COMSAE Phase 2 Practice Exam (Form
C108-Style) Questions And Correct
Answers (Verified Answers) Plus
Rationales 2025|2026 Q&A | Instant
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Q1. A 25-year-old man has acute onset flank pain and hematuria. No fever.
Urinalysis: RBCs, no WBCs, no bacteria. Most likely diagnosis?
A. Pyelonephritis
B. Nephrolithiasis
C. Glomerulonephritis
D. Renal infarction
Rationale: Nephrolithiasis causes flank pain and hematuria without
infection signs; fever or WBC casts suggest pyelonephritis.
Q2. A 34-year-old woman develops amenorrhea and galactorrhea. MRI
shows pituitary adenoma. Which medication can treat her symptoms?
,A. Bromide
B. Cabergoline
C. Propylthiouracil
D. Leuprolide
Rationale: Cabergoline, a dopamine agonist, suppresses prolactin secretion
and shrinks prolactinomas.
Q3. A 68-year-old man with COPD has worsening dyspnea and wheezing.
ABG: pH 7.31, PaCO₂ 60, PaO₂ 55. Best initial management?
A. Non-invasive positive pressure ventilation
B. Immediate intubation
C. High-flow oxygen > 10 L/min
D. IV steroids only
Rationale: NIPPV improves ventilation and reduces CO₂ retention in COPD
exacerbations.
Q4. A 17-year-old with sore throat develops splenomegaly. Heterophile
antibody test positive. Advice?
A. Return to sports immediately
B. Avoid contact sports for ≥ 3 weeks
C. Begin steroids
D. Tonsillectomy
Rationale: Mononucleosis from EBV risks splenic rupture; rest from
contact sports is required.
,Q5. A 56-year-old man with chronic GERD has dysphagia for solids. Next
step?
A. Barium swallow
B. Upper endoscopy
C. Manometry
D. pH probe
Rationale: Alarm symptoms require endoscopy to rule out Barrett’s or
adenocarcinoma.
Q6. A newborn has continuous machinery murmur at left infraclavicular
area. Diagnosis?
A. ASD
B. VSD
C. PDA
D. TOF
Rationale: Patent ductus arteriosus causes continuous murmur from
persistent left-to-right shunt.
Q7. A 30-year-old woman with fatigue, weight gain, and cold intolerance.
TSH ↑, T₄ ↓. Diagnosis?
A. Central hypothyroidism
B. Primary hypothyroidism (Hashimoto)
C. Subacute thyroiditis
D. Factitious hypothyroidism
, Rationale: High TSH with low T₄ indicates primary thyroid failure, usually
autoimmune.
Q8. A 45-year-old man has chest pain relieved by nitroglycerin. ECG normal.
Next diagnostic test?
A. Exercise stress test
B. Coronary angiography
C. Echocardiography
D. CT chest
Rationale: Stable angina with normal baseline ECG → stress test for
ischemia confirmation.
Q9. A 4-year-old boy has barking cough and inspiratory stridor. Best initial
management?
A. Antibiotics
B. Dexamethasone and nebulized epinephrine
C. Intubation immediately
D. Antihistamines
Rationale: Croup (parainfluenza) responds to steroids and racemic
epinephrine for airway swelling.
Q10. A 72-year-old man has progressive memory loss, normal
consciousness, hallucinations, parkinsonism. Diagnosis?
A. Alzheimer
B. Lewy body dementia
C. Frontotemporal dementia
C108-Style) Questions And Correct
Answers (Verified Answers) Plus
Rationales 2025|2026 Q&A | Instant
Download Pdf
Q1. A 25-year-old man has acute onset flank pain and hematuria. No fever.
Urinalysis: RBCs, no WBCs, no bacteria. Most likely diagnosis?
A. Pyelonephritis
B. Nephrolithiasis
C. Glomerulonephritis
D. Renal infarction
Rationale: Nephrolithiasis causes flank pain and hematuria without
infection signs; fever or WBC casts suggest pyelonephritis.
Q2. A 34-year-old woman develops amenorrhea and galactorrhea. MRI
shows pituitary adenoma. Which medication can treat her symptoms?
,A. Bromide
B. Cabergoline
C. Propylthiouracil
D. Leuprolide
Rationale: Cabergoline, a dopamine agonist, suppresses prolactin secretion
and shrinks prolactinomas.
Q3. A 68-year-old man with COPD has worsening dyspnea and wheezing.
ABG: pH 7.31, PaCO₂ 60, PaO₂ 55. Best initial management?
A. Non-invasive positive pressure ventilation
B. Immediate intubation
C. High-flow oxygen > 10 L/min
D. IV steroids only
Rationale: NIPPV improves ventilation and reduces CO₂ retention in COPD
exacerbations.
Q4. A 17-year-old with sore throat develops splenomegaly. Heterophile
antibody test positive. Advice?
A. Return to sports immediately
B. Avoid contact sports for ≥ 3 weeks
C. Begin steroids
D. Tonsillectomy
Rationale: Mononucleosis from EBV risks splenic rupture; rest from
contact sports is required.
,Q5. A 56-year-old man with chronic GERD has dysphagia for solids. Next
step?
A. Barium swallow
B. Upper endoscopy
C. Manometry
D. pH probe
Rationale: Alarm symptoms require endoscopy to rule out Barrett’s or
adenocarcinoma.
Q6. A newborn has continuous machinery murmur at left infraclavicular
area. Diagnosis?
A. ASD
B. VSD
C. PDA
D. TOF
Rationale: Patent ductus arteriosus causes continuous murmur from
persistent left-to-right shunt.
Q7. A 30-year-old woman with fatigue, weight gain, and cold intolerance.
TSH ↑, T₄ ↓. Diagnosis?
A. Central hypothyroidism
B. Primary hypothyroidism (Hashimoto)
C. Subacute thyroiditis
D. Factitious hypothyroidism
, Rationale: High TSH with low T₄ indicates primary thyroid failure, usually
autoimmune.
Q8. A 45-year-old man has chest pain relieved by nitroglycerin. ECG normal.
Next diagnostic test?
A. Exercise stress test
B. Coronary angiography
C. Echocardiography
D. CT chest
Rationale: Stable angina with normal baseline ECG → stress test for
ischemia confirmation.
Q9. A 4-year-old boy has barking cough and inspiratory stridor. Best initial
management?
A. Antibiotics
B. Dexamethasone and nebulized epinephrine
C. Intubation immediately
D. Antihistamines
Rationale: Croup (parainfluenza) responds to steroids and racemic
epinephrine for airway swelling.
Q10. A 72-year-old man has progressive memory loss, normal
consciousness, hallucinations, parkinsonism. Diagnosis?
A. Alzheimer
B. Lewy body dementia
C. Frontotemporal dementia
