COMSAE Phase 2 – Form 115i (student
version) Exam Questions With Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant
Download Pdf.
1. A 68-year-old man presents with sudden painless loss of vision in
his right eye. Funduscopic examination reveals a pale retina with a
cherry-red spot at the macula. What is the most likely diagnosis?
A. Retinal detachment
B. Central retinal vein occlusion
C. Central retinal artery occlusion
D. Acute angle-closure glaucoma
E. Vitreous hemorrhage
Rationale: Central retinal artery occlusion classically presents with
sudden, painless monocular vision loss and a pale retina with a cherry-
red macula. It is considered an ocular emergency and is often associated
with embolic disease.
2. A 24-year-old woman develops fatigue, weight gain, dry skin, and
constipation. Laboratory testing shows elevated TSH and low free
T4 levels. Which condition is most likely?
,A. Graves disease
B. Subacute thyroiditis
C. Secondary hypothyroidism
D. Hashimoto thyroiditis
E. Toxic multinodular goiter
Rationale: Hashimoto thyroiditis is the most common cause of primary
hypothyroidism in developed countries. Patients typically have elevated
TSH, low free T4, and symptoms of metabolic slowing.
3. A patient develops fever, flank pain, and costovertebral angle
tenderness. Urinalysis reveals white blood cell casts. Which
diagnosis is most likely?
A. Cystitis
B. Urethritis
C. Nephrolithiasis
D. Interstitial nephritis
E. Acute pyelonephritis
Rationale: White blood cell casts indicate renal parenchymal
inflammation. When accompanied by fever and flank pain, acute
pyelonephritis is the most likely diagnosis.
4. A 59-year-old smoker reports hematuria without pain. Which
diagnosis should be strongly suspected?
A. Renal artery stenosis
B. Glomerulonephritis
,C. Bladder cancer
D. Polycystic kidney disease
E. Benign prostatic hyperplasia
Rationale: Painless hematuria in an older smoker is bladder cancer until
proven otherwise. Transitional cell carcinoma is the most common type.
5. A newborn develops bilious vomiting shortly after birth.
Abdominal radiography demonstrates a double-bubble sign. What
is the most likely diagnosis?
A. Pyloric stenosis
B. Meconium ileus
C. Intussusception
D. Hirschsprung disease
E. Duodenal atresia
Rationale: The double-bubble sign is characteristic of duodenal atresia.
Bilious vomiting shortly after birth is a classic presentation.
6. A 42-year-old woman experiences episodic palpitations, sweating,
and headaches. Blood pressure is persistently elevated. Which
tumor is most likely responsible?
A. Aldosteronoma
B. Pituitary adenoma
C. Thyroid adenoma
D. Pheochromocytoma
E. Adrenal cortical carcinoma
, Rationale: The triad of headaches, palpitations, and diaphoresis in a
patient with hypertension strongly suggests pheochromocytoma, a
catecholamine-secreting adrenal medullary tumor.
7. A patient with chronic alcohol use develops confusion,
ophthalmoplegia, and ataxia. Which vitamin deficiency is
responsible?
A. Vitamin B12
B. Vitamin C
C. Vitamin D
D. Folate
E. Thiamine (Vitamin B1)
Rationale: Wernicke encephalopathy results from thiamine deficiency
and presents with confusion, ophthalmoplegia, and ataxia.
8. A child presents with barking cough, inspiratory stridor, and
hoarseness. What is the most likely diagnosis?
A. Epiglottitis
B. Bronchiolitis
C. Asthma
D. Croup
E. Foreign body aspiration
Rationale: Croup is caused by viral inflammation of the upper airway
and produces a barking cough and inspiratory stridor.
version) Exam Questions With Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant
Download Pdf.
1. A 68-year-old man presents with sudden painless loss of vision in
his right eye. Funduscopic examination reveals a pale retina with a
cherry-red spot at the macula. What is the most likely diagnosis?
A. Retinal detachment
B. Central retinal vein occlusion
C. Central retinal artery occlusion
D. Acute angle-closure glaucoma
E. Vitreous hemorrhage
Rationale: Central retinal artery occlusion classically presents with
sudden, painless monocular vision loss and a pale retina with a cherry-
red macula. It is considered an ocular emergency and is often associated
with embolic disease.
2. A 24-year-old woman develops fatigue, weight gain, dry skin, and
constipation. Laboratory testing shows elevated TSH and low free
T4 levels. Which condition is most likely?
,A. Graves disease
B. Subacute thyroiditis
C. Secondary hypothyroidism
D. Hashimoto thyroiditis
E. Toxic multinodular goiter
Rationale: Hashimoto thyroiditis is the most common cause of primary
hypothyroidism in developed countries. Patients typically have elevated
TSH, low free T4, and symptoms of metabolic slowing.
3. A patient develops fever, flank pain, and costovertebral angle
tenderness. Urinalysis reveals white blood cell casts. Which
diagnosis is most likely?
A. Cystitis
B. Urethritis
C. Nephrolithiasis
D. Interstitial nephritis
E. Acute pyelonephritis
Rationale: White blood cell casts indicate renal parenchymal
inflammation. When accompanied by fever and flank pain, acute
pyelonephritis is the most likely diagnosis.
4. A 59-year-old smoker reports hematuria without pain. Which
diagnosis should be strongly suspected?
A. Renal artery stenosis
B. Glomerulonephritis
,C. Bladder cancer
D. Polycystic kidney disease
E. Benign prostatic hyperplasia
Rationale: Painless hematuria in an older smoker is bladder cancer until
proven otherwise. Transitional cell carcinoma is the most common type.
5. A newborn develops bilious vomiting shortly after birth.
Abdominal radiography demonstrates a double-bubble sign. What
is the most likely diagnosis?
A. Pyloric stenosis
B. Meconium ileus
C. Intussusception
D. Hirschsprung disease
E. Duodenal atresia
Rationale: The double-bubble sign is characteristic of duodenal atresia.
Bilious vomiting shortly after birth is a classic presentation.
6. A 42-year-old woman experiences episodic palpitations, sweating,
and headaches. Blood pressure is persistently elevated. Which
tumor is most likely responsible?
A. Aldosteronoma
B. Pituitary adenoma
C. Thyroid adenoma
D. Pheochromocytoma
E. Adrenal cortical carcinoma
, Rationale: The triad of headaches, palpitations, and diaphoresis in a
patient with hypertension strongly suggests pheochromocytoma, a
catecholamine-secreting adrenal medullary tumor.
7. A patient with chronic alcohol use develops confusion,
ophthalmoplegia, and ataxia. Which vitamin deficiency is
responsible?
A. Vitamin B12
B. Vitamin C
C. Vitamin D
D. Folate
E. Thiamine (Vitamin B1)
Rationale: Wernicke encephalopathy results from thiamine deficiency
and presents with confusion, ophthalmoplegia, and ataxia.
8. A child presents with barking cough, inspiratory stridor, and
hoarseness. What is the most likely diagnosis?
A. Epiglottitis
B. Bronchiolitis
C. Asthma
D. Croup
E. Foreign body aspiration
Rationale: Croup is caused by viral inflammation of the upper airway
and produces a barking cough and inspiratory stridor.
