Page 1 of 81
COMSAE EXAM PREP NEWEST 2026 | ACTUAL EXAM ALL
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
{150 Q & A} GRADED A+ | BRAND NEW 2026/2027 UPDATE |
100% GUARANTEED PASS.
✅ A 22 - year - old woman presents to the office for evaluation of malaise
and easy bruising. She also reports increased menses over the past 2
months. Review of records reveals a hospital admission 6 months ago
secondary to viral pneumonia. Physical examinatio n findings are normal.
Laboratory study results are normal except for a platelet count of 45 ×
103/mcL (reference range: 150 - 450 × 103/mcL). The most likely diagnosis
is
A. factor VII deficiency
B. IgA vasculitis (Henoch - Schönlein purpura)
C. idiopathic thrombocytopenic purpura
D. thrombotic thrombocytopenic purpura
E. von Willebrand disease - ✔✔✔ Correct Answer > C. IDIOPATHIC
THROMBOCYTOPENIC PURPURA (ITP)
An acquired form of a low platelet count secondary to antibody formation
against GpIIb/IIIa on platelets, without any perturbation of the structure or
function of WBCs, RBCs, or coagulation factors (i.e., isolated
thrombocytopenia). It is a diagnosis of ex clusion without specific clinical
or laboratory parameters.
✅ A 21- year - old woman presents to the office with a 6 - month history of
increasing low back pain. She reports that she competes as a figure
skater, and the pain began following a bad landing. She describes the pain
,Page 2 of 135
as achy and localized to the lumbosacral junction. A radiograph of the
spine taken 1 month ago reveals the findings shown in the exhibit.
Neurologic examination findings are normal, with no focal motor deficits.
Structural examination reveals increased ton e in the lumbar
paravertebral muscles with midline tenderness in the lumbosacral area.
Which of the following injuries did this patient most likely sustain?
A. acute L3 flexion somatic dysfunction
B .acute right unilateral sacral flexion
C. fracture of the L5 pars interarticularis
D. L5 vertebral compression fracture
E. muscle strain of the quadratus lumborum - ✔✔✔ Correct Answer >
C. FRACTURE OF THE L5 PARS INTERARTICULARIS
RADIOGRAPHY
The clinical scenario describes a neonate w/respiratory distress
immediately after birth, w/ signs including tachypnea, nasal flaring,
intercostal and subcostal retractions, decreased lung sounds on the left,
and a rightward shift of the heart sounds. The scaphoid abdomen is
particularly concerning for congenital diaphragmatic hernia (CDH), a
condition where abdominal contents herniate into the chest, leading to
lung hypoplasia and displacement of the heart and mediastinum.
Chest radiography is the most appropriate diagnostic test to confirm the
diagnosis by visualizing the herniated abdominal organs within the chest
cavity. Other options, such as arterial blood gas analysis or
echocardiography, do not provide the immediate a natomical information
needed in this scenario.
,Page 3 of 81
A 22 - year - old primigravid woman at 13 weeks' gestation presents to the
office for her first prenatal examination. She reports experiencing vaginal
discharge for the past 3 days. On questioning, she says that she has had 3
different sexual partners in the past month. She reports no history of
sexually transmitted infections. Pelvic examination reveals a uterus
compatible with dates, slight tenderness to palpation, and no adnexal
masses. Further examination reveals thin, white, malodorous discharge,
which is found to h ave a pH of 5.5. Microscopic examination reveals
epithelial cells covered with short coccobacillus - type bacteria. What is
this patient at the greatest risk of developing? a. abruptio placentae
b. future ectopic pregnancy
c. gestational diabetes
d. gestational hypertension
e. preterm labor - ✔✔✔ Correct Answer > E. preterm labor The patient
described has findings consistent with bacterial vaginosis (BV), as
indicated by the thin, white, malodorous discharge, a vaginal pH of 5.5,
and the presence of clue cells (epithelial cells covered with
coccobacillus - type bacte ria) on microscopy. Bacterial vaginosis during
pregnancy is associated with an increased risk of preterm labor and
delivery. Therefore, the patient is at the greatest risk of developing
preterm labor. Gestational diabet es (option C) is not directly associated
with BV, making preterm labor the more appropriate choice.
An 18- year - old man is brought to the emergency department by EMS after
he was involved in a high - speed motor vehicle collision, during which he
struck his chest on the steering wheel. He is now experiencing shortness
, Page 4 of 135
of breath. On arrival, he is awake and reports severe chest pain. He
appears to be in significant distress.
Vital signs reveal:
BP= 86/50 mmHg, HR= 130/min, RR= 30/min, Oxygen saturation= 80% on
room air P.E. reveals:
- Distended neck veins
- Midline trachea
- Bruising on the left chest wall with pain on palpation but no obvious
crepitation
- Hyperresonance of the left chest on percussion
- Normal lung sounds on the right
- Significantly diminished lung sounds on the left - Significant left upper
quadrant abdominal tenderness
Which of the following is the most appropriate initial intervention?
a. endotracheal intubation
b. needle decompression
c. normal saline bolus
d. pericardiocentesis
e. thoracotomy - ✔✔✔ Correct Answer > B. NEEDLE DECOMPRESSION This
patient presents with signs and symptoms indicative of a tension
pneumothorax, which is a medical emergency. The findings of distended
neck veins, hyperresonance on the left side of the chest, diminished
lung sounds on the left , and severe respiratory distress with
hypotension are all classic signs. Immediate needle decompression is
the correct initial intervention to relieve the pressure in the pleural
space, allowing the lung to re - expand an d improving the patient's
hemodynamics and respiratory status.
