. COMSAE 114 EXAM / LATEST COMSAE 114 APPROVED EXAM
2026/2027 HIGH YIELD PRACTICE QUESTIONS AND CURRENT UPDATED
STUDY GUIDE COMPLETE ACCURATE QUESTIONS
1. A 45-year-old man presents with crushing substernal chest pain
radiating to the left arm, diaphoresis, and nausea. ECG shows ST-
segment elevation in leads II, III, and aVF. Which coronary artery is
most likely occluded?
A. Left anterior descending artery
B. Right coronary artery
C. Left circumflex artery
D. Left main coronary artery
Answer: B
2. A 30-year-old woman presents with fever, right lower quadrant
pain, and cervical motion tenderness. Which is the most likely
diagnosis?
A. Appendicitis
B. Pelvic inflammatory disease
C. Ectopic pregnancy
D. Ovarian torsion
Answer: B
3. A 65-year-old man presents with sudden onset of severe
headache, vomiting, and neck stiffness. CT shows subarachnoid
hemorrhage. Which is the most likely cause?
A. Hypertensive intracerebral hemorrhage
B. Ruptured berry aneurysm
pg. 1
,C. Arteriovenous malformation
D. Traumatic brain injury
Answer: B
4. A 50-year-old man presents with progressive dyspnea, dry cough,
and bilateral inspiratory crackles. High-resolution CT shows
honeycombing. Which is the most likely diagnosis?
A. Idiopathic pulmonary fibrosis
B. Chronic obstructive pulmonary disease
C. Asthma
D. Pulmonary embolism
Answer: A
5. A 25-year-old woman presents with fatigue, pallor, and heavy
menstrual bleeding. Labs show microcytic anemia. Which is the
most likely cause?
A. Vitamin B12 deficiency
B. Iron deficiency anemia
C. Folate deficiency
D. Anemia of chronic disease
Answer: B
6. A 60-year-old man presents with painless hematuria. Which is the
most important next step?
A. Urine culture
B. Cystoscopy and upper tract imaging
C. Antibiotic therapy
D. Observation
pg. 2
,Answer: B
7. A 35-year-old woman presents with weight loss, heat intolerance,
and tremor. Labs show elevated free T4 and suppressed TSH.
Which is the most likely diagnosis?
A. Hashimoto thyroiditis
B. Graves disease
C. Subacute thyroiditis
D. Toxic adenoma
Answer: B
8. A 70-year-old man presents with sudden onset of monocular
vision loss. Fundoscopic exam shows a pale retina with a cherry-
red spot. Which is the most likely diagnosis?
A. Central retinal artery occlusion
B. Central retinal vein occlusion
C. Retinal detachment
D. Macular degeneration
Answer: A
9. A 40-year-old man presents with recurrent episodes of wheezing,
chest tightness, and cough triggered by exercise. Which is the
most likely diagnosis?
A. Chronic obstructive pulmonary disease
B. Asthma
C. Pulmonary embolism
D. Gastroesophageal reflux disease
Answer: B
pg. 3
, 10. A 55-year-old woman presents with bone pain,
hypercalcemia, and multiple lytic lesions on X-ray. Which is the
most likely diagnosis?
A. Osteoporosis
B. Paget disease
C. Multiple myeloma
D. Metastatic breast cancer
Answer: C
11. A 28-year-old man presents with fever, cough, and night
sweats. Chest X-ray shows upper lobe infiltrates with cavitation.
Which is the most likely diagnosis?
A. Community-acquired pneumonia
B. Pulmonary tuberculosis
C. Lung abscess
D. Fungal pneumonia
Answer: B
12. A 50-year-old woman presents with fatigue, weight gain, and
cold intolerance. Labs show elevated TSH and low free T4. Which
is the most likely diagnosis?
A. Graves disease
B. Hashimoto thyroiditis
C. Subacute thyroiditis
D. Toxic adenoma
Answer: B
pg. 4
2026/2027 HIGH YIELD PRACTICE QUESTIONS AND CURRENT UPDATED
STUDY GUIDE COMPLETE ACCURATE QUESTIONS
1. A 45-year-old man presents with crushing substernal chest pain
radiating to the left arm, diaphoresis, and nausea. ECG shows ST-
segment elevation in leads II, III, and aVF. Which coronary artery is
most likely occluded?
A. Left anterior descending artery
B. Right coronary artery
C. Left circumflex artery
D. Left main coronary artery
Answer: B
2. A 30-year-old woman presents with fever, right lower quadrant
pain, and cervical motion tenderness. Which is the most likely
diagnosis?
A. Appendicitis
B. Pelvic inflammatory disease
C. Ectopic pregnancy
D. Ovarian torsion
Answer: B
3. A 65-year-old man presents with sudden onset of severe
headache, vomiting, and neck stiffness. CT shows subarachnoid
hemorrhage. Which is the most likely cause?
A. Hypertensive intracerebral hemorrhage
B. Ruptured berry aneurysm
pg. 1
,C. Arteriovenous malformation
D. Traumatic brain injury
Answer: B
4. A 50-year-old man presents with progressive dyspnea, dry cough,
and bilateral inspiratory crackles. High-resolution CT shows
honeycombing. Which is the most likely diagnosis?
A. Idiopathic pulmonary fibrosis
B. Chronic obstructive pulmonary disease
C. Asthma
D. Pulmonary embolism
Answer: A
5. A 25-year-old woman presents with fatigue, pallor, and heavy
menstrual bleeding. Labs show microcytic anemia. Which is the
most likely cause?
A. Vitamin B12 deficiency
B. Iron deficiency anemia
C. Folate deficiency
D. Anemia of chronic disease
Answer: B
6. A 60-year-old man presents with painless hematuria. Which is the
most important next step?
A. Urine culture
B. Cystoscopy and upper tract imaging
C. Antibiotic therapy
D. Observation
pg. 2
,Answer: B
7. A 35-year-old woman presents with weight loss, heat intolerance,
and tremor. Labs show elevated free T4 and suppressed TSH.
Which is the most likely diagnosis?
A. Hashimoto thyroiditis
B. Graves disease
C. Subacute thyroiditis
D. Toxic adenoma
Answer: B
8. A 70-year-old man presents with sudden onset of monocular
vision loss. Fundoscopic exam shows a pale retina with a cherry-
red spot. Which is the most likely diagnosis?
A. Central retinal artery occlusion
B. Central retinal vein occlusion
C. Retinal detachment
D. Macular degeneration
Answer: A
9. A 40-year-old man presents with recurrent episodes of wheezing,
chest tightness, and cough triggered by exercise. Which is the
most likely diagnosis?
A. Chronic obstructive pulmonary disease
B. Asthma
C. Pulmonary embolism
D. Gastroesophageal reflux disease
Answer: B
pg. 3
, 10. A 55-year-old woman presents with bone pain,
hypercalcemia, and multiple lytic lesions on X-ray. Which is the
most likely diagnosis?
A. Osteoporosis
B. Paget disease
C. Multiple myeloma
D. Metastatic breast cancer
Answer: C
11. A 28-year-old man presents with fever, cough, and night
sweats. Chest X-ray shows upper lobe infiltrates with cavitation.
Which is the most likely diagnosis?
A. Community-acquired pneumonia
B. Pulmonary tuberculosis
C. Lung abscess
D. Fungal pneumonia
Answer: B
12. A 50-year-old woman presents with fatigue, weight gain, and
cold intolerance. Labs show elevated TSH and low free T4. Which
is the most likely diagnosis?
A. Graves disease
B. Hashimoto thyroiditis
C. Subacute thyroiditis
D. Toxic adenoma
Answer: B
pg. 4
