COMSAE LEVEL 2 FORM A PRACTICE
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS
RATIONALES 2025 Q&A | INSTANT
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1. A 45-year-old woman presents with fatigue, weight gain, and
constipation. Her TSH is elevated, and free T4 is low. What is the
most likely diagnosis?
Hypothyroidism
Hypothyroidism presents with elevated TSH and low free T4 due
to primary thyroid failure.
2. A patient presents with sudden onset severe headache, neck
stiffness, and photophobia. CT shows blood in the subarachnoid
space. What is the next best step?
,Perform cerebral angiography
Subarachnoid hemorrhage is most commonly due to ruptured
berry aneurysm, which should be localized for potential
intervention.
3. A 23-year-old man is diagnosed with gonococcal urethritis.
Which medication should be added to his treatment to cover
possible co-infection?
Doxycycline
Patients with gonorrhea are at high risk for chlamydial co-
infection; doxycycline or azithromycin is indicated.
4. A 2-month-old infant has projectile non-bilious vomiting and a
palpable olive-shaped mass in the abdomen. What is the most
likely diagnosis?
Pyloric stenosis
Projectile non-bilious vomiting and palpable olive mass are
classic for hypertrophic pyloric stenosis.
5. A patient with COPD develops increasing CO₂ retention.
Which acid-base disorder is expected?
Respiratory acidosis
, Hypoventilation in COPD causes CO₂ retention leading to
respiratory acidosis.
6. A 28-year-old man has right costovertebral angle tenderness,
fever, and dysuria. Urinalysis shows WBC casts. What is the most
likely diagnosis?
Acute pyelonephritis
WBC casts indicate renal parenchymal infection consistent with
pyelonephritis.
7. A patient presents with a maculopapular rash that started on
the face and spread to the trunk. He has Koplik spots. What is
the diagnosis?
Measles
Koplik spots and rash spreading from face downward are
classic for measles.
8. A 60-year-old man with history of hypertension develops
sudden, painless vision loss in one eye with a cherry red spot on
fundoscopic exam. Diagnosis?
Central retinal artery occlusion
A cherry red spot indicates CRAO due to retinal ischemia.
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS
RATIONALES 2025 Q&A | INSTANT
DOWNLOAD PDF
1. A 45-year-old woman presents with fatigue, weight gain, and
constipation. Her TSH is elevated, and free T4 is low. What is the
most likely diagnosis?
Hypothyroidism
Hypothyroidism presents with elevated TSH and low free T4 due
to primary thyroid failure.
2. A patient presents with sudden onset severe headache, neck
stiffness, and photophobia. CT shows blood in the subarachnoid
space. What is the next best step?
,Perform cerebral angiography
Subarachnoid hemorrhage is most commonly due to ruptured
berry aneurysm, which should be localized for potential
intervention.
3. A 23-year-old man is diagnosed with gonococcal urethritis.
Which medication should be added to his treatment to cover
possible co-infection?
Doxycycline
Patients with gonorrhea are at high risk for chlamydial co-
infection; doxycycline or azithromycin is indicated.
4. A 2-month-old infant has projectile non-bilious vomiting and a
palpable olive-shaped mass in the abdomen. What is the most
likely diagnosis?
Pyloric stenosis
Projectile non-bilious vomiting and palpable olive mass are
classic for hypertrophic pyloric stenosis.
5. A patient with COPD develops increasing CO₂ retention.
Which acid-base disorder is expected?
Respiratory acidosis
, Hypoventilation in COPD causes CO₂ retention leading to
respiratory acidosis.
6. A 28-year-old man has right costovertebral angle tenderness,
fever, and dysuria. Urinalysis shows WBC casts. What is the most
likely diagnosis?
Acute pyelonephritis
WBC casts indicate renal parenchymal infection consistent with
pyelonephritis.
7. A patient presents with a maculopapular rash that started on
the face and spread to the trunk. He has Koplik spots. What is
the diagnosis?
Measles
Koplik spots and rash spreading from face downward are
classic for measles.
8. A 60-year-old man with history of hypertension develops
sudden, painless vision loss in one eye with a cherry red spot on
fundoscopic exam. Diagnosis?
Central retinal artery occlusion
A cherry red spot indicates CRAO due to retinal ischemia.
