Page 1 of 153
COMSAE Phase 2 Form 111 Exam–ACTUAL
QUESTIONS AND ANSWERS LATEST UPDATE
THIS YEAR
COMSAE Phase 2 Form 111 Exam
Here are the summarized short point-form content areas for COMSAE Phase 2 Form 111
Content areas (summarized, short point-form)
• Internal medicine (cardiology, pulmonology, gastroenterology, nephrology, endocrinology,
rheumatology, hematology, oncology, infectious disease)
• Surgery (perioperative care, trauma, surgical complications, wound healing, breast, colorectal,
vascular)
• Pediatrics (growth and development, vaccination, common infections, congenital disorders,
adolescent medicine)
• Obstetrics & gynecology (prenatal care, labor and delivery, complications, contraception, STIs,
menstrual disorders)
• Psychiatry (major depressive disorder, bipolar, anxiety, psychosis, substance use, personality
disorders, suicide risk)
• Neurology (stroke, seizure, headache, movement disorders, neuromuscular disease, dementia)
• Osteopathic principles & OMM (somatic dysfunction, viscerosomatic reflexes, Chapman reflexes,
counterstrain, HVLA, Still technique, lymphatic treatment, rib raising, pelvic/sacral/CV4, OMT for
specific conditions)
• Preventive medicine & public health (screening guidelines, immunization schedules, counseling,
biostatistics, epidemiology)
• Emergency medicine & critical care (resuscitation, shock, trauma, toxicology, airway
management, ACLS)
• Ethics, law, & patient safety (informed consent, capacity, advance directives, medical errors,
end-of-life care)
• Musculoskeletal & rehabilitation (back pain, arthritis, fractures, sports medicine, OMT for
somatic dysfunction)
• Dermatology (rash, skin cancer, infectious dermatoses, drug eruptions)
1. A 62-year-old man with hypertension and diabetes presents with acute-onset substernal chest
pressure radiating to the jaw, diaphoresis, and nausea. ECG shows ST-segment elevation in leads V1-V4.
Which coronary artery is most likely occluded?
A) Right coronary artery
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B) Left circumflex artery
C) Left anterior descending artery
D) Left main coronary artery
Answer: C
Rationale: Anterior ST elevation (V1-V4) indicates left anterior descending (LAD) artery occlusion.
2. A 34-year-old woman presents with palpitations, heat intolerance, weight loss despite increased
appetite, and a fine tremor. TSH is <0.01 mIU/L with elevated free T4. Which antibody is most specific
for the underlying etiology?
A) Anti-thyroglobulin antibody
B) Anti-thyroid peroxidase antibody
C) TSH receptor antibody
D) Anti-microsomal antibody
Answer: C
Rationale: TSH receptor antibodies (TRAb) are diagnostic for Graves’ disease, the most common cause of
hyperthyroidism.
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3. A 55-year-old man with a 30-pack-year smoking history presents with new-onset hemoptysis and
weight loss. Chest CT shows a 4 cm central lung mass with mediastinal lymphadenopathy. Biopsy reveals
small cell carcinoma. Which paraneoplastic syndrome is most commonly associated with this histology?
A) Hypercalcemia
B) SIADH (hyponatremia)
C) Cushing syndrome
D) Lambert-Eaton myasthenic syndrome
Answer: B
Rationale: SIADH is the most common paraneoplastic syndrome in small cell lung cancer; Lambert-Eaton
is also associated but less common.
4. A 28-year-old G1P0 at 32 weeks gestation presents with new-onset hypertension (150/95 mmHg) and
proteinuria (2+ on dipstick). She denies headache or visual changes. What is the most appropriate next
step?
A) Immediate delivery by cesarean section
B) Hospitalization for blood pressure control and monitoring
C) Outpatient labetalol with weekly follow-up
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D) Magnesium sulfate prophylaxis
Answer: B
Rationale: Gestational hypertension or preeclampsia without severe features at 32 weeks requires
hospitalization for monitoring and BP control.
5. A 45-year-old woman presents with fatigue, arthralgias, malar rash, and oral ulcers. ANA is positive at
1:640, and anti-dsDNA antibodies are elevated. Which renal finding on biopsy indicates the poorest
prognosis?
A) Minimal change disease
B) Membranous nephropathy
C) Focal segmental glomerulosclerosis
D) Diffuse proliferative glomerulonephritis
Answer: D
Rationale: Class IV diffuse proliferative lupus nephritis carries the highest risk of progression to end-
stage renal disease.
