COMSAE Phase 3 Assessment Form C
Questions With Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A | Instant
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1. A 62-year-old man presents with chest pain radiating to the left
arm and diaphoresis. ECG shows ST 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
Answer: B. Right coronary artery
Rationale: ST elevation in leads II, III, and aVF indicates an
inferior wall myocardial infarction. The right coronary artery
commonly supplies the inferior portion of the heart in most
individuals, making it the most likely site of occlusion.
2. A 45-year-old woman presents with fatigue, weight gain, and cold
intolerance. Lab tests show elevated TSH and low free T4. What is
, the most likely diagnosis?
A. Graves disease
B. Subacute thyroiditis
C. Primary hypothyroidism
D. Secondary hypothyroidism
Answer: C. Primary hypothyroidism
Rationale: Elevated TSH with low free T4 indicates primary
failure of the thyroid gland itself, most commonly due to
Hashimoto thyroiditis.
3. A newborn has a continuous “machine-like” murmur. Which
defect is most likely present?
A. Ventricular septal defect
B. Patent ductus arteriosus
C. Atrial septal defect
D. Tetralogy of Fallot
Answer: B. Patent ductus arteriosus
Rationale: A continuous machinery murmur is classic for patent
ductus arteriosus, caused by persistent fetal connection between
aorta and pulmonary artery.
4. A patient presents with fever, flank pain, and costovertebral angle
tenderness. Urinalysis shows leukocyte esterase and nitrites. What
, organism is most likely?
A. Staphylococcus saprophyticus
B. Escherichia coli
C. Proteus mirabilis
D. Klebsiella pneumoniae
Answer: B. Escherichia coli
Rationale: E. coli is the most common cause of acute
pyelonephritis and urinary tract infections, especially in
community-acquired cases.
5. A 30-year-old man has episodic headaches, sweating, and
palpitations. Plasma metanephrines are elevated. What is the
diagnosis?
A. Cushing syndrome
B. Pheochromocytoma
C. Addison disease
D. Hyperthyroidism
Answer: B. Pheochromocytoma
Rationale: Episodic symptoms of catecholamine excess with
elevated metanephrines strongly indicate pheochromocytoma.
6. A patient has right lower quadrant pain and fever. CT shows
inflamed, dilated appendix. What is the most likely diagnosis?
, A. Diverticulitis
B. Appendicitis
C. Crohn disease
D. Mesenteric ischemia
Answer: B. Appendicitis
Rationale: Classic presentation of right lower quadrant pain with
imaging confirming appendix inflammation is acute appendicitis.
7. A child presents with a slapped-cheek rash and mild anemia.
Which virus is responsible?
A. Epstein-Barr virus
B. Parvovirus B19
C. Measles virus
D. Rubella virus
Answer: B. Parvovirus B19
Rationale: Parvovirus B19 causes erythema infectiosum and can
suppress erythropoiesis leading to transient aplastic anemia.
8. A patient with COPD is started on oxygen therapy. What is the
most important risk to monitor?
A. Respiratory alkalosis
B. Oxygen toxicity
C. CO2 retention
Questions With Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A | Instant
Download Pdf
1. A 62-year-old man presents with chest pain radiating to the left
arm and diaphoresis. ECG shows ST 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
Answer: B. Right coronary artery
Rationale: ST elevation in leads II, III, and aVF indicates an
inferior wall myocardial infarction. The right coronary artery
commonly supplies the inferior portion of the heart in most
individuals, making it the most likely site of occlusion.
2. A 45-year-old woman presents with fatigue, weight gain, and cold
intolerance. Lab tests show elevated TSH and low free T4. What is
, the most likely diagnosis?
A. Graves disease
B. Subacute thyroiditis
C. Primary hypothyroidism
D. Secondary hypothyroidism
Answer: C. Primary hypothyroidism
Rationale: Elevated TSH with low free T4 indicates primary
failure of the thyroid gland itself, most commonly due to
Hashimoto thyroiditis.
3. A newborn has a continuous “machine-like” murmur. Which
defect is most likely present?
A. Ventricular septal defect
B. Patent ductus arteriosus
C. Atrial septal defect
D. Tetralogy of Fallot
Answer: B. Patent ductus arteriosus
Rationale: A continuous machinery murmur is classic for patent
ductus arteriosus, caused by persistent fetal connection between
aorta and pulmonary artery.
4. A patient presents with fever, flank pain, and costovertebral angle
tenderness. Urinalysis shows leukocyte esterase and nitrites. What
, organism is most likely?
A. Staphylococcus saprophyticus
B. Escherichia coli
C. Proteus mirabilis
D. Klebsiella pneumoniae
Answer: B. Escherichia coli
Rationale: E. coli is the most common cause of acute
pyelonephritis and urinary tract infections, especially in
community-acquired cases.
5. A 30-year-old man has episodic headaches, sweating, and
palpitations. Plasma metanephrines are elevated. What is the
diagnosis?
A. Cushing syndrome
B. Pheochromocytoma
C. Addison disease
D. Hyperthyroidism
Answer: B. Pheochromocytoma
Rationale: Episodic symptoms of catecholamine excess with
elevated metanephrines strongly indicate pheochromocytoma.
6. A patient has right lower quadrant pain and fever. CT shows
inflamed, dilated appendix. What is the most likely diagnosis?
, A. Diverticulitis
B. Appendicitis
C. Crohn disease
D. Mesenteric ischemia
Answer: B. Appendicitis
Rationale: Classic presentation of right lower quadrant pain with
imaging confirming appendix inflammation is acute appendicitis.
7. A child presents with a slapped-cheek rash and mild anemia.
Which virus is responsible?
A. Epstein-Barr virus
B. Parvovirus B19
C. Measles virus
D. Rubella virus
Answer: B. Parvovirus B19
Rationale: Parvovirus B19 causes erythema infectiosum and can
suppress erythropoiesis leading to transient aplastic anemia.
8. A patient with COPD is started on oxygen therapy. What is the
most important risk to monitor?
A. Respiratory alkalosis
B. Oxygen toxicity
C. CO2 retention
