COMSAE Phase II Form 114 Practice
Exam Questions And Correct Answers
(Verified Answers) Plus Rationales
2025|2026 Q&A | Instant Download Pdf
1. A 25-year-old primigravida at 36 weeks presents with severe headache,
visual disturbances, and proteinuria. Blood pressure is 160/110 mmHg.
Best initial management?
A. Hydralazine
B. Magnesium sulfate
C. Oxytocin
D. Antibiotics
Rationale: Magnesium sulfate is given to prevent eclamptic seizures in
severe pre-eclampsia.
2. A newborn has respiratory distress soon after birth; chest X-ray shows
ground-glass appearance and air-bronchograms. Diagnosis?
A. Meconium aspiration syndrome
B. Respiratory distress syndrome
C. Transient tachypnea of the newborn
D. Neonatal pneumonia
,Rationale: Ground-glass appearance with air-bronchograms is
characteristic of neonatal respiratory distress syndrome (surfactant
deficiency).
3. Best next step in a child with suspected meningitis before lumbar
puncture?
A. Immediate LP
B. CT scan
C. Empiric antibiotics
D. Wait and observe
Rationale: Start empiric antibiotics immediately if meningitis is suspected;
do not delay for imaging or diagnostics.
4. A 50-year-old with newly diagnosed hypertension, BUN/creatinine
elevated, mild hyperkalemia. Which antihypertensive?
A. Hydrochlorothiazide
B. ACE inhibitor
C. Beta-blocker
D. Calcium-channel blocker
Rationale: ACE inhibitors help in renal protection in hypertensive patients
with early kidney impairment, although monitor potassium and creatinine.
5. A 30-year-old with sudden palpitations; ECG shows irregularly irregular
narrow QRS tachycardia at 180 bpm. Next management?
,A. Carotid massage (if no contraindications)
B. IV adenosine
C. Synchronized cardioversion
D. Carotid massage (if no carotid bruits)
Rationale: For SVT with narrow QRS and stable patient, vagal maneuvers
such as carotid sinus massage are first-line.
6. A patient with peptic ulcer disease and H. pylori infection – best
eradication regimen?
A. Clarithromycin + amoxicillin + PPI
B. Metronidazole + PPI
C. Amoxicillin + clarithromycin + omeprazole
D. Bismuth only
Rationale: Standard triple therapy combines PPI with amoxicillin and
clarithromycin for H. pylori eradication.
7. A 40-year-old diabetic with foot ulcer: most important initial step?
A. Start antibiotics
B. Immediate debridement
C. Evaluate vascular supply and infection severity
D. Hyperbaric oxygen
Rationale: Assessing vascular supply and infection defines management
(debridement, antibiotics, vascular intervention).
, 8. Best next step in a HIV-positive patient with CD4 count of 120 cells/µL
and positive Toxoplasma IgG?
A. Start TMP-SMX prophylaxis
B. Initiate pyrimethamine-sulfadiazine
C. Start TMP-SMX prophylaxis
D. No treatment required
Rationale: TMP-SMX is indicated for prophylaxis against Toxoplasma in
HIV patients with low CD4 and positive IgG.
9. A child with tonsillitis, fever, drooling, “hot-potato” voice — likely
diagnosis?
A. Peritonsillar abscess
B. Epiglottitis
C. Peritonsillar abscess
D. Retropharyngeal abscess
Rationale: Unilateral bulging tonsil, dysphagia, drooling, muffled voice are
classic for peritonsillar abscess.
10. First-line treatment in severe asthma exacerbation in ER?
A. Oral steroids
B. Inhaled high-flow beta-agonist + oxygen
C. IV magnesium immediately
D. Subcutaneous epinephrine
Rationale: High-flow inhaled β2-agonists and oxygen are the initial
emergency treatment for acute severe asthma.
Exam Questions And Correct Answers
(Verified Answers) Plus Rationales
2025|2026 Q&A | Instant Download Pdf
1. A 25-year-old primigravida at 36 weeks presents with severe headache,
visual disturbances, and proteinuria. Blood pressure is 160/110 mmHg.
Best initial management?
A. Hydralazine
B. Magnesium sulfate
C. Oxytocin
D. Antibiotics
Rationale: Magnesium sulfate is given to prevent eclamptic seizures in
severe pre-eclampsia.
2. A newborn has respiratory distress soon after birth; chest X-ray shows
ground-glass appearance and air-bronchograms. Diagnosis?
A. Meconium aspiration syndrome
B. Respiratory distress syndrome
C. Transient tachypnea of the newborn
D. Neonatal pneumonia
,Rationale: Ground-glass appearance with air-bronchograms is
characteristic of neonatal respiratory distress syndrome (surfactant
deficiency).
3. Best next step in a child with suspected meningitis before lumbar
puncture?
A. Immediate LP
B. CT scan
C. Empiric antibiotics
D. Wait and observe
Rationale: Start empiric antibiotics immediately if meningitis is suspected;
do not delay for imaging or diagnostics.
4. A 50-year-old with newly diagnosed hypertension, BUN/creatinine
elevated, mild hyperkalemia. Which antihypertensive?
A. Hydrochlorothiazide
B. ACE inhibitor
C. Beta-blocker
D. Calcium-channel blocker
Rationale: ACE inhibitors help in renal protection in hypertensive patients
with early kidney impairment, although monitor potassium and creatinine.
5. A 30-year-old with sudden palpitations; ECG shows irregularly irregular
narrow QRS tachycardia at 180 bpm. Next management?
,A. Carotid massage (if no contraindications)
B. IV adenosine
C. Synchronized cardioversion
D. Carotid massage (if no carotid bruits)
Rationale: For SVT with narrow QRS and stable patient, vagal maneuvers
such as carotid sinus massage are first-line.
6. A patient with peptic ulcer disease and H. pylori infection – best
eradication regimen?
A. Clarithromycin + amoxicillin + PPI
B. Metronidazole + PPI
C. Amoxicillin + clarithromycin + omeprazole
D. Bismuth only
Rationale: Standard triple therapy combines PPI with amoxicillin and
clarithromycin for H. pylori eradication.
7. A 40-year-old diabetic with foot ulcer: most important initial step?
A. Start antibiotics
B. Immediate debridement
C. Evaluate vascular supply and infection severity
D. Hyperbaric oxygen
Rationale: Assessing vascular supply and infection defines management
(debridement, antibiotics, vascular intervention).
, 8. Best next step in a HIV-positive patient with CD4 count of 120 cells/µL
and positive Toxoplasma IgG?
A. Start TMP-SMX prophylaxis
B. Initiate pyrimethamine-sulfadiazine
C. Start TMP-SMX prophylaxis
D. No treatment required
Rationale: TMP-SMX is indicated for prophylaxis against Toxoplasma in
HIV patients with low CD4 and positive IgG.
9. A child with tonsillitis, fever, drooling, “hot-potato” voice — likely
diagnosis?
A. Peritonsillar abscess
B. Epiglottitis
C. Peritonsillar abscess
D. Retropharyngeal abscess
Rationale: Unilateral bulging tonsil, dysphagia, drooling, muffled voice are
classic for peritonsillar abscess.
10. First-line treatment in severe asthma exacerbation in ER?
A. Oral steroids
B. Inhaled high-flow beta-agonist + oxygen
C. IV magnesium immediately
D. Subcutaneous epinephrine
Rationale: High-flow inhaled β2-agonists and oxygen are the initial
emergency treatment for acute severe asthma.
