COMSAE Phase 1 Form 108: High-Yield Practice
Questions with Answers and Rationales
Cardiology (Questions 1-10)
,Question 1
A 54-year-old man presents with crushing substernal chest pain radiating to the left arm. ECG
shows ST elevation 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
Answer: C. Right coronary artery
*Rationale:* Inferior wall myocardial infarction is classically associated with occlusion of the right
coronary artery, which supplies leads II, III, and aVF in most individuals .
Question 2
,A 65-year-old man with long-standing hypertension develops left ventricular hypertrophy. Which
mechanism best explains this change?
- A. Myocyte hyperplasia
- B. Myocyte hypertrophy due to increased afterload
- C. Fatty infiltration of myocardium
- D. Autoimmune destruction of cardiac cells
Answer: B. Myocyte hypertrophy due to increased afterload
*Rationale:* Chronic pressure overload causes individual cardiomyocytes to enlarge (not multiply),
leading to concentric hypertrophy .
Question 3
, A 72-year-old man with hypertension and diabetes presents with substernal chest pressure
radiating to the left arm. An ECG shows ST-segment elevation in leads V1-V4. Which coronary
artery is most likely occluded?
- A. Right coronary artery
- B. Left circumflex
- C. Left anterior descending (LAD)
- D. Left main coronary artery
Answer: C. Left anterior descending (LAD)
*Rationale:* Leads V1-V4 correspond to the anterior wall and septum, supplied by the LAD.
Anterior STEMI indicates LAD occlusion .
Question 4
Questions with Answers and Rationales
Cardiology (Questions 1-10)
,Question 1
A 54-year-old man presents with crushing substernal chest pain radiating to the left arm. ECG
shows ST elevation 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
Answer: C. Right coronary artery
*Rationale:* Inferior wall myocardial infarction is classically associated with occlusion of the right
coronary artery, which supplies leads II, III, and aVF in most individuals .
Question 2
,A 65-year-old man with long-standing hypertension develops left ventricular hypertrophy. Which
mechanism best explains this change?
- A. Myocyte hyperplasia
- B. Myocyte hypertrophy due to increased afterload
- C. Fatty infiltration of myocardium
- D. Autoimmune destruction of cardiac cells
Answer: B. Myocyte hypertrophy due to increased afterload
*Rationale:* Chronic pressure overload causes individual cardiomyocytes to enlarge (not multiply),
leading to concentric hypertrophy .
Question 3
, A 72-year-old man with hypertension and diabetes presents with substernal chest pressure
radiating to the left arm. An ECG shows ST-segment elevation in leads V1-V4. Which coronary
artery is most likely occluded?
- A. Right coronary artery
- B. Left circumflex
- C. Left anterior descending (LAD)
- D. Left main coronary artery
Answer: C. Left anterior descending (LAD)
*Rationale:* Leads V1-V4 correspond to the anterior wall and septum, supplied by the LAD.
Anterior STEMI indicates LAD occlusion .
Question 4