COMSAE Phase 2 Cognitive Evaluation Form C
Questions With Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A | Instant
Download Pdf
1. A 62-year-old man presents with progressive dyspnea, chronic
cough, and a 40-pack-year smoking history. Pulmonary function
tests show FEV1/FVC of 55%. Which of the following is the most
likely diagnosis?
A. Asthma
B. Chronic bronchitis
C. Emphysema
D. Pulmonary fibrosis
Answer: C. Emphysema
Rationale: A reduced FEV1/FVC ratio indicates obstructive lung
disease. In a heavy smoker with progressive dyspnea and chronic
symptoms, emphysema is most likely due to alveolar wall destruction
and loss of elastic recoil.
, 2. A 24-year-old woman presents with episodes of palpitations,
tremor, and heat intolerance. Lab tests show decreased TSH and
elevated T3/T4. What is the most likely diagnosis?
A. Hashimoto thyroiditis
B. Graves disease
C. Thyroid cancer
D. Subacute thyroiditis
Answer: B. Graves disease
Rationale: Hyperthyroidism with suppressed TSH and elevated thyroid
hormones, especially in a young woman with adrenergic symptoms, is
most consistent with Graves disease due to autoantibodies stimulating
the TSH receptor.
3. A patient presents with chest pain relieved by nitroglycerin. ECG
shows ST depression during pain episodes. What is the most likely
diagnosis?
A. Stable angina
B. Unstable angina
C. STEMI
D. Pericarditis
,Answer: A. Stable angina
Rationale: Stable angina is characterized by predictable chest pain
with exertion and ST depression due to transient subendocardial
ischemia, relieved by rest or nitrates.
4. A newborn presents with cyanosis that improves with crying and
worsens with feeding. A harsh systolic murmur is heard. Most
likely diagnosis?
A. Patent ductus arteriosus
B. Tetralogy of Fallot
C. Transposition of great arteries
D. Ventricular septal defect
Answer: B. Tetralogy of Fallot
Rationale: Tetralogy of Fallot causes right-to-left shunting leading to
cyanotic spells (“tet spells”) that worsen with increased oxygen
demand such as feeding and improve with squatting/crying.
5. A patient has right lower quadrant pain, fever, and leukocytosis.
Which structure is most likely inflamed?
A. Gallbladder
B. Appendix
, C. Pancreas
D. Sigmoid colon
Answer: B. Appendix
Rationale: Classic presentation of appendicitis includes RLQ pain,
fever, and leukocytosis due to inflammation of the vermiform
appendix.
6. A 55-year-old man with chronic alcohol use presents with tremors,
confusion, and ophthalmoplegia. Which vitamin deficiency is most
likely?
A. Vitamin B1
B. Vitamin B6
C. Vitamin B12
D. Vitamin C
Answer: A. Vitamin B1
Rationale: Wernicke encephalopathy is caused by thiamine (B1)
deficiency and is characterized by confusion, ataxia, and
ophthalmoplegia, especially in alcoholics.
Questions With Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A | Instant
Download Pdf
1. A 62-year-old man presents with progressive dyspnea, chronic
cough, and a 40-pack-year smoking history. Pulmonary function
tests show FEV1/FVC of 55%. Which of the following is the most
likely diagnosis?
A. Asthma
B. Chronic bronchitis
C. Emphysema
D. Pulmonary fibrosis
Answer: C. Emphysema
Rationale: A reduced FEV1/FVC ratio indicates obstructive lung
disease. In a heavy smoker with progressive dyspnea and chronic
symptoms, emphysema is most likely due to alveolar wall destruction
and loss of elastic recoil.
, 2. A 24-year-old woman presents with episodes of palpitations,
tremor, and heat intolerance. Lab tests show decreased TSH and
elevated T3/T4. What is the most likely diagnosis?
A. Hashimoto thyroiditis
B. Graves disease
C. Thyroid cancer
D. Subacute thyroiditis
Answer: B. Graves disease
Rationale: Hyperthyroidism with suppressed TSH and elevated thyroid
hormones, especially in a young woman with adrenergic symptoms, is
most consistent with Graves disease due to autoantibodies stimulating
the TSH receptor.
3. A patient presents with chest pain relieved by nitroglycerin. ECG
shows ST depression during pain episodes. What is the most likely
diagnosis?
A. Stable angina
B. Unstable angina
C. STEMI
D. Pericarditis
,Answer: A. Stable angina
Rationale: Stable angina is characterized by predictable chest pain
with exertion and ST depression due to transient subendocardial
ischemia, relieved by rest or nitrates.
4. A newborn presents with cyanosis that improves with crying and
worsens with feeding. A harsh systolic murmur is heard. Most
likely diagnosis?
A. Patent ductus arteriosus
B. Tetralogy of Fallot
C. Transposition of great arteries
D. Ventricular septal defect
Answer: B. Tetralogy of Fallot
Rationale: Tetralogy of Fallot causes right-to-left shunting leading to
cyanotic spells (“tet spells”) that worsen with increased oxygen
demand such as feeding and improve with squatting/crying.
5. A patient has right lower quadrant pain, fever, and leukocytosis.
Which structure is most likely inflamed?
A. Gallbladder
B. Appendix
, C. Pancreas
D. Sigmoid colon
Answer: B. Appendix
Rationale: Classic presentation of appendicitis includes RLQ pain,
fever, and leukocytosis due to inflammation of the vermiform
appendix.
6. A 55-year-old man with chronic alcohol use presents with tremors,
confusion, and ophthalmoplegia. Which vitamin deficiency is most
likely?
A. Vitamin B1
B. Vitamin B6
C. Vitamin B12
D. Vitamin C
Answer: A. Vitamin B1
Rationale: Wernicke encephalopathy is caused by thiamine (B1)
deficiency and is characterized by confusion, ataxia, and
ophthalmoplegia, especially in alcoholics.
