COMSAE Phase 1,2,3 Form 111 Practice
Exam 200 Questions And Correct
Answers (Verified Answers) Plus
Rationales 2025|2026 Q&A | Instant
Download Pdf
Question 1
A 24-year-old male presents with fever, sore throat, and fatigue. Exam shows
posterior cervical lymphadenopathy and splenomegaly. Which organism is most
likely responsible?
A) Streptococcus pyogenes
B) Epstein-Barr virus
C) Cytomegalovirus
D) Toxoplasma gondii
Rationale: This presentation is classic for infectious mononucleosis caused by
Epstein-Barr virus (EBV), characterized by fever, pharyngitis, posterior cervical
lymphadenopathy, and splenomegaly. CMV can cause a similar syndrome but
typically lacks severe pharyngitis. The Monospot test (heterophile antibody) would
be positive in EBV infection .
Question 2
Which cranial nerve is responsible for facial expression?
A) CN V
B) CN VII
,C) CN IX
D) CN X
Rationale: The facial nerve (CN VII) innervates the muscles of facial expression.
It also provides taste to the anterior two-thirds of the tongue via the chorda
tympani. CN V (trigeminal) is responsible for mastication and facial sensation. CN
IX (glossopharyngeal) supplies the stylopharyngeus and taste to posterior tongue.
CN X (vagus) supplies palatal and laryngeal muscles .
Question 3
A patient has right-sided weakness and aphasia. Which cerebral artery is most
likely affected?
A) Posterior cerebral artery
B) Anterior cerebral artery
C) Middle cerebral artery
D) Basilar artery
Rationale: The middle cerebral artery (MCA) supplies the lateral cerebral cortex,
including Broca’s area (dominant hemisphere for expressive language) and the
primary motor cortex for the face and upper extremity. MCA stroke presents with
contralateral weakness (face/arm > leg) and aphasia (if dominant hemisphere) or
neglect (if non-dominant) .
Question 4
Which vitamin deficiency is associated with scurvy?
,A) Vitamin A
B) Vitamin B1
C) Vitamin B12
D) Vitamin C
Rationale: Scurvy is caused by vitamin C (ascorbic acid) deficiency. Vitamin C is
a cofactor for collagen synthesis (prolyl and lysyl hydroxylases). Clinical
manifestations include perifollicular hemorrhages, bleeding gums, poor wound
healing, and “corkscrew” hairs. Vitamin B1 deficiency causes beriberi; B12
deficiency causes subacute combined degeneration; Vitamin A deficiency causes
night blindness .
Question 5
Which vitamin deficiency is most likely in a 60-year-old man with chronic alcohol
use presenting with confusion, ataxia, and ophthalmoplegia?
A) Vitamin B6 (pyridoxine)
B) Vitamin B12 (cobalamin)
C) Vitamin C
D) Vitamin B1 (thiamine)
Rationale: Wernicke encephalopathy presents with the classic triad of confusion,
ataxia, and ophthalmoplegia—caused by thiamine (vitamin B1) deficiency,
commonly seen in chronic alcohol use disorder. Treatment is IV thiamine, which
must be given BEFORE glucose to prevent precipitating or worsening
encephalopathy. Untreated, this can progress to Korsakoff syndrome with memory
loss and confabulation .
, Question 6
What is the primary site of erythropoietin production in adults?
A) Liver
B) Kidney
C) Spleen
D) Bone marrow
Rationale: Erythropoietin (EPO) is mainly produced by interstitial fibroblasts of
the kidney in response to hypoxia, stimulating RBC production in bone marrow.
The liver produces EPO in fetal life but contributes little in adults. Anemia of
chronic kidney disease is due to EPO deficiency and responds to exogenous EPO
(epoetin alfa) .
Question 7
A 45-year-old woman with fatigue has low hemoglobin, low MCV, and low
ferritin. What is the most likely cause?
A) Thalassemia
B) Anemia of chronic disease
C) Iron deficiency anemia
D) Sideroblastic anemia
Rationale: Low ferritin is diagnostic of iron deficiency anemia. Ferritin reflects
body iron stores—low levels indicate depletion. MCV is low (microcytic).
Thalassemia also causes microcytic anemia but ferritin is normal or elevated.
Anemia of chronic disease typically presents with normal or elevated ferritin .
