COMSAE LEVEL 2 111 STUDY GUIDE
2026 COMPLETE QUESTIONS WITH
100% CORRECT ANSWERS || 100%
GUARANTEED PASS <RECENT
VERSION>
Medicine / Infectious Disease
1. A 65-year-old man with a history of COPD presents with fever, chills, and a
productive cough of rust-colored sputum. On physical exam, you note dullness
to percussion and bronchial breath sounds in the right lower lobe. What is the
most likely causative organism?
A) Mycoplasma pneumoniae
B) Streptococcus pneumoniae
C) Klebsiella pneumoniae
D) Staphylococcus aureus
2. A 30-year-old woman recently returned from a camping trip in the Midwest
presents with fever, headache, and a petechial rash that began on her wrists
and ankles. What is the most appropriate empiric treatment?
A) Doxycycline
B) Amoxicillin
C) Acyclovir
D) Fluconazole
3. A patient with HIV (CD4 count 80) presents with headache, fever, and
confusion. An MRI shows multiple ring-enhancing lesions. What is the most
likely diagnosis?
A) Progressive multifocal leukoencephalopathy (PML)
B) Toxoplasmosis
C) Primary CNS lymphoma
D) Cryptococcal meningitis
,4. A 40-year-old man presents with jaundice, nausea, and right upper
quadrant pain after returning from Mexico. He reports eating street food. Lab
work shows elevated ALT and AST. Which hepatitis virus is most likely
responsible?
A) Hepatitis A
B) Hepatitis B
C) Hepatitis C
D) Hepatitis E
5. What is the mechanism of action of Vancomycin?
A) Inhibits cell wall synthesis by binding to penicillin-binding proteins (PBPs)
B) Inhibits protein synthesis at the 50S ribosomal subunit
C) Inhibits cell wall synthesis by binding to D-Ala-D-Ala peptide precursors
D) Inhibits DNA gyrase
Surgery / Trauma
6. During a splenectomy for a traumatic splenic rupture, the surgeon must be
cautious of injury to which nearby structure that can cause a "boring" pain
referred to the left shoulder if damaged?
A) Tail of the pancreas
B) Splenic flexure of the colon
C) Diaphragm
D) Left kidney
7. A patient presents with acute, severe right lower quadrant pain, nausea, and
vomiting. On exam, you find rebound tenderness and guarding. The patient
reports the pain migrated from the periumbilical area. What is the most likely
diagnosis?
A) Diverticulitis
B) Cholecystitis
C) Appendicitis
D) Ectopic pregnancy
8. A 55-year-old male presents with painless jaundice, weight loss, and a
palpable gallbladder (Courvoisier's sign). What is the most likely diagnosis?
A) Alcoholic pancreatitis
, B) Choledocholithiasis
C) Pancreatic cancer
D) Hepatitis
9. What is the most common complication following a total thyroidectomy?
A) Recurrent laryngeal nerve injury
B) Hypoparathyroidism
C) Superior laryngeal nerve injury
D) Hematoma
10. A patient with a history of alcohol use disorder presents with hematemesis.
Endoscopy reveals dilated veins in the distal esophagus. What is the initial
management of choice for acute bleeding?
A) Propranolol
B) Octreotide
C) Band Ligation
D) Balloon tamponade
Pediatrics
11. A 2-month-old infant presents with a barking cough, inspiratory stridor,
and mild fever. The symptoms are worse at night. What is the most likely
diagnosis?
A) Epiglottitis
B) Bacterial tracheitis
C) Croup (Laryngotracheobronchitis)
D) Foreign body aspiration
12. A 5-year-old child presents with a slapped-cheek appearance and a lacy,
reticular rash on the extremities. What is the causative agent?
A) Parvovirus B19
B) Rubella
C) Rubeola
D) Human Herpesvirus 6
13. What is the most common cause of intellectual disability in males?
A) Down Syndrome
2026 COMPLETE QUESTIONS WITH
100% CORRECT ANSWERS || 100%
GUARANTEED PASS <RECENT
VERSION>
Medicine / Infectious Disease
1. A 65-year-old man with a history of COPD presents with fever, chills, and a
productive cough of rust-colored sputum. On physical exam, you note dullness
to percussion and bronchial breath sounds in the right lower lobe. What is the
most likely causative organism?
A) Mycoplasma pneumoniae
B) Streptococcus pneumoniae
C) Klebsiella pneumoniae
D) Staphylococcus aureus
2. A 30-year-old woman recently returned from a camping trip in the Midwest
presents with fever, headache, and a petechial rash that began on her wrists
and ankles. What is the most appropriate empiric treatment?
A) Doxycycline
B) Amoxicillin
C) Acyclovir
D) Fluconazole
3. A patient with HIV (CD4 count 80) presents with headache, fever, and
confusion. An MRI shows multiple ring-enhancing lesions. What is the most
likely diagnosis?
A) Progressive multifocal leukoencephalopathy (PML)
B) Toxoplasmosis
C) Primary CNS lymphoma
D) Cryptococcal meningitis
,4. A 40-year-old man presents with jaundice, nausea, and right upper
quadrant pain after returning from Mexico. He reports eating street food. Lab
work shows elevated ALT and AST. Which hepatitis virus is most likely
responsible?
A) Hepatitis A
B) Hepatitis B
C) Hepatitis C
D) Hepatitis E
5. What is the mechanism of action of Vancomycin?
A) Inhibits cell wall synthesis by binding to penicillin-binding proteins (PBPs)
B) Inhibits protein synthesis at the 50S ribosomal subunit
C) Inhibits cell wall synthesis by binding to D-Ala-D-Ala peptide precursors
D) Inhibits DNA gyrase
Surgery / Trauma
6. During a splenectomy for a traumatic splenic rupture, the surgeon must be
cautious of injury to which nearby structure that can cause a "boring" pain
referred to the left shoulder if damaged?
A) Tail of the pancreas
B) Splenic flexure of the colon
C) Diaphragm
D) Left kidney
7. A patient presents with acute, severe right lower quadrant pain, nausea, and
vomiting. On exam, you find rebound tenderness and guarding. The patient
reports the pain migrated from the periumbilical area. What is the most likely
diagnosis?
A) Diverticulitis
B) Cholecystitis
C) Appendicitis
D) Ectopic pregnancy
8. A 55-year-old male presents with painless jaundice, weight loss, and a
palpable gallbladder (Courvoisier's sign). What is the most likely diagnosis?
A) Alcoholic pancreatitis
, B) Choledocholithiasis
C) Pancreatic cancer
D) Hepatitis
9. What is the most common complication following a total thyroidectomy?
A) Recurrent laryngeal nerve injury
B) Hypoparathyroidism
C) Superior laryngeal nerve injury
D) Hematoma
10. A patient with a history of alcohol use disorder presents with hematemesis.
Endoscopy reveals dilated veins in the distal esophagus. What is the initial
management of choice for acute bleeding?
A) Propranolol
B) Octreotide
C) Band Ligation
D) Balloon tamponade
Pediatrics
11. A 2-month-old infant presents with a barking cough, inspiratory stridor,
and mild fever. The symptoms are worse at night. What is the most likely
diagnosis?
A) Epiglottitis
B) Bacterial tracheitis
C) Croup (Laryngotracheobronchitis)
D) Foreign body aspiration
12. A 5-year-old child presents with a slapped-cheek appearance and a lacy,
reticular rash on the extremities. What is the causative agent?
A) Parvovirus B19
B) Rubella
C) Rubeola
D) Human Herpesvirus 6
13. What is the most common cause of intellectual disability in males?
A) Down Syndrome
