COMSAE Phase 2 – Form 101b Exam
practise Questions With Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf.
1. A 62-year-old man presents with crushing substernal chest pain
radiating to the left arm for 45 minutes. ECG shows ST elevations
in leads II, III, and aVF. Which coronary artery is most likely
occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Posterior descending artery
E. Obtuse marginal artery
Rationale: Inferior wall myocardial infarctions involving leads II, III, and
aVF are classically associated with occlusion of the right coronary artery
(RCA). The RCA often supplies the inferior myocardium and AV node.
Patients may also present with bradycardia or hypotension due to right
ventricular involvement.
2. A 25-year-old woman develops fever, malar rash, and joint pain.
Laboratory testing reveals positive anti-dsDNA antibodies. Which
condition is most likely?
A. Rheumatoid arthritis
B. Systemic lupus erythematosus
C. Sjögren syndrome
,D. Scleroderma
E. Dermatomyositis
Rationale: Anti-double-stranded DNA antibodies are highly specific for
systemic lupus erythematosus (SLE). Clinical findings often include malar
rash, arthralgia, nephritis, and hematologic abnormalities.
3. A newborn has continuous machine-like cardiac murmur. Which
congenital defect is most likely?
A. Tetralogy of Fallot
B. Ventricular septal defect
C. Coarctation of the aorta
D. Patent ductus arteriosus
E. Atrial septal defect
Rationale: A patent ductus arteriosus (PDA) produces a classic
continuous “machine-like” murmur. Persistence of fetal circulation
between the pulmonary artery and aorta leads to left-to-right shunting
and bounding pulses.
4. A 45-year-old alcoholic presents with confusion, ataxia, and
ophthalmoplegia. Which vitamin deficiency is most likely?
A. Vitamin B12
B. Niacin
C. Folate
D. Pyridoxine
E. Thiamine
Rationale: The triad of confusion, ophthalmoplegia, and ataxia suggests
Wernicke encephalopathy due to thiamine (vitamin B1) deficiency,
commonly associated with chronic alcoholism.
, 5. A patient presents with sudden onset unilateral facial paralysis
affecting the forehead and lower face. Which diagnosis is most
likely?
A. Stroke
B. Trigeminal neuralgia
C. Myasthenia gravis
D. Bell palsy
E. Temporal arteritis
Rationale: Bell palsy involves peripheral CN VII dysfunction causing
ipsilateral paralysis of both the upper and lower face. Stroke usually
spares forehead muscles due to bilateral cortical innervation.
6. A diabetic patient presents with fever and flank pain. Urinalysis
shows white blood cell casts. Which diagnosis is most likely?
A. Cystitis
B. Renal cell carcinoma
C. Glomerulonephritis
D. Nephrolithiasis
E. Pyelonephritis
Rationale: White blood cell casts are characteristic of pyelonephritis, an
upper urinary tract infection involving renal parenchyma. Fever, flank
pain, and urinary symptoms commonly coexist.
7. A child presents with barking cough and inspiratory stridor that
worsens at night. What is the most likely diagnosis?
A. Epiglottitis
B. Asthma
C. Bronchiolitis
, D. Croup
E. Foreign body aspiration
Rationale: Croup (laryngotracheobronchitis) classically presents with
barking cough, inspiratory stridor, and nighttime worsening. It is most
commonly caused by parainfluenza virus.
8. Which electrolyte abnormality is most commonly associated with
muscle weakness and flattened T waves on ECG?
A. Hyperkalemia
B. Hypercalcemia
C. Hypernatremia
D. Hyponatremia
E. Hypokalemia
Rationale: Hypokalemia causes muscle weakness, cramps, and
characteristic ECG changes including flattened T waves, U waves, and ST
depression.
9. A 70-year-old smoker presents with hematuria and painless
weight loss. Which diagnosis should be highest on the differential?
A. Kidney stone
B. Urinary tract infection
C. Bladder cancer
D. Benign prostatic hyperplasia
E. Acute prostatitis
Rationale: Painless hematuria in an older smoker strongly suggests
bladder cancer, particularly urothelial carcinoma. Smoking is the major
risk factor.
practise Questions With Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf.
