COMSAE 115 EXAM / ACTUAL COMSAE 115 EXAM
LATEST 2026
COMPLETE ACCURATE EXAM REAL QUESTIONS
AND CORRECT VERIFIED SOLUTIONS WITH
RATIONALES (DETAILED ANSWERS)
NEWEST UPDATED VERSION 2026 EDITION
GUARANTEED SUCCESS
A+ (BRAND NEW!) STUDY GUIDE INCLUDED
1. A 45-year-old male presents with acute onset of severe, tearing chest
pain radiating to the back. Blood pressure is 150/90 in the right arm and
100/60 in the left arm. Which of the following is the most appropriate
next step?
A) Administer thrombolytic
B) Obtain a chest x-ray
C) CORRECT ANSWER: Obtain a contrast-enhanced chest CT
D) Start beta-blockers immediately
Rationale: The presentation suggests aortic dissection. Contrast-
enhanced chest CT is the definitive imaging study. Thrombolytics are
contraindicated.
2. A 30-year-old female with fatigue, weight gain, and cold intolerance.
Labs: TSH 15 µIU/mL (normal 0.5–5), free T4 0.5 ng/dL (normal 0.8–
1.8). Thyroid peroxidase antibodies are positive. What is the first-line
treatment?
A) Methimazole
B) CORRECT ANSWER: Levothyroxine
,C) Radioactive iodine ablation
D) Thyroidectomy
Rationale: Hashimoto thyroiditis with hypothyroidism is treated with
levothyroxine replacement.
3. A 68-year-old male with a history of heart failure presents with
shortness of breath and frothy sputum. Lung auscultation reveals
crackles bilaterally. Which medication is most appropriate for acute
management?
A) Digoxin
B) CORRECT ANSWER: Furosemide
C) Spironolactone
D) Carvedilol
Rationale: Acute pulmonary edema requires loop diuretics like
furosemide for rapid volume reduction.
4. A 55-year-old female presents with episodic headaches, palpitations,
and sweating. BP 180/110 mmHg. Physical exam shows a palpable
abdominal mass that is pulsatile. What is the most likely diagnosis?
A) Renal artery stenosis
B) CORRECT ANSWER: Pheochromocytoma
C) Primary hyperaldosteronism
D) Aortic aneurysm
Rationale: Triad of headache, palpitations, sweating with episodic
hypertension suggests pheochromocytoma.
,5. A 20-year-old college student reports fever, sore throat, and fatigue.
Exam: pharyngeal exudates, lymphadenopathy, splenomegaly. Which
diagnostic test is most specific?
A) Monospot test
B) CORRECT ANSWER: EBV-specific antibody testing (VCA
IgM)
C) Throat culture
D) Complete blood count
Rationale: Monospot can be falsely positive; EBV VCA IgM is highly
specific for acute infection.
6. A 65-year-old smoker presents with hemoptysis and weight loss.
Chest CT shows a 4 cm spiculated lung mass. Which of the following is
the most appropriate next step?
A) PET-CT
B) CORRECT ANSWER: Tissue biopsy via bronchoscopy
C) Empiric antibiotics
D) Serial imaging in 3 months
Rationale: Tissue diagnosis is required before treatment; bronchoscopy
is appropriate for central lesions.
7. A 50-year-old diabetic with worsening vision over 3 months.
Fundoscopic exam shows dot-blot hemorrhages and hard exudates. No
neovascularization. What is the stage of diabetic retinopathy?
A) Mild nonproliferative
B) CORRECT ANSWER: Severe nonproliferative
C) Proliferative
D) Macular edema
, Rationale: Dot-blot hemorrhages and hard exudates indicate
nonproliferative diabetic retinopathy; severe disease has more extensive
findings.
8. A 28-year-old female with joint pain, malar rash, oral ulcers. ANA
positive, anti-dsDNA positive. Which medication reduces mortality and
prevents lupus nephritis?
A) NSAIDs
B) Hydroxychloroquine
C) CORRECT ANSWER: Mycophenolate mofetil
D) Prednisone alone
Rationale: Mycophenolate is first-line for lupus nephritis.
Hydroxychloroquine helps symptoms but not nephritis.
9. A 72-year-old male with sudden onset of aphasia and right-sided
weakness. Last known well 3 hours ago. CT head shows no hemorrhage.
BP 185/100. What is the next step?
A) Lower BP to <140/90 before thrombolytic
B) CORRECT ANSWER: Administer IV alteplase
C) Start aspirin 325 mg
D) Transfer for mechanical thrombectomy without tPA
10. A 58-year-old man with long-standing hypertension develops sudden
tearing chest pain radiating to the back. Chest x-ray shows a widened
mediastinum. Which diagnostic test is most appropriate?
