COMSAE Phase 2 Cognitive Evaluation Form D
Questions With Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A | Instant
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1. A 67-year-old man presents with chest pain radiating to the left
arm and diaphoresis. ECG shows ST-segment elevation in leads II,
III, and aVF. Which artery is most likely occluded?
A. Left anterior descending artery
B. Right coronary artery
C. Left circumflex artery
D. Left main coronary artery
Rationale: Inferior wall myocardial infarction is indicated by ST
elevation in leads II, III, and aVF. This region is most commonly
supplied by the right coronary artery in a right-dominant circulation.
, 2. A 25-year-old woman presents with episodic palpitations,
sweating, and headache. Plasma metanephrines are elevated.
What is the most likely diagnosis?
A. Hyperthyroidism
B. Pheochromocytoma
C. Addison disease
D. Cushing syndrome
Rationale: The triad of episodic headache, sweating, and palpitations
with elevated catecholamine metabolites strongly suggests
pheochromocytoma.
3. A child presents with a "slapped cheek" rash. Which virus is
responsible?
A. Measles virus
B. Parvovirus B19
C. Rubella virus
D. Varicella-zoster virus
Rationale: Erythema infectiosum, or fifth disease, is caused by
Parvovirus B19 and is characterized by a slapped-cheek facial rash.
, 4. A 60-year-old smoker has hematuria. Cystoscopy reveals papillary
tumors. What is the most likely diagnosis?
A. Renal cell carcinoma
B. Transitional cell carcinoma of the bladder
C. Squamous cell carcinoma of the bladder
D. Wilms tumor
Rationale: Smoking is a major risk factor for urothelial (transitional
cell) carcinoma, which often presents with painless hematuria and
papillary lesions.
5. Which condition is associated with prolonged PT and normal PTT?
A. Hemophilia A
B. Vitamin K deficiency
C. von Willebrand disease
D. Factor VIII deficiency
Rationale: Vitamin K deficiency affects factors II, VII, IX, and X; factor
VII has the shortest half-life, leading to early PT prolongation.
6. A 30-year-old woman has heat intolerance, weight loss, and
exophthalmos. What antibody is most likely present?
, A. Anti-thyroid peroxidase
B. TSH receptor-stimulating antibody
C. Anti-thyroglobulin antibody
D. Anti-TSH antibody
Rationale: Graves disease is caused by TSH receptor-stimulating
antibodies leading to hyperthyroidism and ophthalmopathy.
7. A patient has chronic alcohol use and confusion with
ophthalmoplegia. What vitamin deficiency is responsible?
A. Vitamin B12
B. Thiamine (Vitamin B1)
C. Folate
D. Niacin
Rationale: Wernicke encephalopathy is due to thiamine deficiency and
presents with confusion, ophthalmoplegia, and ataxia.
8. A neonate presents with cataracts, deafness, and PDA. Which
infection is most likely?
A. Toxoplasmosis
B. Rubella
Questions With Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A | Instant
Download Pdf
1. A 67-year-old man presents with chest pain radiating to the left
arm and diaphoresis. ECG shows ST-segment elevation in leads II,
III, and aVF. Which artery is most likely occluded?
A. Left anterior descending artery
B. Right coronary artery
C. Left circumflex artery
D. Left main coronary artery
Rationale: Inferior wall myocardial infarction is indicated by ST
elevation in leads II, III, and aVF. This region is most commonly
supplied by the right coronary artery in a right-dominant circulation.
, 2. A 25-year-old woman presents with episodic palpitations,
sweating, and headache. Plasma metanephrines are elevated.
What is the most likely diagnosis?
A. Hyperthyroidism
B. Pheochromocytoma
C. Addison disease
D. Cushing syndrome
Rationale: The triad of episodic headache, sweating, and palpitations
with elevated catecholamine metabolites strongly suggests
pheochromocytoma.
3. A child presents with a "slapped cheek" rash. Which virus is
responsible?
A. Measles virus
B. Parvovirus B19
C. Rubella virus
D. Varicella-zoster virus
Rationale: Erythema infectiosum, or fifth disease, is caused by
Parvovirus B19 and is characterized by a slapped-cheek facial rash.
, 4. A 60-year-old smoker has hematuria. Cystoscopy reveals papillary
tumors. What is the most likely diagnosis?
A. Renal cell carcinoma
B. Transitional cell carcinoma of the bladder
C. Squamous cell carcinoma of the bladder
D. Wilms tumor
Rationale: Smoking is a major risk factor for urothelial (transitional
cell) carcinoma, which often presents with painless hematuria and
papillary lesions.
5. Which condition is associated with prolonged PT and normal PTT?
A. Hemophilia A
B. Vitamin K deficiency
C. von Willebrand disease
D. Factor VIII deficiency
Rationale: Vitamin K deficiency affects factors II, VII, IX, and X; factor
VII has the shortest half-life, leading to early PT prolongation.
6. A 30-year-old woman has heat intolerance, weight loss, and
exophthalmos. What antibody is most likely present?
, A. Anti-thyroid peroxidase
B. TSH receptor-stimulating antibody
C. Anti-thyroglobulin antibody
D. Anti-TSH antibody
Rationale: Graves disease is caused by TSH receptor-stimulating
antibodies leading to hyperthyroidism and ophthalmopathy.
7. A patient has chronic alcohol use and confusion with
ophthalmoplegia. What vitamin deficiency is responsible?
A. Vitamin B12
B. Thiamine (Vitamin B1)
C. Folate
D. Niacin
Rationale: Wernicke encephalopathy is due to thiamine deficiency and
presents with confusion, ophthalmoplegia, and ataxia.
8. A neonate presents with cataracts, deafness, and PDA. Which
infection is most likely?
A. Toxoplasmosis
B. Rubella
