COMSAE Form 113 Practice Exam
Version 3 Questions And Correct
Answers (Verified Answers) Plus
Rationales 2025 Q&A | Instant
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1. A 24-year-old woman presents with fatigue and pallor. Labs show
hemoglobin 8.2 g/dL, MCV 72 fL, and serum ferritin 10 ng/mL. What is
the most likely cause of her anemia?
A. Vitamin B12 deficiency
B. Hemolytic anemia
C. Iron deficiency anemia
D. Anemia of chronic disease
Iron deficiency anemia is the most common cause of microcytic anemia
and is supported by low ferritin and MCV.
2. A 55-year-old man has substernal chest pain radiating to the left arm,
worsened with exertion. ECG shows ST depressions. What is the most
appropriate next step?
,A. Order a chest X-ray
B. Administer aspirin and start nitrates
C. Obtain echocardiogram
D. Begin thrombolytics immediately
This is likely unstable angina or NSTEMI. Immediate management includes
antiplatelet therapy and nitrates.
3. A patient presents with a sudden thunderclap headache. CT is
negative. What is the next best step?
A. Start IV magnesium sulfate
B. Perform lumbar puncture
C. MRI brain
D. Observe and discharge
If CT is negative in suspected subarachnoid hemorrhage, LP is necessary to
detect xanthochromia.
4. A 6-year-old girl has a sore throat and sandpaper-like rash. What is the
most likely diagnosis?
A. Kawasaki disease
B. Roseola
C. Scarlet fever
D. Measles
Scarlet fever presents with strep pharyngitis and a rough erythematous
rash due to erythrogenic toxins.
, 5. A 22-year-old man with a history of schizophrenia presents with
confusion, muscle rigidity, and fever. Labs show elevated CPK. What is
the most likely cause?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Malignant hyperthermia
D. Acute dystonia
Neuroleptic malignant syndrome is a life-threatening reaction to
antipsychotics characterized by rigidity and hyperthermia.
6. A 70-year-old man presents with urinary urgency, frequency, and
weak stream. DRE reveals an enlarged prostate. What is the initial
treatment?
A. Surgery
B. Catheterization
C. Alpha-adrenergic antagonist
D. 5-alpha-reductase inhibitor
Alpha blockers like tamsulosin relieve urinary symptoms by relaxing
smooth muscle.
7. A 5-year-old boy presents with hemarthrosis after minor trauma. Labs
show elevated PTT, normal PT. What is the most likely diagnosis?
A. Von Willebrand disease
B. Hemophilia A
C. Vitamin K deficiency
D. DIC
, Hemophilia A (factor VIII deficiency) causes prolonged PTT and joint
bleeding.
8. A patient with Crohn's disease presents with fatigue and glossitis. Labs
show MCV 110 fL and hypersegmented neutrophils. What is the
cause?
A. Iron deficiency
B. Anemia of chronic disease
C. Vitamin B12 deficiency
D. Folate deficiency
Crohn’s can involve terminal ileum, impairing B12 absorption, leading to
macrocytic anemia.
9. A newborn presents with continuous machinery-like murmur at the
left infraclavicular area. What is the most likely diagnosis?
A. Tetralogy of Fallot
B. Patent ductus arteriosus
C. Atrial septal defect
D. Ventricular septal defect
PDA causes a continuous murmur due to persistent flow from aorta to
pulmonary artery.
10. A 40-year-old woman has bilateral morning stiffness in the
hands lasting over 1 hour. What is the most likely diagnosis?
Version 3 Questions And Correct
Answers (Verified Answers) Plus
Rationales 2025 Q&A | Instant
Download Pdf
1. A 24-year-old woman presents with fatigue and pallor. Labs show
hemoglobin 8.2 g/dL, MCV 72 fL, and serum ferritin 10 ng/mL. What is
the most likely cause of her anemia?
A. Vitamin B12 deficiency
B. Hemolytic anemia
C. Iron deficiency anemia
D. Anemia of chronic disease
Iron deficiency anemia is the most common cause of microcytic anemia
and is supported by low ferritin and MCV.
2. A 55-year-old man has substernal chest pain radiating to the left arm,
worsened with exertion. ECG shows ST depressions. What is the most
appropriate next step?
,A. Order a chest X-ray
B. Administer aspirin and start nitrates
C. Obtain echocardiogram
D. Begin thrombolytics immediately
This is likely unstable angina or NSTEMI. Immediate management includes
antiplatelet therapy and nitrates.
3. A patient presents with a sudden thunderclap headache. CT is
negative. What is the next best step?
A. Start IV magnesium sulfate
B. Perform lumbar puncture
C. MRI brain
D. Observe and discharge
If CT is negative in suspected subarachnoid hemorrhage, LP is necessary to
detect xanthochromia.
4. A 6-year-old girl has a sore throat and sandpaper-like rash. What is the
most likely diagnosis?
A. Kawasaki disease
B. Roseola
C. Scarlet fever
D. Measles
Scarlet fever presents with strep pharyngitis and a rough erythematous
rash due to erythrogenic toxins.
, 5. A 22-year-old man with a history of schizophrenia presents with
confusion, muscle rigidity, and fever. Labs show elevated CPK. What is
the most likely cause?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Malignant hyperthermia
D. Acute dystonia
Neuroleptic malignant syndrome is a life-threatening reaction to
antipsychotics characterized by rigidity and hyperthermia.
6. A 70-year-old man presents with urinary urgency, frequency, and
weak stream. DRE reveals an enlarged prostate. What is the initial
treatment?
A. Surgery
B. Catheterization
C. Alpha-adrenergic antagonist
D. 5-alpha-reductase inhibitor
Alpha blockers like tamsulosin relieve urinary symptoms by relaxing
smooth muscle.
7. A 5-year-old boy presents with hemarthrosis after minor trauma. Labs
show elevated PTT, normal PT. What is the most likely diagnosis?
A. Von Willebrand disease
B. Hemophilia A
C. Vitamin K deficiency
D. DIC
, Hemophilia A (factor VIII deficiency) causes prolonged PTT and joint
bleeding.
8. A patient with Crohn's disease presents with fatigue and glossitis. Labs
show MCV 110 fL and hypersegmented neutrophils. What is the
cause?
A. Iron deficiency
B. Anemia of chronic disease
C. Vitamin B12 deficiency
D. Folate deficiency
Crohn’s can involve terminal ileum, impairing B12 absorption, leading to
macrocytic anemia.
9. A newborn presents with continuous machinery-like murmur at the
left infraclavicular area. What is the most likely diagnosis?
A. Tetralogy of Fallot
B. Patent ductus arteriosus
C. Atrial septal defect
D. Ventricular septal defect
PDA causes a continuous murmur due to persistent flow from aorta to
pulmonary artery.
10. A 40-year-old woman has bilateral morning stiffness in the
hands lasting over 1 hour. What is the most likely diagnosis?
