COMSAE PHASE 1 (ASA 107 i ) 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 107 i ) LEVEL 1 EXAM |FULL
REVISED EXAM
COMSAE Phase 1 (ASA 107i) – Level 1 Actual Exam
Total Questions: 100
Time Limit: 4 hours
1. A 45-year-old male presents with acute onset of severe, tearing chest pain
radiating to the back. Blood pressure is 100/60 mm Hg in the right arm and
70/40 mm Hg in the left arm. Which of the following is the most appropriate
next step?
A. Administer alteplase
B. Obtain a stat chest X-ray
C. Start IV nitroglycerin drip
D. Obtain a stat CT angiography of the chest – CORRECT ANSWER
2. A 28-year-old female with systemic lupus erythematosus presents with
pleuritic chest pain and dyspnea. ECG shows diffuse ST elevations. Which of
the following is the most likely diagnosis?
A. Acute myocardial infarction
B. Pericarditis – CORRECT ANSWER
C. Pulmonary embolism
D. Costochondritis
3. During a routine physical exam, you palpate the right radial artery and
note a quick, sharp rise then a sudden collapse. This pulse is most consistent
,with which condition?
A. Aortic stenosis
B. Aortic regurgitation – CORRECT ANSWER
C. Hypertrophic cardiomyopathy
D. Cardiac tamponade
4. A 60-year-old man with hypertension and diabetes presents with painless
hematuria. Which of the following is the most appropriate initial imaging
study?
A. Renal ultrasound
B. CT urogram – CORRECT ANSWER
C. KUB radiograph
D. MRI abdomen
5. A 22-year-old college student reports recurrent episodes of palpitations,
sweating, and headache lasting 10 minutes. During an episode, blood pressure
is 180/110 mm Hg. Which laboratory finding would confirm the diagnosis?
A. Elevated serum metanephrines – CORRECT ANSWER
B. Low serum cortisol
C. Elevated TSH
D. Hypokalemia
6. A 55-year-old smoker presents with morning cough and sputum production
for 3 months each year for the past 2 years. Pulmonary function tests show
FEV1/FVC ratio of 65%. Which of the following is the most likely diagnosis?
A. Asthma
B. Chronic bronchitis – CORRECT ANSWER
C. Emphysema
D. Bronchiectasis
, 7. A patient with a history of alcohol use disorder is found to have asterixis,
ascites, and jaundice. Which of the following laboratory findings is most
consistent with this presentation?
A. Elevated AST and ALT with AST/ALT ratio >2 – CORRECT ANSWER
B. Elevated alkaline phosphatase with normal transaminases
C. Elevated bilirubin with normal ammonia
D. Low serum albumin with normal INR
8. A 35-year-old female presents with fatigue, cold intolerance, and weight
gain. Labs show TSH 25 µIU/mL, free T4 0.4 ng/dL. Which of the following is
the most appropriate treatment?
A. Methimazole
B. Levothyroxine – CORRECT ANSWER
C. Liothyronine alone
D. Radioactive iodine
9. A 70-year-old male presents with a several-day history of severe right lower
quadrant pain, nausea, and fever. Examination reveals a palpable, tender
right lower quadrant mass. Which of the following is the most likely
diagnosis?
A. Appendicitis
B. Diverticulitis with phlegmon – CORRECT ANSWER
C. Cecal volvulus
D. Strangulated inguinal hernia
10. A newborn has bilious emesis and a distended abdomen. Abdominal X-ray
shows a “double-bubble” sign. Which of the following is the most likely
diagnosis?
ACCURATE TEST APPROVED QUESTIONS AND CORRECT
DETAILED ANSWERS (100% CORRECT VERIFIED SOLUTIONS)
NEWEST UPDATED VERSION 2026 EDITION |GUARANTEED PASS A+
|ACTUAL COMSAE PHASE (ASA 107 i ) LEVEL 1 EXAM |FULL
REVISED EXAM
COMSAE Phase 1 (ASA 107i) – Level 1 Actual Exam
Total Questions: 100
Time Limit: 4 hours
1. A 45-year-old male presents with acute onset of severe, tearing chest pain
radiating to the back. Blood pressure is 100/60 mm Hg in the right arm and
70/40 mm Hg in the left arm. Which of the following is the most appropriate
next step?
A. Administer alteplase
B. Obtain a stat chest X-ray
C. Start IV nitroglycerin drip
D. Obtain a stat CT angiography of the chest – CORRECT ANSWER
2. A 28-year-old female with systemic lupus erythematosus presents with
pleuritic chest pain and dyspnea. ECG shows diffuse ST elevations. Which of
the following is the most likely diagnosis?
A. Acute myocardial infarction
B. Pericarditis – CORRECT ANSWER
C. Pulmonary embolism
D. Costochondritis
3. During a routine physical exam, you palpate the right radial artery and
note a quick, sharp rise then a sudden collapse. This pulse is most consistent
,with which condition?
A. Aortic stenosis
B. Aortic regurgitation – CORRECT ANSWER
C. Hypertrophic cardiomyopathy
D. Cardiac tamponade
4. A 60-year-old man with hypertension and diabetes presents with painless
hematuria. Which of the following is the most appropriate initial imaging
study?
A. Renal ultrasound
B. CT urogram – CORRECT ANSWER
C. KUB radiograph
D. MRI abdomen
5. A 22-year-old college student reports recurrent episodes of palpitations,
sweating, and headache lasting 10 minutes. During an episode, blood pressure
is 180/110 mm Hg. Which laboratory finding would confirm the diagnosis?
A. Elevated serum metanephrines – CORRECT ANSWER
B. Low serum cortisol
C. Elevated TSH
D. Hypokalemia
6. A 55-year-old smoker presents with morning cough and sputum production
for 3 months each year for the past 2 years. Pulmonary function tests show
FEV1/FVC ratio of 65%. Which of the following is the most likely diagnosis?
A. Asthma
B. Chronic bronchitis – CORRECT ANSWER
C. Emphysema
D. Bronchiectasis
, 7. A patient with a history of alcohol use disorder is found to have asterixis,
ascites, and jaundice. Which of the following laboratory findings is most
consistent with this presentation?
A. Elevated AST and ALT with AST/ALT ratio >2 – CORRECT ANSWER
B. Elevated alkaline phosphatase with normal transaminases
C. Elevated bilirubin with normal ammonia
D. Low serum albumin with normal INR
8. A 35-year-old female presents with fatigue, cold intolerance, and weight
gain. Labs show TSH 25 µIU/mL, free T4 0.4 ng/dL. Which of the following is
the most appropriate treatment?
A. Methimazole
B. Levothyroxine – CORRECT ANSWER
C. Liothyronine alone
D. Radioactive iodine
9. A 70-year-old male presents with a several-day history of severe right lower
quadrant pain, nausea, and fever. Examination reveals a palpable, tender
right lower quadrant mass. Which of the following is the most likely
diagnosis?
A. Appendicitis
B. Diverticulitis with phlegmon – CORRECT ANSWER
C. Cecal volvulus
D. Strangulated inguinal hernia
10. A newborn has bilious emesis and a distended abdomen. Abdominal X-ray
shows a “double-bubble” sign. Which of the following is the most likely
diagnosis?
