COMSAE Verified Multiple Choice and
Conceptual Actual Emended Exam Questions
With Reviewed 100% Correct Detailed Answers
Guaranteed Pass!!Current Update
Q1. A 28-year-old man presents with sore throat, foul taste, and white patches on
the tongue. Scraping causes bleeding. He has a history of transfusion reaction and
hemophilia. Diagnosis?
A) Viral pharyngitis
B) Oral & esophageal candidiasis
C) Leukoplakia
D) Bacterial pharyngitis
Answer: B
Rationale: White plaques that bleed when scraped = candidiasis.
Q2. A 22-year-old pregnant woman with thin, white, malodorous vaginal
discharge. Clue cells noted. What pregnancy complication is she at highest risk
for?
A) Abruptio placentae
B) Preterm labor
C) Gestational diabetes
D) Gestational hypertension
Answer: B
Rationale: Bacterial vaginosis increases risk of preterm labor.
,Q3. A 19-year-old woman has sharp chest pain while jogging. Exam:
hyperresonant right chest, decreased breath sounds, trachea midline. Diagnosis?
A) PE
B) Spontaneous pneumothorax
C) Pericarditis
D) Asthma attack
Answer: B
Rationale: Sudden pleuritic pain, hyperresonance, midline trachea = spontaneous
PTX.
Q4. An 18-year-old in MVC. BP 86/50, HR 130, distended neck veins, trachea
midline, hyperresonance on left, absent breath sounds. Next step?
A) Intubation
B) Needle decompression
C) IV fluids
D) Thoracotomy
Answer: B
Rationale: Tension PTX → immediate needle decompression.
Q5. A 4-month-old with 2 days of rhinorrhea, cough, mild fever, faint expiratory
wheezes. OMM exam: warm, boggy tissue T1–T4. Most likely diagnosis?
A) Asthma
B) Bronchiolitis
C) Croup
D) Influenza
Answer: B
Rationale: RSV bronchiolitis → infants, wheezing, URI symptoms. Viscerosomatic
reflex T1–T4 (lungs).
,Q6. A 2-year-old with red stools, colicky pain, vomiting, and “target sign” on US.
Diagnosis?
A) Intussusception
B) Volvulus
C) Hirschsprung’s disease
D) Pyloric stenosis
Answer: A
Rationale: Classic intussusception.
Q7. A 48-year-old woman with sudden upper abdominal pain, nausea, distended
abdomen, diffuse tenderness, free air under diaphragm on CXR. Next step?
A) IV fluids
B) CT abdomen
C) Immediate surgical consult
D) Endoscopy
Answer: C
Rationale: Perforated viscus → surgical emergency.
Q8. A 23-year-old collapses playing basketball. Murmur: systolic ejection along
sternal border, louder with Valsalva. Diagnosis?
A) Aortic stenosis
B) HOCM
C) Pulmonic stenosis
D) Mitral regurgitation
Answer: B
Rationale: Valsalva ↑ murmur in HOCM.
Q9. A 67-year-old with angina. Murmur: systolic crescendo-decrescendo radiating
to neck, ↑ with squatting. Associated finding?
, A) Bounding pulses
B) Delayed carotid upstroke
C) Wide pulse pressure
D) Pulsus paradoxus
Answer: B
Rationale: Aortic stenosis → delayed carotid pulse.
Q10. A diastolic blowing murmur, ↑ with handgrip, consistent with:
A) Aortic regurgitation (Austin Flint murmur)
B) Mitral stenosis
C) Pulmonic regurgitation
D) Mitral regurgitation
Answer: A
Rationale: Austin Flint murmur = aortic regurgitation.
Q11. Holosystolic murmur radiating to axilla, ↑ with handgrip. Diagnosis?
A) Mitral regurgitation
B) VSD
C) Aortic stenosis
D) Tricuspid regurgitation
Answer: A
Rationale: Classic MR.
Q12. Rumbling diastolic murmur with opening snap, new atrial fibrillation.
Diagnosis?
