1
COMSAE Phase 1 Form 114: 176 Question Test Bank All
questions with correct verified answers & detailed rationales
– graded A+ for the newest 2026 actual exam
Section 1: Anatomy & Neuroanatomy (Questions 1–25)
1. A 48-year-old man presents with difficulty chewing and deviation of the jaw
to the right upon opening the mouth. Which nerve is most likely affected?
A. Left trigeminal nerve (V3)
B. Right trigeminal nerve (V3)
C. Left facial nerve
D. Right facial nerve
: Correct Answer : B. Right trigeminal nerve (V3)
Rationale: The motor fibers of the trigeminal nerve (V3) innervate the muscles of
mastication, including the lateral pterygoid. Unilateral damage causes the jaw to
deviate toward the weak side (ipsilateral) when opening due to unopposed action
of the intact lateral pterygoid. Here, deviation to the right indicates right V3
involvement.
2. A 55-year-old woman with a pituitary adenoma reports difficulty seeing
objects in her peripheral vision. Visual field testing shows loss of the temporal
visual fields in both eyes. What anatomical structure is being compressed?
A. Optic chiasm
B. Right optic nerve
C. Left optic tract
D. Lateral geniculate nucleus
: Correct Answer : A. Optic chiasm
Rationale: The optic chiasm contains crossing fibers from the nasal retinas of both
eyes. Compression from a pituitary tumor interrupts these fibers, causing loss of
the temporal visual fields in each eye (bitemporal hemianopia).
pg. 1
,2
3. A 65-year-old male alcoholic presents with confusion, nystagmus, and a
broad-based ataxic gait. MRI reveals atrophy of the cerebellar vermis and
mammillary bodies. Which vitamin deficiency is most likely?
A. Vitamin B12
B. Thiamine (B1)
C. Folate
D. Vitamin E
: Correct Answer : B. Thiamine (B1)
Rationale: Wernicke-Korsakoff syndrome is caused by thiamine deficiency and is
characterized by degeneration of the mammillary bodies, thalamus, and
cerebellar vermis, leading to the classic triad of confusion,
ophthalmoplegia/nystagmus, and ataxia.
4. A 34-year-old man has a knife wound to the upper medial arm. He has
sensory loss on the medial forearm and weakness of finger abduction and
adduction. Which nerve is injured?
A. Ulnar nerve
B. Median nerve
C. Radial nerve
D. Medial antebrachial cutaneous nerve
: Correct Answer : A. Ulnar nerve
*Rationale: The ulnar nerve innervates the intrinsic hand muscles responsible for
finger abduction/adduction (interossei) and provides sensation to the medial 1½
fingers and corresponding palm. A wound to the upper medial arm could injure
the ulnar nerve as it descends. Median nerve injury would affect thumb
opposition and sensation of lateral palm.*
5. A child is born with a port-wine stain over the forehead and upper eyelid. At 2
years, the child develops seizures. Which syndrome is most likely?
A. Neurofibromatosis type 1
B. Tuberous sclerosis
pg. 2
,3
C. Sturge-Weber syndrome
D. von Hippel-Lindau disease
: Correct Answer : C. Sturge-Weber syndrome
*Rationale: Sturge-Weber syndrome is a neurocutaneous disorder characterized
by a facial port-wine stain in the V1/V2 trigeminal distribution, ipsilateral
leptomeningeal angiomas, and seizures. The presence of the port-wine stain and
seizures is classic.*
6. A 22-year-old woman falls and fractures the surgical neck of her humerus. She
cannot abduct her arm beyond 15 degrees. Which nerve is damaged?
A. Axillary nerve
B. Radial nerve
C. Musculocutaneous nerve
D. Suprascapular nerve
: Correct Answer : A. Axillary nerve
Rationale: The axillary nerve wraps around the surgical neck of the humerus and
innervates the deltoid. Injury leads to deltoid paralysis, limiting shoulder
abduction beyond the initial 15 degrees (supraspinatus). Sensory loss occurs over
the deltoid region.
