicate upper UTI.
6.
A patient has asthma exacerbation. Which drug is FIRST-line for acute relief?
A. Inhaled corticosteroid
B. Albuterol
C. Montelukast
D. Theophylline
Answer: B. Albuterol
Rationale: Short-acting beta-agonists provide immediate bronchodilation.
7.
A patient has right upper quadrant pain after fatty meals. Ultrasound shows
gallstones. Diagnosis?
A. Hepatitis
B. Cholelithiasis
C. Pancreatitis
D. Gastritis
Answer: B. Cholelithiasis
Rationale: Gallstones cause biliary colic after fatty meals.
8.
A patient presents with metabolic acidosis and elevated anion gap. Most likely
cause?
A. Vomiting
B. Diarrhea
C. Lactic acidosis
D. Hyperventilation
, Answer: C. Lactic acidosis
Rationale: Lactic acid increases anion gap metabolic acidosis.
9.
A 60-year-old smoker has hematuria and flank mass. Most likely diagnosis?
A. Renal cell carcinoma
B. Bladder infection
C. Kidney stone
D. Polycystic kidney disease
Answer: A. Renal cell carcinoma
Rationale: Classic triad includes hematuria and flank mass.
10.
A patient has difficulty extending wrist after humeral shaft fracture. Nerve
injured?
A. Median nerve
B. Radial nerve
C. Ulnar nerve
D. Axillary nerve
Answer: B. Radial nerve
Rationale: Radial nerve injury causes wrist drop.
11.
A child presents with slapped cheek rash. Causative agent?
A. Rubella virus
B. Parvovirus B19
C. Measles virus
D. Varicella zoster virus
Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant download Pdf
1.
A 68-year-old man presents with chest pain radiating to the left arm, diaphoresis,
and nausea. 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. Left circumflex artery
D. Left main coronary artery
Answer: B. Right coronary artery
Rationale: Inferior wall MI (II, III, aVF) is most commonly due to RCA occlusion.
2.
A patient with COPD has chronic CO₂ retention. What is the PRIMARY renal
compensation?
A. Increased bicarbonate excretion
B. Increased bicarbonate retention
C. Increased hydrogen excretion only
D. Decreased sodium reabsorption
Answer: B. Increased bicarbonate retention
Rationale: Kidneys compensate respiratory acidosis by retaining HCO₃⁻.
,3.
A newborn has a holosystolic murmur at the left lower sternal border and failure
to thrive. Most likely diagnosis?
A. Atrial septal defect
B. Ventricular septal defect
C. Patent ductus arteriosus
D. Tetralogy of Fallot
Answer: B. Ventricular septal defect
Rationale: VSD causes holosystolic murmur and CHF symptoms in infants.
4.
A patient present with tremor, heat intolerance, and weight loss. Labs show low
TSH and high T3/T4. Likely diagnosis?
A. Hashimoto thyroiditis
B. Graves’ disease
C. Thyroid cancer
D. Secondary hypothyroidism
Answer: B. Graves’ disease
Rationale: Autoimmune TSH receptor stimulation causes hyperthyroidism.
5.
A 25-year-old has fever, flank pain, and costovertebral angle tenderness. Most
likely diagnosis?
A. Cystitis
B. Pyelonephritis
C. Glomerulonephritis
D. Kidney stone
,Answer: B. Pyelonephritis
Rationale: Systemic symptoms + CVA tenderness indicate upper UTI.
6.
A patient has asthma exacerbation. Which drug is FIRST-line for acute relief?
A. Inhaled corticosteroid
B. Albuterol
C. Montelukast
D. Theophylline
Answer: B. Albuterol
Rationale: Short-acting beta-agonists provide immediate bronchodilation.
7.
A patient has right upper quadrant pain after fatty meals. Ultrasound shows
gallstones. Diagnosis?
A. Hepatitis
B. Cholelithiasis
C. Pancreatitis
D. Gastritis
Answer: B. Cholelithiasis
Rationale: Gallstones cause biliary colic after fatty meals.
8.
A patient presents with metabolic acidosis and elevated anion gap. Most likely
cause?
A. Vomiting
B. Diarrhea
C. Lactic acidosis
D. Hyperventilation
, Answer: C. Lactic acidosis
Rationale: Lactic acid increases anion gap metabolic acidosis.
9.
A 60-year-old smoker has hematuria and flank mass. Most likely diagnosis?
A. Renal cell carcinoma
B. Bladder infection
C. Kidney stone
D. Polycystic kidney disease
Answer: A. Renal cell carcinoma
Rationale: Classic triad includes hematuria and flank mass.
10.
A patient has difficulty extending wrist after humeral shaft fracture. Nerve
injured?
A. Median nerve
B. Radial nerve
C. Ulnar nerve
D. Axillary nerve
Answer: B. Radial nerve
Rationale: Radial nerve injury causes wrist drop.
11.
A child presents with slapped cheek rash. Causative agent?
A. Rubella virus
B. Parvovirus B19
C. Measles virus
D. Varicella zoster virus
