COMSAE 115 EXAM / ACTUAL COMSAE 115 EXAM LATEST 2026
COMPLETE ACCURATE EXAM REAL QUESTIONS AND CORRECT
VERIFIED SOLUTIONS WITH RATIONALES (DETAILED ANSWERS)
NEWEST UPDATED VERSION 2026 EDITION |GUARANTEED SUCCESS
A+ (BRAND NEW!) STUDY GUIDE INCLUDED
1. A 45-year-old male presents with acute onset of severe, tearing chest pain radiating to
the back. Blood pressure is 150/90 in the right arm and 100/60 in the left arm. Which of
the following is the most appropriate next step?
A) Administer thrombolytic
B) Obtain a chest x-ray
C) CORRECT ANSWER: Obtain a contrast-enhanced chest CT
D) Start beta-blockers immediately
Rationale: The presentation suggests aortic dissection. Contrast-enhanced chest CT is
the definitive imaging study. Thrombolytic are contraindicated.
2. A 30-year-old female with fatigue, weight gain, and cold intolerance. Labs: TSH 15
µIU/mL (normal 0.5–5), free T4 0.5 ng/ld. (normal 0.8–1.8). Thyroid peroxidase antibodies
are positive. What is the first-line treatment?
A) Methimazole
B) CORRECT ANSWER: Levothyroxine
C) Radioactive iodine ablation
D) Thyroidectomy
Rationale: Hashimoto thyroiditis with hypothyroidism is treated with levothyroxine
replacement.
3. A 68-year-old male with a history of heart failure presents with shortness of breath and
frothy sputum. Lung auscultation reveals crackles bilaterally. Which medication is most
appropriate for acute management?
, A) Digoxin
B) CORRECT ANSWER: Furosemide
C) Spironolactone
D) Carvedilol
Rationale: Acute pulmonary edema requires loop diuretics like furosemide for rapid
volume reduction.
4. A 55-year-old female presents with episodic headaches, palpitations, and sweating. BP
180/110 mmHg. Physical exam shows a palpable abdominal mass that is pulsatile. What
is the most likely diagnosis?
A) Renal artery stenosis
B) CORRECT ANSWER: Pheochromocytoma
C) Primary hyperaldosteronism
D) Aortic aneurysm
Rationale: Triad of headache, palpitations, sweating with episodic hypertension suggests
pheochromocytoma.
5. A 20-year-old college student reports fever, sore throat, and fatigue. Exam: pharyngeal
exudates, lymphadenopathy, splenomegaly. Which diagnostic test is most specific?
A) Monopod test
B) CORRECT ANSWER: EBV-specific antibody testing (VCA IgM)
C) Throat culture
D) Complete blood count
Rationale: Monopod can be false positive; EBV VCA IgM is highly specific for acute
infection.
6. A 65-year-old smoker presents with hemoptysis and weight loss. Chest CT shows a 4 cm
speculated lung mass. Which of the following is the most appropriate next step?
A) PET-CT
B) CORRECT ANSWER: Tissue biopsy via bronchoscopy
, C) Empiric antibiotics
D) Serial imaging in 3 months
Rationale: Tissue diagnosis is required before treatment; bronchoscopy is appropriate
for central lesions.
7. A 50-year-old diabetic with worsening vision over 3 months. Fundoscopic exam shows
dot-blot hemorrhages and hard exudates. No neovascularization. What is the stage of
diabetic retinopathy?
A) Mild no proliferative
B) CORRECT ANSWER: Severe no proliferative
C) Proliferative
D) Macular edema
Rationale: Dot-blot hemorrhages and hard exudates indicate no proliferative; severe has
more findings.
8. A 28-year-old female with joint pain, malar rash, oral ulcers. ANA positive, anti-dsDNA
positive. Which medication reduces mortality and prevents lupus nephritis?
A) NSAIDs
B) Hydroxychloroquine
C) CORRECT ANSWER: Mycophenolate mufti
D) Prednisone alone
Rationale: Mycophenolate is first-line for lupus nephritis; hydroxychloroquine helps
symptoms but not nephritis.
9. A 72-year-old male with sudden onset of aphasia and right-sided weakness. Last known
well 3 hours ago. CT head shows no hemorrhage. BP 185/100. What is the next step?
