COMSAE Phase 2 Form BSA 118 Exam
Practice Questions & [Verified Answers],
Plus Explained Rationales|2026 Latest
Update| Instant Download PDF
1.
A 67-year-old man presents with sudden severe chest pain radiating to
the back, described as “tearing.” BP is 180/100 in right arm and 150/90
in left arm. What is the most likely diagnosis?
A. Acute MI
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
Answer: C. Aortic dissection
Rationale: Sudden tearing chest pain with inter-arm blood pressure
difference is classic for aortic dissection due to intimal tear and false
lumen formation.
2.
A 24-year-old woman has fatigue, weight gain, and cold intolerance.
TSH is high, T4 is low. Diagnosis?
A. Graves disease
B. Hashimoto thyroiditis
,C. Subacute thyroiditis
D. Pituitary adenoma
Answer: B. Hashimoto thyroiditis
Rationale: Primary hypothyroidism with elevated TSH and low T4 is
most consistent with Hashimoto thyroiditis, an autoimmune
destruction of thyroid follicles.
3.
A 55-year-old smoker presents with hematuria. Painless. Most likely
diagnosis?
A. Renal stones
B. Bladder cancer
C. Pyelonephritis
D. Glomerulonephritis
Answer: B. Bladder cancer
Rationale: Painless gross hematuria in an older smoker is classic for
transitional cell carcinoma of the bladder.
4.
A newborn has projectile vomiting, hypochloremic metabolic alkalosis,
and a palpable olive-like mass. Diagnosis?
A. Intussusception
B. Pyloric stenosis
C. Hirschsprung disease
D. Necrotizing enterocolitis
,Answer: B. Pyloric stenosis
Rationale: Hypertrophic pyloric stenosis causes projectile non-bilious
vomiting and metabolic alkalosis due to HCl loss.
5.
A 32-year-old woman presents with exophthalmos, heat intolerance,
and weight loss. Next step?
A. Methimazole
B. Levothyroxine
C. Propranolol only
D. Radioiodine immediately
Answer: A. Methimazole
Rationale: Graves disease is treated first-line with methimazole; beta-
blockers are adjunct for symptom control.
6.
A patient develops fever, muscle rigidity, and autonomic instability
after starting haloperidol. Diagnosis?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Malignant hyperthermia
D. Anticholinergic toxicity
Answer: B. Neuroleptic malignant syndrome
Rationale: Dopamine blockade causes NMS characterized by rigidity,
fever, and autonomic instability.
, 7.
A 45-year-old man with alcoholism presents with confusion, ataxia, and
ophthalmoplegia. Treatment?
A. Thiamine
B. Glucose only
C. Naloxone
D. Vitamin B12
Answer: A. Thiamine
Rationale: Wernicke encephalopathy due to thiamine deficiency must
be treated before glucose administration.
8.
A child has barking cough, inspiratory stridor, and “steeple sign.”
Diagnosis?
A. Epiglottitis
B. Croup
C. Asthma
D. Foreign body aspiration
Answer: B. Croup
Rationale: Parainfluenza virus causes subglottic narrowing leading to
steeple sign and barking cough.
9.
A 60-year-old man has tremor at rest, rigidity, and bradykinesia.
Diagnosis?
Practice Questions & [Verified Answers],
Plus Explained Rationales|2026 Latest
Update| Instant Download PDF
1.
A 67-year-old man presents with sudden severe chest pain radiating to
the back, described as “tearing.” BP is 180/100 in right arm and 150/90
in left arm. What is the most likely diagnosis?
A. Acute MI
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
Answer: C. Aortic dissection
Rationale: Sudden tearing chest pain with inter-arm blood pressure
difference is classic for aortic dissection due to intimal tear and false
lumen formation.
2.
A 24-year-old woman has fatigue, weight gain, and cold intolerance.
TSH is high, T4 is low. Diagnosis?
A. Graves disease
B. Hashimoto thyroiditis
,C. Subacute thyroiditis
D. Pituitary adenoma
Answer: B. Hashimoto thyroiditis
Rationale: Primary hypothyroidism with elevated TSH and low T4 is
most consistent with Hashimoto thyroiditis, an autoimmune
destruction of thyroid follicles.
3.
A 55-year-old smoker presents with hematuria. Painless. Most likely
diagnosis?
A. Renal stones
B. Bladder cancer
C. Pyelonephritis
D. Glomerulonephritis
Answer: B. Bladder cancer
Rationale: Painless gross hematuria in an older smoker is classic for
transitional cell carcinoma of the bladder.
4.
A newborn has projectile vomiting, hypochloremic metabolic alkalosis,
and a palpable olive-like mass. Diagnosis?
A. Intussusception
B. Pyloric stenosis
C. Hirschsprung disease
D. Necrotizing enterocolitis
,Answer: B. Pyloric stenosis
Rationale: Hypertrophic pyloric stenosis causes projectile non-bilious
vomiting and metabolic alkalosis due to HCl loss.
5.
A 32-year-old woman presents with exophthalmos, heat intolerance,
and weight loss. Next step?
A. Methimazole
B. Levothyroxine
C. Propranolol only
D. Radioiodine immediately
Answer: A. Methimazole
Rationale: Graves disease is treated first-line with methimazole; beta-
blockers are adjunct for symptom control.
6.
A patient develops fever, muscle rigidity, and autonomic instability
after starting haloperidol. Diagnosis?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Malignant hyperthermia
D. Anticholinergic toxicity
Answer: B. Neuroleptic malignant syndrome
Rationale: Dopamine blockade causes NMS characterized by rigidity,
fever, and autonomic instability.
, 7.
A 45-year-old man with alcoholism presents with confusion, ataxia, and
ophthalmoplegia. Treatment?
A. Thiamine
B. Glucose only
C. Naloxone
D. Vitamin B12
Answer: A. Thiamine
Rationale: Wernicke encephalopathy due to thiamine deficiency must
be treated before glucose administration.
8.
A child has barking cough, inspiratory stridor, and “steeple sign.”
Diagnosis?
A. Epiglottitis
B. Croup
C. Asthma
D. Foreign body aspiration
Answer: B. Croup
Rationale: Parainfluenza virus causes subglottic narrowing leading to
steeple sign and barking cough.
9.
A 60-year-old man has tremor at rest, rigidity, and bradykinesia.
Diagnosis?
