COMLEX Level 2 QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWES) Q&A 2026 VERSION
|INSTANT DOWNLOADED PDF
1. A 65-year-old man presents with sudden onset chest pain radiating
to his back. BP is 180/110 mmHg in the right arm and 160/100 mmHg
in the left arm. Which is the most likely diagnosis?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Tension pneumothorax
Answer: C. Aortic dissection
Rationale: Sudden tearing chest pain radiating to the back with
asymmetric blood pressures is classic for aortic dissection.
2. A 25-year-old woman presents with fatigue, pallor, and spoon-
shaped nails. Labs show microcytic hypochromic anemia. Which is the
most likely cause?
A. Iron deficiency
B. Vitamin B12 deficiency
C. Folate deficiency
D. Aplastic anemia
Answer: A. Iron deficiency
Rationale: Microcytic hypochromic anemia with spoon nails is typical of
iron deficiency.
,3. A 70-year-old man presents with tremor at rest, bradykinesia, and a
shuffling gait. What is the most likely diagnosis?
A. Essential tremor
B. Parkinson’s disease
C. Huntington’s disease
D. Amyotrophic lateral sclerosis
Answer: B. Parkinson’s disease
Rationale: Resting tremor, bradykinesia, and shuffling gait are hallmark
features of Parkinson’s disease.
4. A 4-year-old boy has a barking cough, inspiratory stridor, and fever.
What is the most likely diagnosis?
A. Asthma
B. Croup (laryngotracheobronchitis)
C. Epiglottitis
D. Bronchiolitis
Answer: B. Croup (laryngotracheobronchitis)
Rationale: Barking cough and inspiratory stridor in a child are
characteristic of viral croup.
5. A 35-year-old woman presents with weight gain, cold intolerance,
constipation, and dry skin. Labs show high TSH and low free T4. What
is the most likely diagnosis?
A. Hyperthyroidism
B. Hypothyroidism
,C. Graves’ disease
D. Subacute thyroiditis
Answer: B. Hypothyroidism
Rationale: High TSH and low T4 indicate primary hypothyroidism.
6. A 55-year-old man presents with painless hematuria. What is the
most likely diagnosis?
A. Urinary tract infection
B. Bladder cancer
C. Kidney stones
D. BPH
Answer: B. Bladder cancer
Rationale: Painless hematuria in an adult, especially over 50, is highly
suggestive of bladder cancer.
7. A 28-year-old woman presents with polyuria, polydipsia, and
polyphagia. Labs show fasting glucose 210 mg/dL. What is the most
likely diagnosis?
A. Type 1 diabetes mellitus
B. Type 2 diabetes mellitus
C. Diabetes insipidus
D. Hyperthyroidism
Answer: A. Type 1 diabetes mellitus
Rationale: Acute onset of classic symptoms in a young adult with
hyperglycemia suggests type 1 diabetes.
, 8. A 60-year-old man presents with dysphagia to solids only.
Endoscopy shows a Schatzki ring. What is the most likely underlying
cause?
A. Achalasia
B. Esophageal cancer
C. Peptic stricture
D. Schatzki ring
Answer: D. Schatzki ring
Rationale: Intermittent solid food dysphagia with a thin mucosal ring at
the gastroesophageal junction is a Schatzki ring.
9. A 45-year-old woman presents with fatigue and jaundice. Labs
show elevated ALP, positive anti-mitochondrial antibodies, and
increased bilirubin. What is the most likely diagnosis?
A. Autoimmune hepatitis
B. Primary biliary cholangitis
C. Primary sclerosing cholangitis
D. Hepatitis B
Answer: B. Primary biliary cholangitis
Rationale: Middle-aged women with fatigue, cholestatic pattern (high
ALP), and AMA positivity indicate primary biliary cholangitis.
10. A 3-year-old boy presents with fever, conjunctivitis, strawberry
tongue, and rash on the palms and soles. What is the most likely
diagnosis?
