COMSAE Score Prediction Assessment
Questions With Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A | Instant
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1. A 68-year-old man presents with sudden onset chest pain
radiating to the back. Blood pressure is 180/100 in the right arm
and 160/90 in the left arm. Which is the most likely diagnosis?
A. Acute pericarditis
B. Pulmonary embolism
C. Aortic dissection
D. Myocardial infarction
Correct answer: C. Aortic dissection
Rationale: Aortic dissection classically presents with sudden
tearing chest pain radiating to the back and unequal blood
pressures between arms due to involvement of branch vessels.
2. A 55-year-old woman has fatigue, weight gain, and cold
intolerance. Labs show elevated TSH and low free T4. What is the
, most likely diagnosis?
A. Graves disease
B. Hypothyroidism
C. Subacute thyroiditis
D. Tertiary hyperthyroidism
Correct answer: B. Hypothyroidism
Rationale: High TSH with low T4 indicates primary
hypothyroidism, often due to Hashimoto thyroiditis.
3. A patient with asthma is started on a medication that causes
bronchodilation via β2 receptor activation. Which drug is most
likely prescribed?
A. Propranolol
B. Albuterol
C. Atropine
D. Montelukast
Correct answer: B. Albuterol
Rationale: Albuterol is a short-acting β2 agonist that relaxes
bronchial smooth muscle.
,4. A 30-year-old man presents with painless hematuria. Imaging
shows a renal mass in the upper pole. Most likely diagnosis?
A. Wilms tumor
B. Renal cell carcinoma
C. Bladder cancer
D. Polycystic kidney disease
Correct answer: B. Renal cell carcinoma
Rationale: Renal cell carcinoma often presents with painless
hematuria and a renal mass in adults.
5. A child presents with fever, strawberry tongue, and cervical
lymphadenopathy. What is the diagnosis?
A. Scarlet fever
B. Kawasaki disease
C. Measles
D. Rubella
Correct answer: B. Kawasaki disease
Rationale: Kawasaki disease presents with fever >5 days,
mucocutaneous changes, and lymphadenopathy.
, 6. A patient has acute pancreatitis. Which lab value is most specific?
A. ALT
B. Amylase
C. Lipase
D. ALP
Correct answer: C. Lipase
Rationale: Lipase is more specific and remains elevated longer
than amylase in pancreatitis.
7. A 45-year-old man has progressive dysphagia for solids and
liquids. Barium swallow shows a “bird beak” appearance.
Diagnosis?
A. Achalasia
B. GERD
C. Esophageal cancer
D. Schatzki ring
Correct answer: A. Achalasia
Rationale: Achalasia involves failure of LES relaxation, producing
bird-beak narrowing.
Questions With Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A | Instant
Download Pdf
1. A 68-year-old man presents with sudden onset chest pain
radiating to the back. Blood pressure is 180/100 in the right arm
and 160/90 in the left arm. Which is the most likely diagnosis?
A. Acute pericarditis
B. Pulmonary embolism
C. Aortic dissection
D. Myocardial infarction
Correct answer: C. Aortic dissection
Rationale: Aortic dissection classically presents with sudden
tearing chest pain radiating to the back and unequal blood
pressures between arms due to involvement of branch vessels.
2. A 55-year-old woman has fatigue, weight gain, and cold
intolerance. Labs show elevated TSH and low free T4. What is the
, most likely diagnosis?
A. Graves disease
B. Hypothyroidism
C. Subacute thyroiditis
D. Tertiary hyperthyroidism
Correct answer: B. Hypothyroidism
Rationale: High TSH with low T4 indicates primary
hypothyroidism, often due to Hashimoto thyroiditis.
3. A patient with asthma is started on a medication that causes
bronchodilation via β2 receptor activation. Which drug is most
likely prescribed?
A. Propranolol
B. Albuterol
C. Atropine
D. Montelukast
Correct answer: B. Albuterol
Rationale: Albuterol is a short-acting β2 agonist that relaxes
bronchial smooth muscle.
,4. A 30-year-old man presents with painless hematuria. Imaging
shows a renal mass in the upper pole. Most likely diagnosis?
A. Wilms tumor
B. Renal cell carcinoma
C. Bladder cancer
D. Polycystic kidney disease
Correct answer: B. Renal cell carcinoma
Rationale: Renal cell carcinoma often presents with painless
hematuria and a renal mass in adults.
5. A child presents with fever, strawberry tongue, and cervical
lymphadenopathy. What is the diagnosis?
A. Scarlet fever
B. Kawasaki disease
C. Measles
D. Rubella
Correct answer: B. Kawasaki disease
Rationale: Kawasaki disease presents with fever >5 days,
mucocutaneous changes, and lymphadenopathy.
, 6. A patient has acute pancreatitis. Which lab value is most specific?
A. ALT
B. Amylase
C. Lipase
D. ALP
Correct answer: C. Lipase
Rationale: Lipase is more specific and remains elevated longer
than amylase in pancreatitis.
7. A 45-year-old man has progressive dysphagia for solids and
liquids. Barium swallow shows a “bird beak” appearance.
Diagnosis?
A. Achalasia
B. GERD
C. Esophageal cancer
D. Schatzki ring
Correct answer: A. Achalasia
Rationale: Achalasia involves failure of LES relaxation, producing
bird-beak narrowing.
