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COMSAE Phase 1 ASA 107i – The Complete 176
Question Test Bank All questions with correct verified
answers & detailed rationales – graded A+ for the
newest 2026 actual exam
Section 1: Anatomy & Neuroanatomy (Questions 1–25)
1. A 52-year-old woman presents with loss of pain and temperature sensation
on the right side of her face and left side of her body. A brainstem lesion is
suspected. Which vascular syndrome is most likely?
A. Anterior spinal artery occlusion
B. Lateral medullary (Wallenberg) syndrome
C. Medial medullary syndrome
D. Basilar artery occlusion
: Correct Answer : B. Lateral medullary (Wallenberg) syndrome
Rationale: Wallenberg syndrome is caused by occlusion of the posterior inferior
cerebellar artery (PICA). It results in loss of pain and temperature on the ipsilateral
face (trigeminal nucleus) and contralateral body (spinothalamic tract). Other
features include dysphagia, vertigo, and Horner syndrome.
2. A 45-year-old man has a tumor compressing the right optic nerve just before
the optic chiasm. Which visual field defect would be expected?
A. Bitemporal hemianopia
B. Right nasal hemianopia
C. Right monocular blindness
D. Left homonymous hemianopia
: Correct Answer : C. Right monocular blindness
Rationale: A lesion anterior to the optic chiasm (e.g., optic nerve) causes complete
visual loss in the ipsilateral eye. Bitemporal hemianopia occurs with chiasmal
lesions. Homonymous hemianopia occurs with lesions posterior to the chiasm.
pg. 1
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3. A 65-year-old man has difficulty climbing stairs and rising from a chair. On
examination, he has a waddling gait. Which muscle group is primarily affected?
A. Distal leg muscles
B. Proximal pelvic girdle muscles
C. Trunk flexors
D. Neck extensors
: Correct Answer : B. Proximal pelvic girdle muscles
Rationale: Proximal muscle weakness causes difficulty with hip extension and
results in a Trendelenburg/waddling gait. This pattern is seen in myopathies such
as polymyositis and muscular dystrophy.
4. A child with a “port-wine stain” on the face develops seizures. Which
syndrome is most likely?
A. Neurofibromatosis type 1
B. Tuberous sclerosis
C. Sturge-Weber syndrome
D. von Hippel-Lindau disease
: Correct Answer : C. Sturge-Weber syndrome
Rationale: Sturge-Weber is a neurocutaneous disorder with a facial port-wine
stain (trigeminal distribution) and ipsilateral leptomeningeal angiomas, causing
seizures. Tuberous sclerosis involves ash-leaf spots and tubers.
5. A 34-year-old man sustains a fracture of the medial epicondyle of the
humerus. Which nerve is most at risk?
A. Radial nerve
B. Ulnar nerve
C. Median nerve
D. Axillary nerve
: Correct Answer : B. Ulnar nerve
Rationale: The ulnar nerve passes posterior to the medial epicondyle and is
vulnerable to injury with fractures in this region. Damage leads to claw hand and
sensory loss over the ulnar 1½ fingers.
pg. 2
,3
6. A 70-year-old woman falls and lands on her outstretched hand. She has a
fracture of the distal radius with dorsal angulation. What is this fracture called?
A. Colles fracture
B. Smith fracture
C. Boxer’s fracture
D. Monteggia fracture
: Correct Answer : A. Colles fracture
Rationale: A Colles fracture is a distal radius fracture with dorsal angulation, often
resulting from a fall on an outstretched hand (FOOSH). Smith fracture is a reverse
Colles (volar angulation). Boxer's fracture involves the 5th metacarpal.
7. A 28-year-old woman has a loss of sensation over the lateral forearm and
thumb, and a diminished brachioradialis reflex after a motorcycle accident.
Which nerve root is most likely affected?
A. C5
B. C6
C. C7
D. C8
: Correct Answer : B. C6
Rationale: C6 dermatome includes the lateral forearm and thumb. The
brachioradialis reflex is C6. C5 is shoulder abduction and biceps reflex. C7 is triceps
and middle finger. C8 is ulnar hand.
