COMSAE Phase 1 – Form ASA 107i Intensive
Review: Exam-Focused Practice Questions,
Detailed Answer Keys, and Step-by-Step
Rationales (PDF)
1. presents with sudden onset of substernal chest pain. ECG
shows ST elevation in leads II, III, and aVF. Which artery is the
most likely culprit?
A) Left Anterior Descending B) Circumflex C) Left Main D)
Right Coronary Artery
Rationale: ST elevation in leads II, III, and aVF signifies an
inferior wall myocardial infarction, which is most commonly
caused by an occlusion of the right coronary artery.
2. A 30-year-old female presents with fatigue and cold
intolerance. Labs reveal low Free T4 and high TSH. What
is the most common cause in the US?
A) Hashimoto thyroiditis B) Iodine deficiency C) Subacute
granulomatous thyroiditis D) Thyroid lymphoma
Rationale: Hashimoto thyroiditis is the most common cause
of hypothyroidism in iodine-sufficient areas like the United
States, characterized by autoimmune destruction of the
thyroid gland.
, 3. A patient with a history of recurrent kidney stones has a
stone analysis showing calcium oxalate. Which dietary
recommendation is most appropriate?
A) Increase sodium intake B) Increase fluid intake and
decrease sodium C) Decrease calcium intake D) Increase
oxalate-rich food intake
Rationale: High sodium intake increases urinary calcium
excretion. Increasing fluid intake lowers the concentration of
stone-forming salts, and maintaining adequate (not
restricted) calcium intake is recommended.
4. Which part of the nephron is responsible for the
greatest amount of water reabsorption regardless of
hydration status?
A) Ascending limb of the Loop of Henle B) Distal convoluted
tubule C) Proximal convoluted tubule D) Collecting duct
Rationale: The proximal convoluted tubule is highly
permeable to water and is responsible for reabsorbing
approximately 65% of the filtered water, irrespective of
hormonal control.
5. A 45-year-old male with chronic alcoholism presents
with confusion, ophthalmoplegia, and ataxia. What is
the most appropriate immediate treatment?
A) Glucose infusion B) Thiamine followed by glucose C)
Naloxone D) Flumazenil
Rationale: Wernicke encephalopathy is caused by thiamine
deficiency. Giving glucose before thiamine can precipitate or
, worsen neurological symptoms; thiamine must always be
administered first.
6. A 50-year-old male presents with episodic joint pain in
the big toe. Synovial fluid analysis shows needle-shaped,
negatively birefringent crystals. What is the diagnosis?
A) Pseudogout B) Gout C) Rheumatoid arthritis D) Septic
arthritis
Rationale: Needle-shaped, negatively birefringent crystals are
diagnostic of monosodium urate crystals found in gout.
7. A patient with a mechanical heart valve is on chronic
anticoagulation. Which lab value is monitored for
Warfarin?
A) PTT B) PT/INR C) Bleeding time D) Platelet count
Rationale: Warfarin inhibits vitamin K-dependent clotting
factors, which is monitored via the Prothrombin Time (PT),
usually reported as the International Normalized Ratio (INR).
8. Which vitamin deficiency is associated with scurvy,
presenting with gingival swelling and perifollicular
hemorrhages?
A) Vitamin A B) Vitamin C C) Vitamin D D) Vitamin B12
Rationale: Vitamin C (ascorbic acid) is essential for collagen
synthesis. Deficiency leads to weakened connective tissue,
manifesting as scurvy.
9. A 25-year-old female presents with a butterfly rash on
her face that spares the nasolabial folds. What is the
most specific antibody for this condition?
Review: Exam-Focused Practice Questions,
Detailed Answer Keys, and Step-by-Step
Rationales (PDF)
1. presents with sudden onset of substernal chest pain. ECG
shows ST elevation in leads II, III, and aVF. Which artery is the
most likely culprit?
A) Left Anterior Descending B) Circumflex C) Left Main D)
Right Coronary Artery
Rationale: ST elevation in leads II, III, and aVF signifies an
inferior wall myocardial infarction, which is most commonly
caused by an occlusion of the right coronary artery.
2. A 30-year-old female presents with fatigue and cold
intolerance. Labs reveal low Free T4 and high TSH. What
is the most common cause in the US?
A) Hashimoto thyroiditis B) Iodine deficiency C) Subacute
granulomatous thyroiditis D) Thyroid lymphoma
Rationale: Hashimoto thyroiditis is the most common cause
of hypothyroidism in iodine-sufficient areas like the United
States, characterized by autoimmune destruction of the
thyroid gland.
, 3. A patient with a history of recurrent kidney stones has a
stone analysis showing calcium oxalate. Which dietary
recommendation is most appropriate?
A) Increase sodium intake B) Increase fluid intake and
decrease sodium C) Decrease calcium intake D) Increase
oxalate-rich food intake
Rationale: High sodium intake increases urinary calcium
excretion. Increasing fluid intake lowers the concentration of
stone-forming salts, and maintaining adequate (not
restricted) calcium intake is recommended.
4. Which part of the nephron is responsible for the
greatest amount of water reabsorption regardless of
hydration status?
A) Ascending limb of the Loop of Henle B) Distal convoluted
tubule C) Proximal convoluted tubule D) Collecting duct
Rationale: The proximal convoluted tubule is highly
permeable to water and is responsible for reabsorbing
approximately 65% of the filtered water, irrespective of
hormonal control.
5. A 45-year-old male with chronic alcoholism presents
with confusion, ophthalmoplegia, and ataxia. What is
the most appropriate immediate treatment?
A) Glucose infusion B) Thiamine followed by glucose C)
Naloxone D) Flumazenil
Rationale: Wernicke encephalopathy is caused by thiamine
deficiency. Giving glucose before thiamine can precipitate or
, worsen neurological symptoms; thiamine must always be
administered first.
6. A 50-year-old male presents with episodic joint pain in
the big toe. Synovial fluid analysis shows needle-shaped,
negatively birefringent crystals. What is the diagnosis?
A) Pseudogout B) Gout C) Rheumatoid arthritis D) Septic
arthritis
Rationale: Needle-shaped, negatively birefringent crystals are
diagnostic of monosodium urate crystals found in gout.
7. A patient with a mechanical heart valve is on chronic
anticoagulation. Which lab value is monitored for
Warfarin?
A) PTT B) PT/INR C) Bleeding time D) Platelet count
Rationale: Warfarin inhibits vitamin K-dependent clotting
factors, which is monitored via the Prothrombin Time (PT),
usually reported as the International Normalized Ratio (INR).
8. Which vitamin deficiency is associated with scurvy,
presenting with gingival swelling and perifollicular
hemorrhages?
A) Vitamin A B) Vitamin C C) Vitamin D D) Vitamin B12
Rationale: Vitamin C (ascorbic acid) is essential for collagen
synthesis. Deficiency leads to weakened connective tissue,
manifesting as scurvy.
9. A 25-year-old female presents with a butterfly rash on
her face that spares the nasolabial folds. What is the
most specific antibody for this condition?
