COMSAE Phase 2 Practice Exam d d d d
(Form C118
d d
Style) Questions And Correct Answers (
d d d d d
Verified Answers) Plus Rationales |202 d d d d
6 Q&A | Instant Download Pdf
d d d d d
1. A 28-year-old woman presents with fatigue and cold intolerance. TSH is
d d d d d d d d d d d
9.0 µU/mL, free T4 is low. What is the most likely diagnosis?
d d d d d d d d d d d
A. Subacute thyroiditis d
B. Hashimoto thyroiditis d
C. Central hypothyroidism
d
D. Graves disease
d
Rationale: Hashimoto thyroiditis is the most common cause of hypothyroidis
d d d d d d d d d
m in iodine-sufficient areas, with elevated TSH and low T4._
d d d d d d d d d
,2. A 65-year-
d
old man with COPD presents with dyspnea. ABG shows pH 7.35, pCO₂ 55, HCO
d d d d d d d d d d d d d
₃⁻ 30. Diagnosis?
d d
A. Compensated respiratory acidosis d d
B. Acute respiratory acidosis
d d
C. Metabolic alkalosis d
D. Mixed acid-base disorder d d
Rationale: Chronic CO₂ retention with compensatory bicarbonate elevation ind
d d d d d d d d
icates compensated respiratory acidosis._
d d d
3. A 7-year-
d
old boy develops a sore throat, fever, and sandpaper rash. Diagnosis?
d d d d d d d d d d
A. Scarlet fever d
B. Kawasaki disease d
C. Rubella
D. Fifth disease d
Rationale: Scarlet fever results from group A Streptococcus infection with er
d d d d d d d d d d
ythrogenic toxin._ d
4. A 45-year-
d
old man with hypertension develops swelling after starting lisinopril. Cau
d d d d d d d d d
se?
A. Allergic urticaria d
B. Bradykinin-mediated angioedema d
C. Histamine reaction d
,D. IgE-mediated anaphylaxis d
Rationale: ACE inhibitors increase bradykinin levels, leading to non-
d d d d d d d d
pitting angioedema._
d
5. A 24-year-
d
old woman has right lower quadrant pain, positive hCG, and empty uterus
d d d d d d d d d d d d
on ultrasound. Diagnosis?
d d
A. Ectopic pregnancy d
B. Appendicitis
C. Ovarian torsion d
D. Corpus luteum cyst d d
Rationale: Positive pregnancy test with no intrauterine gestation is diag
d d d d d d d d d
nostic for ectopic pregnancy._
d d d
6. A 12-year-
d
old girl presents with polyuria and polydipsia. Labs: glucose 350 mg/dL, low C-
d d d d d d d d d d d d
peptide. Diagnosis? d
A. Type 1 diabetes mellitus
d d d
B. Type 2 diabetes mellitus
d d d
C. MODY
D. Insulinoma
Rationale: Low C- d d
peptide indicates absent endogenous insulin production typical of Type 1 DM._
d d d d d d d d d d
, 7. A 66-year-
d
old man develops confusion after starting furosemide. Sodium 122 mEq/L. D
d d d d d d d d d d
iagnosis?
A. Hypovolemic hyponatremia d
B. SIADH
C. Hypervolemic hyponatremia d
D. Pseudohyponatremia
Rationale: Loop diuretics cause sodium and water loss, leading to hypov
d d d d d d d d d d
olemic hyponatremia._
d
8. A 56-year-old smoker has a painless hematuria. Next best step?
d d d d d d d d d
A. Cystoscopy
B. Urine culture d
C. Renal ultrasound d
D. PSA test d
Rationale: Painless hematuria in a smoker requires cystoscopy to evaluate for
d d d d d d d d d d
d bladder cancer._ d
9. A 22-year-
d
old woman develops fever and flank pain 3 days after cystitis. Next step?