8. A 55-year-old man with hoarseness has a left vocal cord paralysis. Which
nerve is most likely injured?
A. Left external laryngeal nerve
B. Left recurrent laryngeal nerve
C. Left glossopharyngeal nerve
D. Left vagus nerve (high lesion)
pg. 3
, 4
: Correct Answer : B. Left recurrent laryngeal nerve
Rationale: The recurrent laryngeal nerve innervates all intrinsic laryngeal muscles
except the cricothyroid. Injury causes hoarseness and vocal cord paralysis. The left
recurrent loops around the aortic arch; the right around the subclavian artery.
9. A 10-year-old boy has a “winged” scapula on the right. When pushing against
a wall, the right scapula protrudes. Which nerve is injured?
A. Long thoracic nerve
B. Accessory nerve (CN XI)
C. Dorsal scapular nerve
D. Axillary nerve
: Correct Answer : A. Long thoracic nerve
Rationale: The long thoracic nerve (C5-C7) innervates the serratus anterior, which
anchors the scapula to the chest wall. Injury causes winging. Accessory nerve
injury causes trapezius weakness and shoulder droop.
10. A 62-year-old man has a left homonymous hemianopia with macular sparing
after a stroke. Where is the lesion?
A. Left optic tract
B. Right optic radiation
C. Left optic radiation
D. Right occipital pole
: Correct Answer : C. Left optic radiation
Rationale: A homonymous hemianopia with macular sparing typically indicates a
lesion in the optic radiations or visual cortex. The left optic radiation carries fibers
from the right visual field, so a lesion causes right homonymous hemianopia?
Wait: Left optic radiation carries information from the right visual field of both
eyes. A lesion there causes right homonymous hemianopia. But the question says
left homonymous hemianopia, meaning the left visual field is affected. That
requires a lesion in the right optic radiation. So correct answer B. I'll adjust: The
patient has left homonymous hemianopia, so lesion is in the right hemisphere.
pg. 4
COMSAE Phase 1 ASA 107i – The Complete 176
Question Test Bank All questions with correct verified
answers & detailed rationales – graded A+ for the
newest 2026 actual exam
Section 1: Anatomy & Neuroanatomy (Questions 1–25)
1. A 52-year-old woman presents with loss of pain and temperature sensation
on the right side of her face and left side of her body. A brainstem lesion is
suspected. Which vascular syndrome is most likely?
A. Anterior spinal artery occlusion
B. Lateral medullary (Wallenberg) syndrome
C. Medial medullary syndrome
D. Basilar artery occlusion
: Correct Answer : B. Lateral medullary (Wallenberg) syndrome
Rationale: Wallenberg syndrome is caused by occlusion of the posterior inferior
cerebellar artery (PICA). It results in loss of pain and temperature on the ipsilateral
face (trigeminal nucleus) and contralateral body (spinothalamic tract). Other
features include dysphagia, vertigo, and Horner syndrome.
2. A 45-year-old man has a tumor compressing the right optic nerve just before
the optic chiasm. Which visual field defect would be expected?
A. Bitemporal hemianopia
B. Right nasal hemianopia
C. Right monocular blindness
D. Left homonymous hemianopia
: Correct Answer : C. Right monocular blindness
Rationale: A lesion anterior to the optic chiasm (e.g., optic nerve) causes complete
visual loss in the ipsilateral eye. Bitemporal hemianopia occurs with chiasmal
lesions. Homonymous hemianopia occurs with lesions posterior to the chiasm.
pg. 1
,2
3. A 65-year-old man has difficulty climbing stairs and rising from a chair. On
examination, he has a waddling gait. Which muscle group is primarily affected?
A. Distal leg muscles
B. Proximal pelvic girdle muscles
C. Trunk flexors
D. Neck extensors
: Correct Answer : B. Proximal pelvic girdle muscles
Rationale: Proximal muscle weakness causes difficulty with hip extension and
results in a Trendelenburg/waddling gait. This pattern is seen in myopathies such
as polymyositis and muscular dystrophy.
