Page 1 of 78
COMSAE 114 Comprehensive Practice Exam Study Guide | Newest 2026
Edition | Complete Review Questions, Detailed Answer Explanations, High-
Yield Concepts, Board-Style Practice Tests & Exam Preparation Resource |
Instant PDF Download Available
COMSAE 114 Comprehensive Practice Exam Study Guide
1. A 45-year-old female presents with hemoptysis, dyspnea, and rapidly
progressive kidney failure. Urinalysis shows proteinuria and lower extremity
edema is noted. Which of the following is the most likely diagnosis?
A) Wegener's granulomatosis
B) Goodpasture syndrome
C) Microscopic polyangiitis
D) IgA nephropathy
E) Alport syndrome
Rationale: Goodpasture syndrome is characterized by damage to alveolar and
renal glomerular basement membranes by cytotoxic antibodies, presenting with
hemoptysis, dyspnea, rapidly progressive kidney failure, and proteinuria with
lower extremity edema.
2. A 28-year-old pregnant patient at 36 weeks gestation is placed in the supine
position for an ultrasound. She suddenly becomes lightheaded and
hypotensive. What is the underlying mechanism for this presentation?
A) Supine hypotension syndrome
B) Aortocaval compression
C) Vena cava thrombosis
D) Orthostatic hypotension
E) Pulmonary embolism
Rationale: Aortocaval compression occurs when the gravid uterus compresses the
aorta and vena cava in the supine position, reducing venous return and causing
hypotension and lightheadedness in pregnant patients.
,Page 2 of 78
3. A 55-year-old male with essential hypertension and no comorbidities should
be started on which of the following as first-line therapy?
A) ACE inhibitor
B) Beta-blocker
C) Thiazide diuretic
D) Calcium channel blocker
E) Alpha-blocker
Rationale: For essential hypertension without comorbidities, thiazide diuretics are
recommended as first-line therapy based on clinical guidelines for their efficacy
and cardiovascular event reduction benefits.
4. A 32-year-old patient presents with photosensitivity, oral ulcers, arthritis,
and a malar rash. Laboratory studies reveal positive ANA and anti-dsDNA
antibodies. Which condition is most consistent with these findings?
A) Sarcoidosis
B) Systemic lupus erythematosus
C) Rheumatoid arthritis
D) Scleroderma
E) Dermatomyositis
Rationale: The combination of photosensitivity, oral ulcers, arthritis, malar rash,
positive ANA, and anti-dsDNA antibodies is classic for systemic lupus
erythematosus, fitting the SOAP BRAIN MD mnemonic criteria.
5. A 24-year-old woman presents with severe abdominal pain, nausea, and
vomiting at 34 weeks gestation. Laboratory studies reveal elevated LFTs,
direct bilirubin, and she reports bleeding gums. What is the most likely
diagnosis?
A) HELLP syndrome
B) Acute fatty liver of pregnancy
C) Cholestasis of pregnancy
D) Viral hepatitis
E) Preeclampsia
,Page 3 of 78
Rationale: Acute fatty liver of pregnancy presents with microvesicular fatty
infiltration of hepatocytes causing nausea, vomiting, jaundice, bleeding gums,
elevated LFTs, and direct bilirubin in the third trimester.
6. A 6-month-old infant is brought to the clinic for routine vaccination. The
mother requests the rotavirus vaccine. Which of the following is a critical
limitation regarding this vaccine administration?
A) Cannot be given with other live vaccines
B) Must be started before 15 weeks and completed by 8 months
C) Requires a booster at 12 months
D) Contraindicated in breastfed infants
E) Only available as an injectable formulation
Rationale: Rotavirus vaccination has a strict age limitation; it must be started
before 15 weeks of age and completed by 8 months to avoid increased risk of
intussusception if given later.
7. A 68-year-old male presents with altered mental status, severe hypothermia,
bradycardia, hypotension, and nonpitting puffiness. Deep tendon reflexes are
diminished. What is the most likely diagnosis?
