COMSAE Phase 1 – Form ASA 104
Intensive Review: Exam-Focused Practice
Questions, Detailed Answer Keys, and
Step-by-Step Rationales (PDF)
1. Which of the following is the most common cause of
community-acquired pneumonia in adults?
A. Streptococcus pneumoniae
B. Haemophilus influenzae
C. Mycoplasma pneumoniae
D. Staphylococcus aureus
Rationale: Streptococcus pneumoniae remains the most
common etiology for community-acquired pneumonia in
adults.
2. A 45-year-old female presents with fatigue, weight gain,
and cold intolerance. Labs show TSH 12.0 mIU/L and free
T4 0.6 ng/dL. What is the most likely diagnosis?
A. Secondary hypothyroidism
B. Primary hypothyroidism
C. Subclinical hypothyroidism
D. Hyperthyroidism
,Rationale: Elevated TSH with low free T4 is diagnostic of
primary hypothyroidism.
3. Which of the following nerves is most commonly injured
in a mid-shaft humerus fracture?
A. Axillary nerve
B. Musculocutaneous nerve
C. Radial nerve
D. Median nerve
Rationale: The radial nerve travels in the spiral groove of the
humerus and is highly susceptible to injury in mid-shaft
fractures.
4. A patient with a history of hypertension presents with
sudden, severe "tearing" chest pain radiating to the
back. Which imaging modality is the gold standard for
diagnosis?
A. Chest X-ray
B. Transthoracic echocardiogram
C. CT angiography
D. MRI
Rationale: CT angiography is the diagnostic modality of
choice for suspected aortic dissection.
5. What is the classic triad of symptoms for Normal
Pressure Hydrocephalus?
A. Tremor, rigidity, bradykinesia
,B. Urinary incontinence, gait disturbance, dementia
C. Fever, headache, neck stiffness
D. Dyspnea, cough, chest pain
Rationale: Normal Pressure Hydrocephalus presents with
"wet, wobbly, and wacky" (urinary incontinence, gait
disturbance, and dementia).
6. Which medication is the first-line treatment for an acute
gout flare in a patient without renal impairment?
A. Allopurinol
B. Indomethacin
C. Probenecid
D. Acetaminophen
Rationale: NSAIDs like indomethacin are first-line for acute
flares; allopurinol is for long-term management.
7. A patient has a positive Phalen’s maneuver. This is used
to diagnose which condition?
A. Cubital tunnel syndrome
B. De Quervain's tenosynovitis
C. Carpal tunnel syndrome
D. Rotator cuff tear
Rationale: Phalen’s maneuver (flexion of the wrists) is a
provocative test for carpal tunnel syndrome.
8. Which vitamin deficiency is associated with Wernicke-
Korsakoff syndrome?
, A. B1 (Thiamine)
B. B3 (Niacin)
C. B12 (Cobalamin)
D. C (Ascorbic acid)
Rationale: Wernicke-Korsakoff syndrome is a neurological
disorder caused by thiamine (B1) deficiency, typically in
chronic alcohol use.
9. What is the most common site for an ectopic
pregnancy?
A. Ovary
B. Cervix
C. Ampulla of the fallopian tube
D. Abdominal cavity
Rationale: The ampulla of the fallopian tube is the most
frequent location for an ectopic pregnancy.
10. A patient presents with "strawberry tongue" and a
sandpaper-like rash. What is the most likely diagnosis?
A. Measles
B. Scarlet fever
C. Roseola
D. Rubella
Rationale: Scarlet fever, caused by Group A Streptococcus, is
characterized by a sand-paper rash and strawberry tongue.
Intensive Review: Exam-Focused Practice
Questions, Detailed Answer Keys, and
Step-by-Step Rationales (PDF)
1. Which of the following is the most common cause of
community-acquired pneumonia in adults?
A. Streptococcus pneumoniae
B. Haemophilus influenzae
C. Mycoplasma pneumoniae
D. Staphylococcus aureus
Rationale: Streptococcus pneumoniae remains the most
common etiology for community-acquired pneumonia in
adults.
2. A 45-year-old female presents with fatigue, weight gain,
and cold intolerance. Labs show TSH 12.0 mIU/L and free
T4 0.6 ng/dL. What is the most likely diagnosis?
A. Secondary hypothyroidism
B. Primary hypothyroidism
C. Subclinical hypothyroidism
D. Hyperthyroidism
,Rationale: Elevated TSH with low free T4 is diagnostic of
primary hypothyroidism.
3. Which of the following nerves is most commonly injured
in a mid-shaft humerus fracture?
A. Axillary nerve
B. Musculocutaneous nerve
C. Radial nerve
D. Median nerve
Rationale: The radial nerve travels in the spiral groove of the
humerus and is highly susceptible to injury in mid-shaft
fractures.
4. A patient with a history of hypertension presents with
sudden, severe "tearing" chest pain radiating to the
back. Which imaging modality is the gold standard for
diagnosis?
A. Chest X-ray
B. Transthoracic echocardiogram
C. CT angiography
D. MRI
Rationale: CT angiography is the diagnostic modality of
choice for suspected aortic dissection.
5. What is the classic triad of symptoms for Normal
Pressure Hydrocephalus?
A. Tremor, rigidity, bradykinesia
,B. Urinary incontinence, gait disturbance, dementia
C. Fever, headache, neck stiffness
D. Dyspnea, cough, chest pain
Rationale: Normal Pressure Hydrocephalus presents with
"wet, wobbly, and wacky" (urinary incontinence, gait
disturbance, and dementia).
6. Which medication is the first-line treatment for an acute
gout flare in a patient without renal impairment?
A. Allopurinol
B. Indomethacin
C. Probenecid
D. Acetaminophen
Rationale: NSAIDs like indomethacin are first-line for acute
flares; allopurinol is for long-term management.
7. A patient has a positive Phalen’s maneuver. This is used
to diagnose which condition?
A. Cubital tunnel syndrome
B. De Quervain's tenosynovitis
C. Carpal tunnel syndrome
D. Rotator cuff tear
Rationale: Phalen’s maneuver (flexion of the wrists) is a
provocative test for carpal tunnel syndrome.
8. Which vitamin deficiency is associated with Wernicke-
Korsakoff syndrome?
, A. B1 (Thiamine)
B. B3 (Niacin)
C. B12 (Cobalamin)
D. C (Ascorbic acid)
Rationale: Wernicke-Korsakoff syndrome is a neurological
disorder caused by thiamine (B1) deficiency, typically in
chronic alcohol use.
9. What is the most common site for an ectopic
pregnancy?
A. Ovary
B. Cervix
C. Ampulla of the fallopian tube
D. Abdominal cavity
Rationale: The ampulla of the fallopian tube is the most
frequent location for an ectopic pregnancy.
10. A patient presents with "strawberry tongue" and a
sandpaper-like rash. What is the most likely diagnosis?
A. Measles
B. Scarlet fever
C. Roseola
D. Rubella
Rationale: Scarlet fever, caused by Group A Streptococcus, is
characterized by a sand-paper rash and strawberry tongue.
