COMSAE PHASE 1 (ASA 113) LEVEL 1 EXAM LATEST 2026/2027
ACCURATE TEST APPROVED QUESTIONS AND CORRECT
DETAILED ANSWERS (100% CORRECT VERIFIED SOLUTIONS)
NEWEST UPDATED VERSION 2026 EDITION |GUARANTEED PASS A+
|ACTUAL COMSAE PHASE (ASA 113) LEVEL 1 EXAM |JUST
RELEASED
1. A 45-year-old male presents with acute onset of severe, tearing chest pain
radiating to the back. Blood pressure is 150/90 in the right arm and 110/70 in the
left arm. What is the most likely diagnosis?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection – CORRECT ANSWER
D. Pericarditis
2. A patient with hypertension is started on a thiazide diuretic. Which electrolyte
abnormality is most commonly associated with this medication?
A. Hypernatremia
B. Hypokalemia – CORRECT ANSWER
C. Hypercalcemia
D. Hypomagnesemia
3. Which of the following is the most sensitive test for diagnosing iron deficiency
anemia?
A. Serum iron
B. Total iron-binding capacity (TIBC)
C. Ferritin – CORRECT ANSWER
D. Hemoglobin electrophoresis
,4. A 22-year-old woman presents with acute pelvic pain and a positive pregnancy
test. Transvaginal ultrasound shows an empty uterus and a complex adnexal mass.
What is the next best step?
A. Serial beta-hCG monitoring
B. Methotrexate – CORRECT ANSWER
C. Dilation and curettage
D. Observation
5. Which of the following is a characteristic finding in diabetic ketoacidosis
(DKA)?
A. Respiratory acidosis
B. Anion gap metabolic acidosis – CORRECT ANSWER
C. Normal serum glucose
D. Metabolic alkalosis
6. A 67-year-old man with a history of COPD presents with worsening dyspnea
and peripheral edema. Jugular venous distension is noted. Which physical exam
finding would most suggest cor pulmonale?
A. Parasternal heave – CORRECT ANSWER
B. Displaced apical impulse
C. Systolic murmur at apex
D. Diminished breath sounds
7. Which of the following is the first-line treatment for generalized anxiety
disorder?
A. Propranolol
, B. Sertraline – CORRECT ANSWER
C. Alprazolam
D. Buspirone as monotherapy
8. A 55-year-old male with diabetes presents with painless unilateral lower
extremity swelling and erythema. Venous duplex ultrasound shows non-
compressible deep veins. Which medication is contraindicated?
A. Heparin
B. Enoxaparin in setting of thrombocytopenia – CORRECT ANSWER
C. Warfarin
D. Rivaroxaban
9. A patient with known cirrhosis presents with confusion, asterixis, and elevated
ammonia. What is the first-line pharmacologic treatment?
A. Neomycin
B. Lactulose – CORRECT ANSWER
C. Rifaximin alone
D. Metronidazole
10. Which ECG finding is most specific for pericarditis?
A. Diffuse ST-segment elevations – CORRECT ANSWER
B. Q waves in inferior leads
C. PR segment depression only
D. Tall peaked T waves
11. A 70-year-old woman with osteoporosis is started on alendronate. Which
instruction must be given to prevent esophageal injury?
ACCURATE TEST APPROVED QUESTIONS AND CORRECT
DETAILED ANSWERS (100% CORRECT VERIFIED SOLUTIONS)
NEWEST UPDATED VERSION 2026 EDITION |GUARANTEED PASS A+
|ACTUAL COMSAE PHASE (ASA 113) LEVEL 1 EXAM |JUST
RELEASED
1. A 45-year-old male presents with acute onset of severe, tearing chest pain
radiating to the back. Blood pressure is 150/90 in the right arm and 110/70 in the
left arm. What is the most likely diagnosis?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection – CORRECT ANSWER
D. Pericarditis
2. A patient with hypertension is started on a thiazide diuretic. Which electrolyte
abnormality is most commonly associated with this medication?
A. Hypernatremia
B. Hypokalemia – CORRECT ANSWER
C. Hypercalcemia
D. Hypomagnesemia
3. Which of the following is the most sensitive test for diagnosing iron deficiency
anemia?
A. Serum iron
B. Total iron-binding capacity (TIBC)
C. Ferritin – CORRECT ANSWER
D. Hemoglobin electrophoresis
,4. A 22-year-old woman presents with acute pelvic pain and a positive pregnancy
test. Transvaginal ultrasound shows an empty uterus and a complex adnexal mass.
What is the next best step?
A. Serial beta-hCG monitoring
B. Methotrexate – CORRECT ANSWER
C. Dilation and curettage
D. Observation
5. Which of the following is a characteristic finding in diabetic ketoacidosis
(DKA)?
A. Respiratory acidosis
B. Anion gap metabolic acidosis – CORRECT ANSWER
C. Normal serum glucose
D. Metabolic alkalosis
6. A 67-year-old man with a history of COPD presents with worsening dyspnea
and peripheral edema. Jugular venous distension is noted. Which physical exam
finding would most suggest cor pulmonale?
A. Parasternal heave – CORRECT ANSWER
B. Displaced apical impulse
C. Systolic murmur at apex
D. Diminished breath sounds
7. Which of the following is the first-line treatment for generalized anxiety
disorder?
A. Propranolol
, B. Sertraline – CORRECT ANSWER
C. Alprazolam
D. Buspirone as monotherapy
8. A 55-year-old male with diabetes presents with painless unilateral lower
extremity swelling and erythema. Venous duplex ultrasound shows non-
compressible deep veins. Which medication is contraindicated?
A. Heparin
B. Enoxaparin in setting of thrombocytopenia – CORRECT ANSWER
C. Warfarin
D. Rivaroxaban
9. A patient with known cirrhosis presents with confusion, asterixis, and elevated
ammonia. What is the first-line pharmacologic treatment?
A. Neomycin
B. Lactulose – CORRECT ANSWER
C. Rifaximin alone
D. Metronidazole
10. Which ECG finding is most specific for pericarditis?
A. Diffuse ST-segment elevations – CORRECT ANSWER
B. Q waves in inferior leads
C. PR segment depression only
D. Tall peaked T waves
11. A 70-year-old woman with osteoporosis is started on alendronate. Which
instruction must be given to prevent esophageal injury?
