COMSAE Phase 1 Form 104 Questions With
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant Download Pdf
1. A 45-year-old man presents with crushing substernal chest pain
radiating to the left arm. ECG shows ST-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. Posterior descending artery
Correct answer: C
Rationale: ST elevation in leads II, III, and aVF indicates an inferior
wall myocardial infarction. The right coronary artery most commonly
supplies the inferior wall of the heart in right-dominant circulation.
2. A newborn has cyanosis that improves when crying and worsens
when feeding. A harsh systolic murmur is heard. What is the most
likely diagnosis?
, A. Tetralogy of Fallot
B. Transposition of the great arteries
C. Truncus arteriosus
D. Total anomalous pulmonary venous return
Correct answer: A
Rationale: Tetralogy of Fallot causes “tet spells” due to right-to-left
shunting that worsens with increased oxygen demand such as feeding
and improves with increased systemic vascular resistance such as
crying.
3. Which vitamin deficiency is associated with prolonged PT and
bleeding tendency?
A. Vitamin A
B. Vitamin D
C. Vitamin K
D. Vitamin E
Correct answer: C
Rationale: Vitamin K is required for synthesis of clotting factors II, VII,
IX, and X. Deficiency leads to prolonged prothrombin time and
bleeding.
, 4. A patient has tremor, heat intolerance, and weight loss. Lab tests
show low TSH and high T3/T4. What is the most likely diagnosis?
A. Hashimoto thyroiditis
B. Graves disease
C. Subacute thyroiditis
D. Thyroid cancer
Correct answer: B
Rationale: Graves disease is an autoimmune condition causing
stimulation of TSH receptors leading to increased thyroid hormone
production and suppressed TSH.
5. A 60-year-old smoker presents with hematuria. Cytology reveals
urothelial carcinoma. What is the most significant risk factor?
A. Alcohol use
B. Smoking
C. High-fat diet
D. Viral infection
Correct answer: B
, Rationale: Smoking is the strongest risk factor for bladder (urothelial)
carcinoma due to carcinogens excreted in urine.
6. Which structure is primarily responsible for filtration in the
kidney?
A. Loop of Henle
B. Distal convoluted tubule
C. Glomerulus
D. Collecting duct
Correct answer: C
Rationale: The glomerulus performs blood filtration through its
fenestrated capillaries and basement membrane.
7. A patient presents with fever, flank pain, and positive CVA
tenderness. What is the most likely diagnosis?
A. Cystitis
B. Pyelonephritis
C. Glomerulonephritis
D. Kidney stone
Correct answer: B
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant Download Pdf
1. A 45-year-old man presents with crushing substernal chest pain
radiating to the left arm. ECG shows ST-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. Posterior descending artery
Correct answer: C
Rationale: ST elevation in leads II, III, and aVF indicates an inferior
wall myocardial infarction. The right coronary artery most commonly
supplies the inferior wall of the heart in right-dominant circulation.
2. A newborn has cyanosis that improves when crying and worsens
when feeding. A harsh systolic murmur is heard. What is the most
likely diagnosis?
, A. Tetralogy of Fallot
B. Transposition of the great arteries
C. Truncus arteriosus
D. Total anomalous pulmonary venous return
Correct answer: A
Rationale: Tetralogy of Fallot causes “tet spells” due to right-to-left
shunting that worsens with increased oxygen demand such as feeding
and improves with increased systemic vascular resistance such as
crying.
3. Which vitamin deficiency is associated with prolonged PT and
bleeding tendency?
A. Vitamin A
B. Vitamin D
C. Vitamin K
D. Vitamin E
Correct answer: C
Rationale: Vitamin K is required for synthesis of clotting factors II, VII,
IX, and X. Deficiency leads to prolonged prothrombin time and
bleeding.
, 4. A patient has tremor, heat intolerance, and weight loss. Lab tests
show low TSH and high T3/T4. What is the most likely diagnosis?
A. Hashimoto thyroiditis
B. Graves disease
C. Subacute thyroiditis
D. Thyroid cancer
Correct answer: B
Rationale: Graves disease is an autoimmune condition causing
stimulation of TSH receptors leading to increased thyroid hormone
production and suppressed TSH.
5. A 60-year-old smoker presents with hematuria. Cytology reveals
urothelial carcinoma. What is the most significant risk factor?
A. Alcohol use
B. Smoking
C. High-fat diet
D. Viral infection
Correct answer: B
, Rationale: Smoking is the strongest risk factor for bladder (urothelial)
carcinoma due to carcinogens excreted in urine.
6. Which structure is primarily responsible for filtration in the
kidney?
A. Loop of Henle
B. Distal convoluted tubule
C. Glomerulus
D. Collecting duct
Correct answer: C
Rationale: The glomerulus performs blood filtration through its
fenestrated capillaries and basement membrane.
7. A patient presents with fever, flank pain, and positive CVA
tenderness. What is the most likely diagnosis?
A. Cystitis
B. Pyelonephritis
C. Glomerulonephritis
D. Kidney stone
Correct answer: B