7. A 70-year-old woman slips and falls, landing on her right hip. The right leg is
shortened and externally rotated. Which type of fracture is most likely?
A. Intertrochanteric fracture
B. Femoral neck fracture
C. Subtrochanteric fracture
D. Pubic ramus fracture
: Correct Answer : B. Femoral neck fracture
Rationale: Femoral neck fractures (intracapsular) classically present with a
shortened and externally rotated leg, and are common in elderly osteoporotic
women after a fall. They risk avascular necrosis of the femoral head due to
disruption of the medial circumflex femoral artery.
pg. 3
, 4
8. A 5-year-old boy has a “claw hand” deformity with hyperextension at the
MCP joints and flexion at the IP joints of the ring and little fingers. Sensation is
lost over the medial hand. Which nerve is injured?
A. Median nerve
B. Radial nerve
C. Ulnar nerve
D. Axillary nerve
: Correct Answer : C. Ulnar nerve
*Rationale: Ulnar nerve injury at the wrist or elbow causes paralysis of the
intrinsic hand muscles (interossei, lumbricals 3/4) resulting in clawing of the ring
and little fingers. Sensory loss occurs over the ulnar 1½ fingers.*
9. A 28-year-old man has a fracture of the mid-shaft of the humerus after a
motor vehicle accident. He cannot extend his wrist or fingers. Which nerve is
injured?
A. Axillary nerve
B. Radial nerve
C. Median nerve
D. Musculocutaneous nerve
: Correct Answer : B. Radial nerve
Rationale: The radial nerve runs in the radial groove of the humerus and is
commonly injured with mid-shaft fractures. This causes wrist drop (loss of forearm
extensors) and inability to extend the fingers and thumb.
10. A patient has a hoarse voice and difficulty swallowing after a thyroidectomy.
Which nerve is most likely injured?
A. External laryngeal nerve
B. Recurrent laryngeal nerve
C. Hypoglossal nerve
D. Glossopharyngeal nerve
pg. 4
COMSAE Phase 1 Form 114: 176 Question Test Bank All
questions with correct verified answers & detailed rationales
– graded A+ for the newest 2026 actual exam
Section 1: Anatomy & Neuroanatomy (Questions 1–25)
1. A 48-year-old man presents with difficulty chewing and deviation of the jaw
to the right upon opening the mouth. Which nerve is most likely affected?
A. Left trigeminal nerve (V3)
B. Right trigeminal nerve (V3)
C. Left facial nerve
D. Right facial nerve
: Correct Answer : B. Right trigeminal nerve (V3)
Rationale: The motor fibers of the trigeminal nerve (V3) innervate the muscles of
mastication, including the lateral pterygoid. Unilateral damage causes the jaw to
deviate toward the weak side (ipsilateral) when opening due to unopposed action
of the intact lateral pterygoid. Here, deviation to the right indicates right V3
involvement.
2. A 55-year-old woman with a pituitary adenoma reports difficulty seeing
objects in her peripheral vision. Visual field testing shows loss of the temporal
visual fields in both eyes. What anatomical structure is being compressed?
A. Optic chiasm
B. Right optic nerve
C. Left optic tract
D. Lateral geniculate nucleus
: Correct Answer : A. Optic chiasm
Rationale: The optic chiasm contains crossing fibers from the nasal retinas of both
eyes. Compression from a pituitary tumor interrupts these fibers, causing loss of
the temporal visual fields in each eye (bitemporal hemianopia).
pg. 1
,2
3. A 65-year-old male alcoholic presents with confusion, nystagmus, and a
broad-based ataxic gait. MRI reveals atrophy of the cerebellar vermis and
mammillary bodies. Which vitamin deficiency is most likely?
A. Vitamin B12
B. Thiamine (B1)
C. Folate
D. Vitamin E
: Correct Answer : B. Thiamine (B1)
Rationale: Wernicke-Korsakoff syndrome is caused by thiamine deficiency and is
characterized by degeneration of the mammillary bodies, thalamus, and
cerebellar vermis, leading to the classic triad of confusion,
ophthalmoplegia/nystagmus, and ataxia.
