COMSAE Comprehensive Midterm Assessment
Form CMA 106 Exam Practice Questions &
[Verified Answers], Plus Explained
Rationales|2026 Latest Update| Instant
Download PDF
1. A 24-year-old woman presents with fatigue, pallor, and pica.
Laboratory studies reveal hemoglobin 8.5 g/dL, MCV 68 fL, ferritin
7 ng/mL, serum iron low, and TIBC elevated. Which of the
following is the most likely mechanism responsible for her
anemia?
A. Decreased globin chain synthesis
B. Impaired DNA synthesis
C. Defective heme synthesis due to iron deficiency
D. Bone marrow aplasia
E. Increased erythrocyte destruction
Answer: C. Defective heme synthesis due to iron deficiency
Rationale: Iron deficiency anemia causes impaired heme synthesis,
producing microcytic hypochromic anemia with low ferritin, low serum
iron, and elevated TIBC. Pica and koilonychia are characteristic findings.
2. A 67-year-old man develops crushing substernal chest pain
radiating to his left arm. ECG demonstrates ST-segment elevations
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
E. Diagonal branch
Answer: C. Right coronary artery
Rationale: Inferior myocardial infarction involving leads II, III, and aVF is
most commonly caused by occlusion of the right coronary artery.
Bradycardia and AV block may also occur due to SA and AV nodal
ischemia.
3. A 5-year-old boy has recurrent respiratory infections, steatorrhea,
and failure to thrive. Sweat chloride testing is elevated. Which
abnormality underlies this disorder?
A. Defective sodium channel
B. Defective chloride channel
C. Abnormal collagen synthesis
D. Impaired ciliary motion
E. Deficient surfactant production
Answer: B. Defective chloride channel
Rationale: Cystic fibrosis is caused by mutations in the CFTR chloride
channel leading to thick secretions, pancreatic insufficiency,
bronchiectasis, and elevated sweat chloride concentrations.
4. A patient with chronic alcoholism presents with confusion,
ophthalmoplegia, and ataxia. Which vitamin deficiency is most
likely responsible?
A. Vitamin B12
B. Folate
C. Thiamine
D. Riboflavin
E. Pyridoxine
,Answer: C. Thiamine
Rationale: The classic triad of Wernicke encephalopathy consists of
confusion, ophthalmoplegia, and ataxia due to thiamine deficiency.
Immediate thiamine administration should precede glucose.
5. A newborn develops bilious vomiting within the first day of life.
Imaging reveals a double-bubble sign. What is the diagnosis?
A. Pyloric stenosis
B. Hirschsprung disease
C. Duodenal atresia
D. Intussusception
E. Meckel diverticulum
Answer: C. Duodenal atresia
Rationale: Duodenal atresia presents with bilious vomiting and a
double-bubble sign representing dilation of the stomach and proximal
duodenum. It is associated with Down syndrome.
6. Which nephron segment is impermeable to water and responsible
for dilution of tubular fluid?
A. Proximal convoluted tubule
B. Thin descending limb
C. Thin ascending limb
D. Thick ascending limb
E. Collecting duct
Answer: D. Thick ascending limb
Rationale: The thick ascending limb actively reabsorbs sodium,
potassium, and chloride while remaining impermeable to water, making
it the kidney's diluting segment.
7. A patient with Graves disease has which antibody?
, A. Anti-thyroglobulin antibody
B. TSH receptor-stimulating antibody
C. Anti-intrinsic factor antibody
D. Anti-mitochondrial antibody
E. Anti-centromere antibody
Answer: B. TSH receptor-stimulating antibody
Rationale: Graves disease results from IgG antibodies stimulating the
TSH receptor, causing hyperthyroidism, ophthalmopathy, and diffuse
goiter.
8. Which cranial nerve is responsible for lateral eye movement?
A. Oculomotor nerve
B. Trochlear nerve
C. Trigeminal nerve
D. Abducens nerve
E. Facial nerve
Answer: D. Abducens nerve
Rationale: The abducens nerve innervates the lateral rectus muscle,
which abducts the eye. Injury produces inability to move the eye
laterally and horizontal diplopia.
