COMSAE Phase 2 – BSA 113i Questions With
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant Download Pdf
1. A 65-year-old man with a history of hypertension presents with
sudden-onset chest pain radiating to the back. Blood pressure is
180/100 in the right arm and 150/90 in the left arm. What is the
most likely diagnosis?
A. Myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
Answer: C. Aortic dissection
Rationale: Unequal blood pressures between arms, tearing chest
pain radiating to the back, and severe hypertension are classic
for aortic dissection due to intimal tear and false lumen
formation.
,2. A 23-year-old woman presents with tremor, heat intolerance, and
weight loss. Labs show low TSH and elevated T3/T4. What is the
most likely diagnosis?
A. Hashimoto thyroiditis
B. Graves disease
C. Thyroid cancer
D. Subacute thyroiditis
Answer: B. Graves disease
Rationale: Suppressed TSH with elevated thyroid hormones and
hyperthyroid symptoms suggests Graves disease, an
autoimmune condition mediated by TSH receptor-stimulating
antibodies.
3. A patient with chronic alcoholism presents with confusion, ataxia,
and ophthalmoplegia. What is the most appropriate immediate
treatment?
A. Oral glucose
B. IV thiamine
C. Naloxone
D. Vitamin B12
Answer: B. IV thiamine
, Rationale: Wernicke encephalopathy due to thiamine deficiency
requires immediate IV thiamine before glucose administration to
prevent worsening neurologic injury.
4. A newborn has cyanosis that does not improve with oxygen. A
harsh systolic murmur is present. What is the most likely
diagnosis?
A. Ventricular septal defect
B. Tetralogy of Fallot
C. Patent ductus arteriosus
D. Atrial septal defect
Answer: B. Tetralogy of Fallot
Rationale: Cyanotic congenital heart disease unresponsive to
oxygen plus murmur suggests Tetralogy of Fallot due to right
ventricular outflow obstruction.
5. A 45-year-old man presents with right upper quadrant pain after
fatty meals. Ultrasound shows gallstones. What is the most likely
diagnosis?
A. Cholecystitis
B. Cholelithiasis
, C. Pancreatitis
D. Hepatitis
Answer: B. Cholelithiasis
Rationale: Symptomatic gallstones causing postprandial RUQ
pain without infection indicate cholelithiasis.
6. A patient presents with fever, cough, and rust-colored sputum.
What organism is most likely?
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Klebsiella pneumoniae
D. Legionella pneumophila
Answer: B. Streptococcus pneumoniae
Rationale: Rust-colored sputum and lobar pneumonia are classic
for Streptococcus pneumoniae infection.
7. A child presents with a barking cough and inspiratory stridor. What
is the best initial treatment?
A. Epinephrine nebulizer
B. Antibiotics
C. Steroids
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant Download Pdf
1. A 65-year-old man with a history of hypertension presents with
sudden-onset chest pain radiating to the back. Blood pressure is
180/100 in the right arm and 150/90 in the left arm. What is the
most likely diagnosis?
A. Myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
Answer: C. Aortic dissection
Rationale: Unequal blood pressures between arms, tearing chest
pain radiating to the back, and severe hypertension are classic
for aortic dissection due to intimal tear and false lumen
formation.
,2. A 23-year-old woman presents with tremor, heat intolerance, and
weight loss. Labs show low TSH and elevated T3/T4. What is the
most likely diagnosis?
A. Hashimoto thyroiditis
B. Graves disease
C. Thyroid cancer
D. Subacute thyroiditis
Answer: B. Graves disease
Rationale: Suppressed TSH with elevated thyroid hormones and
hyperthyroid symptoms suggests Graves disease, an
autoimmune condition mediated by TSH receptor-stimulating
antibodies.
3. A patient with chronic alcoholism presents with confusion, ataxia,
and ophthalmoplegia. What is the most appropriate immediate
treatment?
A. Oral glucose
B. IV thiamine
C. Naloxone
D. Vitamin B12
Answer: B. IV thiamine
, Rationale: Wernicke encephalopathy due to thiamine deficiency
requires immediate IV thiamine before glucose administration to
prevent worsening neurologic injury.
4. A newborn has cyanosis that does not improve with oxygen. A
harsh systolic murmur is present. What is the most likely
diagnosis?
A. Ventricular septal defect
B. Tetralogy of Fallot
C. Patent ductus arteriosus
D. Atrial septal defect
Answer: B. Tetralogy of Fallot
Rationale: Cyanotic congenital heart disease unresponsive to
oxygen plus murmur suggests Tetralogy of Fallot due to right
ventricular outflow obstruction.
5. A 45-year-old man presents with right upper quadrant pain after
fatty meals. Ultrasound shows gallstones. What is the most likely
diagnosis?
A. Cholecystitis
B. Cholelithiasis
, C. Pancreatitis
D. Hepatitis
Answer: B. Cholelithiasis
Rationale: Symptomatic gallstones causing postprandial RUQ
pain without infection indicate cholelithiasis.
6. A patient presents with fever, cough, and rust-colored sputum.
What organism is most likely?
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Klebsiella pneumoniae
D. Legionella pneumophila
Answer: B. Streptococcus pneumoniae
Rationale: Rust-colored sputum and lobar pneumonia are classic
for Streptococcus pneumoniae infection.
7. A child presents with a barking cough and inspiratory stridor. What
is the best initial treatment?
A. Epinephrine nebulizer
B. Antibiotics
C. Steroids
