COMSAE Phase 2 – Form 101b (retired)
Exam Questions With Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf.
1. A 65-year-old man with a history of hypertension presents with
sudden onset chest pain radiating to his back. Blood pressure is
180/100 in the right arm and 150/90 in the left arm. What is the most
likely diagnosis?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
Answer: C. Aortic dissection
Rationale: The combination of tearing chest pain radiating to the back
and a blood pressure differential between arms is classic for aortic
dissection due to involvement of branch vessels of the aorta.
2. A 24-year-old woman presents with tremor, weight loss, heat
intolerance, and exophthalmos. Which antibody is most likely
present?
A. Anti-thyroglobulin
B. Anti-TSH receptor antibody
C. Anti-TPO antibody
D. Anti-mitochondrial antibody
,Answer: B. Anti-TSH receptor antibody
Rationale: Graves disease is caused by stimulatory antibodies against
the TSH receptor, leading to hyperthyroidism and ophthalmopathy.
3. A patient has COPD and is given supplemental oxygen. Which
complication is most concerning in this patient?
A. Respiratory alkalosis
B. Oxygen toxicity
C. CO2 retention leading to respiratory acidosis
D. Hypokalemia
Answer: C. CO2 retention leading to respiratory acidosis
Rationale: COPD patients may rely on hypoxic drive; high oxygen can
reduce respiratory drive and worsen CO2 retention.
4. A 50-year-old man presents with epigastric pain that improves with
eating. Diagnosis?
A. Gastric ulcer
B. Duodenal ulcer
C. Pancreatitis
D. Cholecystitis
Answer: B. Duodenal ulcer
Rationale: Duodenal ulcers typically improve with food intake and are
associated with H. pylori infection.
,5. Which electrolyte abnormality is most commonly associated with
loop diuretics?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Answer: B. Hypokalemia
Rationale: Loop diuretics increase potassium excretion in the distal
nephron.
6. A newborn fails to pass meconium within 48 hours. What is the
most likely diagnosis?
A. Pyloric stenosis
B. Hirschsprung disease
C. Meconium ileus
D. Intussusception
Answer: B. Hirschsprung disease
Rationale: Absence of ganglion cells in the distal colon causes functional
obstruction and delayed passage of meconium.
7. A patient has chest pain relieved by leaning forward. Which
condition is most likely?
A. Myocardial infarction
B. Pericarditis
, C. Aortic stenosis
D. GERD
Answer: B. Pericarditis
Rationale: Pericarditis pain improves when sitting up and leaning
forward due to reduced pericardial pressure.
8. Which organism is most commonly associated with community-
acquired pneumonia in adults?
A. Klebsiella pneumoniae
B. Streptococcus pneumoniae
C. Mycoplasma pneumoniae
D. Legionella pneumophila
Answer: B. Streptococcus pneumoniae
Rationale: S. pneumoniae is the most common cause of typical
community-acquired pneumonia.
9. A patient presents with painless hematuria. Which cancer is most
likely?
A. Renal cell carcinoma
B. Bladder cancer
C. Prostate cancer
D. Wilms tumor
Answer: B. Bladder cancer
Rationale: Transitional cell carcinoma of the bladder commonly presents
with painless hematuria.
Exam Questions With Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf.
1. A 65-year-old man with a history of hypertension presents with
sudden onset chest pain radiating to his back. Blood pressure is
180/100 in the right arm and 150/90 in the left arm. What is the most
likely diagnosis?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
Answer: C. Aortic dissection
Rationale: The combination of tearing chest pain radiating to the back
and a blood pressure differential between arms is classic for aortic
dissection due to involvement of branch vessels of the aorta.
2. A 24-year-old woman presents with tremor, weight loss, heat
intolerance, and exophthalmos. Which antibody is most likely
present?
A. Anti-thyroglobulin
B. Anti-TSH receptor antibody
C. Anti-TPO antibody
D. Anti-mitochondrial antibody
,Answer: B. Anti-TSH receptor antibody
Rationale: Graves disease is caused by stimulatory antibodies against
the TSH receptor, leading to hyperthyroidism and ophthalmopathy.
3. A patient has COPD and is given supplemental oxygen. Which
complication is most concerning in this patient?
A. Respiratory alkalosis
B. Oxygen toxicity
C. CO2 retention leading to respiratory acidosis
D. Hypokalemia
Answer: C. CO2 retention leading to respiratory acidosis
Rationale: COPD patients may rely on hypoxic drive; high oxygen can
reduce respiratory drive and worsen CO2 retention.
4. A 50-year-old man presents with epigastric pain that improves with
eating. Diagnosis?
A. Gastric ulcer
B. Duodenal ulcer
C. Pancreatitis
D. Cholecystitis
Answer: B. Duodenal ulcer
Rationale: Duodenal ulcers typically improve with food intake and are
associated with H. pylori infection.
,5. Which electrolyte abnormality is most commonly associated with
loop diuretics?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Answer: B. Hypokalemia
Rationale: Loop diuretics increase potassium excretion in the distal
nephron.
6. A newborn fails to pass meconium within 48 hours. What is the
most likely diagnosis?
A. Pyloric stenosis
B. Hirschsprung disease
C. Meconium ileus
D. Intussusception
Answer: B. Hirschsprung disease
Rationale: Absence of ganglion cells in the distal colon causes functional
obstruction and delayed passage of meconium.
7. A patient has chest pain relieved by leaning forward. Which
condition is most likely?
A. Myocardial infarction
B. Pericarditis
, C. Aortic stenosis
D. GERD
Answer: B. Pericarditis
Rationale: Pericarditis pain improves when sitting up and leaning
forward due to reduced pericardial pressure.
8. Which organism is most commonly associated with community-
acquired pneumonia in adults?
A. Klebsiella pneumoniae
B. Streptococcus pneumoniae
C. Mycoplasma pneumoniae
D. Legionella pneumophila
Answer: B. Streptococcus pneumoniae
Rationale: S. pneumoniae is the most common cause of typical
community-acquired pneumonia.
9. A patient presents with painless hematuria. Which cancer is most
likely?
A. Renal cell carcinoma
B. Bladder cancer
C. Prostate cancer
D. Wilms tumor
Answer: B. Bladder cancer
Rationale: Transitional cell carcinoma of the bladder commonly presents
with painless hematuria.