A) Transthoracic echocardiography
B) Ventilation-perfusion scan
LATEST 2026
COMPLETE ACCURATE EXAM REAL QUESTIONS
AND CORRECT VERIFIED SOLUTIONS WITH
RATIONALES (DETAILED ANSWERS)
NEWEST UPDATED VERSION 2026 EDITION
GUARANTEED SUCCESS
A+ (BRAND NEW!) STUDY GUIDE INCLUDED
1. A 45-year-old male presents with acute onset of severe, tearing chest
pain radiating to the back. Blood pressure is 150/90 in the right arm and
100/60 in the left arm. Which of the following is the most appropriate
next step?
A) Administer thrombolytic
B) Obtain a chest x-ray
C) CORRECT ANSWER: Obtain a contrast-enhanced chest CT
D) Start beta-blockers immediately
Rationale: The presentation suggests aortic dissection. Contrast-
enhanced chest CT is the definitive imaging study. Thrombolytics are
contraindicated.
2. A 30-year-old female with fatigue, weight gain, and cold intolerance.
Labs: TSH 15 µIU/mL (normal 0.5–5), free T4 0.5 ng/dL (normal 0.8–
1.8). Thyroid peroxidase antibodies are positive. What is the first-line
treatment?
A) Methimazole
B) CORRECT ANSWER: Levothyroxine
,C) Radioactive iodine ablation
D) Thyroidectomy
Rationale: Hashimoto thyroiditis with hypothyroidism is treated with
levothyroxine replacement.
3. A 68-year-old male with a history of heart failure presents with
shortness of breath and frothy sputum. Lung auscultation reveals
crackles bilaterally. Which medication is most appropriate for acute
management?
A) Digoxin
B) CORRECT ANSWER: Furosemide
C) Spironolactone
D) Carvedilol
Rationale: Acute pulmonary edema requires loop diuretics like
furosemide for rapid volume reduction.
4. A 55-year-old female presents with episodic headaches, palpitations,
and sweating. BP 180/110 mmHg. Physical exam shows a palpable
abdominal mass that is pulsatile. What is the most likely diagnosis?
A) Renal artery stenosis
B) CORRECT ANSWER: Pheochromocytoma
C) Primary hyperaldosteronism
D) Aortic aneurysm
Rationale: Triad of headache, palpitations, sweating with episodic
hypertension suggests pheochromocytoma.
,5. A 20-year-old college student reports fever, sore throat, and fatigue.
Exam: pharyngeal exudates, lymphadenopathy, splenomegaly. Which
diagnostic test is most specific?
A) Monospot test
B) CORRECT ANSWER: EBV-specific antibody testing (VCA
IgM)
C) Throat culture
D) Complete blood count
Rationale: Monospot can be falsely positive; EBV VCA IgM is highly
specific for acute infection.
6. A 65-year-old smoker presents with hemoptysis and weight loss.
Chest CT shows a 4 cm spiculated lung mass. Which of the following is
the most appropriate next step?
A) PET-CT
B) CORRECT ANSWER: Tissue biopsy via bronchoscopy
C) Empiric antibiotics
D) Serial imaging in 3 months
Rationale: Tissue diagnosis is required before treatment; bronchoscopy
is appropriate for central lesions.
7. A 50-year-old diabetic with worsening vision over 3 months.
Fundoscopic exam shows dot-blot hemorrhages and hard exudates. No
neovascularization. What is the stage of diabetic retinopathy?
A) Mild nonproliferative
B) CORRECT ANSWER: Severe nonproliferative
C) Proliferative
D) Macular edema
, Rationale: Dot-blot hemorrhages and hard exudates indicate
nonproliferative diabetic retinopathy; severe disease has more extensive
findings.
8. A 28-year-old female with joint pain, malar rash, oral ulcers. ANA
positive, anti-dsDNA positive. Which medication reduces mortality and
prevents lupus nephritis?
A) NSAIDs
B) Hydroxychloroquine
C) CORRECT ANSWER: Mycophenolate mofetil
D) Prednisone alone
Rationale: Mycophenolate is first-line for lupus nephritis.
Hydroxychloroquine helps symptoms but not nephritis.
9. A 72-year-old male with sudden onset of aphasia and right-sided
weakness. Last known well 3 hours ago. CT head shows no hemorrhage.
BP 185/100. What is the next step?
A) Lower BP to <140/90 before thrombolytic
B) CORRECT ANSWER: Administer IV alteplase
C) Start aspirin 325 mg
D) Transfer for mechanical thrombectomy without tPA
10. A 58-year-old man with long-standing hypertension develops sudden
tearing chest pain radiating to the back. Chest x-ray shows a widened
mediastinum. Which diagnostic test is most appropriate?
A) Transthoracic echocardiography
B) Ventilation-perfusion scan
