COMSAE Phase 2 – Form 116 (current)
Questions With Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf.
1. A 67-year-old man with a history of smoking presents with
painless hematuria and weight loss. Urinalysis confirms blood but
no infection. Which of the following is the most likely diagnosis?
A. Renal cell carcinoma
B. Transitional cell carcinoma of the bladder
C. Benign prostatic hyperplasia
D. Acute pyelonephritis
E. Ureteral stone
Correct Answer: B. Transitional cell carcinoma of the bladder
Painless hematuria in an older smoker is highly suggestive of bladder
cancer, especially transitional cell carcinoma (urothelial carcinoma).
Smoking is the strongest risk factor. Renal cell carcinoma may also
present with hematuria but often includes flank pain and a palpable
mass.
2. A 24-year-old woman presents with fatigue, heat intolerance,
weight loss, and palpitations. Physical examination reveals
exophthalmos and diffuse goiter. Which antibody is most likely
elevated?
,A. Anti-thyroid peroxidase antibody
B. Anti-thyroglobulin antibody
C. Thyroid-stimulating immunoglobulin
D. Anti-TSH antibody
E. Anti-mitochondrial antibody
Correct Answer: C. Thyroid-stimulating immunoglobulin
This patient has Graves disease, characterized by hyperthyroidism,
diffuse goiter, and ophthalmopathy. Thyroid-stimulating
immunoglobulins activate TSH receptors, leading to excessive thyroid
hormone production.
3. A 58-year-old woman suddenly develops unilateral facial drooping
involving the mouth but sparing the forehead. Which artery is
most likely occluded?
A. Anterior cerebral artery
B. Posterior cerebral artery
C. Middle cerebral artery
D. Basilar artery
E. Vertebral artery
Correct Answer: C. Middle cerebral artery
Forehead sparing suggests an upper motor neuron lesion, commonly
due to stroke affecting the contralateral motor cortex supplied by the
middle cerebral artery. The forehead receives bilateral cortical
innervation.
4. A newborn develops bilious vomiting shortly after birth.
Abdominal radiograph demonstrates a “double bubble” sign.
Which condition is most likely present?
,A. Hirschsprung disease
B. Duodenal atresia
C. Pyloric stenosis
D. Meconium ileus
E. Intussusception
Correct Answer: B. Duodenal atresia
The “double bubble” sign indicates air in the stomach and proximal
duodenum, classic for duodenal atresia. Bilious vomiting in a newborn is
highly suggestive of intestinal obstruction distal to the ampulla of Vater.
5. A patient develops fever, hypotension, and diffuse erythematous
rash after prolonged tampon use. Which organism is the most
likely cause?
A. Streptococcus pyogenes
B. Escherichia coli
C. Staphylococcus aureus
D. Clostridium difficile
E. Neisseria meningitidis
Correct Answer: C. Staphylococcus aureus
Tampon-associated toxic shock syndrome is caused by toxin-producing
Staphylococcus aureus. TSST-1 acts as a superantigen, triggering
massive cytokine release leading to fever, rash, and hypotension.
6. A 42-year-old man presents with epigastric pain relieved by eating.
Endoscopy reveals a duodenal ulcer. Which organism is most
commonly implicated?
, A. Giardia lamblia
B. Helicobacter pylori
C. Campylobacter jejuni
D. Staphylococcus epidermidis
E. Clostridium perfringens
Correct Answer: B. Helicobacter pylori
Duodenal ulcers classically improve with meals and are strongly
associated with Helicobacter pylori infection. The organism increases
gastrin secretion and reduces somatostatin activity.
7. A 19-year-old college student presents with fever, neck stiffness,
and petechial rash. CSF reveals gram-negative diplococci. Which
organism is responsible?
A. Streptococcus pneumoniae
B. Listeria monocytogenes
C. Neisseria meningitidis
D. Haemophilus influenzae
E. Staphylococcus aureus
Correct Answer: C. Neisseria meningitidis
Neisseria meningitidis causes bacterial meningitis in young adults and
often presents with petechial rash due to endotoxin-mediated vascular
injury. Gram-negative diplococci are diagnostic.
8. A patient with chronic alcohol use develops confusion,
ophthalmoplegia, and ataxia. Which vitamin deficiency is
responsible?
