COMSAE Phase 2 Form BSA 122 Clinical
Simulation Exam Practice Questions &
[Verified Answers], Plus Explained
Rationales|2026 Latest Update| Instant
Download PDF
1
A 64-year-old man with long-standing hypertension presents with
sudden tearing chest pain radiating to the back. BP is 190/100 in right
arm and 160/90 in left arm. What is the diagnosis?
A. MI
B. PE
C. Aortic dissection
D. Pericarditis
Answer: C. Aortic dissection
Rationale: Unequal arm BP + tearing pain = classic Stanford type A
dissection due to intimal tear with false lumen formation.
2
A 23-year-old woman has palpitations, heat intolerance, and weight
loss. TSH is low and free T4 is high. Diagnosis?
A. Hashimoto thyroiditis
B. Graves disease
C. Thyroid cancer
,D. Subacute thyroiditis
Answer: B. Graves disease
Rationale: Hyperthyroidism with suppressed TSH + elevated T4
strongly indicates Graves disease due to TSH receptor antibodies.
3
A diabetic patient presents with fruity breath and Kussmaul
respirations. Lab shows pH 7.1, glucose 600. Diagnosis?
A. HHS
B. DKA
C. Lactic acidosis
D. Renal failure
Answer: B. DKA
Rationale: Acidosis + ketones + hyperglycemia define diabetic
ketoacidosis from insulin deficiency and lipolysis.
4
A newborn has bilious vomiting and “double bubble” sign on X-ray.
Diagnosis?
A. Pyloric stenosis
B. Duodenal atresia
C. NEC
D. Malrotation
Answer: B. Duodenal atresia
Rationale: Double bubble indicates proximal duodenal obstruction,
often associated with Down syndrome.
,5
A 55-year-old smoker has hematuria and painless bladder mass. Most
likely diagnosis?
A. Renal cell carcinoma
B. Bladder cancer
C. UTI
D. Stones
Answer: B. Bladder cancer
Rationale: Painless hematuria in smoker strongly suggests transitional
cell carcinoma of bladder.
6
A child presents with slapped cheek rash and mild anemia. Virus?
A. EBV
B. Parvovirus B19
C. CMV
D. RSV
Answer: B. Parvovirus B19
Rationale: Causes erythema infectiosum and infects erythroid
precursors causing aplastic crisis.
7
A patient has fever, confusion, and hyperreflexia after starting SSRI +
MAOI. Diagnosis?
A. NMS
B. Serotonin syndrome
C. Malignant hyperthermia
D. Stroke
, Answer: B. Serotonin syndrome
Rationale: Hyperreflexia + autonomic instability + drug interaction =
serotonin excess.
8
A man has RUQ pain, fever, and jaundice. Diagnosis?
A. Cholecystitis
B. Ascending cholangitis
C. Hepatitis
D. Pancreatitis
Answer: B. Ascending cholangitis
Rationale: Charcot triad = fever, RUQ pain, jaundice due to biliary
infection.
9
A patient has tremor at rest, rigidity, and bradykinesia. Diagnosis?
A. Huntington
B. Parkinson disease
C. MS
D. ALS
Answer: B. Parkinson disease
Rationale: Dopamine deficiency in substantia nigra causes resting
tremor and rigidity.
10
A woman has recurrent miscarriages and prolonged PTT. Diagnosis?
A. Hemophilia A
Simulation Exam Practice Questions &
[Verified Answers], Plus Explained
Rationales|2026 Latest Update| Instant
Download PDF
1
A 64-year-old man with long-standing hypertension presents with
sudden tearing chest pain radiating to the back. BP is 190/100 in right
arm and 160/90 in left arm. What is the diagnosis?
A. MI
B. PE
C. Aortic dissection
D. Pericarditis
Answer: C. Aortic dissection
Rationale: Unequal arm BP + tearing pain = classic Stanford type A
dissection due to intimal tear with false lumen formation.
2
A 23-year-old woman has palpitations, heat intolerance, and weight
loss. TSH is low and free T4 is high. Diagnosis?
A. Hashimoto thyroiditis
B. Graves disease
C. Thyroid cancer
,D. Subacute thyroiditis
Answer: B. Graves disease
Rationale: Hyperthyroidism with suppressed TSH + elevated T4
strongly indicates Graves disease due to TSH receptor antibodies.
3
A diabetic patient presents with fruity breath and Kussmaul
respirations. Lab shows pH 7.1, glucose 600. Diagnosis?
A. HHS
B. DKA
C. Lactic acidosis
D. Renal failure
Answer: B. DKA
Rationale: Acidosis + ketones + hyperglycemia define diabetic
ketoacidosis from insulin deficiency and lipolysis.
4
A newborn has bilious vomiting and “double bubble” sign on X-ray.
Diagnosis?
A. Pyloric stenosis
B. Duodenal atresia
C. NEC
D. Malrotation
Answer: B. Duodenal atresia
Rationale: Double bubble indicates proximal duodenal obstruction,
often associated with Down syndrome.
,5
A 55-year-old smoker has hematuria and painless bladder mass. Most
likely diagnosis?
A. Renal cell carcinoma
B. Bladder cancer
C. UTI
D. Stones
Answer: B. Bladder cancer
Rationale: Painless hematuria in smoker strongly suggests transitional
cell carcinoma of bladder.
6
A child presents with slapped cheek rash and mild anemia. Virus?
A. EBV
B. Parvovirus B19
C. CMV
D. RSV
Answer: B. Parvovirus B19
Rationale: Causes erythema infectiosum and infects erythroid
precursors causing aplastic crisis.
7
A patient has fever, confusion, and hyperreflexia after starting SSRI +
MAOI. Diagnosis?
A. NMS
B. Serotonin syndrome
C. Malignant hyperthermia
D. Stroke
, Answer: B. Serotonin syndrome
Rationale: Hyperreflexia + autonomic instability + drug interaction =
serotonin excess.
8
A man has RUQ pain, fever, and jaundice. Diagnosis?
A. Cholecystitis
B. Ascending cholangitis
C. Hepatitis
D. Pancreatitis
Answer: B. Ascending cholangitis
Rationale: Charcot triad = fever, RUQ pain, jaundice due to biliary
infection.
9
A patient has tremor at rest, rigidity, and bradykinesia. Diagnosis?
A. Huntington
B. Parkinson disease
C. MS
D. ALS
Answer: B. Parkinson disease
Rationale: Dopamine deficiency in substantia nigra causes resting
tremor and rigidity.
10
A woman has recurrent miscarriages and prolonged PTT. Diagnosis?
A. Hemophilia A