4. A child with a “port-wine stain” on the face develops seizures. Which
syndrome is most likely?
A. Neurofibromatosis type 1
B. Tuberous sclerosis
C. Sturge-Weber syndrome
D. von Hippel-Lindau disease
: Correct Answer : C. Sturge-Weber syndrome
Rationale: Sturge-Weber is a neurocutaneous disorder with a facial port-wine
stain (trigeminal distribution) and ipsilateral leptomeningeal angiomas, causing
seizures. Tuberous sclerosis involves ash-leaf spots and tubers.
5. A 34-year-old man sustains a fracture of the medial epicondyle of the
humerus. Which nerve is most at risk?
A. Radial nerve
B. Ulnar nerve
C. Median nerve
D. Axillary nerve
: Correct Answer : B. Ulnar nerve
Rationale: The ulnar nerve passes posterior to the medial epicondyle and is
vulnerable to injury with fractures in this region. Damage leads to claw hand and
sensory loss over the ulnar 1½ fingers.
pg. 2
,3
6. A 70-year-old woman falls and lands on her outstretched hand. She has a
fracture of the distal radius with dorsal angulation. What is this fracture called?
A. Colles fracture
B. Smith fracture
C. Boxer’s fracture
D. Monteggia fracture
: Correct Answer : A. Colles fracture
Rationale: A Colles fracture is a distal radius fracture with dorsal angulation, often
resulting from a fall on an outstretched hand (FOOSH). Smith fracture is a reverse
Colles (volar angulation). Boxer's fracture involves the 5th metacarpal.
7. A 28-year-old woman has a loss of sensation over the lateral forearm and
thumb, and a diminished brachioradialis reflex after a motorcycle accident.
Which nerve root is most likely affected?
A. C5
B. C6
C. C7
D. C8
: Correct Answer : B. C6
Rationale: C6 dermatome includes the lateral forearm and thumb. The
brachioradialis reflex is C6. C5 is shoulder abduction and biceps reflex. C7 is triceps
and middle finger. C8 is ulnar hand.
8. A 55-year-old man with hoarseness has a left vocal cord paralysis. Which
nerve is most likely injured?
A. Left external laryngeal nerve
B. Left recurrent laryngeal nerve
C. Left glossopharyngeal nerve
D. Left vagus nerve (high lesion)
pg. 3
, 4
: Correct Answer : B. Left recurrent laryngeal nerve
Rationale: The recurrent laryngeal nerve innervates all intrinsic laryngeal muscles
except the cricothyroid. Injury causes hoarseness and vocal cord paralysis. The left
recurrent loops around the aortic arch; the right around the subclavian artery.
9. A 10-year-old boy has a “winged” scapula on the right. When pushing against
a wall, the right scapula protrudes. Which nerve is injured?
A. Long thoracic nerve
B. Accessory nerve (CN XI)
C. Dorsal scapular nerve
D. Axillary nerve
: Correct Answer : A. Long thoracic nerve
Rationale: The long thoracic nerve (C5-C7) innervates the serratus anterior, which
anchors the scapula to the chest wall. Injury causes winging. Accessory nerve
injury causes trapezius weakness and shoulder droop.
10. A 62-year-old man has a left homonymous hemianopia with macular sparing
after a stroke. Where is the lesion?
A. Left optic tract
B. Right optic radiation
C. Left optic radiation
D. Right occipital pole
: Correct Answer : C. Left optic radiation
Rationale: A homonymous hemianopia with macular sparing typically indicates a
lesion in the optic radiations or visual cortex. The left optic radiation carries fibers
from the right visual field, so a lesion causes right homonymous hemianopia?
Wait: Left optic radiation carries information from the right visual field of both
eyes. A lesion there causes right homonymous hemianopia. But the question says
left homonymous hemianopia, meaning the left visual field is affected. That
requires a lesion in the right optic radiation. So correct answer B. I'll adjust: The
patient has left homonymous hemianopia, so lesion is in the right hemisphere.
pg. 4
