COMSAE Phase 1 Form 115 Practice Exam
Questions And Correct Verified Detailed Answers
(GUARANTEED PASS)
About This Exam
This practice examination is designed to mirror the style and content of
the NBOME COMSAE Phase 1 (Form 115) and COMLEX-USA Level 1. It covers
high-yield topics including pathology, pharmacology, microbiology,
physiology, biochemistry, osteopathic principles, and clinical reasoning.
Each question is presented in a clinical vignette format with a verified
answer and detailed rationale .
QUESTIONS 1–100
Question 1:
A 24-year-old woman presents with fever, fatigue, and pallor. Laboratory
tests reveal hemoglobin of 8 g/dL, MCV 70 fL, and serum ferritin of 5
ng/mL. What is the most likely diagnosis?
A) Vitamin B12 deficiency
B) Iron deficiency anemia
,C) Hemolytic anemia
D) Aplastic anemia
VERIFIED ANSWER: B) Iron deficiency anemia
Rationale: The low MCV (70 fL) indicates microcytic anemia. Low ferritin
(5 ng/mL) confirms iron deficiency. Vitamin B12 deficiency typically
causes macrocytic anemia, hemolytic anemia shows elevated reticulocyte
count and LDH, and aplastic anemia presents with pancytopenia .
Question 2:
Which cranial nerve is responsible for the sensation of taste on the
anterior two-thirds of the tongue?
A) Trigeminal (CN V)
B) Facial (CN VII)
C) Glossopharyngeal (CN IX)
D) Vagus (CN X)
VERIFIED ANSWER: B) Facial (CN VII)
Rationale: CN VII (facial nerve) via the chorda tympani branch carries
taste sensation from the anterior two-thirds of the tongue. CN IX carries
taste from the posterior third, and CN V carries general sensation but not
taste .
,Question 3:
A patient presents with a severe headache described as "the worst ever,"
neck stiffness, and photophobia. Which of the following is the most
appropriate initial test?
A) MRI brain
B) Non-contrast CT scan of the head
C) Lumbar puncture
D) EEG
VERIFIED ANSWER: B) Non-contrast CT scan of the head
Rationale: A sudden, severe headache raises suspicion for subarachnoid
hemorrhage. Non-contrast CT is the initial imaging of choice. Lumbar
puncture is indicated if CT is negative but clinical suspicion remains .
Question 4:
A 23-year-old man presents with fever, cough, and rusty sputum. Lung
exam shows crackles in the right lower lobe. Chest X-ray shows lobar
consolidation. The most likely organism is:
A) Haemophilus influenzae
B) Mycoplasma pneumoniae
C) Streptococcus pneumoniae
D) Chlamydophila pneumoniae
VERIFIED ANSWER: C) Streptococcus pneumoniae
, Rationale: S. pneumoniae is the most common cause of lobar pneumonia
with rusty sputum. The clinical presentation of lobar consolidation on X-
ray with productive cough and fever is classic for pneumococcal
pneumonia .
Question 5:
A patient with hyperthyroidism shows exophthalmos and pretibial
myxedema. The underlying mechanism is:
A) Low TSH receptor antibodies
B) Autoimmune stimulation of TSH receptors
C) Destruction of thyroid follicles
D) Excess iodine intake
VERIFIED ANSWER: B) Autoimmune stimulation of TSH receptors
Rationale: Graves disease involves TSH receptor-stimulating antibodies
that cause hyperthyroidism, exophthalmos, and pretibial myxedema. The
antibodies continuously stimulate the TSH receptor, leading to
uncontrolled thyroid hormone production .
Question 6:
A 7-year-old child presents with fever, sore throat, and a sandpaper-like
rash. On exam, the tongue appears red and swollen (strawberry tongue).
What is the most likely diagnosis?
Questions And Correct Verified Detailed Answers
(GUARANTEED PASS)
About This Exam
This practice examination is designed to mirror the style and content of
the NBOME COMSAE Phase 1 (Form 115) and COMLEX-USA Level 1. It covers
high-yield topics including pathology, pharmacology, microbiology,
physiology, biochemistry, osteopathic principles, and clinical reasoning.
Each question is presented in a clinical vignette format with a verified
answer and detailed rationale .
QUESTIONS 1–100
Question 1:
A 24-year-old woman presents with fever, fatigue, and pallor. Laboratory
tests reveal hemoglobin of 8 g/dL, MCV 70 fL, and serum ferritin of 5
ng/mL. What is the most likely diagnosis?
A) Vitamin B12 deficiency
B) Iron deficiency anemia
,C) Hemolytic anemia
D) Aplastic anemia
VERIFIED ANSWER: B) Iron deficiency anemia
Rationale: The low MCV (70 fL) indicates microcytic anemia. Low ferritin
(5 ng/mL) confirms iron deficiency. Vitamin B12 deficiency typically
causes macrocytic anemia, hemolytic anemia shows elevated reticulocyte
count and LDH, and aplastic anemia presents with pancytopenia .
Question 2:
Which cranial nerve is responsible for the sensation of taste on the
anterior two-thirds of the tongue?
A) Trigeminal (CN V)
B) Facial (CN VII)
C) Glossopharyngeal (CN IX)
D) Vagus (CN X)
VERIFIED ANSWER: B) Facial (CN VII)
Rationale: CN VII (facial nerve) via the chorda tympani branch carries
taste sensation from the anterior two-thirds of the tongue. CN IX carries
taste from the posterior third, and CN V carries general sensation but not
taste .
,Question 3:
A patient presents with a severe headache described as "the worst ever,"
neck stiffness, and photophobia. Which of the following is the most
appropriate initial test?
A) MRI brain
B) Non-contrast CT scan of the head
C) Lumbar puncture
D) EEG
VERIFIED ANSWER: B) Non-contrast CT scan of the head
Rationale: A sudden, severe headache raises suspicion for subarachnoid
hemorrhage. Non-contrast CT is the initial imaging of choice. Lumbar
puncture is indicated if CT is negative but clinical suspicion remains .
Question 4:
A 23-year-old man presents with fever, cough, and rusty sputum. Lung
exam shows crackles in the right lower lobe. Chest X-ray shows lobar
consolidation. The most likely organism is:
A) Haemophilus influenzae
B) Mycoplasma pneumoniae
C) Streptococcus pneumoniae
D) Chlamydophila pneumoniae
VERIFIED ANSWER: C) Streptococcus pneumoniae
, Rationale: S. pneumoniae is the most common cause of lobar pneumonia
with rusty sputum. The clinical presentation of lobar consolidation on X-
ray with productive cough and fever is classic for pneumococcal
pneumonia .
Question 5:
A patient with hyperthyroidism shows exophthalmos and pretibial
myxedema. The underlying mechanism is:
A) Low TSH receptor antibodies
B) Autoimmune stimulation of TSH receptors
C) Destruction of thyroid follicles
D) Excess iodine intake
VERIFIED ANSWER: B) Autoimmune stimulation of TSH receptors
Rationale: Graves disease involves TSH receptor-stimulating antibodies
that cause hyperthyroidism, exophthalmos, and pretibial myxedema. The
antibodies continuously stimulate the TSH receptor, leading to
uncontrolled thyroid hormone production .
Question 6:
A 7-year-old child presents with fever, sore throat, and a sandpaper-like
rash. On exam, the tongue appears red and swollen (strawberry tongue).
What is the most likely diagnosis?
