COMSAE Phase 2 Form 104 Exam
Practice Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf
1. A 62-year-old man with a history of chronic smoking presents with
progressive dyspnea and a chronic productive cough. Pulmonary
function tests show FEV1/FVC ratio of 55% with minimal reversibility
after bronchodilator use. Which is the most likely diagnosis?
A. Asthma
B. Bronchiectasis
C. Chronic obstructive pulmonary disease (COPD)
D. Pulmonary fibrosis
This presentation with a reduced FEV1/FVC ratio and poor
bronchodilator response is characteristic of COPD, commonly
associated with long-term smoking.
2. A 24-year-old woman presents with episodic wheezing, chest
tightness, and nighttime cough. Symptoms improve with albuterol.
Which immune mechanism is most associated with her condition?
, A. Type II hypersensitivity
B. Type III hypersensitivity
C. Type I hypersensitivity
D. Type IV hypersensitivity
Asthma is primarily mediated by IgE-driven Type I hypersensitivity
involving mast cell degranulation.
3. A patient presents with crushing substernal chest pain radiating to the
left arm. ECG shows ST elevation in leads II, III, and aVF. Which artery
is most likely occluded?
A. Left anterior descending artery
B. Circumflex artery
C. Right coronary artery
D. Left main coronary artery
Inferior wall myocardial infarctions are most commonly due to right
coronary artery occlusion.
4. A 45-year-old man has fatigue, pruritus after hot showers, and
splenomegaly. Labs show elevated hematocrit. What is the most likely
diagnosis?
A. Chronic myelogenous leukemia
B. Essential thrombocythemia
C. Polycythemia vera
D. Myelodysplastic syndrome
, Polycythemia vera is a myeloproliferative disorder characterized by
increased red blood cell mass and JAK2 mutation.
5. A newborn has persistent jaundice and dark urine. Labs show elevated
unconjugated bilirubin. Which enzyme deficiency is most likely?
A. Glucuronyl transferase
B. Galactose-1-phosphate uridyltransferase
C. UDP-glucuronosyltransferase
D. Phenylalanine hydroxylase
Crigler-Najjar syndrome involves deficiency of UDP-
glucuronosyltransferase leading to impaired bilirubin conjugation.
6. A 30-year-old man presents with tremor, rigidity, and bradykinesia.
Loss of dopamine-producing neurons is seen in which brain region?
A. Caudate nucleus
B. Cerebellar cortex
C. Substantia nigra pars compacta
D. Red nucleus
Parkinson disease is due to degeneration of dopaminergic neurons in
the substantia nigra pars compacta.
7. A patient presents with severe epigastric pain relieved by eating.
Which organism is most likely responsible?
A. Helicobacter pylori
B. Escherichia coli
C. Helicobacter pylori
, D. Staphylococcus aureus
H. pylori infection is strongly associated with duodenal ulcers causing
pain relief with food.
8. A 55-year-old woman has painless jaundice and a palpable gallbladder.
Which diagnosis is most likely?
A. Gallstones
B. Hepatitis A
C. Pancreatic adenocarcinoma
D. Cholecystitis
Courvoisier sign suggests pancreatic cancer causing biliary
obstruction.
9. A patient has muscle weakness that worsens with use and improves
with rest. Autoantibodies are directed against which receptor?
A. Dopamine receptor
B. Nicotinic acetylcholine receptor
C. Postsynaptic acetylcholine receptor
D. GABA receptor
Myasthenia gravis involves antibodies against postsynaptic
acetylcholine receptors at the neuromuscular junction.
10. A 33-year-old woman presents with exophthalmos, heat
intolerance, and weight loss. Which antibody is most likely elevated?
A. Anti-TPO antibodies
B. Anti-TSH receptor antibodies
Practice Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf
1. A 62-year-old man with a history of chronic smoking presents with
progressive dyspnea and a chronic productive cough. Pulmonary
function tests show FEV1/FVC ratio of 55% with minimal reversibility
after bronchodilator use. Which is the most likely diagnosis?
A. Asthma
B. Bronchiectasis
C. Chronic obstructive pulmonary disease (COPD)
D. Pulmonary fibrosis
This presentation with a reduced FEV1/FVC ratio and poor
bronchodilator response is characteristic of COPD, commonly
associated with long-term smoking.
2. A 24-year-old woman presents with episodic wheezing, chest
tightness, and nighttime cough. Symptoms improve with albuterol.
Which immune mechanism is most associated with her condition?
, A. Type II hypersensitivity
B. Type III hypersensitivity
C. Type I hypersensitivity
D. Type IV hypersensitivity
Asthma is primarily mediated by IgE-driven Type I hypersensitivity
involving mast cell degranulation.
3. A patient presents with crushing substernal chest pain radiating to the
left arm. ECG shows ST elevation in leads II, III, and aVF. Which artery
is most likely occluded?
A. Left anterior descending artery
B. Circumflex artery
C. Right coronary artery
D. Left main coronary artery
Inferior wall myocardial infarctions are most commonly due to right
coronary artery occlusion.
4. A 45-year-old man has fatigue, pruritus after hot showers, and
splenomegaly. Labs show elevated hematocrit. What is the most likely
diagnosis?
A. Chronic myelogenous leukemia
B. Essential thrombocythemia
C. Polycythemia vera
D. Myelodysplastic syndrome
, Polycythemia vera is a myeloproliferative disorder characterized by
increased red blood cell mass and JAK2 mutation.
5. A newborn has persistent jaundice and dark urine. Labs show elevated
unconjugated bilirubin. Which enzyme deficiency is most likely?
A. Glucuronyl transferase
B. Galactose-1-phosphate uridyltransferase
C. UDP-glucuronosyltransferase
D. Phenylalanine hydroxylase
Crigler-Najjar syndrome involves deficiency of UDP-
glucuronosyltransferase leading to impaired bilirubin conjugation.
6. A 30-year-old man presents with tremor, rigidity, and bradykinesia.
Loss of dopamine-producing neurons is seen in which brain region?
A. Caudate nucleus
B. Cerebellar cortex
C. Substantia nigra pars compacta
D. Red nucleus
Parkinson disease is due to degeneration of dopaminergic neurons in
the substantia nigra pars compacta.
7. A patient presents with severe epigastric pain relieved by eating.
Which organism is most likely responsible?
A. Helicobacter pylori
B. Escherichia coli
C. Helicobacter pylori
, D. Staphylococcus aureus
H. pylori infection is strongly associated with duodenal ulcers causing
pain relief with food.
8. A 55-year-old woman has painless jaundice and a palpable gallbladder.
Which diagnosis is most likely?
A. Gallstones
B. Hepatitis A
C. Pancreatic adenocarcinoma
D. Cholecystitis
Courvoisier sign suggests pancreatic cancer causing biliary
obstruction.
9. A patient has muscle weakness that worsens with use and improves
with rest. Autoantibodies are directed against which receptor?
A. Dopamine receptor
B. Nicotinic acetylcholine receptor
C. Postsynaptic acetylcholine receptor
D. GABA receptor
Myasthenia gravis involves antibodies against postsynaptic
acetylcholine receptors at the neuromuscular junction.
10. A 33-year-old woman presents with exophthalmos, heat
intolerance, and weight loss. Which antibody is most likely elevated?
A. Anti-TPO antibodies
B. Anti-TSH receptor antibodies
