COMSAE Phase 2 BSA 119 Clinical
Knowledge Assessment Exam Questions
and Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant
Download Pdf.
1. A 62-year-old man with hypertension presents with sudden severe
tearing chest pain radiating to the back. Blood pressure is 180/100 in
the right arm and 150/90 in the left arm. What is the most likely
diagnosis?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
Correct answer: C. Aortic dissection
Rationale: The classic presentation of aortic dissection includes sudden,
severe “tearing” chest pain radiating to the back and blood pressure
discrepancies between limbs due to involvement of branch vessels.
Hypertension is the major risk factor. MI and PE do not typically cause
inter-arm BP differences.
,2. A 24-year-old woman presents with dysuria and urinary frequency.
Urinalysis shows leukocyte esterase and nitrites. What is the most
likely organism?
A. Staphylococcus saprophyticus
B. Escherichia coli
C. Klebsiella pneumoniae
D. Proteus mirabilis
Correct answer: B. Escherichia coli
Rationale: E. coli is responsible for the majority of uncomplicated
urinary tract infections due to its ability to adhere to uroepithelial cells
via P fimbriae. Nitrite positivity suggests Gram-negative bacteria
capable of nitrate reduction, strongly pointing to E. coli.
3. A patient has tremor at rest, bradykinesia, and rigidity. Which brain
structure is primarily affected?
A. Cerebellum
B. Substantia nigra
C. Hippocampus
D. Caudate nucleus only
Correct answer: B. Substantia nigra
Rationale: Parkinson disease is caused by degeneration of dopaminergic
neurons in the substantia nigra pars compacta, leading to decreased
dopamine in the basal ganglia circuitry and resulting in motor
symptoms.
,4. A child presents with barking cough and inspiratory stridor. What is
the best initial treatment?
A. Antibiotics
B. Nebulized epinephrine and dexamethasone
C. Heliox therapy only
D. Intubation immediately
Correct answer: B. Nebulized epinephrine and dexamethasone
Rationale: Croup (laryngotracheobronchitis) is usually viral
(parainfluenza). Steroids reduce airway inflammation, and nebulized
epinephrine provides rapid temporary relief of airway obstruction.
5. A 45-year-old man has epigastric pain that improves with meals.
Diagnosis?
A. Gastric ulcer
B. Duodenal ulcer
C. Pancreatitis
D. GERD
Correct answer: B. Duodenal ulcer
Rationale: Duodenal ulcers typically improve with food intake because
food buffers acid. Gastric ulcers usually worsen with eating.
6. A newborn has failure to pass meconium within 48 hours and a
distended abdomen. What is the diagnosis?
A. Meconium ileus
B. Hirschsprung disease
, C. Pyloric stenosis
D. Necrotizing enterocolitis
Correct answer: B. Hirschsprung disease
Rationale: Hirschsprung disease is caused by failure of neural crest
migration leading to absence of ganglion cells in distal colon, causing
functional obstruction and delayed meconium passage.
7. A patient has hypocalcemia with positive Chvostek and Trousseau
signs. What hormone is deficient?
A. Calcitonin
B. Parathyroid hormone
C. Vitamin D only
D. Aldosterone
Correct answer: B. Parathyroid hormone
Rationale: PTH increases serum calcium via bone resorption, renal
reabsorption, and activation of vitamin D. Its deficiency leads to
hypocalcemia and neuromuscular excitability.
8. A smoker has chronic productive cough for 3 months over 2
consecutive years. Diagnosis?
A. Emphysema
B. Chronic bronchitis
C. Bronchiectasis
D. Asthma
Correct answer: B. Chronic bronchitis
Knowledge Assessment Exam Questions
and Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant
Download Pdf.
1. A 62-year-old man with hypertension presents with sudden severe
tearing chest pain radiating to the back. Blood pressure is 180/100 in
the right arm and 150/90 in the left arm. What is the most likely
diagnosis?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
Correct answer: C. Aortic dissection
Rationale: The classic presentation of aortic dissection includes sudden,
severe “tearing” chest pain radiating to the back and blood pressure
discrepancies between limbs due to involvement of branch vessels.
Hypertension is the major risk factor. MI and PE do not typically cause
inter-arm BP differences.
,2. A 24-year-old woman presents with dysuria and urinary frequency.
Urinalysis shows leukocyte esterase and nitrites. What is the most
likely organism?
A. Staphylococcus saprophyticus
B. Escherichia coli
C. Klebsiella pneumoniae
D. Proteus mirabilis
Correct answer: B. Escherichia coli
Rationale: E. coli is responsible for the majority of uncomplicated
urinary tract infections due to its ability to adhere to uroepithelial cells
via P fimbriae. Nitrite positivity suggests Gram-negative bacteria
capable of nitrate reduction, strongly pointing to E. coli.
3. A patient has tremor at rest, bradykinesia, and rigidity. Which brain
structure is primarily affected?
A. Cerebellum
B. Substantia nigra
C. Hippocampus
D. Caudate nucleus only
Correct answer: B. Substantia nigra
Rationale: Parkinson disease is caused by degeneration of dopaminergic
neurons in the substantia nigra pars compacta, leading to decreased
dopamine in the basal ganglia circuitry and resulting in motor
symptoms.
,4. A child presents with barking cough and inspiratory stridor. What is
the best initial treatment?
A. Antibiotics
B. Nebulized epinephrine and dexamethasone
C. Heliox therapy only
D. Intubation immediately
Correct answer: B. Nebulized epinephrine and dexamethasone
Rationale: Croup (laryngotracheobronchitis) is usually viral
(parainfluenza). Steroids reduce airway inflammation, and nebulized
epinephrine provides rapid temporary relief of airway obstruction.
5. A 45-year-old man has epigastric pain that improves with meals.
Diagnosis?
A. Gastric ulcer
B. Duodenal ulcer
C. Pancreatitis
D. GERD
Correct answer: B. Duodenal ulcer
Rationale: Duodenal ulcers typically improve with food intake because
food buffers acid. Gastric ulcers usually worsen with eating.
6. A newborn has failure to pass meconium within 48 hours and a
distended abdomen. What is the diagnosis?
A. Meconium ileus
B. Hirschsprung disease
, C. Pyloric stenosis
D. Necrotizing enterocolitis
Correct answer: B. Hirschsprung disease
Rationale: Hirschsprung disease is caused by failure of neural crest
migration leading to absence of ganglion cells in distal colon, causing
functional obstruction and delayed meconium passage.
7. A patient has hypocalcemia with positive Chvostek and Trousseau
signs. What hormone is deficient?
A. Calcitonin
B. Parathyroid hormone
C. Vitamin D only
D. Aldosterone
Correct answer: B. Parathyroid hormone
Rationale: PTH increases serum calcium via bone resorption, renal
reabsorption, and activation of vitamin D. Its deficiency leads to
hypocalcemia and neuromuscular excitability.
8. A smoker has chronic productive cough for 3 months over 2
consecutive years. Diagnosis?
A. Emphysema
B. Chronic bronchitis
C. Bronchiectasis
D. Asthma
Correct answer: B. Chronic bronchitis
