COMSAE PHASE 2 FORM 104 EXAMINATION QUESTIONS
AND CORRECT ANSWER WITH EXPLANATION GRADED
A+ STUDY GUIDE FOR OSTEOPATHIC MEDICAL STUDENT
1.
A 68-year-old man presents with crushing substernal chest pain radiating to the left arm. The
first diagnostic test should be:
A. Colonoscopy
B. ECG
C. MRI abdomen
D. Lumbar puncture
Answer: B
Rationale: ECG rapidly identifies acute coronary syndromes.
2.
A patient with sudden left-sided weakness and slurred speech most likely has:
A. Stroke
B. Migraine
C. Bell palsy
D. GERD
Answer: A
Rationale: Acute focal neurologic deficits suggest stroke.
3.
Hyperglycemia, ketonemia, and metabolic acidosis are classic for:
A. Hyperosmolar syndrome
B. Diabetic ketoacidosis
C. SIADH
D. Hypercalcemia
Answer: B
Rationale: DKA is characterized by ketosis and acidosis.
,4.
An unstable patient with supraventricular tachycardia requires:
A. Synchronized cardioversion
B. Observation only
C. Antibiotics
D. Aspirin
Answer: A
Rationale: Hemodynamic instability requires urgent cardioversion.
5.
Fever, photophobia, and nuchal rigidity indicate:
A. Meningitis
B. Migraine
C. Sinusitis
D. GERD
Answer: A
Rationale: Meningeal irritation causes these classic symptoms.
6.
The first-line treatment for severe anaphylaxis is:
A. Intramuscular epinephrine
B. Acetaminophen
C. Insulin
D. Aspirin
Answer: A
Rationale: Epinephrine rapidly reverses airway edema and shock.
7.
A chronic smoker with hemoptysis and weight loss should be evaluated for:
A. Lung cancer
B. Asthma
C. GERD
D. Appendicitis
, Answer: A
Rationale: Smoking and hemoptysis strongly suggest malignancy.
8.
RUQ abdominal pain after fatty meals most likely suggests:
A. Cholelithiasis
B. Pancreatitis
C. Appendicitis
D. Diverticulitis
Answer: A
Rationale: Gallstones commonly cause biliary colic after meals.
9.
The leading cause of chronic kidney disease is:
A. Diabetes mellitus
B. Trauma
C. Asthma
D. Pneumonia
Answer: A
Rationale: Diabetes progressively damages renal vasculature.
10.
Initial management of septic shock includes:
A. IV fluids and broad-spectrum antibiotics
B. Radiation therapy
C. Colonoscopy
D. Observation only
Answer: A
Rationale: Early fluid resuscitation and antibiotics improve survival.
11.
AND CORRECT ANSWER WITH EXPLANATION GRADED
A+ STUDY GUIDE FOR OSTEOPATHIC MEDICAL STUDENT
1.
A 68-year-old man presents with crushing substernal chest pain radiating to the left arm. The
first diagnostic test should be:
A. Colonoscopy
B. ECG
C. MRI abdomen
D. Lumbar puncture
Answer: B
Rationale: ECG rapidly identifies acute coronary syndromes.
2.
A patient with sudden left-sided weakness and slurred speech most likely has:
A. Stroke
B. Migraine
C. Bell palsy
D. GERD
Answer: A
Rationale: Acute focal neurologic deficits suggest stroke.
3.
Hyperglycemia, ketonemia, and metabolic acidosis are classic for:
A. Hyperosmolar syndrome
B. Diabetic ketoacidosis
C. SIADH
D. Hypercalcemia
Answer: B
Rationale: DKA is characterized by ketosis and acidosis.
,4.
An unstable patient with supraventricular tachycardia requires:
A. Synchronized cardioversion
B. Observation only
C. Antibiotics
D. Aspirin
Answer: A
Rationale: Hemodynamic instability requires urgent cardioversion.
5.
Fever, photophobia, and nuchal rigidity indicate:
A. Meningitis
B. Migraine
C. Sinusitis
D. GERD
Answer: A
Rationale: Meningeal irritation causes these classic symptoms.
6.
The first-line treatment for severe anaphylaxis is:
A. Intramuscular epinephrine
B. Acetaminophen
C. Insulin
D. Aspirin
Answer: A
Rationale: Epinephrine rapidly reverses airway edema and shock.
7.
A chronic smoker with hemoptysis and weight loss should be evaluated for:
A. Lung cancer
B. Asthma
C. GERD
D. Appendicitis
, Answer: A
Rationale: Smoking and hemoptysis strongly suggest malignancy.
8.
RUQ abdominal pain after fatty meals most likely suggests:
A. Cholelithiasis
B. Pancreatitis
C. Appendicitis
D. Diverticulitis
Answer: A
Rationale: Gallstones commonly cause biliary colic after meals.
9.
The leading cause of chronic kidney disease is:
A. Diabetes mellitus
B. Trauma
C. Asthma
D. Pneumonia
Answer: A
Rationale: Diabetes progressively damages renal vasculature.
10.
Initial management of septic shock includes:
A. IV fluids and broad-spectrum antibiotics
B. Radiation therapy
C. Colonoscopy
D. Observation only
Answer: A
Rationale: Early fluid resuscitation and antibiotics improve survival.
11.