9. A patient develops sudden unilateral facial paralysis involving the
forehead. The diagnosis is:
A. Stroke
B. Myasthenia gravis
C. Bell palsy
D. Trigeminal neuralgia
E. Multiple sclerosis
Answer: C. Bell palsy
Form CMA 106 Exam Practice Questions &
[Verified Answers], Plus Explained
Rationales|2026 Latest Update| Instant
Download PDF
1. A 24-year-old woman presents with fatigue, pallor, and pica.
Laboratory studies reveal hemoglobin 8.5 g/dL, MCV 68 fL, ferritin
7 ng/mL, serum iron low, and TIBC elevated. Which of the
following is the most likely mechanism responsible for her
anemia?
A. Decreased globin chain synthesis
B. Impaired DNA synthesis
C. Defective heme synthesis due to iron deficiency
D. Bone marrow aplasia
E. Increased erythrocyte destruction
Answer: C. Defective heme synthesis due to iron deficiency
Rationale: Iron deficiency anemia causes impaired heme synthesis,
producing microcytic hypochromic anemia with low ferritin, low serum
iron, and elevated TIBC. Pica and koilonychia are characteristic findings.
2. A 67-year-old man develops crushing substernal chest pain
radiating to his left arm. ECG demonstrates ST-segment elevations
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
E. Diagonal branch
Answer: C. Right coronary artery
Rationale: Inferior myocardial infarction involving leads II, III, and aVF is
most commonly caused by occlusion of the right coronary artery.
Bradycardia and AV block may also occur due to SA and AV nodal
ischemia.
3. A 5-year-old boy has recurrent respiratory infections, steatorrhea,
and failure to thrive. Sweat chloride testing is elevated. Which
abnormality underlies this disorder?
A. Defective sodium channel
B. Defective chloride channel
C. Abnormal collagen synthesis
D. Impaired ciliary motion
E. Deficient surfactant production
Answer: B. Defective chloride channel
Rationale: Cystic fibrosis is caused by mutations in the CFTR chloride
channel leading to thick secretions, pancreatic insufficiency,
bronchiectasis, and elevated sweat chloride concentrations.
4. A patient with chronic alcoholism presents with confusion,
ophthalmoplegia, and ataxia. Which vitamin deficiency is most
likely responsible?
A. Vitamin B12
B. Folate
C. Thiamine
D. Riboflavin
E. Pyridoxine
,Answer: C. Thiamine
Rationale: The classic triad of Wernicke encephalopathy consists of
confusion, ophthalmoplegia, and ataxia due to thiamine deficiency.
Immediate thiamine administration should precede glucose.
5. A newborn develops bilious vomiting within the first day of life.
Imaging reveals a double-bubble sign. What is the diagnosis?
A. Pyloric stenosis
B. Hirschsprung disease
C. Duodenal atresia
D. Intussusception
E. Meckel diverticulum
Answer: C. Duodenal atresia
Rationale: Duodenal atresia presents with bilious vomiting and a
double-bubble sign representing dilation of the stomach and proximal
duodenum. It is associated with Down syndrome.
6. Which nephron segment is impermeable to water and responsible
for dilution of tubular fluid?
A. Proximal convoluted tubule
B. Thin descending limb
C. Thin ascending limb
D. Thick ascending limb
E. Collecting duct
Answer: D. Thick ascending limb
Rationale: The thick ascending limb actively reabsorbs sodium,
potassium, and chloride while remaining impermeable to water, making
it the kidney's diluting segment.
7. A patient with Graves disease has which antibody?
, A. Anti-thyroglobulin antibody
B. TSH receptor-stimulating antibody
C. Anti-intrinsic factor antibody
D. Anti-mitochondrial antibody
E. Anti-centromere antibody
Answer: B. TSH receptor-stimulating antibody
Rationale: Graves disease results from IgG antibodies stimulating the
TSH receptor, causing hyperthyroidism, ophthalmopathy, and diffuse
goiter.
8. Which cranial nerve is responsible for lateral eye movement?
A. Oculomotor nerve
B. Trochlear nerve
C. Trigeminal nerve
D. Abducens nerve
E. Facial nerve
Answer: D. Abducens nerve
Rationale: The abducens nerve innervates the lateral rectus muscle,
which abducts the eye. Injury produces inability to move the eye
laterally and horizontal diplopia.
9. A patient develops sudden unilateral facial paralysis involving the
forehead. The diagnosis is:
A. Stroke
B. Myasthenia gravis
C. Bell palsy
D. Trigeminal neuralgia
E. Multiple sclerosis
Answer: C. Bell palsy
