Comsae Phase 2-Bsa 118 Practice Exam:
Comprehensive Clinical Mastery
Questions With Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf.
Question 1
A 65-year-old man with a history of hypertension presents with sudden
onset chest pain radiating to his back. Blood pressure is 190/110 mmHg
in the right arm and 160/90 mmHg in the left arm. Which is the most
likely diagnosis?
A. Acute pericarditis
B. Myocardial infarction
C. Aortic dissection
D. Pulmonary embolism
Answer: C
Rationale: Aortic dissection classically presents with sudden tearing
chest pain radiating to the back and blood pressure discrepancy
between arms due to involvement of aortic branches. Hypertension is a
major risk factor.
Question 2
A 22-year-old woman presents with fever, flank pain, and dysuria.
Urinalysis shows nitrites and leukocyte esterase. What is the most likely
,organism?
A. Staphylococcus saprophyticus
B. Escherichia coli
C. Klebsiella pneumoniae
D. Proteus mirabilis
Answer: B
Rationale: E. coli is the most common cause of both uncomplicated
cystitis and pyelonephritis due to ascending infection from the
perineum.
Question 3
A patient presents with wheezing, urticaria, hypotension, and facial
swelling after a bee sting. What is the first-line treatment?
A. Diphenhydramine
B. Albuterol
C. Epinephrine
D. Prednisone
Answer: C
Rationale: Epinephrine is the first-line treatment for anaphylaxis as it
rapidly reverses bronchoconstriction, vasodilation, and airway edema.
Question 4
A 55-year-old man has chronic alcohol use and presents with confusion,
ophthalmoplegia, and ataxia. What deficiency is most likely?
A. Vitamin B12
B. Thiamine (B1)
,C. Folate
D. Niacin
Answer: B
Rationale: Wernicke encephalopathy is due to thiamine deficiency and
presents with the classic triad of confusion, ataxia, and
ophthalmoplegia.
Question 5
A newborn has a “machine-like” murmur and bounding pulses. What is
the most likely diagnosis?
A. Ventricular septal defect
B. Patent ductus arteriosus
C. Tetralogy of Fallot
D. Coarctation of aorta
Answer: B
Rationale: Patent ductus arteriosus causes continuous “machine-like”
murmur and bounding pulses due to persistent connection between
aorta and pulmonary artery.
Question 6
A patient has hemoptysis, hematuria, and linear IgG deposits on kidney
biopsy. Diagnosis?
A. Goodpasture syndrome
B. IgA nephropathy
C. Post-streptococcal GN
D. Lupus nephritis
, Answer: A
Rationale: Goodpasture syndrome involves anti-GBM antibodies causing
pulmonary hemorrhage and rapidly progressive glomerulonephritis.
Question 7
A 30-year-old woman has exophthalmos, heat intolerance, and weight
loss. Labs show low TSH and high T3/T4. Cause?
A. Hashimoto thyroiditis
B. Graves disease
C. Thyroid carcinoma
D. Subacute thyroiditis
Answer: B
Rationale: Graves disease is an autoimmune condition with TSH
receptor antibodies stimulating excess thyroid hormone production.
Question 8
A patient presents with crushing chest pain. ECG shows ST elevation in
leads II, III, aVF. Which artery is involved?
A. LAD
B. Right coronary artery
C. Left circumflex
D. Posterior descending artery only
Answer: B
Rationale: Inferior wall MI is classically due to right coronary artery
occlusion affecting leads II, III, and aVF.
Comprehensive Clinical Mastery
Questions With Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf.
Question 1
A 65-year-old man with a history of hypertension presents with sudden
onset chest pain radiating to his back. Blood pressure is 190/110 mmHg
in the right arm and 160/90 mmHg in the left arm. Which is the most
likely diagnosis?
A. Acute pericarditis
B. Myocardial infarction
C. Aortic dissection
D. Pulmonary embolism
Answer: C
Rationale: Aortic dissection classically presents with sudden tearing
chest pain radiating to the back and blood pressure discrepancy
between arms due to involvement of aortic branches. Hypertension is a
major risk factor.
Question 2
A 22-year-old woman presents with fever, flank pain, and dysuria.
Urinalysis shows nitrites and leukocyte esterase. What is the most likely
,organism?
A. Staphylococcus saprophyticus
B. Escherichia coli
C. Klebsiella pneumoniae
D. Proteus mirabilis
Answer: B
Rationale: E. coli is the most common cause of both uncomplicated
cystitis and pyelonephritis due to ascending infection from the
perineum.
Question 3
A patient presents with wheezing, urticaria, hypotension, and facial
swelling after a bee sting. What is the first-line treatment?
A. Diphenhydramine
B. Albuterol
C. Epinephrine
D. Prednisone
Answer: C
Rationale: Epinephrine is the first-line treatment for anaphylaxis as it
rapidly reverses bronchoconstriction, vasodilation, and airway edema.
Question 4
A 55-year-old man has chronic alcohol use and presents with confusion,
ophthalmoplegia, and ataxia. What deficiency is most likely?
A. Vitamin B12
B. Thiamine (B1)
,C. Folate
D. Niacin
Answer: B
Rationale: Wernicke encephalopathy is due to thiamine deficiency and
presents with the classic triad of confusion, ataxia, and
ophthalmoplegia.
Question 5
A newborn has a “machine-like” murmur and bounding pulses. What is
the most likely diagnosis?
A. Ventricular septal defect
B. Patent ductus arteriosus
C. Tetralogy of Fallot
D. Coarctation of aorta
Answer: B
Rationale: Patent ductus arteriosus causes continuous “machine-like”
murmur and bounding pulses due to persistent connection between
aorta and pulmonary artery.
Question 6
A patient has hemoptysis, hematuria, and linear IgG deposits on kidney
biopsy. Diagnosis?
A. Goodpasture syndrome
B. IgA nephropathy
C. Post-streptococcal GN
D. Lupus nephritis
, Answer: A
Rationale: Goodpasture syndrome involves anti-GBM antibodies causing
pulmonary hemorrhage and rapidly progressive glomerulonephritis.
Question 7
A 30-year-old woman has exophthalmos, heat intolerance, and weight
loss. Labs show low TSH and high T3/T4. Cause?
A. Hashimoto thyroiditis
B. Graves disease
C. Thyroid carcinoma
D. Subacute thyroiditis
Answer: B
Rationale: Graves disease is an autoimmune condition with TSH
receptor antibodies stimulating excess thyroid hormone production.
Question 8
A patient presents with crushing chest pain. ECG shows ST elevation in
leads II, III, aVF. Which artery is involved?
A. LAD
B. Right coronary artery
C. Left circumflex
D. Posterior descending artery only
Answer: B
Rationale: Inferior wall MI is classically due to right coronary artery
occlusion affecting leads II, III, and aVF.
