COMSAE Phase 2–Style Practice Exam (Form 106 Inspired) (2025–2026) – Practice Test Questions, Verified Answers, and Rationales

COMSAE Phase 2–Style Practice Exam (Form
106 Inspired) Test Questions And Correct
Answers (Verified Answers) Plus Rationales
2025/2026 Q&A | Instant Download Pdf
1.
A 45-year-old woman presents with progressive fatigue and conjunctival pallor.
Labs show MCV 72 fL, Hb 9.8 g/dL, ferritin low, TIBC high. What
is the most likely cause?
• A. Thalassemia minor
• B. Iron deficiency anemia
• C. Anemia of chronic disease
• D. Lead poisoning
Rationale: Microcytic anemia with low ferritin and high TIBC is classic for iron
deficiency.


2.
A 25-year-old woman develops sudden pleuritic chest pain and dyspnea after
starting oral contraceptives. HR 120, O2 sat 88%. CT angiography shows filling
defect in pulmonary arteries. Next best step?
• A. Aspirin
• B. Anticoagulation with heparin
• C. IVC filter
• D. Thrombolysis

,Rationale: Stable PE requires anticoagulation first; thrombolysis reserved for
massive PE with hemodynamic instability.


3.
A 60-year-old man has exertional chest pain relieved by rest. Stress test shows ST
depressions.
What is the most appropriate long-term therapy to reduce mortality?
• A. Nitroglycerin as needed
• B. Beta blocker
• C. Calcium channel blocker
• D. Aspirin only
Rationale: Beta blockers improve survival in stable angina by decreasing
myocardial oxygen demand.


4.
A 7-year-old boy has recurrent infections, eczema, and thrombocytopenia. Which
condition is most likely?
• A. Bruton's agammaglobulinemia
• B. Wiskott–Aldrich syndrome
• C. DiGeorge syndrome
• D. SCID
Rationale: Triad = immunodeficiency, eczema, thrombocytopenia.


5.
A 30-year-old man with HIV presents with headache and fever. CSF: opening
pressure high, India ink prep positive. Most appropriate initial treatment?

, • A. Fluconazole oral
• B. Amphotericin B + flucytosine
• C. TMP-SMX
• D. Acyclovir
Rationale: Cryptococcus meningitis is treated initially with amphotericin B and
flucytosine.


6.
A 55-year-old man with hypertension presents with tearing chest pain radiating to
the back. BP 180/100, asymmetric pulses. Best initial diagnostic test?
• A. Chest X-ray
• B. CT angiography of chest/abdomen
• C. Cardiac enzymes
• D. Echocardiogram
Rationale: CTA is the best initial test for aortic dissection (if stable). TEE if unstable.


7.
A 28-year-old woman develops symmetric morning joint stiffness >1 hour, sparing
DIP joints.
Which test is most specific? •
A. ANA
• B. Rheumatoid factor
• C. Anti-CCP antibody
• D. ESR
Rationale: Anti-CCP is most specific for rheumatoid arthritis.

, 8.
A 40-year-old alcoholic has confusion, ataxia, and nystagmus.
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mWhich vitamin deficiency is most likely?
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• A. Niacin
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• B. Thiamine
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• C. Vitamin B12
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• D. Folate
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Rationale: Wernicke encephalopathy = thiamine deficiency.
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A 16-year-old girl presents with abdominal pain, amenorrhea, and a blue
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mbulging mass at the vaginal introitus. Diagnosis?
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• A. Ovarian torsion
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• B. Imperforate hymen
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• C. Endometriosis
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• D. Ectopic pregnancy
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Rationale: Imperforate hymen → hematocolpos → bulging bluish mass.
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A 70-year-old man with COPD has increased shortness of breath. ABG: pH
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m7.28, PaCO₂ 60, PaO₂ 55.
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Best management?
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• A. High-flow O₂ only
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• B. BiPAP noninvasive ventilation
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• C. IV steroids only
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