COMSAE Phase 2 Form 114 Practice Exam
Questions And Correct Answers (Verified
Answers) Plus Rationales 2025|2026 Q&A |
Instant Download Pdf
Question 1
A 55-year-old man presents with acute, severe tearing chest pain radiating to the
back. BP is 180/100 mm Hg in the right arm and 140/80 mm Hg in the left arm.
What is the most appropriate immediate imaging study?
A) Chest X-ray
B) Transesophageal echocardiography
C) CT angiography of the chest
D) MRI of the chest
Correct ,,,answer,,,: C
Rationale: Acute aortic dissection is the primary concern. CT angiography is
rapid, widely available, and highly sensitive. Transesophageal echo is an
alternative but more operator-dependent.
Question 2
A 28-year-old woman with SLE presents with flank pain, hematuria, and
hypertension. Urinalysis shows RBC casts. What is the most likely renal
pathology?
A) Focal segmental glomerulosclerosis
B) Membranous nephropathy
,C) Diffuse proliferative glomerulonephritis
D) Minimal change disease
Correct ,,,answer,,,: C
Rationale: Active lupus nephritis (class IV – diffuse proliferative) commonly
presents with hematuria, RBC casts, hypertension, and proteinuria.
Question 3
A 35-year-old man has low-grade fever, night sweats, and non-productive cough.
Chest X-ray shows bilateral hilar lymphadenopathy. Elevated serum ACE level.
Most likely diagnosis?
A) Tuberculosis
B) Sarcoidosis
C) Hodgkin lymphoma
D) Coccidioidomycosis
Correct ,,,answer,,,: B
Rationale: Bilateral hilar lymphadenopathy with elevated ACE is classic for
sarcoidosis.
Question 4
A 68-year-old man on hemodialysis has bone pain, Ca 8.0 mg/dL, P 6.5 mg/dL,
PTH 800 pg/mL. Most appropriate treatment for bone disease?
A) Calcium carbonate with meals
B) Oral calcitriol
C) Aluminum hydroxide
D) Sevelamer carbonate
,Correct ,,,answer,,,: B
Rationale: Renal osteodystrophy with secondary hyperparathyroidism is treated
with active vitamin D (calcitriol) to suppress PTH.
Question 5
During a structural exam, a supine patient’s right ASIS is inferior to the left. What
is the most likely somatic dysfunction?
A) Right anterior innominate
B) Right posterior innominate
C) Left anterior innominate
D) Left posterior innominate
Correct ,,,answer,,,: B
Rationale: An inferior ASIS indicates posterior rotation of the ilium on that side.
Right ASIS inferior → right posterior innominate.
Question 6
A 45-year-old woman has fatigue, weight gain, cold intolerance, constipation. TSH
25 µIU/mL, free T4 0.4 ng/dL. Which antibody is most likely positive?
A) Thyroid peroxidase (TPO) antibody
B) Thyroid-stimulating immunoglobulin (TSI)
C) Anti-thyroglobulin antibody
D) TSH receptor blocking antibody
Correct ,,,answer,,,: A
Rationale: Hashimoto thyroiditis is the most common cause of hypothyroidism;
TPO antibodies are present in >90% of cases.
, Question 7
A 55-year-old man with type 2 diabetes is started on a medication that causes
weight loss and increases GLP-1 activity. Which medication?
A) Metformin
B) Sitagliptin
C) Liraglutide
D) Empagliflozin
Correct ,,,answer,,,: C
Rationale: Liraglutide is a GLP-1 receptor agonist that increases insulin secretion,
promotes weight loss, and lowers HbA1c.
Question 8
A 22-year-old man has a seizure. Labs: hypocalcemia, hyperphosphatemia, low
PTH. Most likely underlying diagnosis?
A) Pseudohypoparathyroidism
B) Primary hyperparathyroidism
C) Hypoparathyroidism
D) Vitamin D deficiency
Correct ,,,answer,,,: C
Rationale: Hypoparathyroidism causes low PTH → low calcium, high
phosphorus. Pseudohypoparathyroidism has high PTH with end-organ resistance.
