COMSAE Phase 2 Form 112 Practice Exam
Practice Questions And Correct Answers
(Verified Answers) Plus Rationale 2026
Q&A| Instant Download Pdf
1. A 64-year-old man presents with crushing substernal chest pain
for 45 minutes. ECG shows ST-segment elevations in leads II, III, and
aVF. Which coronary artery is most likely occluded?
A. Left anterior descending
B. Left circumflex
C. Right coronary artery
D. Left main coronary artery
Answer: B.
Inferior-wall myocardial infarctions are commonly caused by right
coronary artery occlusion; however, among the listed choices, the
right coronary artery is the classic vessel. Therefore, the correct
answer is C, not B.
Correct Answer: C. Right coronary artery.
The RCA commonly supplies the inferior wall through the posterior
descending artery.
2. A 23-year-old woman has fatigue, weight loss, heat intolerance,
tremor, and diffuse goiter. TSH is suppressed and free T4 is elevated.
Which antibody is most specific for her condition?
A. Anti-thyroid peroxidase
B. Antithyroglobulin
C. TSH receptor-stimulating antibody
D. Antinuclear antibody
,Answer: C. TSH receptor-stimulating antibody.
Graves disease results from antibodies that stimulate the TSH
receptor.
3. A 71-year-old woman develops sudden right-sided weakness and
aphasia 90 minutes ago. CT shows no hemorrhage. Which treatment
is most appropriate if no contraindications are present?
A. Aspirin only
B. IV thrombolytic therapy
C. Warfarin
D. Heparin infusion
Answer: B. IV thrombolytic therapy.
An eligible patient with an acute ischemic stroke presenting within
the appropriate treatment window may receive IV thrombolysis after
intracranial hemorrhage is excluded.
4. A 35-year-old woman has malar erythema, photosensitivity, oral
ulcers, arthritis, and proteinuria. Which antibody is most specific for
systemic lupus erythematosus?
A. ANA
B. Anti-dsDNA
C. Anti-centromere
D. Anti-histone
Answer: B. Anti-dsDNA.
Anti-dsDNA has high specificity for SLE and correlates with lupus
nephritis activity.
5. A 58-year-old man with COPD has worsening dyspnea and
increased sputum purulence and volume. Which treatment is
appropriate?
A. Inhaled corticosteroid alone
B. Bronchodilator therapy with systemic corticosteroid and
appropriate antibiotics
,C. Immediate lung transplantation
D. Long-term anticoagulation
Answer: B. Bronchodilator therapy with systemic corticosteroid and
appropriate antibiotics.
An acute COPD exacerbation is treated with intensified
bronchodilation, systemic corticosteroids, and antibiotics when
bacterial features are present.
6. A 28-year-old woman presents with fever, flank pain, nausea, and
costovertebral-angle tenderness. Urinalysis shows pyuria and
bacteriuria. What is the most likely diagnosis?
A. Cystitis
B. Pyelonephritis
C. Nephrolithiasis
D. Interstitial cystitis
Answer: B. Pyelonephritis.
Fever and flank pain with urinary inflammatory findings strongly
indicate an upper urinary tract infection.
7. A 4-year-old child has barking cough, hoarseness, and inspiratory
stridor that worsens at night. What is the most likely diagnosis?
A. Epiglottitis
B. Croup
C. Bronchiolitis
D. Bacterial tracheitis
Answer: B. Croup.
Croup is usually viral and produces a characteristic barking cough and
inspiratory stridor.
8. A 67-year-old man with atrial fibrillation develops acute severe
abdominal pain that seems disproportionate to the physical
examination. Which diagnosis should be suspected?
A. Diverticulitis
, B. Acute mesenteric ischemia
C. Acute pancreatitis
D. Cholecystitis
Answer: B. Acute mesenteric ischemia.
Embolic occlusion of the superior mesenteric artery is an important
cause of severe abdominal pain out of proportion to examination
findings, especially with atrial fibrillation.
9. A 42-year-old woman has recurrent episodes of wheezing, chest
tightness, and cough triggered by exercise and allergens. Which
finding supports asthma?
A. Fixed airflow obstruction
B. Reversible airflow obstruction
C. Restrictive lung disease
D. Reduced total lung capacity
Answer: B. Reversible airflow obstruction.
Asthma is characterized by variable respiratory symptoms and
reversible bronchoconstriction.
10. A 60-year-old smoker has painless gross hematuria. Which
diagnosis must be excluded?
A. Renal cell carcinoma
B. Bladder urothelial carcinoma
C. Acute pyelonephritis
D. Nephrotic syndrome
Answer: B. Bladder urothelial carcinoma.
Painless gross hematuria in an older smoker is a classic presentation
of urothelial malignancy.
11. A patient with diabetic ketoacidosis has glucose 480 mg/dL, pH
7.12, and positive serum ketones. What is the initial treatment?
