COMSAE Phase 1 Form 104 Test Questions And
Correct Answers (Verified Answers) Plus
Rationales 2025/2026 Q&A | Instant
Download Pdf
1. A 24-year-old woman has polyuria, polydipsia, weight loss, and random
glucose 298 mg/dL. Anti-GAD antibodies are positive. Best initial therapy?
A. Metformin
B. Sitagliptin
C. Insulin
D. Pioglitazone
E. Acarbose
Type 1 diabetes requires exogenous insulin due to autoimmune β-cell
destruction; oral agents are ineffective early.
2. A 67-year-old with exertional chest pressure relieved by rest. Which change
explains his pain?
A. Increased coronary blood flow reserve
B. Decreased myocardial O₂ demand
C. Fixed atherosclerotic narrowing limiting flow during exertion
D. Coronary vasospasm at rest
E. Increased diastolic filling time
Stable angina is due to fixed stenosis causing supply–demand mismatch
with exertion.
3. A 3-day-old has projectile nonbilious vomiting; olive-like mass in
epigastrium. Acid-base finding?
A. Metabolic acidosis, low anion gap
B. Respiratory acidosis
C. Metabolic alkalosis with hypochloremia and hypokalemia
D. Respiratory alkalosis
E. Normal
, Vomiting gastric HCl causes chloride-depletion metabolic alkalosis and
secondary hypokalemia.
4. A 45-year-old with asthma uses albuterol frequently. Which receptor is
targeted?
A. M3
B. β1
C. β2
D. H1
E. α1
Short-acting β2-agonists cause bronchodilation via smooth muscle
relaxation.
5. A 26-year-old man with watery diarrhea after camping. Trophozoites with
ventral sucking disk. Treatment?
A. Metronidazole + PPI
B. TMP-SMX
C. Metronidazole
D. Praziquantel
E. Albendazole
Giardia lamblia is treated with metronidazole.
6. A 58-year-old with chronic alcohol use has dilated cardiomyopathy. Which
hemodynamic change?
A. Increased ejection fraction
B. Increased end-diastolic volume
C. Decreased end-systolic volume
D. Increased contractility
E. Decreased preload
Dilated ventricles have increased EDV and reduced EF.
7. A 32-year-old G2P1 at 10 weeks with severe right lower quadrant pain,
hypotension, positive β-hCG. Diagnosis?
A. Ovarian torsion
B. Ruptured ectopic pregnancy
C. Appendicitis
D. Corpus luteum cyst
, E. UTI
Hemodynamic instability + early pregnancy + abdominal pain suggests
ruptured ectopic (usually tubal).
8. A patient with schizophrenia has persistent galactorrhea on antipsychotic.
Which drug most likely?
A. Clozapine
B. Quetiapine
C. Risperidone
D. Aripiprazole
E. Ziprasidone
Risperidone strongly blocks D2 → hyperprolactinemia.
9. A 7-year-old boy has hemarthrosis after minor trauma; ↑PTT, normal PT.
Deficiency?
A. Factor VII
B. Factor VIII
C. Factor X
D. Fibrinogen
E. vWF only
Hemophilia A (VIII) shows prolonged aPTT and deep tissue bleeding.
10.OMM: A 35-year-old with acute low back strain, severe pain, protective
muscle spasm. Best initial OMT?
A. HVLA
B. Cranial
C. Counterstrain
D. Muscle energy direct
E. Still technique
Counterstrain is gentle and indicated in acute, hypertonic tender points.
11.A 64-year-old with COPD exacerbation is given high-flow O₂. What may
worsen?
A. Mucus production
B. CO₂ retention due to V/Q mismatch and Haldane effect
C. Bronchoconstriction
D. Hemoglobin affinity for O₂ decreases
Correct Answers (Verified Answers) Plus
Rationales 2025/2026 Q&A | Instant
Download Pdf
1. A 24-year-old woman has polyuria, polydipsia, weight loss, and random
glucose 298 mg/dL. Anti-GAD antibodies are positive. Best initial therapy?
A. Metformin
B. Sitagliptin
C. Insulin
D. Pioglitazone
E. Acarbose
Type 1 diabetes requires exogenous insulin due to autoimmune β-cell
destruction; oral agents are ineffective early.
2. A 67-year-old with exertional chest pressure relieved by rest. Which change
explains his pain?
A. Increased coronary blood flow reserve
B. Decreased myocardial O₂ demand
C. Fixed atherosclerotic narrowing limiting flow during exertion
D. Coronary vasospasm at rest
E. Increased diastolic filling time
Stable angina is due to fixed stenosis causing supply–demand mismatch
with exertion.
3. A 3-day-old has projectile nonbilious vomiting; olive-like mass in
epigastrium. Acid-base finding?
A. Metabolic acidosis, low anion gap
B. Respiratory acidosis
C. Metabolic alkalosis with hypochloremia and hypokalemia
D. Respiratory alkalosis
E. Normal
, Vomiting gastric HCl causes chloride-depletion metabolic alkalosis and
secondary hypokalemia.
4. A 45-year-old with asthma uses albuterol frequently. Which receptor is
targeted?
A. M3
B. β1
C. β2
D. H1
E. α1
Short-acting β2-agonists cause bronchodilation via smooth muscle
relaxation.
5. A 26-year-old man with watery diarrhea after camping. Trophozoites with
ventral sucking disk. Treatment?
A. Metronidazole + PPI
B. TMP-SMX
C. Metronidazole
D. Praziquantel
E. Albendazole
Giardia lamblia is treated with metronidazole.
6. A 58-year-old with chronic alcohol use has dilated cardiomyopathy. Which
hemodynamic change?
A. Increased ejection fraction
B. Increased end-diastolic volume
C. Decreased end-systolic volume
D. Increased contractility
E. Decreased preload
Dilated ventricles have increased EDV and reduced EF.
7. A 32-year-old G2P1 at 10 weeks with severe right lower quadrant pain,
hypotension, positive β-hCG. Diagnosis?
A. Ovarian torsion
B. Ruptured ectopic pregnancy
C. Appendicitis
D. Corpus luteum cyst
, E. UTI
Hemodynamic instability + early pregnancy + abdominal pain suggests
ruptured ectopic (usually tubal).
8. A patient with schizophrenia has persistent galactorrhea on antipsychotic.
Which drug most likely?
A. Clozapine
B. Quetiapine
C. Risperidone
D. Aripiprazole
E. Ziprasidone
Risperidone strongly blocks D2 → hyperprolactinemia.
9. A 7-year-old boy has hemarthrosis after minor trauma; ↑PTT, normal PT.
Deficiency?
A. Factor VII
B. Factor VIII
C. Factor X
D. Fibrinogen
E. vWF only
Hemophilia A (VIII) shows prolonged aPTT and deep tissue bleeding.
10.OMM: A 35-year-old with acute low back strain, severe pain, protective
muscle spasm. Best initial OMT?
A. HVLA
B. Cranial
C. Counterstrain
D. Muscle energy direct
E. Still technique
Counterstrain is gentle and indicated in acute, hypertonic tender points.
11.A 64-year-old with COPD exacerbation is given high-flow O₂. What may
worsen?
A. Mucus production
B. CO₂ retention due to V/Q mismatch and Haldane effect
C. Bronchoconstriction
D. Hemoglobin affinity for O₂ decreases
