COMSAE Phase 1 Form 116 (NBOME Self-Assessment Exam For COMLEX Level 1 Preparation) Question And Correct Answers (Verified Answers) Plus Rationales 2026 Q&A Instant Download Pdf

COMSAE Phase 1 Form 116 (NBOME
Self-Assessment Exam For COMLEX
Level 1 Preparation) Question And
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
Pdf

Question 1
A 45-year-old man presents with 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. Right coronary artery
C. Left circumflex artery
D. Posterior descending artery
Rationale: Inferior wall MI (II, III, aVF) is most commonly caused by occlusion of
the right coronary artery, which supplies the AV node and inferior myocardium
in most individuals. The LAD supplies anterior wall, circumflex lateral wall, and
PDA may be a branch but RCA is primary culprit in inferior MI.


Question 2
A child presents with a "slapped cheek" rash. What is the causative organism?
A. Parvovirus B19
B. Epstein-Barr virus

,C. Rubella virus
D. Coxsackievirus A16
Rationale: Parvovirus B19 causes erythema infectiosum (fifth disease),
characterized by slapped cheek rash and reticular body rash. EBV causes
mononucleosis, rubella causes postauricular rash, and Coxsackie causes hand-
foot-mouth disease.


Question 3
Which vitamin deficiency is associated with Wernicke encephalopathy?
A. Vitamin C
B. Vitamin B12
C. Thiamine (Vitamin B1)
D. Vitamin B6
Rationale: Thiamine deficiency leads to Wernicke encephalopathy characterized
by confusion, ophthalmoplegia, and ataxia. Common in alcoholism. B12 causes
neuropathy, B6 causes sideroblastic anemia, and vitamin C causes scurvy.


Question 4
Which structure is most important for initiating the heartbeat?
A. AV node
B. Bundle of His
C. Purkinje fibers
D. SA node
Rationale: The sinoatrial (SA) node is the primary pacemaker of the heart,
generating spontaneous depolarizations that initiate each cardiac cycle.


Question 5

,A patient with COPD is most likely to have which acid-base disorder?
A. Metabolic alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Respiratory alkalosis
Rationale: COPD causes hypoventilation leading to CO₂ retention and chronic
respiratory acidosis with compensatory metabolic alkalosis.


Question 6
Which antibody is most specific for systemic lupus erythematosus?
A. Anti-histone
B. Anti-Smith
C. Anti-Ro
D. Anti-double stranded DNA
Rationale: Anti-dsDNA antibodies are highly specific for SLE and correlate with
disease activity, particularly lupus nephritis.


Question 7
Which neurotransmitter is decreased in Parkinson disease?
A. GABA
B. Glutamate
C. Dopamine
D. Acetylcholine
Rationale: Parkinson disease is due to degeneration of dopaminergic neurons in
the substantia nigra pars compacta.


Question 8

, Which type of hypersensitivity is involved in anaphylaxis?
A. Type I
B. Type II
C. Type III
D. Type IV
Rationale: Anaphylaxis is an IgE-mediated Type I hypersensitivity reaction
involving mast cell degranulation and histamine release.


Question 9
Which organ is primarily responsible for gluconeogenesis?
A. Muscle
B. Brain
C. Adipose tissue
D. Liver
Rationale: The liver is the main site of gluconeogenesis, producing glucose
during fasting states.


Question 10
Which embryologic structure gives rise to the adrenal medulla?
A. Mesoderm
B. Neural crest cells
C. Endoderm
D. Ectoderm
Rationale: The adrenal medulla originates from neural crest cells, which also
form sympathetic ganglia.


Question 11