COMSAE Phase 1 Form 115 Practice Exam Questions And Correct
Answers (Verified Answers) Plus Rationales 2025|2026 Q&A | Instant
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,General Medicine & Pathophysiology
Q1. A 24-year-old male presents with acute onset of severe right lower
quadrant pain, nausea, and fever. Physical exam reveals McBurney's
point tenderness. Which structure is most likely inflamed?
A) Cecum
B) Appendix
C) Ileum
D) Sigmoid colon
Correct ,,,,,answer,,,: B
Rationale: Acute appendicitis classically presents with periumbilical pain
migrating to RLQ (McBurney's point), nausea, fever, and localized
tenderness. The appendix is a blind-ended tube arising from the cecum;
inflammation causes localized peritonitis at McBurney's point .
Q2. A 45-year-old female with type 2 diabetes presents with polyuria,
polydipsia, and blurred vision. Laboratory studies show hyperglycemia.
Which hormone deficiency is primarily responsible for her symptoms?
A) Glucagon
B) Insulin
C) Cortisol
D) Epinephrine
Correct ,,,,,answer,,,: B
Rationale: Insulin deficiency or resistance in type 2 diabetes leads to
hyperglycemia, causing osmotic diuresis (polyuria), dehydration
(polydipsia), and lens osmotic changes (blurred vision). Glucagon raises
glucose; cortisol and epinephrine are counterregulatory hormones .
,Q3. Which cranial nerve is tested by asking a patient to shrug their
shoulders against resistance?
A) CN IX (Glossopharyngeal)
B) CN X (Vagus)
C) CN XI (Spinal accessory)
D) CN XII (Hypoglossal)
Correct ,,,,,answer,,,: C
Rationale: CN XI innervates the sternocleidomastoid and trapezius
muscles. Shoulder shrug against resistance tests trapezius function. CN
IX/X test gag reflex; CN XII tests tongue protrusion .
Q4. A 60-year-old male with chronic alcohol use presents with
confusion, ataxia, and ophthalmoplegia. Which vitamin deficiency is
most likely?
A) Vitamin B1 (Thiamine)
B) Vitamin B12 (Cobalamin)
C) Vitamin C (Ascorbic acid)
D) Vitamin D (Cholecalciferol)
Correct ,,,,,answer,,,: A
Rationale: Wernicke encephalopathy (confusion, ataxia,
ophthalmoplegia) results from thiamine deficiency, common in chronic
alcoholism due to poor intake, malabsorption, and impaired utilization .
Q5. A 55-year-old male presents with crushing substernal chest pain
radiating to the left arm, diaphoresis, and nausea. ECG shows ST-
segment elevation in leads II, III, and aVF. Which coronary artery is
most likely occluded?
, A) Left anterior descending (LAD)
B) Left circumflex (LCx)
C) Right coronary artery (RCA)
D) Posterior descending artery (PDA)
Correct ,,,,,answer,,,: C
Rationale: Inferior wall MI (ST elevation in II, III, aVF) is typically caused by
RCA occlusion. LAD occlusion causes anterior MI (V1-V4); LCx causes
lateral MI (I, aVL, V5-V6); PDA is usually a branch of RCA .
Q6. A 24-year-old male presents with a cough and night sweats. A chest
X-ray shows a cavitary lesion in the right upper lobe. Sputum culture
grows acid-fast bacilli. Which cytokine is primarily responsible for the
formation of the granulomas seen in this patient?
A) IL-4
B) IL-10
C) IFN-gamma
D) IL-5
Correct ,,,,,answer,,,: C
Rationale: Macrophages present antigen to CD4+ T-cells, which secrete
IL-12 to induce Th1 differentiation. Th1 cells then secrete IFN-gamma to
activate macrophages, leading to granuloma formation in M. tuberculosis
infection .
Q7. A 24-year-old woman presents with fever, fatigue, and pallor.
Laboratory tests reveal hemoglobin of 8 g/dL, MCV 70 fL, and serum
ferritin of 5 ng/mL. What is the most likely diagnosis?
