COMSAE Phase 1 Form 116 Practice Exam
Questions And Correct Answers (Verified
Answers) Plus Rationales 2026|2027 Q&A |
Instant Download Pdf
Q1
A 24-year-old man presents with sudden onset severe right-sided flank pain
radiating to the groin and hematuria. CT shows a 4-mm stone in the proximal
ureter. Which of the following is the most likely composition of this stone?
A. Calcium oxalate
B. Struvite
C. Uric acid
D. Cystine
E. Calcium phosphate
A. Calcium oxalate
Calcium oxalate stones are the most common kidney stones, often associated with
hypercalciuria, hyperoxaluria, or low urine volume.
Q2
A 55-year-old man with hypertension and type 2 diabetes presents with
progressive dyspnea on exertion and orthopnea. Echocardiogram shows LV
,ejection fraction of 25%. Which of the following medications has been shown to
reduce mortality in this condition?
A. Furosemide
B. Digoxin
C. Carvedilol
D. Hydralazine alone
E. Ivabradine
C. Carvedilol
Beta-blockers (carvedilol, metoprolol succinate, bisoprolol) reduce mortality in
HFrEF; diuretics improve symptoms but not survival.
Q3
A 30-year-old woman presents with fatigue, cold intolerance, and weight gain.
TSH is 15 mIU/L (high), free T4 is low. Anti-TPO antibodies are positive. Which of
the following is the most likely diagnosis?
A. Graves disease
B. Subacute thyroiditis
C. Hashimoto thyroiditis
D. Toxic multinodular goiter
E. TSH-secreting pituitary adenoma
C. Hashimoto thyroiditis
Chronic autoimmune thyroiditis causes primary hypothyroidism with high TSH, low
T4, and positive anti-TPO antibodies.
,Q4
A 6-year-old boy presents with recurrent sinopulmonary infections and low levels
of all immunoglobulin classes. Flow cytometry shows absent CD19+ B cells. Which
of the following is the most likely diagnosis?
A. DiGeorge syndrome
B. X-linked agammaglobulinemia
C. Severe combined immunodeficiency (SCID)
D. Wiskott-Aldrich syndrome
E. Chronic granulomatous disease
B. X-linked agammaglobulinemia
Defect in BTK tyrosine kinase leads to absent mature B cells and low
immunoglobulins, with recurrent bacterial infections after maternal IgG wanes.
Q5
A 45-year-old man presents with acute onset severe epigastric pain radiating to
the back and elevated serum lipase. He has a history of heavy alcohol use. Which
of the following is the most likely mechanism of injury in this condition?
A. Bacterial overgrowth
B. Autoimmune destruction of acinar cells
C. Premature activation of pancreatic enzymes within the pancreas
D. Ischemia of the pancreatic head
E. Direct viral cytopathic effect
, C. Premature activation of pancreatic enzymes within the pancreas
Acute pancreatitis involves intrapancreatic activation of trypsin and other
enzymes, leading to autodigestion and inflammation.
Q6
A 22-year-old woman presents with primary amenorrhea, short stature, and
widely spaced nipples. Karyotype shows 45,X. Which of the following is the most
likely diagnosis?
A. Androgen insensitivity syndrome
B. Turner syndrome
C. Klinefelter syndrome
D. Müllerian agenesis
E. Congenital adrenal hyperplasia
B. Turner syndrome
45,X karyotype with streak ovaries, short stature, and characteristic physical
features indicates Turner syndrome.
Q7
A 70-year-old man presents with progressive memory loss, getting lost in familiar
places, and difficulty managing finances. MMSE is 18/30. MRI shows generalized
cortical atrophy and enlarged ventricles. Which of the following is the most likely
diagnosis?
Questions And Correct Answers (Verified
Answers) Plus Rationales 2026|2027 Q&A |
Instant Download Pdf
Q1
A 24-year-old man presents with sudden onset severe right-sided flank pain
radiating to the groin and hematuria. CT shows a 4-mm stone in the proximal
ureter. Which of the following is the most likely composition of this stone?
A. Calcium oxalate
B. Struvite
C. Uric acid
D. Cystine
E. Calcium phosphate
A. Calcium oxalate
Calcium oxalate stones are the most common kidney stones, often associated with
hypercalciuria, hyperoxaluria, or low urine volume.
Q2
A 55-year-old man with hypertension and type 2 diabetes presents with
progressive dyspnea on exertion and orthopnea. Echocardiogram shows LV
,ejection fraction of 25%. Which of the following medications has been shown to
reduce mortality in this condition?
A. Furosemide
B. Digoxin
C. Carvedilol
D. Hydralazine alone
E. Ivabradine
C. Carvedilol
Beta-blockers (carvedilol, metoprolol succinate, bisoprolol) reduce mortality in
HFrEF; diuretics improve symptoms but not survival.
Q3
A 30-year-old woman presents with fatigue, cold intolerance, and weight gain.
TSH is 15 mIU/L (high), free T4 is low. Anti-TPO antibodies are positive. Which of
the following is the most likely diagnosis?
A. Graves disease
B. Subacute thyroiditis
C. Hashimoto thyroiditis
D. Toxic multinodular goiter
E. TSH-secreting pituitary adenoma
C. Hashimoto thyroiditis
Chronic autoimmune thyroiditis causes primary hypothyroidism with high TSH, low
T4, and positive anti-TPO antibodies.
,Q4
A 6-year-old boy presents with recurrent sinopulmonary infections and low levels
of all immunoglobulin classes. Flow cytometry shows absent CD19+ B cells. Which
of the following is the most likely diagnosis?
A. DiGeorge syndrome
B. X-linked agammaglobulinemia
C. Severe combined immunodeficiency (SCID)
D. Wiskott-Aldrich syndrome
E. Chronic granulomatous disease
B. X-linked agammaglobulinemia
Defect in BTK tyrosine kinase leads to absent mature B cells and low
immunoglobulins, with recurrent bacterial infections after maternal IgG wanes.
Q5
A 45-year-old man presents with acute onset severe epigastric pain radiating to
the back and elevated serum lipase. He has a history of heavy alcohol use. Which
of the following is the most likely mechanism of injury in this condition?
A. Bacterial overgrowth
B. Autoimmune destruction of acinar cells
C. Premature activation of pancreatic enzymes within the pancreas
D. Ischemia of the pancreatic head
E. Direct viral cytopathic effect
, C. Premature activation of pancreatic enzymes within the pancreas
Acute pancreatitis involves intrapancreatic activation of trypsin and other
enzymes, leading to autodigestion and inflammation.
Q6
A 22-year-old woman presents with primary amenorrhea, short stature, and
widely spaced nipples. Karyotype shows 45,X. Which of the following is the most
likely diagnosis?
A. Androgen insensitivity syndrome
B. Turner syndrome
C. Klinefelter syndrome
D. Müllerian agenesis
E. Congenital adrenal hyperplasia
B. Turner syndrome
45,X karyotype with streak ovaries, short stature, and characteristic physical
features indicates Turner syndrome.
Q7
A 70-year-old man presents with progressive memory loss, getting lost in familiar
places, and difficulty managing finances. MMSE is 18/30. MRI shows generalized
cortical atrophy and enlarged ventricles. Which of the following is the most likely
diagnosis?