A. IV insulin before fluids
B. IV isotonic crystalloid
Practice Questions And Correct Answers
(Verified Answers) Plus Rationale 2026
Q&A| Instant Download Pdf
1. A 64-year-old man presents with crushing substernal chest pain
for 45 minutes. ECG shows ST-segment elevations in leads II, III, and
aVF. Which coronary artery is most likely occluded?
A. Left anterior descending
B. Left circumflex
C. Right coronary artery
D. Left main coronary artery
Answer: B.
Inferior-wall myocardial infarctions are commonly caused by right
coronary artery occlusion; however, among the listed choices, the
right coronary artery is the classic vessel. Therefore, the correct
answer is C, not B.
Correct Answer: C. Right coronary artery.
The RCA commonly supplies the inferior wall through the posterior
descending artery.
2. A 23-year-old woman has fatigue, weight loss, heat intolerance,
tremor, and diffuse goiter. TSH is suppressed and free T4 is elevated.
Which antibody is most specific for her condition?
A. Anti-thyroid peroxidase
B. Antithyroglobulin
C. TSH receptor-stimulating antibody
D. Antinuclear antibody
,Answer: C. TSH receptor-stimulating antibody.
Graves disease results from antibodies that stimulate the TSH
receptor.
3. A 71-year-old woman develops sudden right-sided weakness and
aphasia 90 minutes ago. CT shows no hemorrhage. Which treatment
is most appropriate if no contraindications are present?
A. Aspirin only
B. IV thrombolytic therapy
C. Warfarin
D. Heparin infusion
Answer: B. IV thrombolytic therapy.
An eligible patient with an acute ischemic stroke presenting within
the appropriate treatment window may receive IV thrombolysis after
intracranial hemorrhage is excluded.
4. A 35-year-old woman has malar erythema, photosensitivity, oral
ulcers, arthritis, and proteinuria. Which antibody is most specific for
systemic lupus erythematosus?
A. ANA
B. Anti-dsDNA
C. Anti-centromere
D. Anti-histone
Answer: B. Anti-dsDNA.
Anti-dsDNA has high specificity for SLE and correlates with lupus
nephritis activity.
5. A 58-year-old man with COPD has worsening dyspnea and
increased sputum purulence and volume. Which treatment is
appropriate?
A. Inhaled corticosteroid alone
B. Bronchodilator therapy with systemic corticosteroid and
appropriate antibiotics
,C. Immediate lung transplantation
D. Long-term anticoagulation
Answer: B. Bronchodilator therapy with systemic corticosteroid and
appropriate antibiotics.
An acute COPD exacerbation is treated with intensified
bronchodilation, systemic corticosteroids, and antibiotics when
bacterial features are present.
6. A 28-year-old woman presents with fever, flank pain, nausea, and
costovertebral-angle tenderness. Urinalysis shows pyuria and
bacteriuria. What is the most likely diagnosis?
A. Cystitis
B. Pyelonephritis
C. Nephrolithiasis
D. Interstitial cystitis
Answer: B. Pyelonephritis.
Fever and flank pain with urinary inflammatory findings strongly
indicate an upper urinary tract infection.
7. A 4-year-old child has barking cough, hoarseness, and inspiratory
stridor that worsens at night. What is the most likely diagnosis?
A. Epiglottitis
B. Croup
C. Bronchiolitis
D. Bacterial tracheitis
Answer: B. Croup.
Croup is usually viral and produces a characteristic barking cough and
inspiratory stridor.
8. A 67-year-old man with atrial fibrillation develops acute severe
abdominal pain that seems disproportionate to the physical
examination. Which diagnosis should be suspected?
A. Diverticulitis
, B. Acute mesenteric ischemia
C. Acute pancreatitis
D. Cholecystitis
Answer: B. Acute mesenteric ischemia.
Embolic occlusion of the superior mesenteric artery is an important
cause of severe abdominal pain out of proportion to examination
findings, especially with atrial fibrillation.
9. A 42-year-old woman has recurrent episodes of wheezing, chest
tightness, and cough triggered by exercise and allergens. Which
finding supports asthma?
A. Fixed airflow obstruction
B. Reversible airflow obstruction
C. Restrictive lung disease
D. Reduced total lung capacity
Answer: B. Reversible airflow obstruction.
Asthma is characterized by variable respiratory symptoms and
reversible bronchoconstriction.
10. A 60-year-old smoker has painless gross hematuria. Which
diagnosis must be excluded?
A. Renal cell carcinoma
B. Bladder urothelial carcinoma
C. Acute pyelonephritis
D. Nephrotic syndrome
Answer: B. Bladder urothelial carcinoma.
Painless gross hematuria in an older smoker is a classic presentation
of urothelial malignancy.
11. A patient with diabetic ketoacidosis has glucose 480 mg/dL, pH
7.12, and positive serum ketones. What is the initial treatment?
A. IV insulin before fluids
B. IV isotonic crystalloid
