Comsae Verified Multiple Choice and
Conceptual Actual Emended Exam Questions
With Reviewed 100% Correct Detailed Answers
Guaranteed Pass!!Current Update
Q1. A 23-year-old male collapses while playing basketball. On exam: a systolic
ejection murmur along the left sternal border that increases with Valsalva. Most
likely diagnosis?
A) Aortic stenosis
B) Hypertrophic obstructive cardiomyopathy (HOCM)
C) Mitral regurgitation
D) Pulmonic stenosis
Answer: B
Rationale: Murmur louder with Valsalva = HOCM, common cause of sudden death
in young athletes.
Q2. A 67-year-old man presents with exertional dyspnea and chest pain. Exam:
systolic crescendo-decrescendo murmur radiating to the neck, increasing with
squatting. Which finding is expected?
A) Wide pulse pressure
B) Delayed carotid upstroke
C) Bounding pulses
D) Pulsus paradoxus
Answer: B
Rationale: Aortic stenosis = delayed and diminished carotid upstroke.
Q3. A diastolic decrescendo blowing murmur, increasing with handgrip, is heard in
a 55-year-old man. Diagnosis?
,A) Austin Flint murmur due to aortic insufficiency
B) Mitral regurgitation
C) Mitral stenosis
D) Pulmonic regurgitation
Answer: A
Rationale: Austin Flint murmur = aortic regurgitation → low-pitch diastolic
murmur.
Q4. A holosystolic murmur radiating to the axilla, increasing with handgrip, most
likely represents:
A) Mitral regurgitation
B) Aortic stenosis
C) Tricuspid stenosis
D) VSD
Answer: A
Rationale: MR classic presentation.
Q5. A 42-year-old immigrant woman presents with progressive dyspnea and new
atrial fibrillation. Exam: opening snap followed by rumbling diastolic murmur.
Most likely diagnosis?
A) Aortic stenosis
B) Mitral regurgitation
C) Mitral stenosis
D) Tricuspid regurgitation
Answer: C
Rationale: Rheumatic fever complication → mitral stenosis → CHF and AF risk.
Q6. A 74-year-old man with a history of smoking has a pulsatile abdominal mass.
Indication for surgical repair of his abdominal aortic aneurysm (AAA) includes:
,A) Diameter > 5.5 cm
B) Asymptomatic 3.5 cm aneurysm
C) Stable 4.2 cm aneurysm
D) No family history
Answer: A
Rationale: >5.5 cm, rapidly expanding, or symptomatic = surgical indication.
Q7. A 2-year-old presents with red stools, colicky abdominal pain, bilious
vomiting, and a palpable sausage-shaped mass. Ultrasound shows a “target sign.”
Most likely diagnosis?
A) Volvulus
B) Intussusception
C) Hirschsprung’s disease
D) Pyloric stenosis
Answer: B
Rationale: Intussusception classic triad = colicky pain, red stools, sausage-shaped
mass.
Q8. A 52-year-old woman presents with fatigue, weight gain, and constipation.
Labs: positive anti-TPO antibodies. Diagnosis?
A) Hashimoto’s thyroiditis
B) Graves disease
C) Subacute thyroiditis
D) Thyroid carcinoma
Answer: A
Rationale: Hashimoto’s → autoimmune → anti-thyroid peroxidase antibodies.
Q9. A post-thyroidectomy patient develops peri-oral tingling, carpopedal spasm,
and tetany. Labs show ↓Ca²⁺ and ↑PO₄³⁻. Diagnosis?
, A) Hypoparathyroidism
B) Hyperparathyroidism
C) Conn syndrome
D) Pheochromocytoma
Answer: A
Rationale: Accidental removal/damage of parathyroid → hypocalcemia.
Q10. A 60-year-old man has high calcium, low phosphate, and elevated PTH. Most
likely diagnosis?
A) Primary hyperparathyroidism
B) Hypoparathyroidism
C) Hypervitaminosis D
D) Hypercalcemia of malignancy
Answer: A
Rationale: High Ca²⁺, low PO₄³⁻, high PTH = primary hyperparathyroidism.
Q11. A 68-year-old smoker presents with weakness and fractures. Labs: high
calcium, high phosphate, low PTH. Most likely cause?
A) Hypervitaminosis D
B) Hypercalcemia of malignancy from squamous cell carcinoma (PTHrP)
C) Primary hyperparathyroidism
D) Paget’s disease
Answer: B
Rationale: PTHrP secretion mimics PTH → malignancy-related hypercalcemia.
Q12. A patient with sarcoidosis develops hypercalcemia. Which lab helps confirm
the cause?
