COMSAE Phase 2 BSA 116 Clinical
Knowledge Assessment Exam Questions
and Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant
Download Pdf.
1. A 67-year-old man presents with sudden onset chest pain radiating
to the back and unequal blood pressures in both arms. Which is the
most likely diagnosis?
A. Acute myocardial infarction
B. Aortic dissection
C. Pulmonary embolism
D. Pericarditis
Rationale: The sudden tearing chest pain radiating to the back with
blood pressure discrepancy between arms is classic for aortic dissection
due to intimal tear allowing blood to enter the media layer, creating a
false lumen.
2. A 23-year-old woman presents with dysuria and urinary frequency.
Urinalysis shows leukocyte esterase positive and nitrites positive.
What is the most likely organism?
,A. Staphylococcus saprophyticus
B. Escherichia coli
C. Enterococcus faecalis
D. Pseudomonas aeruginosa
Rationale: E. coli is the most common cause of uncomplicated urinary
tract infection and produces nitrites via nitrate reduction.
3. A patient with chronic alcoholism presents with confusion, ataxia,
and ophthalmoplegia. What is the best immediate treatment?
A. Oral glucose
B. Thiamine IV before glucose administration
C. Folic acid
D. Vitamin B12
Rationale: Wernicke encephalopathy due to thiamine deficiency must be
treated urgently with thiamine before glucose to avoid worsening
neurologic injury.
4. A 55-year-old smoker presents with hematuria and flank pain.
Imaging reveals a renal mass. Which type of cancer is most likely?
A. Transitional cell carcinoma
B. Renal cell carcinoma
C. Wilms tumor
D. Angiomyolipoma
Rationale: Renal cell carcinoma is associated with hematuria, flank pain,
and a mass, especially in older smokers.
,5. A newborn has persistent cyanosis that does not improve with
oxygen. Which condition is most likely?
A. Respiratory distress syndrome
B. Transposition of the great arteries
C. Meconium aspiration syndrome
D. Pneumothorax
Rationale: Cyanotic congenital heart disease that does not respond to
oxygen suggests a right-to-left shunt such as transposition of the great
arteries.
6. A patient has fever, jaw claudication, and vision changes. What is
the best next step?
A. Start antibiotics
B. Start high-dose corticosteroids immediately
C. Order CT scan
D. Observe
Rationale: Giant cell arteritis requires immediate steroids to prevent
irreversible vision loss.
7. A child presents with barking cough and inspiratory stridor. What is
the most likely diagnosis?
A. Epiglottitis
B. Croup
, C. Bronchiolitis
D. Asthma
Rationale: Croup is caused by parainfluenza virus and presents with
barking cough and stridor.
8. A patient has tremor at rest, rigidity, and bradykinesia. Which
structure is primarily affected?
A. Cerebellum
B. Substantia nigra
C. Caudate nucleus
D. Hippocampus
Rationale: Parkinson disease is due to degeneration of dopaminergic
neurons in the substantia nigra.
9. A patient presents with exophthalmos, heat intolerance, and weight
loss. Labs show low TSH and high T4. Diagnosis?
A. Hashimoto thyroiditis
B. Graves disease
C. Thyroid cancer
D. Subacute thyroiditis
Rationale: Graves disease is autoimmune hyperthyroidism with
ophthalmopathy.
Knowledge Assessment Exam Questions
and Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant
Download Pdf.
1. A 67-year-old man presents with sudden onset chest pain radiating
to the back and unequal blood pressures in both arms. Which is the
most likely diagnosis?
A. Acute myocardial infarction
B. Aortic dissection
C. Pulmonary embolism
D. Pericarditis
Rationale: The sudden tearing chest pain radiating to the back with
blood pressure discrepancy between arms is classic for aortic dissection
due to intimal tear allowing blood to enter the media layer, creating a
false lumen.
2. A 23-year-old woman presents with dysuria and urinary frequency.
Urinalysis shows leukocyte esterase positive and nitrites positive.
What is the most likely organism?
,A. Staphylococcus saprophyticus
B. Escherichia coli
C. Enterococcus faecalis
D. Pseudomonas aeruginosa
Rationale: E. coli is the most common cause of uncomplicated urinary
tract infection and produces nitrites via nitrate reduction.
3. A patient with chronic alcoholism presents with confusion, ataxia,
and ophthalmoplegia. What is the best immediate treatment?
A. Oral glucose
B. Thiamine IV before glucose administration
C. Folic acid
D. Vitamin B12
Rationale: Wernicke encephalopathy due to thiamine deficiency must be
treated urgently with thiamine before glucose to avoid worsening
neurologic injury.
4. A 55-year-old smoker presents with hematuria and flank pain.
Imaging reveals a renal mass. Which type of cancer is most likely?
A. Transitional cell carcinoma
B. Renal cell carcinoma
C. Wilms tumor
D. Angiomyolipoma
Rationale: Renal cell carcinoma is associated with hematuria, flank pain,
and a mass, especially in older smokers.
,5. A newborn has persistent cyanosis that does not improve with
oxygen. Which condition is most likely?
A. Respiratory distress syndrome
B. Transposition of the great arteries
C. Meconium aspiration syndrome
D. Pneumothorax
Rationale: Cyanotic congenital heart disease that does not respond to
oxygen suggests a right-to-left shunt such as transposition of the great
arteries.
6. A patient has fever, jaw claudication, and vision changes. What is
the best next step?
A. Start antibiotics
B. Start high-dose corticosteroids immediately
C. Order CT scan
D. Observe
Rationale: Giant cell arteritis requires immediate steroids to prevent
irreversible vision loss.
7. A child presents with barking cough and inspiratory stridor. What is
the most likely diagnosis?
A. Epiglottitis
B. Croup
, C. Bronchiolitis
D. Asthma
Rationale: Croup is caused by parainfluenza virus and presents with
barking cough and stridor.
8. A patient has tremor at rest, rigidity, and bradykinesia. Which
structure is primarily affected?
A. Cerebellum
B. Substantia nigra
C. Caudate nucleus
D. Hippocampus
Rationale: Parkinson disease is due to degeneration of dopaminergic
neurons in the substantia nigra.
9. A patient presents with exophthalmos, heat intolerance, and weight
loss. Labs show low TSH and high T4. Diagnosis?
A. Hashimoto thyroiditis
B. Graves disease
C. Thyroid cancer
D. Subacute thyroiditis
Rationale: Graves disease is autoimmune hyperthyroidism with
ophthalmopathy.