d d d d d d d d d d d d
A. Repeat urinalysis d
B. Pelvic ultrasound d
C. IV antibiotics
d
D. Oral nitrofurantoin
d
(Form C118
d d
Style) Questions And Correct Answers (
d d d d d
Verified Answers) Plus Rationales |202 d d d d
6 Q&A | Instant Download Pdf
d d d d d
1. A 28-year-old woman presents with fatigue and cold intolerance. TSH is
d d d d d d d d d d d
9.0 µU/mL, free T4 is low. What is the most likely diagnosis?
d d d d d d d d d d d
A. Subacute thyroiditis d
B. Hashimoto thyroiditis d
C. Central hypothyroidism
d
D. Graves disease
d
Rationale: Hashimoto thyroiditis is the most common cause of hypothyroidis
d d d d d d d d d
m in iodine-sufficient areas, with elevated TSH and low T4._
d d d d d d d d d
,2. A 65-year-
d
old man with COPD presents with dyspnea. ABG shows pH 7.35, pCO₂ 55, HCO
d d d d d d d d d d d d d
₃⁻ 30. Diagnosis?
d d
A. Compensated respiratory acidosis d d
B. Acute respiratory acidosis
d d
C. Metabolic alkalosis d
D. Mixed acid-base disorder d d
Rationale: Chronic CO₂ retention with compensatory bicarbonate elevation ind
d d d d d d d d
icates compensated respiratory acidosis._
d d d
3. A 7-year-
d
old boy develops a sore throat, fever, and sandpaper rash. Diagnosis?
d d d d d d d d d d
A. Scarlet fever d
B. Kawasaki disease d
C. Rubella
D. Fifth disease d
Rationale: Scarlet fever results from group A Streptococcus infection with er
d d d d d d d d d d
ythrogenic toxin._ d
4. A 45-year-
d
old man with hypertension develops swelling after starting lisinopril. Cau
d d d d d d d d d
se?
A. Allergic urticaria d
B. Bradykinin-mediated angioedema d
C. Histamine reaction d
,D. IgE-mediated anaphylaxis d
Rationale: ACE inhibitors increase bradykinin levels, leading to non-
d d d d d d d d
pitting angioedema._
d
5. A 24-year-
d
old woman has right lower quadrant pain, positive hCG, and empty uterus
d d d d d d d d d d d d
on ultrasound. Diagnosis?
d d
A. Ectopic pregnancy d
B. Appendicitis
C. Ovarian torsion d
D. Corpus luteum cyst d d
Rationale: Positive pregnancy test with no intrauterine gestation is diag
d d d d d d d d d
nostic for ectopic pregnancy._
d d d
6. A 12-year-
d
old girl presents with polyuria and polydipsia. Labs: glucose 350 mg/dL, low C-
d d d d d d d d d d d d
peptide. Diagnosis? d
A. Type 1 diabetes mellitus
d d d
B. Type 2 diabetes mellitus
d d d
C. MODY
D. Insulinoma
Rationale: Low C- d d
peptide indicates absent endogenous insulin production typical of Type 1 DM._
d d d d d d d d d d
, 7. A 66-year-
d
old man develops confusion after starting furosemide. Sodium 122 mEq/L. D
d d d d d d d d d d
iagnosis?
A. Hypovolemic hyponatremia d
B. SIADH
C. Hypervolemic hyponatremia d
D. Pseudohyponatremia
Rationale: Loop diuretics cause sodium and water loss, leading to hypov
d d d d d d d d d d
olemic hyponatremia._
d
8. A 56-year-old smoker has a painless hematuria. Next best step?
d d d d d d d d d
A. Cystoscopy
B. Urine culture d
C. Renal ultrasound d
D. PSA test d
Rationale: Painless hematuria in a smoker requires cystoscopy to evaluate for
d d d d d d d d d d
d bladder cancer._ d
9. A 22-year-
d
old woman develops fever and flank pain 3 days after cystitis. Next step?
d d d d d d d d d d d d
A. Repeat urinalysis d
B. Pelvic ultrasound d
C. IV antibiotics
d
D. Oral nitrofurantoin
d
