COMSAE Phase 2 – BSA 115i Questions With
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant Download Pdf
1. A 62-year-old man presents with exertional chest pain relieved by
rest. He has a history of hypertension and hyperlipidemia. Which
of the following is the most likely underlying mechanism?
A. Coronary artery vasospasm
B. Atherosclerotic plaque rupture
C. Fixed atherosclerotic narrowing of coronary arteries
D. Aortic dissection
Correct answer: C
Rationale: Stable angina is most commonly caused by fixed
atherosclerotic narrowing of the coronary arteries, leading to
predictable ischemia during increased oxygen demand such as
exertion.
, 2. A patient presents with acute onset of severe tearing chest pain
radiating to the back. Blood pressure is higher in the right arm
than the left. What is the most likely diagnosis?
A. Myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
Correct answer: C
Rationale: Aortic dissection classically presents with sudden tearing
chest pain radiating to the back and blood pressure discrepancies
between limbs due to involvement of branch vessels.
3. Which of the following is the most common cause of microcytic
anemia?
A. Iron deficiency
B. Vitamin B12 deficiency
C. Folate deficiency
D. Aplastic anemia
Correct answer: A
,Rationale: Iron deficiency anemia is the most common cause of
microcytic anemia due to impaired hemoglobin synthesis.
4. A 25-year-old woman presents with fatigue and paresthesias. Labs
show macrocytic anemia. Which additional finding is most likely?
A. Hypersegmented neutrophils
B. Basophilic stippling
C. Heinz bodies
D. Spherocytes
Correct answer: A
Rationale: Vitamin B12 deficiency causes megaloblastic anemia
characterized by macrocytosis and hypersegmented neutrophils.
5. A newborn fails to pass meconium within 48 hours. A biopsy
shows absence of ganglion cells in the distal colon. What is the
diagnosis?
A. Meckel diverticulum
B. Hirschsprung disease
C. Intussusception
D. Pyloric stenosis
, Correct answer: B
Rationale: Hirschsprung disease results from failure of neural crest cell
migration leading to absence of ganglion cells and functional
obstruction.
6. A patient with COPD has chronic CO2 retention. Which acid-base
disorder is expected?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Respiratory acidosis
D. Metabolic alkalosis
Correct answer: C
Rationale: COPD causes hypoventilation and CO2 retention, resulting
in respiratory acidosis.
7. Which organism is most commonly associated with community-
acquired pneumonia in healthy adults?
A. Klebsiella pneumoniae
B. Streptococcus pneumoniae
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant Download Pdf
1. A 62-year-old man presents with exertional chest pain relieved by
rest. He has a history of hypertension and hyperlipidemia. Which
of the following is the most likely underlying mechanism?
A. Coronary artery vasospasm
B. Atherosclerotic plaque rupture
C. Fixed atherosclerotic narrowing of coronary arteries
D. Aortic dissection
Correct answer: C
Rationale: Stable angina is most commonly caused by fixed
atherosclerotic narrowing of the coronary arteries, leading to
predictable ischemia during increased oxygen demand such as
exertion.
, 2. A patient presents with acute onset of severe tearing chest pain
radiating to the back. Blood pressure is higher in the right arm
than the left. What is the most likely diagnosis?
A. Myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
Correct answer: C
Rationale: Aortic dissection classically presents with sudden tearing
chest pain radiating to the back and blood pressure discrepancies
between limbs due to involvement of branch vessels.
3. Which of the following is the most common cause of microcytic
anemia?
A. Iron deficiency
B. Vitamin B12 deficiency
C. Folate deficiency
D. Aplastic anemia
Correct answer: A
,Rationale: Iron deficiency anemia is the most common cause of
microcytic anemia due to impaired hemoglobin synthesis.
4. A 25-year-old woman presents with fatigue and paresthesias. Labs
show macrocytic anemia. Which additional finding is most likely?
A. Hypersegmented neutrophils
B. Basophilic stippling
C. Heinz bodies
D. Spherocytes
Correct answer: A
Rationale: Vitamin B12 deficiency causes megaloblastic anemia
characterized by macrocytosis and hypersegmented neutrophils.
5. A newborn fails to pass meconium within 48 hours. A biopsy
shows absence of ganglion cells in the distal colon. What is the
diagnosis?
A. Meckel diverticulum
B. Hirschsprung disease
C. Intussusception
D. Pyloric stenosis
, Correct answer: B
Rationale: Hirschsprung disease results from failure of neural crest cell
migration leading to absence of ganglion cells and functional
obstruction.
6. A patient with COPD has chronic CO2 retention. Which acid-base
disorder is expected?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Respiratory acidosis
D. Metabolic alkalosis
Correct answer: C
Rationale: COPD causes hypoventilation and CO2 retention, resulting
in respiratory acidosis.
7. Which organism is most commonly associated with community-
acquired pneumonia in healthy adults?
A. Klebsiella pneumoniae
B. Streptococcus pneumoniae
