COMSAE Phase 1 Form 111 Questions With
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant Download Pdf
Question 1
A 65-year-old man with a history of hypertension presents with sudden
onset chest pain radiating to the 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: Sudden tearing chest pain radiating to the back plus
unequal blood pressures strongly suggests aortic dissection due to
intimal tear and propagation of blood within the aortic wall.
,Question 2
A 23-year-old woman presents with fatigue, pallor, and pica. Labs show
microcytic hypochromic anemia. What is the most likely cause?
A. Vitamin B12 deficiency
B. Iron deficiency anemia
C. Aplastic anemia
D. Sickle cell disease
Answer: B. Iron deficiency anemia
Rationale: Microcytic hypochromic anemia with pica is classic for iron
deficiency, often due to chronic blood loss or poor intake.
Question 3
A newborn fails to pass meconium within 48 hours and has abdominal
distension. Biopsy shows absence of ganglion cells. Diagnosis?
A. Meconium ileus
B. Hirschsprung disease
C. Pyloric stenosis
D. Intussusception
,Answer: B. Hirschsprung disease
Rationale: Failure to pass meconium and aganglionic segments of
bowel indicate Hirschsprung disease.
Question 4
A patient presents with tremor at rest, bradykinesia, and rigidity. Which
structure is primarily affected?
A. Cerebellum
B. Substantia nigra
C. Caudate nucleus
D. Hippocampus
Answer: B. Substantia nigra
Rationale: Parkinson disease is due to degeneration of dopaminergic
neurons in the substantia nigra pars compacta.
Question 5
A 30-year-old woman has exophthalmos, heat intolerance, and weight
loss. Labs show low TSH and high T4. Diagnosis?
A. Hashimoto thyroiditis
B. Graves disease
, C. Thyroid cancer
D. Subacute thyroiditis
Answer: B. Graves disease
Rationale: Hyperthyroidism with ophthalmopathy and low TSH is
consistent with Graves disease.
Question 6
A patient has jaundice and elevated unconjugated bilirubin. Which
condition is most likely?
A. Gallstones
B. Gilbert syndrome
C. Primary biliary cholangitis
D. Pancreatic cancer
Answer: B. Gilbert syndrome
Rationale: Mild unconjugated hyperbilirubinemia due to decreased
UDP-glucuronyl transferase activity.
Question 7
Which antibiotic inhibits bacterial cell wall synthesis?
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant Download Pdf
Question 1
A 65-year-old man with a history of hypertension presents with sudden
onset chest pain radiating to the 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: Sudden tearing chest pain radiating to the back plus
unequal blood pressures strongly suggests aortic dissection due to
intimal tear and propagation of blood within the aortic wall.
,Question 2
A 23-year-old woman presents with fatigue, pallor, and pica. Labs show
microcytic hypochromic anemia. What is the most likely cause?
A. Vitamin B12 deficiency
B. Iron deficiency anemia
C. Aplastic anemia
D. Sickle cell disease
Answer: B. Iron deficiency anemia
Rationale: Microcytic hypochromic anemia with pica is classic for iron
deficiency, often due to chronic blood loss or poor intake.
Question 3
A newborn fails to pass meconium within 48 hours and has abdominal
distension. Biopsy shows absence of ganglion cells. Diagnosis?
A. Meconium ileus
B. Hirschsprung disease
C. Pyloric stenosis
D. Intussusception
,Answer: B. Hirschsprung disease
Rationale: Failure to pass meconium and aganglionic segments of
bowel indicate Hirschsprung disease.
Question 4
A patient presents with tremor at rest, bradykinesia, and rigidity. Which
structure is primarily affected?
A. Cerebellum
B. Substantia nigra
C. Caudate nucleus
D. Hippocampus
Answer: B. Substantia nigra
Rationale: Parkinson disease is due to degeneration of dopaminergic
neurons in the substantia nigra pars compacta.
Question 5
A 30-year-old woman has exophthalmos, heat intolerance, and weight
loss. Labs show low TSH and high T4. Diagnosis?
A. Hashimoto thyroiditis
B. Graves disease
, C. Thyroid cancer
D. Subacute thyroiditis
Answer: B. Graves disease
Rationale: Hyperthyroidism with ophthalmopathy and low TSH is
consistent with Graves disease.
Question 6
A patient has jaundice and elevated unconjugated bilirubin. Which
condition is most likely?
A. Gallstones
B. Gilbert syndrome
C. Primary biliary cholangitis
D. Pancreatic cancer
Answer: B. Gilbert syndrome
Rationale: Mild unconjugated hyperbilirubinemia due to decreased
UDP-glucuronyl transferase activity.
Question 7
Which antibiotic inhibits bacterial cell wall synthesis?