A) Serum creatinine
B) 1,25-Vitamin D
Conceptual Actual Emended Exam Questions
With Reviewed 100% Correct Detailed Answers
Guaranteed Pass!!Current Update
Q1. A 23-year-old male collapses while playing basketball. On exam: a systolic
ejection murmur along the left sternal border that increases with Valsalva. Most
likely diagnosis?
A) Aortic stenosis
B) Hypertrophic obstructive cardiomyopathy (HOCM)
C) Mitral regurgitation
D) Pulmonic stenosis
Answer: B
Rationale: Murmur louder with Valsalva = HOCM, common cause of sudden death
in young athletes.
Q2. A 67-year-old man presents with exertional dyspnea and chest pain. Exam:
systolic crescendo-decrescendo murmur radiating to the neck, increasing with
squatting. Which finding is expected?
A) Wide pulse pressure
B) Delayed carotid upstroke
C) Bounding pulses
D) Pulsus paradoxus
Answer: B
Rationale: Aortic stenosis = delayed and diminished carotid upstroke.
Q3. A diastolic decrescendo blowing murmur, increasing with handgrip, is heard in
a 55-year-old man. Diagnosis?
,A) Austin Flint murmur due to aortic insufficiency
B) Mitral regurgitation
C) Mitral stenosis
D) Pulmonic regurgitation
Answer: A
Rationale: Austin Flint murmur = aortic regurgitation → low-pitch diastolic
murmur.
Q4. A holosystolic murmur radiating to the axilla, increasing with handgrip, most
likely represents:
A) Mitral regurgitation
B) Aortic stenosis
C) Tricuspid stenosis
D) VSD
Answer: A
Rationale: MR classic presentation.
Q5. A 42-year-old immigrant woman presents with progressive dyspnea and new
atrial fibrillation. Exam: opening snap followed by rumbling diastolic murmur.
Most likely diagnosis?
A) Aortic stenosis
B) Mitral regurgitation
C) Mitral stenosis
D) Tricuspid regurgitation
Answer: C
Rationale: Rheumatic fever complication → mitral stenosis → CHF and AF risk.
Q6. A 74-year-old man with a history of smoking has a pulsatile abdominal mass.
Indication for surgical repair of his abdominal aortic aneurysm (AAA) includes:
,A) Diameter > 5.5 cm
B) Asymptomatic 3.5 cm aneurysm
C) Stable 4.2 cm aneurysm
D) No family history
Answer: A
Rationale: >5.5 cm, rapidly expanding, or symptomatic = surgical indication.
Q7. A 2-year-old presents with red stools, colicky abdominal pain, bilious
vomiting, and a palpable sausage-shaped mass. Ultrasound shows a “target sign.”
Most likely diagnosis?
A) Volvulus
B) Intussusception
C) Hirschsprung’s disease
D) Pyloric stenosis
Answer: B
Rationale: Intussusception classic triad = colicky pain, red stools, sausage-shaped
mass.
Q8. A 52-year-old woman presents with fatigue, weight gain, and constipation.
Labs: positive anti-TPO antibodies. Diagnosis?
A) Hashimoto’s thyroiditis
B) Graves disease
C) Subacute thyroiditis
D) Thyroid carcinoma
Answer: A
Rationale: Hashimoto’s → autoimmune → anti-thyroid peroxidase antibodies.
Q9. A post-thyroidectomy patient develops peri-oral tingling, carpopedal spasm,
and tetany. Labs show ↓Ca²⁺ and ↑PO₄³⁻. Diagnosis?
, A) Hypoparathyroidism
B) Hyperparathyroidism
C) Conn syndrome
D) Pheochromocytoma
Answer: A
Rationale: Accidental removal/damage of parathyroid → hypocalcemia.
Q10. A 60-year-old man has high calcium, low phosphate, and elevated PTH. Most
likely diagnosis?
A) Primary hyperparathyroidism
B) Hypoparathyroidism
C) Hypervitaminosis D
D) Hypercalcemia of malignancy
Answer: A
Rationale: High Ca²⁺, low PO₄³⁻, high PTH = primary hyperparathyroidism.
Q11. A 68-year-old smoker presents with weakness and fractures. Labs: high
calcium, high phosphate, low PTH. Most likely cause?
A) Hypervitaminosis D
B) Hypercalcemia of malignancy from squamous cell carcinoma (PTHrP)
C) Primary hyperparathyroidism
D) Paget’s disease
Answer: B
Rationale: PTHrP secretion mimics PTH → malignancy-related hypercalcemia.
Q12. A patient with sarcoidosis develops hypercalcemia. Which lab helps confirm
the cause?
A) Serum creatinine
B) 1,25-Vitamin D
