COMSAE 115 EXAM 2026/2027 300 MOST
TESTED QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES
(VERIFIEDSOLUTIONS) 2026 EDITION
|BEST DOCUMENT FOR EXAM-TESTBANK
A 58-year-old man with a history of chronic smoking presents with chronic cough, dyspnea, and
barrel-shaped chest. Spirometry shows FEV1/FVC ratio of 60%. Which is the most likely
diagnosis?
A. Asthma
B. COPD
C. Pulmonary fibrosis
D. Bronchiectasis
Correct Answer: B. COPD
Expert Rationale:
COPD is characterized by irreversible airflow limitation, typically due to chronic smoking, with
reduced FEV1/FVC ratio.
COMSAE Focus: Pulmonology
DIF: Application
REF: Obstructive Lung Disease
OBJ: Identify COPD
TOP: Internal Medicine
A newborn fails to pass meconium within 48 hours and has abdominal distension. Which
condition is most likely?
A. Hirschsprung disease
B. Pyloric stenosis
C. Meckel diverticulum
D. Intussusception
Correct Answer: A. Hirschsprung disease
,Expert Rationale:
Failure of neural crest cell migration causes a ganglionic bowel leading to obstruction and failure
to pass meconium.
COMSAE Focus: Pediatrics
DIF: Analysis
REF: Congenital GI Disorders
OBJ: Recognize Hirschsprung disease
TOP: Pediatric Surgery
A patient presents with sudden severe "worst headache of life" and neck stiffness. CT is
negative. What is the next best step?
A. MRI brain
B. Lumbar puncture
C. EEG
D. Start antibiotics
Correct Answer: B. Lumbar puncture
Expert Rationale:
Suspected subarachnoid hemorrhage with negative CT requires lumbar puncture to detect
xanthochromia.
COMSAE Focus: Neurology
DIF: Analysis
REF: Subarachnoid Hemorrhage
OBJ: Diagnose SAH
TOP: Emergency Medicine
A patient presents with fever, cough, and atypical pneumonia. Cold agglutinins are positive.
Which organism is responsible?
A. Streptococcus pneumoniae
B. Mycoplasma pneumoniae
C. Klebsiella pneumoniae
D. Legionella pneumophila
, Correct Answer: B. Mycoplasma pneumoniae
Expert Rationale:
Mycoplasma causes atypical pneumonia and is associated with cold agglutinin hemolytic
anemia.
COMSAE Focus: Infectious Disease
DIF: Recall
REF: Atypical Pneumonia
OBJ: Identify Mycoplasma infection
TOP: Pulmonology
A patient presents with sudden painless vision loss described as a "curtain falling." Which
diagnosis is most likely?
A. Retinal detachment
B. Acute glaucoma
C. Cataract
D. Optic neuritis
Correct Answer: A. Retinal detachment
Expert Rationale:
Retinal detachment causes sudden painless vision loss with curtain-like visual field defect.
COMSAE Focus: Ophthalmology
DIF: Application
REF: Retinal Disorders
OBJ: Recognize retinal detachment
TOP: Emergency Medicine
A child presents with edema, proteinuria, and hypoalbuminemia after a viral illness. Which
condition is most likely?
A. Nephritic syndrome
B. Nephrotic syndrome
C. Pyelonephritis
D. UTI
, Correct Answer: B. Nephrotic syndrome
Expert Rationale:
Minimal change disease is the most common cause of nephrotic syndrome in children.
COMSAE Focus: Nephrology
DIF: Application
REF: Glomerular Disease
OBJ: Identify nephrotic syndrome
TOP: Pediatrics
A patient presents with tremor that improves with alcohol use. Which diagnosis is most likely?
A. Parkinson disease
B. Essential tremor
C. Huntington disease
D. Wilson disease
Correct Answer: B. Essential tremor
Expert Rationale:
Essential tremor is an action tremor improved by alcohol and worsened with movement.
COMSAE Focus: Neurology
DIF: Recall
REF: Movement Disorders
OBJ: Identify essential tremor
TOP: Internal Medicine
A patient presents with chronic diarrhea and weight loss. Stool studies show steatorrhea. Which
enzyme deficiency is most likely?