4. A 34-year-old man has a knife wound to the upper medial arm. He has
sensory loss on the medial forearm and weakness of finger abduction and
adduction. Which nerve is injured?
A. Ulnar nerve
B. Median nerve
C. Radial nerve
D. Medial antebrachial cutaneous nerve
: Correct Answer : A. Ulnar nerve
*Rationale: The ulnar nerve innervates the intrinsic hand muscles responsible for
finger abduction/adduction (interossei) and provides sensation to the medial 1½
fingers and corresponding palm. A wound to the upper medial arm could injure
the ulnar nerve as it descends. Median nerve injury would affect thumb
opposition and sensation of lateral palm.*
5. A child is born with a port-wine stain over the forehead and upper eyelid. At 2
years, the child develops seizures. Which syndrome is most likely?
A. Neurofibromatosis type 1
B. Tuberous sclerosis
pg. 2
,3
C. Sturge-Weber syndrome
D. von Hippel-Lindau disease
: Correct Answer : C. Sturge-Weber syndrome
*Rationale: Sturge-Weber syndrome is a neurocutaneous disorder characterized
by a facial port-wine stain in the V1/V2 trigeminal distribution, ipsilateral
leptomeningeal angiomas, and seizures. The presence of the port-wine stain and
seizures is classic.*
6. A 22-year-old woman falls and fractures the surgical neck of her humerus. She
cannot abduct her arm beyond 15 degrees. Which nerve is damaged?
A. Axillary nerve
B. Radial nerve
C. Musculocutaneous nerve
D. Suprascapular nerve
: Correct Answer : A. Axillary nerve
Rationale: The axillary nerve wraps around the surgical neck of the humerus and
innervates the deltoid. Injury leads to deltoid paralysis, limiting shoulder
abduction beyond the initial 15 degrees (supraspinatus). Sensory loss occurs over
the deltoid region.
7. A 70-year-old woman slips and falls, landing on her right hip. The right leg is
shortened and externally rotated. Which type of fracture is most likely?
A. Intertrochanteric fracture
B. Femoral neck fracture
C. Subtrochanteric fracture
D. Pubic ramus fracture
: Correct Answer : B. Femoral neck fracture
Rationale: Femoral neck fractures (intracapsular) classically present with a
shortened and externally rotated leg, and are common in elderly osteoporotic
women after a fall. They risk avascular necrosis of the femoral head due to
disruption of the medial circumflex femoral artery.
pg. 3
, 4
8. A 5-year-old boy has a “claw hand” deformity with hyperextension at the
MCP joints and flexion at the IP joints of the ring and little fingers. Sensation is
lost over the medial hand. Which nerve is injured?
A. Median nerve
B. Radial nerve
C. Ulnar nerve
D. Axillary nerve
: Correct Answer : C. Ulnar nerve
*Rationale: Ulnar nerve injury at the wrist or elbow causes paralysis of the
intrinsic hand muscles (interossei, lumbricals 3/4) resulting in clawing of the ring
and little fingers. Sensory loss occurs over the ulnar 1½ fingers.*
9. A 28-year-old man has a fracture of the mid-shaft of the humerus after a
motor vehicle accident. He cannot extend his wrist or fingers. Which nerve is
injured?
A. Axillary nerve
B. Radial nerve
C. Median nerve
D. Musculocutaneous nerve
: Correct Answer : B. Radial nerve
Rationale: The radial nerve runs in the radial groove of the humerus and is
commonly injured with mid-shaft fractures. This causes wrist drop (loss of forearm
extensors) and inability to extend the fingers and thumb.
10. A patient has a hoarse voice and difficulty swallowing after a thyroidectomy.
Which nerve is most likely injured?
A. External laryngeal nerve
B. Recurrent laryngeal nerve
C. Hypoglossal nerve
D. Glossopharyngeal nerve
pg. 4
