COMSAE Phase 2 – BSA 119 Practice
Examination (2026 Edition): Comprehensive
Multiple-Choice Questions, Answers, and
Detailed Rationales
Question 1
A 58-year-old man presents with crushing substernal chest
pain radiating to the left arm. ECG shows ST-segment
elevation in leads II, III, and aVF. Which coronary artery is
most likely occluded?
A. Left anterior descending artery
B. Circumflex artery
C. Right coronary artery
D. Left main coronary artery
Rationale: ST-segment elevation in leads II, III, and aVF
indicates an inferior wall myocardial infarction, most
commonly caused by occlusion of the right coronary artery.
Question 2
A patient develops fever, hypotension, and widespread
vasodilation during a severe bacterial infection. Which
mediator is primarily responsible for septic shock-associated
vasodilation?
,A. Histamine
B. Nitric oxide
C. Bradykinin
D. Endothelin
Rationale: Nitric oxide production is markedly increased in
sepsis, causing systemic vasodilation and contributing
significantly to hypotension and shock.
Question 3
A 32-year-old woman has fatigue and pallor. Laboratory
studies reveal microcytic hypochromic anemia. Which
laboratory finding is most consistent with iron deficiency
anemia?
A. Increased ferritin
B. Increased serum iron
C. Decreased ferritin
D. Increased transferrin saturation
Rationale: Ferritin reflects iron stores. Iron deficiency anemia
typically presents with low ferritin, low serum iron, and
increased total iron-binding capacity.
Question 4
A child develops hematuria several weeks after a
streptococcal throat infection. Which mechanism is
responsible?
,A. Direct bacterial invasion
B. IgE-mediated hypersensitivity
C. T-cell destruction
D. Immune complex deposition
Rationale: Poststreptococcal glomerulonephritis results from
immune complex deposition within glomeruli, triggering
inflammation and hematuria.
Question 5
A patient has hypercalcemia and recurrent kidney stones.
Elevated parathyroid hormone levels are noted. Which
diagnosis is most likely?
A. Secondary hyperparathyroidism
B. Hypoparathyroidism
C. Primary hyperparathyroidism
D. Vitamin D deficiency
Rationale: Primary hyperparathyroidism causes excessive PTH
secretion, resulting in hypercalcemia, nephrolithiasis, and
bone resorption.
Question 6
Which cranial nerve is responsible for sensation of the face?
A. Facial nerve
B. Glossopharyngeal nerve
C. Vagus nerve
D. Trigeminal nerve
, Rationale: The trigeminal nerve (CN V) supplies the major
sensory innervation of the face through its ophthalmic,
maxillary, and mandibular branches.
Question 7
A patient with asthma receives albuterol. What is the primary
mechanism of action?
A. Muscarinic receptor blockade
B. Alpha-1 receptor stimulation
C. Beta-2 receptor stimulation
D. Beta-1 receptor blockade
Rationale: Albuterol selectively stimulates beta-2 receptors,
causing relaxation of bronchial smooth muscle and
bronchodilation.
Question 8
Which electrolyte abnormality is most commonly associated
with peaked T waves on ECG?
A. Hyponatremia
B. Hypocalcemia
C. Hypokalemia
D. Hyperkalemia
Rationale: Hyperkalemia classically produces peaked T waves
and can progress to life-threatening cardiac conduction
abnormalities.
Examination (2026 Edition): Comprehensive
Multiple-Choice Questions, Answers, and
Detailed Rationales
Question 1
A 58-year-old man presents with crushing substernal chest
pain radiating to the left arm. ECG shows ST-segment
elevation in leads II, III, and aVF. Which coronary artery is
most likely occluded?
A. Left anterior descending artery
B. Circumflex artery
C. Right coronary artery
D. Left main coronary artery
Rationale: ST-segment elevation in leads II, III, and aVF
indicates an inferior wall myocardial infarction, most
commonly caused by occlusion of the right coronary artery.
Question 2
A patient develops fever, hypotension, and widespread
vasodilation during a severe bacterial infection. Which
mediator is primarily responsible for septic shock-associated
vasodilation?
,A. Histamine
B. Nitric oxide
C. Bradykinin
D. Endothelin
Rationale: Nitric oxide production is markedly increased in
sepsis, causing systemic vasodilation and contributing
significantly to hypotension and shock.
Question 3
A 32-year-old woman has fatigue and pallor. Laboratory
studies reveal microcytic hypochromic anemia. Which
laboratory finding is most consistent with iron deficiency
anemia?
A. Increased ferritin
B. Increased serum iron
C. Decreased ferritin
D. Increased transferrin saturation
Rationale: Ferritin reflects iron stores. Iron deficiency anemia
typically presents with low ferritin, low serum iron, and
increased total iron-binding capacity.
Question 4
A child develops hematuria several weeks after a
streptococcal throat infection. Which mechanism is
responsible?
,A. Direct bacterial invasion
B. IgE-mediated hypersensitivity
C. T-cell destruction
D. Immune complex deposition
Rationale: Poststreptococcal glomerulonephritis results from
immune complex deposition within glomeruli, triggering
inflammation and hematuria.
Question 5
A patient has hypercalcemia and recurrent kidney stones.
Elevated parathyroid hormone levels are noted. Which
diagnosis is most likely?
A. Secondary hyperparathyroidism
B. Hypoparathyroidism
C. Primary hyperparathyroidism
D. Vitamin D deficiency
Rationale: Primary hyperparathyroidism causes excessive PTH
secretion, resulting in hypercalcemia, nephrolithiasis, and
bone resorption.
Question 6
Which cranial nerve is responsible for sensation of the face?
A. Facial nerve
B. Glossopharyngeal nerve
C. Vagus nerve
D. Trigeminal nerve
, Rationale: The trigeminal nerve (CN V) supplies the major
sensory innervation of the face through its ophthalmic,
maxillary, and mandibular branches.
Question 7
A patient with asthma receives albuterol. What is the primary
mechanism of action?
A. Muscarinic receptor blockade
B. Alpha-1 receptor stimulation
C. Beta-2 receptor stimulation
D. Beta-1 receptor blockade
Rationale: Albuterol selectively stimulates beta-2 receptors,
causing relaxation of bronchial smooth muscle and
bronchodilation.
Question 8
Which electrolyte abnormality is most commonly associated
with peaked T waves on ECG?
A. Hyponatremia
B. Hypocalcemia
C. Hypokalemia
D. Hyperkalemia
Rationale: Hyperkalemia classically produces peaked T waves
and can progress to life-threatening cardiac conduction
abnormalities.
