COMSAE Phase 2 – Form BSA 114i (Secure
Browser Testing Standard; Videos) (2026
Edition): Comprehensive Multiple-Choice
Questions, Answers, and Detailed Rationales
1.
A 67-year-old man presents with chest pain radiating to the
left arm. ECG shows ST-segment elevation in leads II, III, and
aVF. Which coronary artery is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Left main coronary artery
Rationale: ST elevation in II, III, and aVF indicates an inferior
wall myocardial infarction, most commonly due to occlusion
of the right coronary artery, which supplies the inferior
portion of the heart in most individuals.
2.
A newborn has a continuous “machine-like” murmur. What is
the most likely diagnosis?
A. Tetralogy of Fallot
B. Ventricular septal defect
,C. Patent ductus arteriosus
D. Atrial septal defect
Rationale: Patent ductus arteriosus causes a continuous
machinery murmur due to persistent blood flow between the
aorta and pulmonary artery.
3.
A patient presents with tremor, weight loss, and heat
intolerance. Lab results show low TSH and elevated T3/T4.
What is the most likely diagnosis?
A. Hashimoto thyroiditis
B. Graves disease
C. Thyroid cancer
D. Subacute thyroiditis
Rationale: Graves disease is the most common cause of
hyperthyroidism and is associated with suppressed TSH and
elevated thyroid hormones due to thyroid-stimulating
immunoglobulins.
4.
Which organism is most commonly associated with peptic
ulcer disease?
A. Streptococcus pyogenes
B. Staphylococcus aureus
C. Helicobacter pylori
D. Clostridium difficile
,Rationale: Helicobacter pylori infection damages gastric
mucosa and is a major cause of peptic ulcer disease.
5.
A patient presents with severe watery diarrhea after
antibiotic use. Which toxin is responsible?
A. Cholera toxin
B. Shiga toxin
C. Toxin A and B (Clostridioides difficile)
D. Enterotoxin B
Rationale: C. difficile produces toxins A and B, leading to
pseudomembranous colitis after antibiotic use.
6.
Which condition is associated with Kayser-Fleischer rings?
A. Wilson disease
B. Hemochromatosis
C. Wilson disease
D. Gilbert syndrome
Rationale: Kayser-Fleischer rings are due to copper deposition
in Descemet’s membrane in Wilson disease.
7.
A patient has right lower quadrant pain and fever. Which
structure is most likely inflamed?
, A. Gallbladder
B. Stomach
C. Appendix
D. Pancreas
Rationale: Classic appendicitis presents with right lower
quadrant pain due to inflammation of the appendix.
8.
Which vitamin deficiency causes scurvy?
A. Vitamin A
B. Vitamin B12
C. Vitamin D
D. Vitamin C
Rationale: Vitamin C deficiency impairs collagen synthesis
leading to bleeding gums and poor wound healing.
9.
A patient has hematuria and hearing loss. What is the most
likely diagnosis?
A. Goodpasture syndrome
B. Alport syndrome
C. IgA nephropathy
D. Minimal change disease
Browser Testing Standard; Videos) (2026
Edition): Comprehensive Multiple-Choice
Questions, Answers, and Detailed Rationales
1.
A 67-year-old man presents with chest pain radiating to the
left arm. ECG shows ST-segment elevation in leads II, III, and
aVF. Which coronary artery is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Left main coronary artery
Rationale: ST elevation in II, III, and aVF indicates an inferior
wall myocardial infarction, most commonly due to occlusion
of the right coronary artery, which supplies the inferior
portion of the heart in most individuals.
2.
A newborn has a continuous “machine-like” murmur. What is
the most likely diagnosis?
A. Tetralogy of Fallot
B. Ventricular septal defect
,C. Patent ductus arteriosus
D. Atrial septal defect
Rationale: Patent ductus arteriosus causes a continuous
machinery murmur due to persistent blood flow between the
aorta and pulmonary artery.
3.
A patient presents with tremor, weight loss, and heat
intolerance. Lab results show low TSH and elevated T3/T4.
What is the most likely diagnosis?
A. Hashimoto thyroiditis
B. Graves disease
C. Thyroid cancer
D. Subacute thyroiditis
Rationale: Graves disease is the most common cause of
hyperthyroidism and is associated with suppressed TSH and
elevated thyroid hormones due to thyroid-stimulating
immunoglobulins.
4.
Which organism is most commonly associated with peptic
ulcer disease?
A. Streptococcus pyogenes
B. Staphylococcus aureus
C. Helicobacter pylori
D. Clostridium difficile
,Rationale: Helicobacter pylori infection damages gastric
mucosa and is a major cause of peptic ulcer disease.
5.
A patient presents with severe watery diarrhea after
antibiotic use. Which toxin is responsible?
A. Cholera toxin
B. Shiga toxin
C. Toxin A and B (Clostridioides difficile)
D. Enterotoxin B
Rationale: C. difficile produces toxins A and B, leading to
pseudomembranous colitis after antibiotic use.
6.
Which condition is associated with Kayser-Fleischer rings?
A. Wilson disease
B. Hemochromatosis
C. Wilson disease
D. Gilbert syndrome
Rationale: Kayser-Fleischer rings are due to copper deposition
in Descemet’s membrane in Wilson disease.
7.
A patient has right lower quadrant pain and fever. Which
structure is most likely inflamed?
, A. Gallbladder
B. Stomach
C. Appendix
D. Pancreas
Rationale: Classic appendicitis presents with right lower
quadrant pain due to inflammation of the appendix.
8.
Which vitamin deficiency causes scurvy?
A. Vitamin A
B. Vitamin B12
C. Vitamin D
D. Vitamin C
Rationale: Vitamin C deficiency impairs collagen synthesis
leading to bleeding gums and poor wound healing.
9.
A patient has hematuria and hearing loss. What is the most
likely diagnosis?
A. Goodpasture syndrome
B. Alport syndrome
C. IgA nephropathy
D. Minimal change disease