1. A 62-year-old man presents with crushing substernal chest pain
radiating to the left arm for 45 minutes. ECG shows ST elevations
in leads II, III, and aVF. Which coronary artery is most likely
occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Posterior descending artery
E. Obtuse marginal artery
Rationale: Inferior wall myocardial infarctions involving leads II, III, and
aVF are classically associated with occlusion of the right coronary artery
(RCA). The RCA often supplies the inferior myocardium and AV node.
Patients may also present with bradycardia or hypotension due to right
ventricular involvement.
2. A 25-year-old woman develops fever, malar rash, and joint pain.
Laboratory testing reveals positive anti-dsDNA antibodies. Which
condition is most likely?
A. Rheumatoid arthritis
B. Systemic lupus erythematosus
C. Sjögren syndrome
,D. Scleroderma
E. Dermatomyositis
Rationale: Anti-double-stranded DNA antibodies are highly specific for
systemic lupus erythematosus (SLE). Clinical findings often include malar
rash, arthralgia, nephritis, and hematologic abnormalities.
3. A newborn has continuous machine-like cardiac murmur. Which
congenital defect is most likely?
A. Tetralogy of Fallot
B. Ventricular septal defect
C. Coarctation of the aorta
D. Patent ductus arteriosus
E. Atrial septal defect
Rationale: A patent ductus arteriosus (PDA) produces a classic
continuous “machine-like” murmur. Persistence of fetal circulation
between the pulmonary artery and aorta leads to left-to-right shunting
and bounding pulses.
4. A 45-year-old alcoholic presents with confusion, ataxia, and
ophthalmoplegia. Which vitamin deficiency is most likely?
A. Vitamin B12
B. Niacin
C. Folate
D. Pyridoxine
E. Thiamine
Rationale: The triad of confusion, ophthalmoplegia, and ataxia suggests
Wernicke encephalopathy due to thiamine (vitamin B1) deficiency,
commonly associated with chronic alcoholism.
, 5. A patient presents with sudden onset unilateral facial paralysis
affecting the forehead and lower face. Which diagnosis is most
likely?
A. Stroke
B. Trigeminal neuralgia
C. Myasthenia gravis
D. Bell palsy
E. Temporal arteritis
Rationale: Bell palsy involves peripheral CN VII dysfunction causing
ipsilateral paralysis of both the upper and lower face. Stroke usually
spares forehead muscles due to bilateral cortical innervation.
6. A diabetic patient presents with fever and flank pain. Urinalysis
shows white blood cell casts. Which diagnosis is most likely?
A. Cystitis
B. Renal cell carcinoma
C. Glomerulonephritis
D. Nephrolithiasis
E. Pyelonephritis
Rationale: White blood cell casts are characteristic of pyelonephritis, an
upper urinary tract infection involving renal parenchyma. Fever, flank
pain, and urinary symptoms commonly coexist.
7. A child presents with barking cough and inspiratory stridor that
worsens at night. What is the most likely diagnosis?
A. Epiglottitis
B. Asthma
C. Bronchiolitis
, D. Croup
E. Foreign body aspiration
Rationale: Croup (laryngotracheobronchitis) classically presents with
barking cough, inspiratory stridor, and nighttime worsening. It is most
commonly caused by parainfluenza virus.
8. Which electrolyte abnormality is most commonly associated with
muscle weakness and flattened T waves on ECG?
A. Hyperkalemia
B. Hypercalcemia
C. Hypernatremia
D. Hyponatremia
E. Hypokalemia
Rationale: Hypokalemia causes muscle weakness, cramps, and
characteristic ECG changes including flattened T waves, U waves, and ST
depression.
9. A 70-year-old smoker presents with hematuria and painless
weight loss. Which diagnosis should be highest on the differential?
A. Kidney stone
B. Urinary tract infection
C. Bladder cancer
D. Benign prostatic hyperplasia
E. Acute prostatitis
Rationale: Painless hematuria in an older smoker strongly suggests
bladder cancer, particularly urothelial carcinoma. Smoking is the major
risk factor.
