COMSAE Phase 1 Form 115 Practice Exam
With Actual Questions & Verified Answers,
Plus Explained Rationales/Expert Verified
For Guaranteed 100% Pass 2026/Latest
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1. A 24-year-old man presents with fatigue and pallor. Labs show
microcytic anemia, low ferritin, and high TIBC. What is the most
likely diagnosis?
A. Anemia of chronic disease
B. Iron deficiency anemia
C. Sideroblastic anemia
D. Thalassemia
B. Iron deficiency anemia
Rationale: Iron deficiency anemia presents with low ferritin and
high TIBC, reflecting depleted iron stores and increased iron-
binding capacity.
2. A patient has hypercalcemia, hypophosphatemia, and elevated
PTH. What is the diagnosis?
A. Secondary hyperparathyroidism
B. Primary hyperparathyroidism
C. Vitamin D deficiency
D. Hypoparathyroidism
B. Primary hyperparathyroidism
Rationale: Elevated PTH with hypercalcemia and low phosphate
is characteristic of primary hyperparathyroidism.
,3. A 65-year-old smoker presents with hematuria. What is the most
likely diagnosis?
A. Renal cell carcinoma
B. Bladder cancer
C. UTI
D. Nephrolithiasis
B. Bladder cancer
Rationale: Smoking is the strongest risk factor for bladder cancer
presenting with painless hematuria.
4. A patient presents with sudden onset chest pain relieved by
leaning forward. Diagnosis?
A. Myocardial infarction
B. Pericarditis
C. Pulmonary embolism
D. Aortic dissection
B. Pericarditis
Rationale: Pericarditis pain improves when leaning forward and
worsens when lying down.
5. Which organism causes rheumatic fever?
A. Staphylococcus aureus
B. Streptococcus pyogenes
C. Streptococcus pneumoniae
D. Enterococcus faecalis
B. Streptococcus pyogenes
Rationale: Rheumatic fever follows untreated group A
Streptococcus infection.
6. A diabetic patient presents with fruity breath and Kussmaul
respirations. Diagnosis?
A. HHS
, B. DKA
C. Lactic acidosis
D. Hypoglycemia
B. DKA
Rationale: Fruity breath and Kussmaul respirations are classic for
diabetic ketoacidosis.
7. What is the mechanism of action of ACE inhibitors?
A. Block calcium channels
B. Inhibit angiotensin I to II conversion
C. Increase sodium excretion
D. Block beta receptors
B. Inhibit angiotensin I to II conversion
Rationale: ACE inhibitors reduce angiotensin II formation,
lowering blood pressure.
8. A newborn has a machine-like murmur. Diagnosis?
A. ASD
B. VSD
C. PDA
D. Tetralogy of Fallot
C. PDA
Rationale: Patent ductus arteriosus produces a continuous
“machine-like” murmur.
9. A patient with COPD has increased CO2 retention. What
compensates?
A. Increased bicarbonate
B. Increased oxygen
C. Decreased pH
D. Decreased CO2
A. Increased bicarbonate
With Actual Questions & Verified Answers,
Plus Explained Rationales/Expert Verified
For Guaranteed 100% Pass 2026/Latest
Update/Instant Download Pdf
1. A 24-year-old man presents with fatigue and pallor. Labs show
microcytic anemia, low ferritin, and high TIBC. What is the most
likely diagnosis?
A. Anemia of chronic disease
B. Iron deficiency anemia
C. Sideroblastic anemia
D. Thalassemia
B. Iron deficiency anemia
Rationale: Iron deficiency anemia presents with low ferritin and
high TIBC, reflecting depleted iron stores and increased iron-
binding capacity.
2. A patient has hypercalcemia, hypophosphatemia, and elevated
PTH. What is the diagnosis?
A. Secondary hyperparathyroidism
B. Primary hyperparathyroidism
C. Vitamin D deficiency
D. Hypoparathyroidism
B. Primary hyperparathyroidism
Rationale: Elevated PTH with hypercalcemia and low phosphate
is characteristic of primary hyperparathyroidism.
,3. A 65-year-old smoker presents with hematuria. What is the most
likely diagnosis?
A. Renal cell carcinoma
B. Bladder cancer
C. UTI
D. Nephrolithiasis
B. Bladder cancer
Rationale: Smoking is the strongest risk factor for bladder cancer
presenting with painless hematuria.
4. A patient presents with sudden onset chest pain relieved by
leaning forward. Diagnosis?
A. Myocardial infarction
B. Pericarditis
C. Pulmonary embolism
D. Aortic dissection
B. Pericarditis
Rationale: Pericarditis pain improves when leaning forward and
worsens when lying down.
5. Which organism causes rheumatic fever?
A. Staphylococcus aureus
B. Streptococcus pyogenes
C. Streptococcus pneumoniae
D. Enterococcus faecalis
B. Streptococcus pyogenes
Rationale: Rheumatic fever follows untreated group A
Streptococcus infection.
6. A diabetic patient presents with fruity breath and Kussmaul
respirations. Diagnosis?
A. HHS
, B. DKA
C. Lactic acidosis
D. Hypoglycemia
B. DKA
Rationale: Fruity breath and Kussmaul respirations are classic for
diabetic ketoacidosis.
7. What is the mechanism of action of ACE inhibitors?
A. Block calcium channels
B. Inhibit angiotensin I to II conversion
C. Increase sodium excretion
D. Block beta receptors
B. Inhibit angiotensin I to II conversion
Rationale: ACE inhibitors reduce angiotensin II formation,
lowering blood pressure.
8. A newborn has a machine-like murmur. Diagnosis?
A. ASD
B. VSD
C. PDA
D. Tetralogy of Fallot
C. PDA
Rationale: Patent ductus arteriosus produces a continuous
“machine-like” murmur.
9. A patient with COPD has increased CO2 retention. What
compensates?
A. Increased bicarbonate
B. Increased oxygen
C. Decreased pH
D. Decreased CO2
A. Increased bicarbonate