A. Lactase deficiency
B. Pancreatic lipase deficiency
C. Amylase deficiency
D. Sucrase deficiency
Correct Answer: B. Pancreatic lipase deficiency
TESTED QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES
(VERIFIEDSOLUTIONS) 2026 EDITION
|BEST DOCUMENT FOR EXAM-TESTBANK
A 58-year-old man with a history of chronic smoking presents with chronic cough, dyspnea, and
barrel-shaped chest. Spirometry shows FEV1/FVC ratio of 60%. Which is the most likely
diagnosis?
A. Asthma
B. COPD
C. Pulmonary fibrosis
D. Bronchiectasis
Correct Answer: B. COPD
Expert Rationale:
COPD is characterized by irreversible airflow limitation, typically due to chronic smoking, with
reduced FEV1/FVC ratio.
COMSAE Focus: Pulmonology
DIF: Application
REF: Obstructive Lung Disease
OBJ: Identify COPD
TOP: Internal Medicine
A newborn fails to pass meconium within 48 hours and has abdominal distension. Which
condition is most likely?
A. Hirschsprung disease
B. Pyloric stenosis
C. Meckel diverticulum
D. Intussusception
Correct Answer: A. Hirschsprung disease
,Expert Rationale:
Failure of neural crest cell migration causes a ganglionic bowel leading to obstruction and failure
to pass meconium.
COMSAE Focus: Pediatrics
DIF: Analysis
REF: Congenital GI Disorders
OBJ: Recognize Hirschsprung disease
TOP: Pediatric Surgery
A patient presents with sudden severe "worst headache of life" and neck stiffness. CT is
negative. What is the next best step?
A. MRI brain
B. Lumbar puncture
C. EEG
D. Start antibiotics
Correct Answer: B. Lumbar puncture
Expert Rationale:
Suspected subarachnoid hemorrhage with negative CT requires lumbar puncture to detect
xanthochromia.
COMSAE Focus: Neurology
DIF: Analysis
REF: Subarachnoid Hemorrhage
OBJ: Diagnose SAH
TOP: Emergency Medicine
A patient presents with fever, cough, and atypical pneumonia. Cold agglutinins are positive.
Which organism is responsible?
A. Streptococcus pneumoniae
B. Mycoplasma pneumoniae
C. Klebsiella pneumoniae
D. Legionella pneumophila
, Correct Answer: B. Mycoplasma pneumoniae
Expert Rationale:
Mycoplasma causes atypical pneumonia and is associated with cold agglutinin hemolytic
anemia.
COMSAE Focus: Infectious Disease
DIF: Recall
REF: Atypical Pneumonia
OBJ: Identify Mycoplasma infection
TOP: Pulmonology
A patient presents with sudden painless vision loss described as a "curtain falling." Which
diagnosis is most likely?
A. Retinal detachment
B. Acute glaucoma
C. Cataract
D. Optic neuritis
Correct Answer: A. Retinal detachment
Expert Rationale:
Retinal detachment causes sudden painless vision loss with curtain-like visual field defect.
COMSAE Focus: Ophthalmology
DIF: Application
REF: Retinal Disorders
OBJ: Recognize retinal detachment
TOP: Emergency Medicine
A child presents with edema, proteinuria, and hypoalbuminemia after a viral illness. Which
condition is most likely?
A. Nephritic syndrome
B. Nephrotic syndrome
C. Pyelonephritis
D. UTI
, Correct Answer: B. Nephrotic syndrome
Expert Rationale:
Minimal change disease is the most common cause of nephrotic syndrome in children.
COMSAE Focus: Nephrology
DIF: Application
REF: Glomerular Disease
OBJ: Identify nephrotic syndrome
TOP: Pediatrics
A patient presents with tremor that improves with alcohol use. Which diagnosis is most likely?
A. Parkinson disease
B. Essential tremor
C. Huntington disease
D. Wilson disease
Correct Answer: B. Essential tremor
Expert Rationale:
Essential tremor is an action tremor improved by alcohol and worsened with movement.
COMSAE Focus: Neurology
DIF: Recall
REF: Movement Disorders
OBJ: Identify essential tremor
TOP: Internal Medicine
A patient presents with chronic diarrhea and weight loss. Stool studies show steatorrhea. Which
enzyme deficiency is most likely?
A. Lactase deficiency
B. Pancreatic lipase deficiency
C. Amylase deficiency
D. Sucrase deficiency
Correct Answer: B. Pancreatic lipase deficiency