A) Lower BP to <140/90 before thrombolytic
B) CORRECT ANSWER: Administer IV alteplase
C) Start aspirin 325 mg
D) Transfer for mechanical thrombectomy without tape
COMPLETE ACCURATE EXAM REAL QUESTIONS AND CORRECT
VERIFIED SOLUTIONS WITH RATIONALES (DETAILED ANSWERS)
NEWEST UPDATED VERSION 2026 EDITION |GUARANTEED SUCCESS
A+ (BRAND NEW!) STUDY GUIDE INCLUDED
1. A 45-year-old male presents with acute onset of severe, tearing chest pain radiating to
the back. Blood pressure is 150/90 in the right arm and 100/60 in the left arm. Which of
the following is the most appropriate next step?
A) Administer thrombolytic
B) Obtain a chest x-ray
C) CORRECT ANSWER: Obtain a contrast-enhanced chest CT
D) Start beta-blockers immediately
Rationale: The presentation suggests aortic dissection. Contrast-enhanced chest CT is
the definitive imaging study. Thrombolytic are contraindicated.
2. A 30-year-old female with fatigue, weight gain, and cold intolerance. Labs: TSH 15
µIU/mL (normal 0.5–5), free T4 0.5 ng/ld. (normal 0.8–1.8). Thyroid peroxidase antibodies
are positive. What is the first-line treatment?
A) Methimazole
B) CORRECT ANSWER: Levothyroxine
C) Radioactive iodine ablation
D) Thyroidectomy
Rationale: Hashimoto thyroiditis with hypothyroidism is treated with levothyroxine
replacement.
3. A 68-year-old male with a history of heart failure presents with shortness of breath and
frothy sputum. Lung auscultation reveals crackles bilaterally. Which medication is most
appropriate for acute management?
, A) Digoxin
B) CORRECT ANSWER: Furosemide
C) Spironolactone
D) Carvedilol
Rationale: Acute pulmonary edema requires loop diuretics like furosemide for rapid
volume reduction.
4. A 55-year-old female presents with episodic headaches, palpitations, and sweating. BP
180/110 mmHg. Physical exam shows a palpable abdominal mass that is pulsatile. What
is the most likely diagnosis?
A) Renal artery stenosis
B) CORRECT ANSWER: Pheochromocytoma
C) Primary hyperaldosteronism
D) Aortic aneurysm
Rationale: Triad of headache, palpitations, sweating with episodic hypertension suggests
pheochromocytoma.
5. A 20-year-old college student reports fever, sore throat, and fatigue. Exam: pharyngeal
exudates, lymphadenopathy, splenomegaly. Which diagnostic test is most specific?
A) Monopod test
B) CORRECT ANSWER: EBV-specific antibody testing (VCA IgM)
C) Throat culture
D) Complete blood count
Rationale: Monopod can be false positive; EBV VCA IgM is highly specific for acute
infection.
6. A 65-year-old smoker presents with hemoptysis and weight loss. Chest CT shows a 4 cm
speculated lung mass. Which of the following is the most appropriate next step?
A) PET-CT
B) CORRECT ANSWER: Tissue biopsy via bronchoscopy
, C) Empiric antibiotics
D) Serial imaging in 3 months
Rationale: Tissue diagnosis is required before treatment; bronchoscopy is appropriate
for central lesions.
7. A 50-year-old diabetic with worsening vision over 3 months. Fundoscopic exam shows
dot-blot hemorrhages and hard exudates. No neovascularization. What is the stage of
diabetic retinopathy?
A) Mild no proliferative
B) CORRECT ANSWER: Severe no proliferative
C) Proliferative
D) Macular edema
Rationale: Dot-blot hemorrhages and hard exudates indicate no proliferative; severe has
more findings.
8. A 28-year-old female with joint pain, malar rash, oral ulcers. ANA positive, anti-dsDNA
positive. Which medication reduces mortality and prevents lupus nephritis?
A) NSAIDs
B) Hydroxychloroquine
C) CORRECT ANSWER: Mycophenolate mufti
D) Prednisone alone
Rationale: Mycophenolate is first-line for lupus nephritis; hydroxychloroquine helps
symptoms but not nephritis.
9. A 72-year-old male with sudden onset of aphasia and right-sided weakness. Last known
well 3 hours ago. CT head shows no hemorrhage. BP 185/100. What is the next step?
A) Lower BP to <140/90 before thrombolytic
B) CORRECT ANSWER: Administer IV alteplase
C) Start aspirin 325 mg
D) Transfer for mechanical thrombectomy without tape
