COMSAE PHASE 2 FORM 114 MOCK
PRACTICE EXAM QUESTIONS AND
ANSWERS
1. A 65-year-old male presents with sudden onset of severe chest pain radiating to his back.
Blood pressure is 180/110 mmHg in the right arm and 140/90 mmHg in the left arm. What is
the most appropriate next step in diagnosis?
A. Transthoracic echocardiogram
B. CT Angiography of the chest
C. Chest X-ray
D. Electrocardiogram
Answer: B
Conceptual Explanation: The clinical presentation of tearing chest pain radiating to the
back with asymmetric blood pressures is highly suggestive of aortic dissection. CT
angiography is the gold standard for diagnosis in stable patients.
2. A 28-year-old G1P0 at 34 weeks gestation presents with a blood pressure of 165/115
mmHg and a severe headache. Urinalysis shows 3+ protein. What is the most appropriate
medication to prevent seizures in this patient?
A. Phenytoin
,B. Valproic acid
C. Diazepam
D. Magnesium sulfate
Answer: D
Conceptual Explanation: Magnesium sulfate is the first-line treatment for seizure
prophylaxis in patients with preeclampsia with severe features or eclampsia.
3. A 4-year-old boy presents with high fever, barking cough, and inspiratory stridor. He is
sitting in a ‘tripod’ position and is drooling. What is the most likely diagnosis?
A. Epiglottitis
B. Croup
C. Bacterial tracheitis
D. Foreign body aspiration
Answer: A
Conceptual Explanation: The tripod position, high fever, and drooling are classic signs of
epiglottitis, which is a medical emergency.
4. During an osteopathic exam, the physician finds that T5 is rotated right. When the patient
flexes, the rotation becomes more asymmetric. When the patient extends, the asymmetry
improves. What is the correct diagnosis for T5?
A. T5 Neutral, Sidebent Left, Rotated Right
, B. T5 Flexed, Rotated Right, Sidebent Right
C. T5 Extended, Rotated Right, Sidebent Right
D. T5 Extended, Rotated Left, Sidebent Left
Answer: C
Conceptual Explanation: According to Fryette’s laws for Type II dysfunctions, if a segment
improves in extension and worsens in flexion, it is an extension dysfunction. Sidebending
and rotation occur to the same side.
5. A 55-year-old female with a history of hypertension and diabetes presents with acute RUQ
pain, fever, and jaundice. Labs show an elevated alkaline phosphatase and bilirubin. What is
the most likely diagnosis?
A. Acute cholecystitis
B. Choledocholithiasis
C. Acute cholangitis
D. Biliary colic
Answer: C
Conceptual Explanation: Charcot’s triad (RUQ pain, fever, jaundice) is classic for acute
cholangitis, typically caused by an ascending infection due to biliary obstruction.
PRACTICE EXAM QUESTIONS AND
ANSWERS
1. A 65-year-old male presents with sudden onset of severe chest pain radiating to his back.
Blood pressure is 180/110 mmHg in the right arm and 140/90 mmHg in the left arm. What is
the most appropriate next step in diagnosis?
A. Transthoracic echocardiogram
B. CT Angiography of the chest
C. Chest X-ray
D. Electrocardiogram
Answer: B
Conceptual Explanation: The clinical presentation of tearing chest pain radiating to the
back with asymmetric blood pressures is highly suggestive of aortic dissection. CT
angiography is the gold standard for diagnosis in stable patients.
2. A 28-year-old G1P0 at 34 weeks gestation presents with a blood pressure of 165/115
mmHg and a severe headache. Urinalysis shows 3+ protein. What is the most appropriate
medication to prevent seizures in this patient?
A. Phenytoin
,B. Valproic acid
C. Diazepam
D. Magnesium sulfate
Answer: D
Conceptual Explanation: Magnesium sulfate is the first-line treatment for seizure
prophylaxis in patients with preeclampsia with severe features or eclampsia.
3. A 4-year-old boy presents with high fever, barking cough, and inspiratory stridor. He is
sitting in a ‘tripod’ position and is drooling. What is the most likely diagnosis?
A. Epiglottitis
B. Croup
C. Bacterial tracheitis
D. Foreign body aspiration
Answer: A
Conceptual Explanation: The tripod position, high fever, and drooling are classic signs of
epiglottitis, which is a medical emergency.
4. During an osteopathic exam, the physician finds that T5 is rotated right. When the patient
flexes, the rotation becomes more asymmetric. When the patient extends, the asymmetry
improves. What is the correct diagnosis for T5?
A. T5 Neutral, Sidebent Left, Rotated Right
, B. T5 Flexed, Rotated Right, Sidebent Right
C. T5 Extended, Rotated Right, Sidebent Right
D. T5 Extended, Rotated Left, Sidebent Left
Answer: C
Conceptual Explanation: According to Fryette’s laws for Type II dysfunctions, if a segment
improves in extension and worsens in flexion, it is an extension dysfunction. Sidebending
and rotation occur to the same side.
5. A 55-year-old female with a history of hypertension and diabetes presents with acute RUQ
pain, fever, and jaundice. Labs show an elevated alkaline phosphatase and bilirubin. What is
the most likely diagnosis?
A. Acute cholecystitis
B. Choledocholithiasis
C. Acute cholangitis
D. Biliary colic
Answer: C
Conceptual Explanation: Charcot’s triad (RUQ pain, fever, jaundice) is classic for acute
cholangitis, typically caused by an ascending infection due to biliary obstruction.