COMSAE Phase 2 Form 111 Exam–ACTUAL
QUESTIONS AND ANSWERS LATEST UPDATE
THIS YEAR
COMSAE Phase 2 Form 111 Exam
Here are the summarized short point-form content areas for COMSAE Phase 2 Form 111
Content areas (summarized, short point-form)
• Internal medicine (cardiology, pulmonology, gastroenterology, nephrology, endocrinology,
rheumatology, hematology, oncology, infectious disease)
• Surgery (perioperative care, trauma, surgical complications, wound healing, breast, colorectal,
vascular)
• Pediatrics (growth and development, vaccination, common infections, congenital disorders,
adolescent medicine)
• Obstetrics & gynecology (prenatal care, labor and delivery, complications, contraception, STIs,
menstrual disorders)
• Psychiatry (major depressive disorder, bipolar, anxiety, psychosis, substance use, personality
disorders, suicide risk)
• Neurology (stroke, seizure, headache, movement disorders, neuromuscular disease, dementia)
• Osteopathic principles & OMM (somatic dysfunction, viscerosomatic reflexes, Chapman reflexes,
counterstrain, HVLA, Still technique, lymphatic treatment, rib raising, pelvic/sacral/CV4, OMT for
specific conditions)
• Preventive medicine & public health (screening guidelines, immunization schedules, counseling,
biostatistics, epidemiology)
• Emergency medicine & critical care (resuscitation, shock, trauma, toxicology, airway
management, ACLS)
• Ethics, law, & patient safety (informed consent, capacity, advance directives, medical errors,
end-of-life care)
• Musculoskeletal & rehabilitation (back pain, arthritis, fractures, sports medicine, OMT for
somatic dysfunction)
• Dermatology (rash, skin cancer, infectious dermatoses, drug eruptions)
1. A 62-year-old man with hypertension and diabetes presents with acute-onset substernal chest
pressure radiating to the jaw, diaphoresis, and nausea. ECG shows ST-segment elevation in leads V1-V4.
Which coronary artery is most likely occluded?
A) Right coronary artery
, Page 2 of 153
B) Left circumflex artery
C) Left anterior descending artery
D) Left main coronary artery
Answer: C
Rationale: Anterior ST elevation (V1-V4) indicates left anterior descending (LAD) artery occlusion.
2. A 34-year-old woman presents with palpitations, heat intolerance, weight loss despite increased
appetite, and a fine tremor. TSH is <0.01 mIU/L with elevated free T4. Which antibody is most specific
for the underlying etiology?
A) Anti-thyroglobulin antibody
B) Anti-thyroid peroxidase antibody
C) TSH receptor antibody
D) Anti-microsomal antibody
Answer: C
Rationale: TSH receptor antibodies (TRAb) are diagnostic for Graves’ disease, the most common cause of
hyperthyroidism.
, Page 3 of 153
3. A 55-year-old man with a 30-pack-year smoking history presents with new-onset hemoptysis and
weight loss. Chest CT shows a 4 cm central lung mass with mediastinal lymphadenopathy. Biopsy reveals
small cell carcinoma. Which paraneoplastic syndrome is most commonly associated with this histology?
A) Hypercalcemia
B) SIADH (hyponatremia)
C) Cushing syndrome
D) Lambert-Eaton myasthenic syndrome
Answer: B
Rationale: SIADH is the most common paraneoplastic syndrome in small cell lung cancer; Lambert-Eaton
is also associated but less common.
4. A 28-year-old G1P0 at 32 weeks gestation presents with new-onset hypertension (150/95 mmHg) and
proteinuria (2+ on dipstick). She denies headache or visual changes. What is the most appropriate next
step?
A) Immediate delivery by cesarean section
B) Hospitalization for blood pressure control and monitoring
C) Outpatient labetalol with weekly follow-up
, Page 4 of 153
D) Magnesium sulfate prophylaxis
Answer: B
Rationale: Gestational hypertension or preeclampsia without severe features at 32 weeks requires
hospitalization for monitoring and BP control.
5. A 45-year-old woman presents with fatigue, arthralgias, malar rash, and oral ulcers. ANA is positive at
1:640, and anti-dsDNA antibodies are elevated. Which renal finding on biopsy indicates the poorest
prognosis?
A) Minimal change disease
B) Membranous nephropathy
C) Focal segmental glomerulosclerosis
D) Diffuse proliferative glomerulonephritis
Answer: D
Rationale: Class IV diffuse proliferative lupus nephritis carries the highest risk of progression to end-
stage renal disease.