A) Addisonian crisis
B) Myxedema coma
C) Thyroid storm
D) Sepsis
E) Hypoglycemia
Rationale: Myxedema coma is severe hypothyroidism presenting with altered
mental status, decreased deep tendon reflexes, severe hypothermia, nonpitting
edema, bradycardia, and hypotension requiring urgent hormone replacement.
8. A 55-year-old male with known iodine-deficient goiter receives iodine
supplementation and subsequently develops thyrotoxicosis. What is this
phenomenon called?
, Page 4 of 78
A) Thyroid storm
B) Graves disease
C) Jod-Basedow phenomenon
D) Hashitoxicosis
E) Toxic multinodular goiter
Rationale: Jod-Basedow phenomenon occurs when iodine replenishment in a
patient with an iodine-deficient goiter triggers thyrotoxicosis due to uncontrolled
thyroid hormone synthesis.
9. A 30-year-old female presents with fever, tachycardia, hyperthermia, and
nervous symptoms. She has a history of Graves disease and recently stopped
her antithyroid medication. What is the most likely diagnosis?
A) Myxedema coma
B) Thyroid storm
C) Panic attack
D) Pheochromocytoma
E) Malignant hyperthermia
Rationale: Thyroid storm is a toxic condition characterized by hyperthermia,
tachycardia, nervous symptoms, and rapid metabolism, typically triggered by
stress or noncompliance with antithyroid medications in Graves disease.
10. A 65-year-old patient presents with progressive behavioral changes,
impaired emotional stability, poor decision-making, and language difficulties.
Neuroimaging shows degeneration of frontal and temporal regions. What is
the most likely diagnosis?
A) Alzheimer disease
B) Vascular dementia
C) Frontotemporal dementia
D) Lewy body dementia
E) Parkinson disease dementia
Rationale: Frontotemporal dementia involves degeneration of frontal and temporal
regions, resulting in badly impaired emotional stability, decision-making, and
language use, distinguishing it from other dementias.
COMSAE 114 Comprehensive Practice Exam Study Guide | Newest 2026
Edition | Complete Review Questions, Detailed Answer Explanations, High-
Yield Concepts, Board-Style Practice Tests & Exam Preparation Resource |
Instant PDF Download Available
COMSAE 114 Comprehensive Practice Exam Study Guide
1. A 45-year-old female presents with hemoptysis, dyspnea, and rapidly
progressive kidney failure. Urinalysis shows proteinuria and lower extremity
edema is noted. Which of the following is the most likely diagnosis?
A) Wegener's granulomatosis
B) Goodpasture syndrome
C) Microscopic polyangiitis
D) IgA nephropathy
E) Alport syndrome
Rationale: Goodpasture syndrome is characterized by damage to alveolar and
renal glomerular basement membranes by cytotoxic antibodies, presenting with
hemoptysis, dyspnea, rapidly progressive kidney failure, and proteinuria with
lower extremity edema.
2. A 28-year-old pregnant patient at 36 weeks gestation is placed in the supine
position for an ultrasound. She suddenly becomes lightheaded and
hypotensive. What is the underlying mechanism for this presentation?
A) Supine hypotension syndrome
B) Aortocaval compression
C) Vena cava thrombosis
D) Orthostatic hypotension
E) Pulmonary embolism
Rationale: Aortocaval compression occurs when the gravid uterus compresses the
aorta and vena cava in the supine position, reducing venous return and causing
hypotension and lightheadedness in pregnant patients.
,Page 2 of 78
3. A 55-year-old male with essential hypertension and no comorbidities should
be started on which of the following as first-line therapy?
A) ACE inhibitor
B) Beta-blocker
C) Thiazide diuretic
D) Calcium channel blocker
E) Alpha-blocker
Rationale: For essential hypertension without comorbidities, thiazide diuretics are
recommended as first-line therapy based on clinical guidelines for their efficacy
and cardiovascular event reduction benefits.
