COMSAE Phase 2 Practice Exam (Form
C118-Style) Questions And Correct
Answers (Verified Answers) Plus
Rationales 2025|2026 Q&A | Instant
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1. A 28-year-old woman presents with fatigue and cold intolerance. TSH is
9.0 µU/mL, free T4 is low. What is the most likely diagnosis?
A. Subacute thyroiditis
B. Hashimoto thyroiditis
C. Central hypothyroidism
D. Graves disease
Rationale: Hashimoto thyroiditis is the most common cause of
hypothyroidism in iodine-sufficient areas, with elevated TSH and low T4._
,2. A 65-year-old man with COPD presents with dyspnea. ABG shows pH 7.35,
pCO₂ 55, HCO₃⁻ 30. Diagnosis?
A. Compensated respiratory acidosis
B. Acute respiratory acidosis
C. Metabolic alkalosis
D. Mixed acid-base disorder
Rationale: Chronic CO₂ retention with compensatory bicarbonate elevation
indicates compensated respiratory acidosis._
3. A 7-year-old boy develops a sore throat, fever, and sandpaper rash.
Diagnosis?
A. Scarlet fever
B. Kawasaki disease
C. Rubella
D. Fifth disease
Rationale: Scarlet fever results from group A Streptococcus infection with
erythrogenic toxin._
4. A 45-year-old man with hypertension develops swelling after starting
lisinopril. Cause?
A. Allergic urticaria
B. Bradykinin-mediated angioedema
C. Histamine reaction
,D. IgE-mediated anaphylaxis
Rationale: ACE inhibitors increase bradykinin levels, leading to non-pitting
angioedema._
5. A 24-year-old woman has right lower quadrant pain, positive hCG, and
empty uterus on ultrasound. Diagnosis?
A. Ectopic pregnancy
B. Appendicitis
C. Ovarian torsion
D. Corpus luteum cyst
Rationale: Positive pregnancy test with no intrauterine gestation is
diagnostic for ectopic pregnancy._
6. A 12-year-old girl presents with polyuria and polydipsia. Labs: glucose 350
mg/dL, low C-peptide. Diagnosis?
A. Type 1 diabetes mellitus
B. Type 2 diabetes mellitus
C. MODY
D. Insulinoma
Rationale: Low C-peptide indicates absent endogenous insulin production
typical of Type 1 DM._
, 7. A 66-year-old man develops confusion after starting furosemide. Sodium
122 mEq/L. Diagnosis?
A. Hypovolemic hyponatremia
B. SIADH
C. Hypervolemic hyponatremia
D. Pseudohyponatremia
Rationale: Loop diuretics cause sodium and water loss, leading to
hypovolemic hyponatremia._
8. A 56-year-old smoker has a painless hematuria. Next best step?
A. Cystoscopy
B. Urine culture
C. Renal ultrasound
D. PSA test
Rationale: Painless hematuria in a smoker requires cystoscopy to evaluate
for bladder cancer._
9. A 22-year-old woman develops fever and flank pain 3 days after cystitis.
Next step?
A. Repeat urinalysis
B. Pelvic ultrasound
C. IV antibiotics
D. Oral nitrofurantoin
C118-Style) Questions And Correct
Answers (Verified Answers) Plus
Rationales 2025|2026 Q&A | Instant
Download Pdf
1. A 28-year-old woman presents with fatigue and cold intolerance. TSH is
9.0 µU/mL, free T4 is low. What is the most likely diagnosis?
A. Subacute thyroiditis
B. Hashimoto thyroiditis
C. Central hypothyroidism
D. Graves disease
Rationale: Hashimoto thyroiditis is the most common cause of
hypothyroidism in iodine-sufficient areas, with elevated TSH and low T4._
,2. A 65-year-old man with COPD presents with dyspnea. ABG shows pH 7.35,
pCO₂ 55, HCO₃⁻ 30. Diagnosis?
A. Compensated respiratory acidosis
B. Acute respiratory acidosis
C. Metabolic alkalosis
D. Mixed acid-base disorder
Rationale: Chronic CO₂ retention with compensatory bicarbonate elevation
indicates compensated respiratory acidosis._
3. A 7-year-old boy develops a sore throat, fever, and sandpaper rash.
Diagnosis?
A. Scarlet fever
B. Kawasaki disease
C. Rubella
D. Fifth disease
Rationale: Scarlet fever results from group A Streptococcus infection with
erythrogenic toxin._
4. A 45-year-old man with hypertension develops swelling after starting
lisinopril. Cause?
A. Allergic urticaria
B. Bradykinin-mediated angioedema
C. Histamine reaction
,D. IgE-mediated anaphylaxis
Rationale: ACE inhibitors increase bradykinin levels, leading to non-pitting
angioedema._
5. A 24-year-old woman has right lower quadrant pain, positive hCG, and
empty uterus on ultrasound. Diagnosis?
A. Ectopic pregnancy
B. Appendicitis
C. Ovarian torsion
D. Corpus luteum cyst
Rationale: Positive pregnancy test with no intrauterine gestation is
diagnostic for ectopic pregnancy._
6. A 12-year-old girl presents with polyuria and polydipsia. Labs: glucose 350
mg/dL, low C-peptide. Diagnosis?
A. Type 1 diabetes mellitus
B. Type 2 diabetes mellitus
C. MODY
D. Insulinoma
Rationale: Low C-peptide indicates absent endogenous insulin production
typical of Type 1 DM._
, 7. A 66-year-old man develops confusion after starting furosemide. Sodium
122 mEq/L. Diagnosis?
A. Hypovolemic hyponatremia
B. SIADH
C. Hypervolemic hyponatremia
D. Pseudohyponatremia
Rationale: Loop diuretics cause sodium and water loss, leading to
hypovolemic hyponatremia._
8. A 56-year-old smoker has a painless hematuria. Next best step?
A. Cystoscopy
B. Urine culture
C. Renal ultrasound
D. PSA test
Rationale: Painless hematuria in a smoker requires cystoscopy to evaluate
for bladder cancer._
9. A 22-year-old woman develops fever and flank pain 3 days after cystitis.
Next step?
A. Repeat urinalysis
B. Pelvic ultrasound
C. IV antibiotics
D. Oral nitrofurantoin
