COMSAE PHASE 1 FORM 113
EXAM
Systems-Based Clinical Vignettes
1.
A 30-year-old woman presents with palpitations, weight loss, and heat
intolerance. Labs show low TSH and high T4. Diagnosis?
A. Hypothyroidism
B. Graves disease
C. Thyroiditis
D. Pituitary adenoma
Answer: B
Rationale: Hyperthyroidism with low TSH and high T4 suggests
Graves disease, an autoimmune stimulation of the thyroid.
2.
A patient presents with confusion, dry skin, and hypernatremia.
Likely cause?
A. SIADH
,B. Diabetes insipidus
C. Addison disease
D. Hypothyroidism
Answer: B
Rationale: Diabetes insipidus leads to free water loss and
hypernatremia.
3.
A child presents with wheezing that improves with bronchodilators.
Diagnosis?
A. COPD
B. Asthma
C. Bronchitis
D. Pneumonia
Answer: B
Rationale: Reversible airway obstruction is characteristic of asthma.
4.
A patient with chronic alcohol use presents with confusion, ataxia,
and ophthalmoplegia. Deficiency?
, A. B12
B. Thiamine
C. Folate
D. Vitamin D
Answer: B
Rationale: Wernicke encephalopathy is due to thiamine deficiency.
5.
A patient with bone pain and elevated alkaline phosphatase likely has:
A. Osteoporosis
B. Paget disease
C. Osteoarthritis
D. RA
Answer: B
Rationale: Paget disease involves increased bone turnover and
elevated ALP.
Cardiology
6.
EXAM
Systems-Based Clinical Vignettes
1.
A 30-year-old woman presents with palpitations, weight loss, and heat
intolerance. Labs show low TSH and high T4. Diagnosis?
A. Hypothyroidism
B. Graves disease
C. Thyroiditis
D. Pituitary adenoma
Answer: B
Rationale: Hyperthyroidism with low TSH and high T4 suggests
Graves disease, an autoimmune stimulation of the thyroid.
2.
A patient presents with confusion, dry skin, and hypernatremia.
Likely cause?
A. SIADH
,B. Diabetes insipidus
C. Addison disease
D. Hypothyroidism
Answer: B
Rationale: Diabetes insipidus leads to free water loss and
hypernatremia.
3.
A child presents with wheezing that improves with bronchodilators.
Diagnosis?
A. COPD
B. Asthma
C. Bronchitis
D. Pneumonia
Answer: B
Rationale: Reversible airway obstruction is characteristic of asthma.
4.
A patient with chronic alcohol use presents with confusion, ataxia,
and ophthalmoplegia. Deficiency?
, A. B12
B. Thiamine
C. Folate
D. Vitamin D
Answer: B
Rationale: Wernicke encephalopathy is due to thiamine deficiency.
5.
A patient with bone pain and elevated alkaline phosphatase likely has:
A. Osteoporosis
B. Paget disease
C. Osteoarthritis
D. RA
Answer: B
Rationale: Paget disease involves increased bone turnover and
elevated ALP.
Cardiology
6.