COMSAE EXAM PREP NEWEST 2026 | ACTUAL EXAM ALL
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
{150 Q & A} GRADED A+ | BRAND NEW 2026/2027 UPDATE |
100% GUARANTEED PASS.
✅ A 22 - year - old woman presents to the office for evaluation of malaise
and easy bruising. She also reports increased menses over the past 2
months. Review of records reveals a hospital admission 6 months ago
secondary to viral pneumonia. Physical examinatio n findings are normal.
Laboratory study results are normal except for a platelet count of 45 ×
103/mcL (reference range: 150 - 450 × 103/mcL). The most likely diagnosis
is
A. factor VII deficiency
B. IgA vasculitis (Henoch - Schönlein purpura)
C. idiopathic thrombocytopenic purpura
D. thrombotic thrombocytopenic purpura
E. von Willebrand disease - ✔✔✔ Correct Answer > C. IDIOPATHIC
THROMBOCYTOPENIC PURPURA (ITP)
An acquired form of a low platelet count secondary to antibody formation
against GpIIb/IIIa on platelets, without any perturbation of the structure or
function of WBCs, RBCs, or coagulation factors (i.e., isolated
thrombocytopenia). It is a diagnosis of ex clusion without specific clinical
or laboratory parameters.
✅ A 21- year - old woman presents to the office with a 6 - month history of
increasing low back pain. She reports that she competes as a figure
skater, and the pain began following a bad landing. She describes the pain
,Page 2 of 135
as achy and localized to the lumbosacral junction. A radiograph of the
spine taken 1 month ago reveals the findings shown in the exhibit.
Neurologic examination findings are normal, with no focal motor deficits.
Structural examination reveals increased ton e in the lumbar
paravertebral muscles with midline tenderness in the lumbosacral area.
Which of the following injuries did this patient most likely sustain?
A. acute L3 flexion somatic dysfunction
B .acute right unilateral sacral flexion
C. fracture of the L5 pars interarticularis
D. L5 vertebral compression fracture
E. muscle strain of the quadratus lumborum - ✔✔✔ Correct Answer >
C. FRACTURE OF THE L5 PARS INTERARTICULARIS
RADIOGRAPHY
The clinical scenario describes a neonate w/respiratory distress
immediately after birth, w/ signs including tachypnea, nasal flaring,
intercostal and subcostal retractions, decreased lung sounds on the left,
and a rightward shift of the heart sounds. The scaphoid abdomen is
particularly concerning for congenital diaphragmatic hernia (CDH), a
condition where abdominal contents herniate into the chest, leading to
lung hypoplasia and displacement of the heart and mediastinum.
Chest radiography is the most appropriate diagnostic test to confirm the
diagnosis by visualizing the herniated abdominal organs within the chest
cavity. Other options, such as arterial blood gas analysis or
echocardiography, do not provide the immediate a natomical information
needed in this scenario.
,Page 3 of 81
A 22 - year - old primigravid woman at 13 weeks' gestation presents to the
office for her first prenatal examination. She reports experiencing vaginal
discharge for the past 3 days. On questioning, she says that she has had 3
different sexual partners in the past month. She reports no history of
sexually transmitted infections. Pelvic examination reveals a uterus
compatible with dates, slight tenderness to palpation, and no adnexal
masses. Further examination reveals thin, white, malodorous discharge,
which is found to h ave a pH of 5.5. Microscopic examination reveals
epithelial cells covered with short coccobacillus - type bacteria. What is
this patient at the greatest risk of developing? a. abruptio placentae
b. future ectopic pregnancy
c. gestational diabetes
d. gestational hypertension
e. preterm labor - ✔✔✔ Correct Answer > E. preterm labor The patient
described has findings consistent with bacterial vaginosis (BV), as
indicated by the thin, white, malodorous discharge, a vaginal pH of 5.5,
and the presence of clue cells (epithelial cells covered with
coccobacillus - type bacte ria) on microscopy. Bacterial vaginosis during
pregnancy is associated with an increased risk of preterm labor and
delivery. Therefore, the patient is at the greatest risk of developing
preterm labor. Gestational diabet es (option C) is not directly associated
with BV, making preterm labor the more appropriate choice.
An 18- year - old man is brought to the emergency department by EMS after
he was involved in a high - speed motor vehicle collision, during which he
struck his chest on the steering wheel. He is now experiencing shortness
, Page 4 of 135
of breath. On arrival, he is awake and reports severe chest pain. He
appears to be in significant distress.
Vital signs reveal:
BP= 86/50 mmHg, HR= 130/min, RR= 30/min, Oxygen saturation= 80% on
room air P.E. reveals:
- Distended neck veins
- Midline trachea
- Bruising on the left chest wall with pain on palpation but no obvious
crepitation
- Hyperresonance of the left chest on percussion
- Normal lung sounds on the right
- Significantly diminished lung sounds on the left - Significant left upper
quadrant abdominal tenderness
Which of the following is the most appropriate initial intervention?
a. endotracheal intubation
b. needle decompression
c. normal saline bolus
d. pericardiocentesis
e. thoracotomy - ✔✔✔ Correct Answer > B. NEEDLE DECOMPRESSION This
patient presents with signs and symptoms indicative of a tension
pneumothorax, which is a medical emergency. The findings of distended
neck veins, hyperresonance on the left side of the chest, diminished
lung sounds on the left , and severe respiratory distress with
hypotension are all classic signs. Immediate needle decompression is
the correct initial intervention to relieve the pressure in the pleural
space, allowing the lung to re - expand an d improving the patient's
hemodynamics and respiratory status.