Questions And Correct Answers (Verified
Answers) Plus Rationales 2025|2026 Q&A |
Instant Download Pdf
Question 1
A 55-year-old man presents with acute, severe tearing chest pain radiating to the
back. BP is 180/100 mm Hg in the right arm and 140/80 mm Hg in the left arm.
What is the most appropriate immediate imaging study?
A) Chest X-ray
B) Transesophageal echocardiography
C) CT angiography of the chest
D) MRI of the chest
Correct ,,,answer,,,: C
Rationale: Acute aortic dissection is the primary concern. CT angiography is
rapid, widely available, and highly sensitive. Transesophageal echo is an
alternative but more operator-dependent.
Question 2
A 28-year-old woman with SLE presents with flank pain, hematuria, and
hypertension. Urinalysis shows RBC casts. What is the most likely renal
pathology?
A) Focal segmental glomerulosclerosis
B) Membranous nephropathy
,C) Diffuse proliferative glomerulonephritis
D) Minimal change disease
Correct ,,,answer,,,: C
Rationale: Active lupus nephritis (class IV – diffuse proliferative) commonly
presents with hematuria, RBC casts, hypertension, and proteinuria.
Question 3
A 35-year-old man has low-grade fever, night sweats, and non-productive cough.
Chest X-ray shows bilateral hilar lymphadenopathy. Elevated serum ACE level.
Most likely diagnosis?
A) Tuberculosis
B) Sarcoidosis
C) Hodgkin lymphoma
D) Coccidioidomycosis
Correct ,,,answer,,,: B
Rationale: Bilateral hilar lymphadenopathy with elevated ACE is classic for
sarcoidosis.
Question 4
A 68-year-old man on hemodialysis has bone pain, Ca 8.0 mg/dL, P 6.5 mg/dL,
PTH 800 pg/mL. Most appropriate treatment for bone disease?
A) Calcium carbonate with meals
B) Oral calcitriol
C) Aluminum hydroxide
D) Sevelamer carbonate
,Correct ,,,answer,,,: B
Rationale: Renal osteodystrophy with secondary hyperparathyroidism is treated
with active vitamin D (calcitriol) to suppress PTH.
Question 5
During a structural exam, a supine patient’s right ASIS is inferior to the left. What
is the most likely somatic dysfunction?
A) Right anterior innominate
B) Right posterior innominate
C) Left anterior innominate
D) Left posterior innominate
Correct ,,,answer,,,: B
Rationale: An inferior ASIS indicates posterior rotation of the ilium on that side.
Right ASIS inferior → right posterior innominate.
Question 6
A 45-year-old woman has fatigue, weight gain, cold intolerance, constipation. TSH
25 µIU/mL, free T4 0.4 ng/dL. Which antibody is most likely positive?
A) Thyroid peroxidase (TPO) antibody
B) Thyroid-stimulating immunoglobulin (TSI)
C) Anti-thyroglobulin antibody
D) TSH receptor blocking antibody
Correct ,,,answer,,,: A
Rationale: Hashimoto thyroiditis is the most common cause of hypothyroidism;
TPO antibodies are present in >90% of cases.
, Question 7
A 55-year-old man with type 2 diabetes is started on a medication that causes
weight loss and increases GLP-1 activity. Which medication?
A) Metformin
B) Sitagliptin
C) Liraglutide
D) Empagliflozin
Correct ,,,answer,,,: C
Rationale: Liraglutide is a GLP-1 receptor agonist that increases insulin secretion,
promotes weight loss, and lowers HbA1c.
Question 8
A 22-year-old man has a seizure. Labs: hypocalcemia, hyperphosphatemia, low
PTH. Most likely underlying diagnosis?
A) Pseudohypoparathyroidism
B) Primary hyperparathyroidism
C) Hypoparathyroidism
D) Vitamin D deficiency
Correct ,,,answer,,,: C
Rationale: Hypoparathyroidism causes low PTH → low calcium, high
phosphorus. Pseudohypoparathyroidism has high PTH with end-organ resistance.
