COMSAE Phase 2 Practice Exam | 100 Questions and answers with rationales 2026 update

COMSAE Phase 2 Practice Exam d d d d




(Form C118
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Style) Questions And Correct Answers (
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Verified Answers) Plus Rationales |202 d d d d




6 Q&A | Instant Download Pdf
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1. A 28-year-old woman presents with fatigue and cold intolerance. TSH is
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9.0 µU/mL, free T4 is low. What is the most likely diagnosis?
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A. Subacute thyroiditis d




B. Hashimoto thyroiditis d




C. Central hypothyroidism
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D. Graves disease
d




Rationale: Hashimoto thyroiditis is the most common cause of hypothyroidis
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m in iodine-sufficient areas, with elevated TSH and low T4._
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,2. A 65-year-
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old man with COPD presents with dyspnea. ABG shows pH 7.35, pCO₂ 55, HCO
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₃⁻ 30. Diagnosis?
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A. Compensated respiratory acidosis d d




B. Acute respiratory acidosis
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C. Metabolic alkalosis d




D. Mixed acid-base disorder d d




Rationale: Chronic CO₂ retention with compensatory bicarbonate elevation ind
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icates compensated respiratory acidosis._
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3. A 7-year-
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old boy develops a sore throat, fever, and sandpaper rash. Diagnosis?
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A. Scarlet fever d




B. Kawasaki disease d




C. Rubella
D. Fifth disease d




Rationale: Scarlet fever results from group A Streptococcus infection with er
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ythrogenic toxin._ d




4. A 45-year-
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old man with hypertension develops swelling after starting lisinopril. Cau
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se?
A. Allergic urticaria d




B. Bradykinin-mediated angioedema d




C. Histamine reaction d

,D. IgE-mediated anaphylaxis d




Rationale: ACE inhibitors increase bradykinin levels, leading to non-
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pitting angioedema._
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5. A 24-year-
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old woman has right lower quadrant pain, positive hCG, and empty uterus
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on ultrasound. Diagnosis?
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A. Ectopic pregnancy d




B. Appendicitis
C. Ovarian torsion d




D. Corpus luteum cyst d d




Rationale: Positive pregnancy test with no intrauterine gestation is diag
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nostic for ectopic pregnancy._
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6. A 12-year-
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old girl presents with polyuria and polydipsia. Labs: glucose 350 mg/dL, low C-
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peptide. Diagnosis? d




A. Type 1 diabetes mellitus
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B. Type 2 diabetes mellitus
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C. MODY
D. Insulinoma
Rationale: Low C- d d




peptide indicates absent endogenous insulin production typical of Type 1 DM._
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, 7. A 66-year-
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old man develops confusion after starting furosemide. Sodium 122 mEq/L. D
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iagnosis?
A. Hypovolemic hyponatremia d




B. SIADH
C. Hypervolemic hyponatremia d




D. Pseudohyponatremia
Rationale: Loop diuretics cause sodium and water loss, leading to hypov
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olemic hyponatremia._
d




8. A 56-year-old smoker has a painless hematuria. Next best step?
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A. Cystoscopy
B. Urine culture d




C. Renal ultrasound d




D. PSA test d




Rationale: Painless hematuria in a smoker requires cystoscopy to evaluate for
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d bladder cancer._ d




9. A 22-year-
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old woman develops fever and flank pain 3 days after cystitis. Next step?
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A. Repeat urinalysis d




B. Pelvic ultrasound d




C. IV antibiotics
d




D. Oral nitrofurantoin
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