COMSAE Phase 2 – Form BSA 102 (Legacy
Primary Care and Emergency Triage Bank)
(2026 Edition): Comprehensive Multiple-
Choice Questions, Answers, and Detailed
Rationales
1.
A 67-year-old man presents with crushing substernal chest
pain radiating to the left arm for 45 minutes. What is the
most appropriate initial diagnostic test?
A. Echocardiogram
B. CT angiography
C. 12-lead ECG
D. Exercise stress test
E. Holter monitor
Answer: C. 12-lead ECG
An ECG should be obtained within 10 minutes of presentation
in suspected acute coronary syndrome. It helps identify ST-
segment elevation myocardial infarction and guides
immediate management. Stress testing is contraindicated
during acute chest pain.
2.
,A 24-year-old woman presents with dysuria, urinary
frequency, and urgency. She is afebrile and otherwise healthy.
Most likely diagnosis?
A. Pyelonephritis
B. Interstitial cystitis
C. Acute uncomplicated cystitis
D. Urethral stricture
E. Nephrolithiasis
Answer: C. Acute uncomplicated cystitis
The classic triad of dysuria, urgency, and frequency without
systemic symptoms suggests uncomplicated cystitis.
Pyelonephritis would typically include fever, flank pain, and
constitutional symptoms.
3.
A patient arrives in the emergency department with severe
respiratory distress. Which intervention takes priority?
A. Chest radiograph
B. Detailed history
C. Laboratory testing
D. Airway assessment and stabilization
E. Medication reconciliation
Answer: D. Airway assessment and stabilization
Emergency triage follows the ABCs: airway, breathing, and
circulation. Airway compromise can rapidly lead to death and
must be addressed before diagnostic studies.
,4.
A 72-year-old woman develops sudden unilateral facial droop
and arm weakness. Symptoms began 30 minutes ago. Most
likely diagnosis?
A. Bell palsy
B. Migraine
C. Seizure
D. Acute ischemic stroke
E. Hypoglycemia
Answer: D. Acute ischemic stroke
Sudden focal neurologic deficits strongly suggest stroke.
Rapid evaluation is necessary because thrombolytic therapy
may be beneficial within the treatment window.
5.
A 5-year-old child presents with barking cough, inspiratory
stridor, and hoarseness. Diagnosis?
A. Epiglottitis
B. Asthma
C. Bronchiolitis
D. Foreign body aspiration
E. Croup
Answer: E. Croup
, Croup is characterized by a barking cough, inspiratory stridor,
and hoarseness due to subglottic inflammation, commonly
caused by parainfluenza virus.
6.
A patient presents with sudden onset tearing chest pain
radiating to the back. Most concerning diagnosis?
A. GERD
B. Myocarditis
C. Aortic dissection
D. Stable angina
E. Costochondritis
Answer: C. Aortic dissection
Tearing chest pain radiating to the back is classic for aortic
dissection. Immediate diagnosis and management are critical
due to high mortality.
7.
Which vital sign abnormality most strongly suggests septic
shock?
A. Bradycardia
B. Hypertension
C. Hypotension despite fluid resuscitation
D. Mild fever only
E. Normal respiratory rate
Primary Care and Emergency Triage Bank)
(2026 Edition): Comprehensive Multiple-
Choice Questions, Answers, and Detailed
Rationales
1.
A 67-year-old man presents with crushing substernal chest
pain radiating to the left arm for 45 minutes. What is the
most appropriate initial diagnostic test?
A. Echocardiogram
B. CT angiography
C. 12-lead ECG
D. Exercise stress test
E. Holter monitor
Answer: C. 12-lead ECG
An ECG should be obtained within 10 minutes of presentation
in suspected acute coronary syndrome. It helps identify ST-
segment elevation myocardial infarction and guides
immediate management. Stress testing is contraindicated
during acute chest pain.
2.
,A 24-year-old woman presents with dysuria, urinary
frequency, and urgency. She is afebrile and otherwise healthy.
Most likely diagnosis?
A. Pyelonephritis
B. Interstitial cystitis
C. Acute uncomplicated cystitis
D. Urethral stricture
E. Nephrolithiasis
Answer: C. Acute uncomplicated cystitis
The classic triad of dysuria, urgency, and frequency without
systemic symptoms suggests uncomplicated cystitis.
Pyelonephritis would typically include fever, flank pain, and
constitutional symptoms.
3.
A patient arrives in the emergency department with severe
respiratory distress. Which intervention takes priority?
A. Chest radiograph
B. Detailed history
C. Laboratory testing
D. Airway assessment and stabilization
E. Medication reconciliation
Answer: D. Airway assessment and stabilization
Emergency triage follows the ABCs: airway, breathing, and
circulation. Airway compromise can rapidly lead to death and
must be addressed before diagnostic studies.
,4.
A 72-year-old woman develops sudden unilateral facial droop
and arm weakness. Symptoms began 30 minutes ago. Most
likely diagnosis?
A. Bell palsy
B. Migraine
C. Seizure
D. Acute ischemic stroke
E. Hypoglycemia
Answer: D. Acute ischemic stroke
Sudden focal neurologic deficits strongly suggest stroke.
Rapid evaluation is necessary because thrombolytic therapy
may be beneficial within the treatment window.
5.
A 5-year-old child presents with barking cough, inspiratory
stridor, and hoarseness. Diagnosis?
A. Epiglottitis
B. Asthma
C. Bronchiolitis
D. Foreign body aspiration
E. Croup
Answer: E. Croup
, Croup is characterized by a barking cough, inspiratory stridor,
and hoarseness due to subglottic inflammation, commonly
caused by parainfluenza virus.
6.
A patient presents with sudden onset tearing chest pain
radiating to the back. Most concerning diagnosis?
A. GERD
B. Myocarditis
C. Aortic dissection
D. Stable angina
E. Costochondritis
Answer: C. Aortic dissection
Tearing chest pain radiating to the back is classic for aortic
dissection. Immediate diagnosis and management are critical
due to high mortality.
7.
Which vital sign abnormality most strongly suggests septic
shock?
A. Bradycardia
B. Hypertension
C. Hypotension despite fluid resuscitation
D. Mild fever only
E. Normal respiratory rate