4. A 32-year-old patient presents with photosensitivity, oral ulcers, arthritis,
and a malar rash. Laboratory studies reveal positive ANA and anti-dsDNA
antibodies. Which condition is most consistent with these findings?
A) Sarcoidosis
B) Systemic lupus erythematosus
C) Rheumatoid arthritis
D) Scleroderma
E) Dermatomyositis
Rationale: The combination of photosensitivity, oral ulcers, arthritis, malar rash,
positive ANA, and anti-dsDNA antibodies is classic for systemic lupus
erythematosus, fitting the SOAP BRAIN MD mnemonic criteria.
5. A 24-year-old woman presents with severe abdominal pain, nausea, and
vomiting at 34 weeks gestation. Laboratory studies reveal elevated LFTs,
direct bilirubin, and she reports bleeding gums. What is the most likely
diagnosis?
A) HELLP syndrome
B) Acute fatty liver of pregnancy
C) Cholestasis of pregnancy
D) Viral hepatitis
E) Preeclampsia
,Page 3 of 78
Rationale: Acute fatty liver of pregnancy presents with microvesicular fatty
infiltration of hepatocytes causing nausea, vomiting, jaundice, bleeding gums,
elevated LFTs, and direct bilirubin in the third trimester.
6. A 6-month-old infant is brought to the clinic for routine vaccination. The
mother requests the rotavirus vaccine. Which of the following is a critical
limitation regarding this vaccine administration?
A) Cannot be given with other live vaccines
B) Must be started before 15 weeks and completed by 8 months
C) Requires a booster at 12 months
D) Contraindicated in breastfed infants
E) Only available as an injectable formulation
Rationale: Rotavirus vaccination has a strict age limitation; it must be started
before 15 weeks of age and completed by 8 months to avoid increased risk of
intussusception if given later.
7. A 68-year-old male presents with altered mental status, severe hypothermia,
bradycardia, hypotension, and nonpitting puffiness. Deep tendon reflexes are
diminished. What is the most likely diagnosis?
A) Addisonian crisis
B) Myxedema coma
C) Thyroid storm
D) Sepsis
E) Hypoglycemia
Rationale: Myxedema coma is severe hypothyroidism presenting with altered
mental status, decreased deep tendon reflexes, severe hypothermia, nonpitting
edema, bradycardia, and hypotension requiring urgent hormone replacement.
8. A 55-year-old male with known iodine-deficient goiter receives iodine
supplementation and subsequently develops thyrotoxicosis. What is this
phenomenon called?
, Page 4 of 78
A) Thyroid storm
B) Graves disease
C) Jod-Basedow phenomenon
D) Hashitoxicosis
E) Toxic multinodular goiter
Rationale: Jod-Basedow phenomenon occurs when iodine replenishment in a
patient with an iodine-deficient goiter triggers thyrotoxicosis due to uncontrolled
thyroid hormone synthesis.
9. A 30-year-old female presents with fever, tachycardia, hyperthermia, and
nervous symptoms. She has a history of Graves disease and recently stopped
her antithyroid medication. What is the most likely diagnosis?
A) Myxedema coma
B) Thyroid storm
C) Panic attack
D) Pheochromocytoma
E) Malignant hyperthermia
Rationale: Thyroid storm is a toxic condition characterized by hyperthermia,
tachycardia, nervous symptoms, and rapid metabolism, typically triggered by
stress or noncompliance with antithyroid medications in Graves disease.
10. A 65-year-old patient presents with progressive behavioral changes,
impaired emotional stability, poor decision-making, and language difficulties.
Neuroimaging shows degeneration of frontal and temporal regions. What is
the most likely diagnosis?
A) Alzheimer disease
B) Vascular dementia
C) Frontotemporal dementia
D) Lewy body dementia
E) Parkinson disease dementia
Rationale: Frontotemporal dementia involves degeneration of frontal and temporal
regions, resulting in badly impaired emotional stability, decision-making, and
language use, distinguishing it from other dementias.