A) Vitamin B12 deficiency
B) Iron deficiency anemia
Answers (Verified Answers) Plus Rationales 2025|2026 Q&A | Instant
Download Pdf
,General Medicine & Pathophysiology
Q1. A 24-year-old male presents with acute onset of severe right lower
quadrant pain, nausea, and fever. Physical exam reveals McBurney's
point tenderness. Which structure is most likely inflamed?
A) Cecum
B) Appendix
C) Ileum
D) Sigmoid colon
Correct ,,,,,answer,,,: B
Rationale: Acute appendicitis classically presents with periumbilical pain
migrating to RLQ (McBurney's point), nausea, fever, and localized
tenderness. The appendix is a blind-ended tube arising from the cecum;
inflammation causes localized peritonitis at McBurney's point .
Q2. A 45-year-old female with type 2 diabetes presents with polyuria,
polydipsia, and blurred vision. Laboratory studies show hyperglycemia.
Which hormone deficiency is primarily responsible for her symptoms?
A) Glucagon
B) Insulin
C) Cortisol
D) Epinephrine
Correct ,,,,,answer,,,: B
Rationale: Insulin deficiency or resistance in type 2 diabetes leads to
hyperglycemia, causing osmotic diuresis (polyuria), dehydration
(polydipsia), and lens osmotic changes (blurred vision). Glucagon raises
glucose; cortisol and epinephrine are counterregulatory hormones .
,Q3. Which cranial nerve is tested by asking a patient to shrug their
shoulders against resistance?
A) CN IX (Glossopharyngeal)
B) CN X (Vagus)
C) CN XI (Spinal accessory)
D) CN XII (Hypoglossal)
Correct ,,,,,answer,,,: C
Rationale: CN XI innervates the sternocleidomastoid and trapezius
muscles. Shoulder shrug against resistance tests trapezius function. CN
IX/X test gag reflex; CN XII tests tongue protrusion .
Q4. A 60-year-old male with chronic alcohol use presents with
confusion, ataxia, and ophthalmoplegia. Which vitamin deficiency is
most likely?
A) Vitamin B1 (Thiamine)
B) Vitamin B12 (Cobalamin)
C) Vitamin C (Ascorbic acid)
D) Vitamin D (Cholecalciferol)
Correct ,,,,,answer,,,: A
Rationale: Wernicke encephalopathy (confusion, ataxia,
ophthalmoplegia) results from thiamine deficiency, common in chronic
alcoholism due to poor intake, malabsorption, and impaired utilization .
Q5. A 55-year-old male presents with crushing substernal chest pain
radiating to the left arm, diaphoresis, and nausea. ECG shows ST-
segment elevation in leads II, III, and aVF. Which coronary artery is
most likely occluded?
, A) Left anterior descending (LAD)
B) Left circumflex (LCx)
C) Right coronary artery (RCA)
D) Posterior descending artery (PDA)
Correct ,,,,,answer,,,: C
Rationale: Inferior wall MI (ST elevation in II, III, aVF) is typically caused by
RCA occlusion. LAD occlusion causes anterior MI (V1-V4); LCx causes
lateral MI (I, aVL, V5-V6); PDA is usually a branch of RCA .
Q6. A 24-year-old male presents with a cough and night sweats. A chest
X-ray shows a cavitary lesion in the right upper lobe. Sputum culture
grows acid-fast bacilli. Which cytokine is primarily responsible for the
formation of the granulomas seen in this patient?
A) IL-4
B) IL-10
C) IFN-gamma
D) IL-5
Correct ,,,,,answer,,,: C
Rationale: Macrophages present antigen to CD4+ T-cells, which secrete
IL-12 to induce Th1 differentiation. Th1 cells then secrete IFN-gamma to
activate macrophages, leading to granuloma formation in M. tuberculosis
infection .
Q7. A 24-year-old woman presents with fever, fatigue, and pallor.
Laboratory tests reveal hemoglobin of 8 g/dL, MCV 70 fL, and serum
ferritin of 5 ng/mL. What is the most likely diagnosis?
A) Vitamin B12 deficiency
B) Iron deficiency anemia
