COMSAE PhASE 1 FOrM 113
,COMSAE PhASE 1 FOrM 113
Question 1 of 180
A 58-year-old woman with a history of hypertension and hyperlipidemia
presents with sudden onset chest pain radiating to her jaw. ECG shows
ST-segment elevations in leads V2–V4. Which coronary artery is most
likely occluded?
A. Right coronary artery
B. Left anterior descending artery
C. Left circumflex artery
D. Posterior descending artery
E. Right marginal artery
Mark for Review □
Correct Answer: B. Left anterior descending artery
Rationale:
ST elevations in V2–V4 indicate an anterior wall myocardial infarction,
most commonly due to occlusion of the left anterior descending (LAD)
artery, which supplies the anterior wall and septum.
Why the other answers are
incorrect: A. RCA causes inferior
MI (II, III, aVF).
C. LCX causes lateral wall MI (I, aVL, V5–V6).
D. PDA is usually a branch of RCA and affects inferior/posterior walls.
E. Right marginal artery supplies right ventricle.
,Key COMSAE Point:
Anterior MI = LAD occlusion (V1–V4)
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Question 2 of 180
A 24-year-old man presents with fever, neck stiffness, and altered
mental status.
CSF analysis shows neutrophilic pleocytosis, low glucose, and elevated
protein. What is the most likely causative organism?
A. Streptococcus pneumoniae
B. Neisseria meningitidis
C. Haemophilus influenzae
D. Listeria monocytogenes
E. Enterovirus
Mark for Review □
Correct Answer: A. Streptococcus pneumoniae
Rationale:
In adults, the most common cause of bacterial meningitis is
Streptococcus pneumoniae, characterized by neutrophilic CSF
predominance, low glucose, and high protein.
Why the other answers are incorrect:
B. N. meningitidis is common in adolescents/college outbreaks.
, C. H. influenzae is now less common due to vaccination.
D. Listeria affects neonates, elderly, and immunocompromised.
E. Enterovirus causes viral meningitis with normal glucose.
Key COMSAE Point:
Adult bacterial meningitis = S. pneumoniae
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Question 3 of 180
A 32-year-old woman presents with heat intolerance, weight loss, and
palpitations. Labs show low TSH and elevated free T4. Which antibody is
most likely present?
A. Anti-thyroid peroxidase
B. Anti-thyroglobulin
C. Thyroid-stimulating immunoglobulin
D. Anti-TSH receptor blocking antibody
E. Anti-TSH receptor IgG only blocking type
Mark for Review □
Correct Answer: C. Thyroid-stimulating immunoglobulin
Rationale:
Graves disease is caused by thyroid-stimulating immunoglobulins that
activate the TSH receptor, leading to increased thyroid hormone
production.
,COMSAE PhASE 1 FOrM 113
Question 1 of 180
A 58-year-old woman with a history of hypertension and hyperlipidemia
presents with sudden onset chest pain radiating to her jaw. ECG shows
ST-segment elevations in leads V2–V4. Which coronary artery is most
likely occluded?
A. Right coronary artery
B. Left anterior descending artery
C. Left circumflex artery
D. Posterior descending artery
E. Right marginal artery
Mark for Review □
Correct Answer: B. Left anterior descending artery
Rationale:
ST elevations in V2–V4 indicate an anterior wall myocardial infarction,
most commonly due to occlusion of the left anterior descending (LAD)
artery, which supplies the anterior wall and septum.
Why the other answers are
incorrect: A. RCA causes inferior
MI (II, III, aVF).
C. LCX causes lateral wall MI (I, aVL, V5–V6).
D. PDA is usually a branch of RCA and affects inferior/posterior walls.
E. Right marginal artery supplies right ventricle.
,Key COMSAE Point:
Anterior MI = LAD occlusion (V1–V4)
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Time Remaining: 00:58:42
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Question 2 of 180
A 24-year-old man presents with fever, neck stiffness, and altered
mental status.
CSF analysis shows neutrophilic pleocytosis, low glucose, and elevated
protein. What is the most likely causative organism?
A. Streptococcus pneumoniae
B. Neisseria meningitidis
C. Haemophilus influenzae
D. Listeria monocytogenes
E. Enterovirus
Mark for Review □
Correct Answer: A. Streptococcus pneumoniae
Rationale:
In adults, the most common cause of bacterial meningitis is
Streptococcus pneumoniae, characterized by neutrophilic CSF
predominance, low glucose, and high protein.
Why the other answers are incorrect:
B. N. meningitidis is common in adolescents/college outbreaks.
, C. H. influenzae is now less common due to vaccination.
D. Listeria affects neonates, elderly, and immunocompromised.
E. Enterovirus causes viral meningitis with normal glucose.
Key COMSAE Point:
Adult bacterial meningitis = S. pneumoniae
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Question 3 of 180
A 32-year-old woman presents with heat intolerance, weight loss, and
palpitations. Labs show low TSH and elevated free T4. Which antibody is
most likely present?
A. Anti-thyroid peroxidase
B. Anti-thyroglobulin
C. Thyroid-stimulating immunoglobulin
D. Anti-TSH receptor blocking antibody
E. Anti-TSH receptor IgG only blocking type
Mark for Review □
Correct Answer: C. Thyroid-stimulating immunoglobulin
Rationale:
Graves disease is caused by thyroid-stimulating immunoglobulins that
activate the TSH receptor, leading to increased thyroid hormone
production.