Exam 200 Questions And Correct
Answers (Verified Answers) Plus
Rationales 2025|2026 Q&A | Instant
Download Pdf
Question 1
A 24-year-old male presents with fever, sore throat, and fatigue. Exam shows
posterior cervical lymphadenopathy and splenomegaly. Which organism is most
likely responsible?
A) Streptococcus pyogenes
B) Epstein-Barr virus
C) Cytomegalovirus
D) Toxoplasma gondii
Rationale: This presentation is classic for infectious mononucleosis caused by
Epstein-Barr virus (EBV), characterized by fever, pharyngitis, posterior cervical
lymphadenopathy, and splenomegaly. CMV can cause a similar syndrome but
typically lacks severe pharyngitis. The Monospot test (heterophile antibody) would
be positive in EBV infection .
Question 2
Which cranial nerve is responsible for facial expression?
A) CN V
B) CN VII
,C) CN IX
D) CN X
Rationale: The facial nerve (CN VII) innervates the muscles of facial expression.
It also provides taste to the anterior two-thirds of the tongue via the chorda
tympani. CN V (trigeminal) is responsible for mastication and facial sensation. CN
IX (glossopharyngeal) supplies the stylopharyngeus and taste to posterior tongue.
CN X (vagus) supplies palatal and laryngeal muscles .
Question 3
A patient has right-sided weakness and aphasia. Which cerebral artery is most
likely affected?
A) Posterior cerebral artery
B) Anterior cerebral artery
C) Middle cerebral artery
D) Basilar artery
Rationale: The middle cerebral artery (MCA) supplies the lateral cerebral cortex,
including Broca’s area (dominant hemisphere for expressive language) and the
primary motor cortex for the face and upper extremity. MCA stroke presents with
contralateral weakness (face/arm > leg) and aphasia (if dominant hemisphere) or
neglect (if non-dominant) .
Question 4
Which vitamin deficiency is associated with scurvy?
,A) Vitamin A
B) Vitamin B1
C) Vitamin B12
D) Vitamin C
Rationale: Scurvy is caused by vitamin C (ascorbic acid) deficiency. Vitamin C is
a cofactor for collagen synthesis (prolyl and lysyl hydroxylases). Clinical
manifestations include perifollicular hemorrhages, bleeding gums, poor wound
healing, and “corkscrew” hairs. Vitamin B1 deficiency causes beriberi; B12
deficiency causes subacute combined degeneration; Vitamin A deficiency causes
night blindness .
Question 5
Which vitamin deficiency is most likely in a 60-year-old man with chronic alcohol
use presenting with confusion, ataxia, and ophthalmoplegia?
A) Vitamin B6 (pyridoxine)
B) Vitamin B12 (cobalamin)
C) Vitamin C
D) Vitamin B1 (thiamine)
Rationale: Wernicke encephalopathy presents with the classic triad of confusion,
ataxia, and ophthalmoplegia—caused by thiamine (vitamin B1) deficiency,
commonly seen in chronic alcohol use disorder. Treatment is IV thiamine, which
must be given BEFORE glucose to prevent precipitating or worsening
encephalopathy. Untreated, this can progress to Korsakoff syndrome with memory
loss and confabulation .
, Question 6
What is the primary site of erythropoietin production in adults?
A) Liver
B) Kidney
C) Spleen
D) Bone marrow
Rationale: Erythropoietin (EPO) is mainly produced by interstitial fibroblasts of
the kidney in response to hypoxia, stimulating RBC production in bone marrow.
The liver produces EPO in fetal life but contributes little in adults. Anemia of
chronic kidney disease is due to EPO deficiency and responds to exogenous EPO
(epoetin alfa) .
Question 7
A 45-year-old woman with fatigue has low hemoglobin, low MCV, and low
ferritin. What is the most likely cause?
A) Thalassemia
B) Anemia of chronic disease
C) Iron deficiency anemia
D) Sideroblastic anemia
Rationale: Low ferritin is diagnostic of iron deficiency anemia. Ferritin reflects
body iron stores—low levels indicate depletion. MCV is low (microcytic).
Thalassemia also causes microcytic anemia but ferritin is normal or elevated.
Anemia of chronic disease typically presents with normal or elevated ferritin .
