COMSAE PHASE 2 FORM 110 — Exam
Study Guide – Practice Questions with
Verified Answers with Rationales.
GRADED A+. Latest 2026/2027 Update
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1.
A 56-year-old man presents with substernal chest pain that began 1 hour ago
while he was mowing the lawn. The pain is pressure-like and radiates to the left
arm. ECG shows ST elevation in leads II, III, and aVF. Next best step in
management?
• A. Give sublingual nitroglycerin
• B. Administer aspirin and activate cardiac catheterization lab
• C. Start IV heparin only
• D. Order a chest X-ray
- Answer✔✔-B. Administer aspirin and activate cardiac catheterization lab ST
elevation in II, III, aVF = inferior STEMI. Reperfusion therapy is required (PCI if
available). Aspirin reduces mortality. Chest X-ray is not appropriate initially, and
nitro is supportive but not definitive.
2.
A 25-year-old woman presents with fever, dysuria, and flank pain. Urinalysis shows
WBC casts. Best treatment?
• A. Oral nitrofurantoin
• B. IV ceftriaxone
• C. Oral ciprofloxacin
• D. IV vancomycin
- Answer✔✔-B. IV ceftriaxone
WBC casts indicate pyelonephritis. Inpatient IV therapy (ceftriaxone) is indicated
for systemic symptoms. Nitrofurantoin is for simple cystitis, not pyelo.
3.
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A 60-year-old man with chronic alcohol use presents with confusion, ataxia, and
ophthalmoplegia. Which vitamin deficiency is most likely?
• A. Vitamin B1 (thiamine)
• B. Vitamin B6 (pyridoxine)
• C. Vitamin B12 (cobalamin)
• D. Vitamin C
- Answer✔✔-A. Vitamin B1 (thiamine)
Classic Wernicke encephalopathy triad: confusion, ataxia, ophthalmoplegia →
thiamine deficiency.
4.
A 32-year-old woman presents with fatigue, weight gain, constipation, and dry
skin. TSH is elevated. Best treatment?
• A. Methimazole
• B. Levothyroxine
• C. Radioactive iodine
• D. Propranolol
- Answer✔✔-B. Levothyroxine
Primary hypothyroidism (high TSH). Levothyroxine is standard treatment.
5.
A 7-year-old boy has a sore throat, fever, and sandpaper-like rash. Rapid strep
antigen test is positive. Best treatment?
• A. Amoxicillin
• B. Azithromycin
• C. Ciprofloxacin
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• D. Supportive care only
- Answer✔✔-A. Amoxicillin
Scarlet fever is caused by Group A strep. Treat with penicillin or amoxicillin.
6.
A 19-year-old male presents after a motorcycle accident. He is hypotensive, has
distended neck veins, and tracheal deviation to the left. Best initial management?
• A. Endotracheal intubation
• B. Needle thoracostomy
• C. Chest tube placement
• D. IV fluids
- Answer✔✔-B. Needle thoracostomy
Tension pneumothorax → immediate decompression with needle thoracostomy,
followed by chest tube.
7.
A 72-year-old man has a resting tremor, bradykinesia, and cogwheel rigidity. Most
appropriate initial therapy?
• A. Levodopa-carbidopa
• B. Bromocriptine
• C. Selegiline
• D. Amantadine
- Answer✔✔-A. Levodopa-carbidopa
Parkinson’s first-line therapy in elderly is levodopa-carbidopa. Dopamine agonists
are more often used in younger patients.
Study Guide – Practice Questions with
Verified Answers with Rationales.
GRADED A+. Latest 2026/2027 Update
, lOMoARcPSD|65951791
1.
A 56-year-old man presents with substernal chest pain that began 1 hour ago
while he was mowing the lawn. The pain is pressure-like and radiates to the left
arm. ECG shows ST elevation in leads II, III, and aVF. Next best step in
management?
• A. Give sublingual nitroglycerin
• B. Administer aspirin and activate cardiac catheterization lab
• C. Start IV heparin only
• D. Order a chest X-ray
- Answer✔✔-B. Administer aspirin and activate cardiac catheterization lab ST
elevation in II, III, aVF = inferior STEMI. Reperfusion therapy is required (PCI if
available). Aspirin reduces mortality. Chest X-ray is not appropriate initially, and
nitro is supportive but not definitive.
2.
A 25-year-old woman presents with fever, dysuria, and flank pain. Urinalysis shows
WBC casts. Best treatment?
• A. Oral nitrofurantoin
• B. IV ceftriaxone
• C. Oral ciprofloxacin
• D. IV vancomycin
- Answer✔✔-B. IV ceftriaxone
WBC casts indicate pyelonephritis. Inpatient IV therapy (ceftriaxone) is indicated
for systemic symptoms. Nitrofurantoin is for simple cystitis, not pyelo.
3.
, lOMoARcPSD|65951791
A 60-year-old man with chronic alcohol use presents with confusion, ataxia, and
ophthalmoplegia. Which vitamin deficiency is most likely?
• A. Vitamin B1 (thiamine)
• B. Vitamin B6 (pyridoxine)
• C. Vitamin B12 (cobalamin)
• D. Vitamin C
- Answer✔✔-A. Vitamin B1 (thiamine)
Classic Wernicke encephalopathy triad: confusion, ataxia, ophthalmoplegia →
thiamine deficiency.
4.
A 32-year-old woman presents with fatigue, weight gain, constipation, and dry
skin. TSH is elevated. Best treatment?
• A. Methimazole
• B. Levothyroxine
• C. Radioactive iodine
• D. Propranolol
- Answer✔✔-B. Levothyroxine
Primary hypothyroidism (high TSH). Levothyroxine is standard treatment.
5.
A 7-year-old boy has a sore throat, fever, and sandpaper-like rash. Rapid strep
antigen test is positive. Best treatment?
• A. Amoxicillin
• B. Azithromycin
• C. Ciprofloxacin
, lOMoARcPSD|65951791
• D. Supportive care only
- Answer✔✔-A. Amoxicillin
Scarlet fever is caused by Group A strep. Treat with penicillin or amoxicillin.
6.
A 19-year-old male presents after a motorcycle accident. He is hypotensive, has
distended neck veins, and tracheal deviation to the left. Best initial management?
• A. Endotracheal intubation
• B. Needle thoracostomy
• C. Chest tube placement
• D. IV fluids
- Answer✔✔-B. Needle thoracostomy
Tension pneumothorax → immediate decompression with needle thoracostomy,
followed by chest tube.
7.
A 72-year-old man has a resting tremor, bradykinesia, and cogwheel rigidity. Most
appropriate initial therapy?
• A. Levodopa-carbidopa
• B. Bromocriptine
• C. Selegiline
• D. Amantadine
- Answer✔✔-A. Levodopa-carbidopa
Parkinson’s first-line therapy in elderly is levodopa-carbidopa. Dopamine agonists
are more often used in younger patients.