A. Measles
B. Scarlet fever
ANSWERS (VERIFIED ANSWES) Q&A 2026 VERSION
|INSTANT DOWNLOADED PDF
1. A 65-year-old man presents with sudden onset chest pain radiating
to his back. BP is 180/110 mmHg in the right arm and 160/100 mmHg
in the left arm. Which is the most likely diagnosis?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Tension pneumothorax
Answer: C. Aortic dissection
Rationale: Sudden tearing chest pain radiating to the back with
asymmetric blood pressures is classic for aortic dissection.
2. A 25-year-old woman presents with fatigue, pallor, and spoon-
shaped nails. Labs show microcytic hypochromic anemia. Which is the
most likely cause?
A. Iron deficiency
B. Vitamin B12 deficiency
C. Folate deficiency
D. Aplastic anemia
Answer: A. Iron deficiency
Rationale: Microcytic hypochromic anemia with spoon nails is typical of
iron deficiency.
,3. A 70-year-old man presents with tremor at rest, bradykinesia, and a
shuffling gait. What is the most likely diagnosis?
A. Essential tremor
B. Parkinson’s disease
C. Huntington’s disease
D. Amyotrophic lateral sclerosis
Answer: B. Parkinson’s disease
Rationale: Resting tremor, bradykinesia, and shuffling gait are hallmark
features of Parkinson’s disease.
4. A 4-year-old boy has a barking cough, inspiratory stridor, and fever.
What is the most likely diagnosis?
A. Asthma
B. Croup (laryngotracheobronchitis)
C. Epiglottitis
D. Bronchiolitis
Answer: B. Croup (laryngotracheobronchitis)
Rationale: Barking cough and inspiratory stridor in a child are
characteristic of viral croup.
5. A 35-year-old woman presents with weight gain, cold intolerance,
constipation, and dry skin. Labs show high TSH and low free T4. What
is the most likely diagnosis?
A. Hyperthyroidism
B. Hypothyroidism
,C. Graves’ disease
D. Subacute thyroiditis
Answer: B. Hypothyroidism
Rationale: High TSH and low T4 indicate primary hypothyroidism.
6. A 55-year-old man presents with painless hematuria. What is the
most likely diagnosis?
A. Urinary tract infection
B. Bladder cancer
C. Kidney stones
D. BPH
Answer: B. Bladder cancer
Rationale: Painless hematuria in an adult, especially over 50, is highly
suggestive of bladder cancer.
7. A 28-year-old woman presents with polyuria, polydipsia, and
polyphagia. Labs show fasting glucose 210 mg/dL. What is the most
likely diagnosis?
A. Type 1 diabetes mellitus
B. Type 2 diabetes mellitus
C. Diabetes insipidus
D. Hyperthyroidism
Answer: A. Type 1 diabetes mellitus
Rationale: Acute onset of classic symptoms in a young adult with
hyperglycemia suggests type 1 diabetes.
, 8. A 60-year-old man presents with dysphagia to solids only.
Endoscopy shows a Schatzki ring. What is the most likely underlying
cause?
A. Achalasia
B. Esophageal cancer
C. Peptic stricture
D. Schatzki ring
Answer: D. Schatzki ring
Rationale: Intermittent solid food dysphagia with a thin mucosal ring at
the gastroesophageal junction is a Schatzki ring.
9. A 45-year-old woman presents with fatigue and jaundice. Labs
show elevated ALP, positive anti-mitochondrial antibodies, and
increased bilirubin. What is the most likely diagnosis?
A. Autoimmune hepatitis
B. Primary biliary cholangitis
C. Primary sclerosing cholangitis
D. Hepatitis B
Answer: B. Primary biliary cholangitis
Rationale: Middle-aged women with fatigue, cholestatic pattern (high
ALP), and AMA positivity indicate primary biliary cholangitis.
10. A 3-year-old boy presents with fever, conjunctivitis, strawberry
tongue, and rash on the palms and soles. What is the most likely
diagnosis?
A. Measles
B. Scarlet fever
