COMSAE Phase 1 Form 114
Exam Test Bank 2026/2027 |
300 Real Questions &
Verified Answers for COMLEX
Level 1 Prep Guaranteed Pass
(GRADED A+)
Question 1
A 45-year-old man presents with fever, chills, and a productive
cough. Chest X-ray shows lobar consolidation. Which of the
following is the most likely causative organism?
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Legionella pneumophila
D. Klebsiella pneumoniae
E. Pseudomonas aeruginosa
Answer: B
,Rationale: Lobar consolidation in a community-acquired
pneumonia is most commonly caused by Streptococcus
pneumoniae. Mycoplasma and Legionella typically present with
atypical pneumonia patterns.
Question 2
Which of the following is the rate-limiting enzyme of the pentose
phosphate pathway?
A. Glucose-6-phosphate dehydrogenase
B. Transketolase
C. 6-phosphogluconate dehydrogenase
D. Ribose-5-phosphate isomerase
E. Phosphofructokinase-1
Answer: A
Rationale: G6PD is the rate-limiting enzyme of the pentose
phosphate pathway, producing NADPH and ribose-5-phosphate.
PFK-1 is rate-limiting for glycolysis.
Question 3
,A 55-year-old woman presents with fatigue, weight gain, and cold
intolerance. TSH is elevated, free T4 is low. Which of the following
is the most likely autoantibody present?
A. Anti-TSH receptor stimulating antibody
B. Anti-thyroid peroxidase antibody
C. Anti-thyroglobulin antibody only
D. Anti-adrenal antibody
E. Anti-islet cell antibody
Answer: B
Rationale: Primary hypothyroidism with elevated TSH and low T4 is
most commonly Hashimoto thyroiditis, associated with anti-thyroid
peroxidase (TPO) antibodies. Anti-TSH receptor stimulating is
Graves.
Question 4
A 30-year-old man with a history of intravenous drug use presents
with a new heart murmur, fever, and splinter hemorrhages. Blood
cultures grow Staphylococcus aureus. What is the most likely
diagnosis?
A. Rheumatic fever
B. Infective endocarditis
C. Pericarditis
, D. Myocarditis
E. Atrial myxoma
Answer: B
Rationale: Fever, new murmur, and positive blood cultures with S.
aureus in an IV drug user suggest infective endocarditis.
Question 5
Which of the following is the primary mechanism of action of
methotrexate?
A. Inhibits dihydrofolate reductase
B. Inhibits thymidylate synthase
C. Inhibits ribonucleotide reductase
D. Inhibits topoisomerase II
E. Inhibits microtubule polymerization
Answer: A
Rationale: Methotrexate inhibits dihydrofolate reductase, reducing
tetrahydrofolate and nucleotide synthesis.
Question 6
Exam Test Bank 2026/2027 |
300 Real Questions &
Verified Answers for COMLEX
Level 1 Prep Guaranteed Pass
(GRADED A+)
Question 1
A 45-year-old man presents with fever, chills, and a productive
cough. Chest X-ray shows lobar consolidation. Which of the
following is the most likely causative organism?
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Legionella pneumophila
D. Klebsiella pneumoniae
E. Pseudomonas aeruginosa
Answer: B
,Rationale: Lobar consolidation in a community-acquired
pneumonia is most commonly caused by Streptococcus
pneumoniae. Mycoplasma and Legionella typically present with
atypical pneumonia patterns.
Question 2
Which of the following is the rate-limiting enzyme of the pentose
phosphate pathway?
A. Glucose-6-phosphate dehydrogenase
B. Transketolase
C. 6-phosphogluconate dehydrogenase
D. Ribose-5-phosphate isomerase
E. Phosphofructokinase-1
Answer: A
Rationale: G6PD is the rate-limiting enzyme of the pentose
phosphate pathway, producing NADPH and ribose-5-phosphate.
PFK-1 is rate-limiting for glycolysis.
Question 3
,A 55-year-old woman presents with fatigue, weight gain, and cold
intolerance. TSH is elevated, free T4 is low. Which of the following
is the most likely autoantibody present?
A. Anti-TSH receptor stimulating antibody
B. Anti-thyroid peroxidase antibody
C. Anti-thyroglobulin antibody only
D. Anti-adrenal antibody
E. Anti-islet cell antibody
Answer: B
Rationale: Primary hypothyroidism with elevated TSH and low T4 is
most commonly Hashimoto thyroiditis, associated with anti-thyroid
peroxidase (TPO) antibodies. Anti-TSH receptor stimulating is
Graves.
Question 4
A 30-year-old man with a history of intravenous drug use presents
with a new heart murmur, fever, and splinter hemorrhages. Blood
cultures grow Staphylococcus aureus. What is the most likely
diagnosis?
A. Rheumatic fever
B. Infective endocarditis
C. Pericarditis
, D. Myocarditis
E. Atrial myxoma
Answer: B
Rationale: Fever, new murmur, and positive blood cultures with S.
aureus in an IV drug user suggest infective endocarditis.
Question 5
Which of the following is the primary mechanism of action of
methotrexate?
A. Inhibits dihydrofolate reductase
B. Inhibits thymidylate synthase
C. Inhibits ribonucleotide reductase
D. Inhibits topoisomerase II
E. Inhibits microtubule polymerization
Answer: A
Rationale: Methotrexate inhibits dihydrofolate reductase, reducing
tetrahydrofolate and nucleotide synthesis.
Question 6
