COMSAE Phase 2 Form 104: Comprehensive -
Question Practice Exam with Answers &
Rationales
,Question 1
A 65-year-old man presents with substernal chest pain that occurs with exertion and is relieved by
rest. His ECG is normal. What is the most likely diagnosis?
A. Acute myocardial infarction
B. Prinzmetal angina
C. Stable angina
D. Unstable angina
Answer: C. Stable angina
,Rationale: Stable angina presents with exertional chest pain relieved by rest or nitroglycerin, due
to fixed atherosclerotic narrowing. Unstable angina presents with pain at rest, and MI would show
ECG/troponin changes .
Question 2
Which biomarker rises earliest in myocardial infarction?
A. Troponin I
B. CK-MB
C. Myoglobin
D. LDH
Answer: C. Myoglobin
, Rationale: Myoglobin rises within 1–3 hours but is less specific than troponin. Troponin is the most
specific marker for myocardial injury .
Question 3
A 22-year-old woman has acute right lower quadrant abdominal pain, fever, and leukocytosis.
What is the most likely diagnosis?
A. Ovarian torsion
B. Ruptured ectopic pregnancy
C. Appendicitis
D. Crohn's disease flare
Answer: C. Appendicitis
Question Practice Exam with Answers &
Rationales
,Question 1
A 65-year-old man presents with substernal chest pain that occurs with exertion and is relieved by
rest. His ECG is normal. What is the most likely diagnosis?
A. Acute myocardial infarction
B. Prinzmetal angina
C. Stable angina
D. Unstable angina
Answer: C. Stable angina
,Rationale: Stable angina presents with exertional chest pain relieved by rest or nitroglycerin, due
to fixed atherosclerotic narrowing. Unstable angina presents with pain at rest, and MI would show
ECG/troponin changes .
Question 2
Which biomarker rises earliest in myocardial infarction?
A. Troponin I
B. CK-MB
C. Myoglobin
D. LDH
Answer: C. Myoglobin
, Rationale: Myoglobin rises within 1–3 hours but is less specific than troponin. Troponin is the most
specific marker for myocardial injury .
Question 3
A 22-year-old woman has acute right lower quadrant abdominal pain, fever, and leukocytosis.
What is the most likely diagnosis?
A. Ovarian torsion
B. Ruptured ectopic pregnancy
C. Appendicitis
D. Crohn's disease flare
Answer: C. Appendicitis