A) Mitral stenosis
B) Aortic stenosis
C) Tricuspid regurgitation
D) Mitral regurgitation
Conceptual Actual Emended Exam Questions
With Reviewed 100% Correct Detailed Answers
Guaranteed Pass!!Current Update
Q1. A 28-year-old man presents with sore throat, foul taste, and white patches on
the tongue. Scraping causes bleeding. He has a history of transfusion reaction and
hemophilia. Diagnosis?
A) Viral pharyngitis
B) Oral & esophageal candidiasis
C) Leukoplakia
D) Bacterial pharyngitis
Answer: B
Rationale: White plaques that bleed when scraped = candidiasis.
Q2. A 22-year-old pregnant woman with thin, white, malodorous vaginal
discharge. Clue cells noted. What pregnancy complication is she at highest risk
for?
A) Abruptio placentae
B) Preterm labor
C) Gestational diabetes
D) Gestational hypertension
Answer: B
Rationale: Bacterial vaginosis increases risk of preterm labor.
,Q3. A 19-year-old woman has sharp chest pain while jogging. Exam:
hyperresonant right chest, decreased breath sounds, trachea midline. Diagnosis?
A) PE
B) Spontaneous pneumothorax
C) Pericarditis
D) Asthma attack
Answer: B
Rationale: Sudden pleuritic pain, hyperresonance, midline trachea = spontaneous
PTX.
Q4. An 18-year-old in MVC. BP 86/50, HR 130, distended neck veins, trachea
midline, hyperresonance on left, absent breath sounds. Next step?
A) Intubation
B) Needle decompression
C) IV fluids
D) Thoracotomy
Answer: B
Rationale: Tension PTX → immediate needle decompression.
Q5. A 4-month-old with 2 days of rhinorrhea, cough, mild fever, faint expiratory
wheezes. OMM exam: warm, boggy tissue T1–T4. Most likely diagnosis?
A) Asthma
B) Bronchiolitis
C) Croup
D) Influenza
Answer: B
Rationale: RSV bronchiolitis → infants, wheezing, URI symptoms. Viscerosomatic
reflex T1–T4 (lungs).
,Q6. A 2-year-old with red stools, colicky pain, vomiting, and “target sign” on US.
Diagnosis?
A) Intussusception
B) Volvulus
C) Hirschsprung’s disease
D) Pyloric stenosis
Answer: A
Rationale: Classic intussusception.
Q7. A 48-year-old woman with sudden upper abdominal pain, nausea, distended
abdomen, diffuse tenderness, free air under diaphragm on CXR. Next step?
A) IV fluids
B) CT abdomen
C) Immediate surgical consult
D) Endoscopy
Answer: C
Rationale: Perforated viscus → surgical emergency.
Q8. A 23-year-old collapses playing basketball. Murmur: systolic ejection along
sternal border, louder with Valsalva. Diagnosis?
A) Aortic stenosis
B) HOCM
C) Pulmonic stenosis
D) Mitral regurgitation
Answer: B
Rationale: Valsalva ↑ murmur in HOCM.
Q9. A 67-year-old with angina. Murmur: systolic crescendo-decrescendo radiating
to neck, ↑ with squatting. Associated finding?
, A) Bounding pulses
B) Delayed carotid upstroke
C) Wide pulse pressure
D) Pulsus paradoxus
Answer: B
Rationale: Aortic stenosis → delayed carotid pulse.
Q10. A diastolic blowing murmur, ↑ with handgrip, consistent with:
A) Aortic regurgitation (Austin Flint murmur)
B) Mitral stenosis
C) Pulmonic regurgitation
D) Mitral regurgitation
Answer: A
Rationale: Austin Flint murmur = aortic regurgitation.
Q11. Holosystolic murmur radiating to axilla, ↑ with handgrip. Diagnosis?
A) Mitral regurgitation
B) VSD
C) Aortic stenosis
D) Tricuspid regurgitation
Answer: A
Rationale: Classic MR.
Q12. Rumbling diastolic murmur with opening snap, new atrial fibrillation.
Diagnosis?
A) Mitral stenosis
B) Aortic stenosis
C) Tricuspid regurgitation
D) Mitral regurgitation
