COMSAE Phase 2 – BSA 118 Questions With
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant Download Pdf
Question 1
A 62-year-old man presents with crushing substernal chest pain
radiating to his left arm for 45 minutes. 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. Posterior descending artery
Correct answer: B
Rationale: ST elevation in leads II, III, and aVF indicates an inferior
myocardial infarction, most commonly caused by occlusion of the right
coronary artery, which typically supplies the inferior wall of the heart.
Question 2
,A 45-year-old woman presents with heat intolerance, weight loss, and
palpitations. Labs show low TSH and elevated free T4. Which condition
is the most likely cause?
A. Hashimoto thyroiditis
B. Graves disease
C. Thyroid cancer
D. Iodine deficiency
Correct answer: B
Rationale: Low TSH with elevated T4 indicates primary
hyperthyroidism. Graves disease is the most common cause and is
autoimmune, involving TSH receptor stimulation.
Question 3
A newborn fails to pass meconium within 48 hours and has abdominal
distension. Which condition is most likely?
A. Pyloric stenosis
B. Hirschsprung disease
C. Intussusception
D. Necrotizing enterocolitis
,Correct answer: B
Rationale: Failure to pass meconium within 48 hours strongly suggests
Hirschsprung disease due to absence of ganglion cells in the distal
colon.
Question 4
A patient presents with fever, neck stiffness, and altered mental status.
CSF shows neutrophilic pleocytosis, low glucose, and high protein. What
is the most likely diagnosis?
A. Viral meningitis
B. Bacterial meningitis
C. Fungal meningitis
D. Subarachnoid hemorrhage
Correct answer: B
Rationale: Bacterial meningitis typically presents with elevated
neutrophils, low CSF glucose, and high protein due to bacterial
metabolism and inflammation.
Question 5
Which medication is most appropriate for acute anaphylaxis?
, A. Diphenhydramine
B. Epinephrine
C. Albuterol
D. Prednisone
Correct answer: B
Rationale: Epinephrine is first-line treatment for anaphylaxis because
it reverses bronchoconstriction, vasodilation, and mucosal edema.
Question 6
A 30-year-old woman presents with episodic flushing, diarrhea, and
wheezing. Urine shows elevated 5-HIAA. What is the most likely
diagnosis?
A. VIPoma
B. Carcinoid syndrome
C. Zollinger-Ellison syndrome
D. Glucagonoma
Correct answer: B
Rationale: Carcinoid tumors secrete serotonin, leading to flushing,
diarrhea, and wheezing; 5-HIAA is a serotonin metabolite.
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant Download Pdf
Question 1
A 62-year-old man presents with crushing substernal chest pain
radiating to his left arm for 45 minutes. 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. Posterior descending artery
Correct answer: B
Rationale: ST elevation in leads II, III, and aVF indicates an inferior
myocardial infarction, most commonly caused by occlusion of the right
coronary artery, which typically supplies the inferior wall of the heart.
Question 2
,A 45-year-old woman presents with heat intolerance, weight loss, and
palpitations. Labs show low TSH and elevated free T4. Which condition
is the most likely cause?
A. Hashimoto thyroiditis
B. Graves disease
C. Thyroid cancer
D. Iodine deficiency
Correct answer: B
Rationale: Low TSH with elevated T4 indicates primary
hyperthyroidism. Graves disease is the most common cause and is
autoimmune, involving TSH receptor stimulation.
Question 3
A newborn fails to pass meconium within 48 hours and has abdominal
distension. Which condition is most likely?
A. Pyloric stenosis
B. Hirschsprung disease
C. Intussusception
D. Necrotizing enterocolitis
,Correct answer: B
Rationale: Failure to pass meconium within 48 hours strongly suggests
Hirschsprung disease due to absence of ganglion cells in the distal
colon.
Question 4
A patient presents with fever, neck stiffness, and altered mental status.
CSF shows neutrophilic pleocytosis, low glucose, and high protein. What
is the most likely diagnosis?
A. Viral meningitis
B. Bacterial meningitis
C. Fungal meningitis
D. Subarachnoid hemorrhage
Correct answer: B
Rationale: Bacterial meningitis typically presents with elevated
neutrophils, low CSF glucose, and high protein due to bacterial
metabolism and inflammation.
Question 5
Which medication is most appropriate for acute anaphylaxis?
, A. Diphenhydramine
B. Epinephrine
C. Albuterol
D. Prednisone
Correct answer: B
Rationale: Epinephrine is first-line treatment for anaphylaxis because
it reverses bronchoconstriction, vasodilation, and mucosal edema.
Question 6
A 30-year-old woman presents with episodic flushing, diarrhea, and
wheezing. Urine shows elevated 5-HIAA. What is the most likely
diagnosis?
A. VIPoma
B. Carcinoid syndrome
C. Zollinger-Ellison syndrome
D. Glucagonoma
Correct answer: B
Rationale: Carcinoid tumors secrete serotonin, leading to flushing,
diarrhea, and wheezing; 5-HIAA is a serotonin metabolite.