Questions With Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf.
1. A 67-year-old man with a history of smoking presents with
painless hematuria and weight loss. Urinalysis confirms blood but
no infection. Which of the following is the most likely diagnosis?
A. Renal cell carcinoma
B. Transitional cell carcinoma of the bladder
C. Benign prostatic hyperplasia
D. Acute pyelonephritis
E. Ureteral stone
Correct Answer: B. Transitional cell carcinoma of the bladder
Painless hematuria in an older smoker is highly suggestive of bladder
cancer, especially transitional cell carcinoma (urothelial carcinoma).
Smoking is the strongest risk factor. Renal cell carcinoma may also
present with hematuria but often includes flank pain and a palpable
mass.
2. A 24-year-old woman presents with fatigue, heat intolerance,
weight loss, and palpitations. Physical examination reveals
exophthalmos and diffuse goiter. Which antibody is most likely
elevated?
,A. Anti-thyroid peroxidase antibody
B. Anti-thyroglobulin antibody
C. Thyroid-stimulating immunoglobulin
D. Anti-TSH antibody
E. Anti-mitochondrial antibody
Correct Answer: C. Thyroid-stimulating immunoglobulin
This patient has Graves disease, characterized by hyperthyroidism,
diffuse goiter, and ophthalmopathy. Thyroid-stimulating
immunoglobulins activate TSH receptors, leading to excessive thyroid
hormone production.
3. A 58-year-old woman suddenly develops unilateral facial drooping
involving the mouth but sparing the forehead. Which artery is
most likely occluded?
A. Anterior cerebral artery
B. Posterior cerebral artery
C. Middle cerebral artery
D. Basilar artery
E. Vertebral artery
Correct Answer: C. Middle cerebral artery
Forehead sparing suggests an upper motor neuron lesion, commonly
due to stroke affecting the contralateral motor cortex supplied by the
middle cerebral artery. The forehead receives bilateral cortical
innervation.
4. A newborn develops bilious vomiting shortly after birth.
Abdominal radiograph demonstrates a “double bubble” sign.
Which condition is most likely present?
,A. Hirschsprung disease
B. Duodenal atresia
C. Pyloric stenosis
D. Meconium ileus
E. Intussusception
Correct Answer: B. Duodenal atresia
The “double bubble” sign indicates air in the stomach and proximal
duodenum, classic for duodenal atresia. Bilious vomiting in a newborn is
highly suggestive of intestinal obstruction distal to the ampulla of Vater.
5. A patient develops fever, hypotension, and diffuse erythematous
rash after prolonged tampon use. Which organism is the most
likely cause?
A. Streptococcus pyogenes
B. Escherichia coli
C. Staphylococcus aureus
D. Clostridium difficile
E. Neisseria meningitidis
Correct Answer: C. Staphylococcus aureus
Tampon-associated toxic shock syndrome is caused by toxin-producing
Staphylococcus aureus. TSST-1 acts as a superantigen, triggering
massive cytokine release leading to fever, rash, and hypotension.
6. A 42-year-old man presents with epigastric pain relieved by eating.
Endoscopy reveals a duodenal ulcer. Which organism is most
commonly implicated?
, A. Giardia lamblia
B. Helicobacter pylori
C. Campylobacter jejuni
D. Staphylococcus epidermidis
E. Clostridium perfringens
Correct Answer: B. Helicobacter pylori
Duodenal ulcers classically improve with meals and are strongly
associated with Helicobacter pylori infection. The organism increases
gastrin secretion and reduces somatostatin activity.
7. A 19-year-old college student presents with fever, neck stiffness,
and petechial rash. CSF reveals gram-negative diplococci. Which
organism is responsible?
A. Streptococcus pneumoniae
B. Listeria monocytogenes
C. Neisseria meningitidis
D. Haemophilus influenzae
E. Staphylococcus aureus
Correct Answer: C. Neisseria meningitidis
Neisseria meningitidis causes bacterial meningitis in young adults and
often presents with petechial rash due to endotoxin-mediated vascular
injury. Gram-negative diplococci are diagnostic.
8. A patient with chronic alcohol use develops confusion,
ophthalmoplegia, and ataxia. Which vitamin deficiency is
responsible?
