COMSAE Phase 1 Form 114 Test Bank | 200+ Practice
Questions with Bold Italic Answers & Rationales –
NBOME Osteopathic Medical Knowledge Self-
Assessment Prep
⭐⭐⭐⭐⭐ *"I passed my COMSAE Phase 1 Form 114 on the first attempt! The
bold italic answers made it easy to review, and the rationales helped me understand the
concepts, not just memorize answers. This was essential for my COMLEX-USA Level 1
prep."* – Sarah M., OMS-II
EXAM OVERVIEW
The COMSAE (Comprehensive Osteopathic Medical Self-Assessment Examination)
Phase 1 Form 114 is a practice examination designed to assess readiness for the
COMLEX-USA Level 1. This guide provides comprehensive practice questions aligned with
the NBOME blueprint.
Component Details
Exam Name COMSAE Phase 1 Form 114
Format Computer-Based, Multiple Choice
Questions Approximately 200-250 items
Time Limit 4 hours 30 minutes (approximately 4 blocks)
Content Osteopathic Principles & Practice, Anatomy,
Areas Biochemistry, Microbiology, Pathology, Pharmacology,
Physiology, Behavioral Science, Clinical Presentation
Purpose Self-assessment for COMLEX-USA Level 1 readiness
, TABLE OF CONTENTS
Section Topic Questions
1 Osteopathic Principles & Practice (OPP) 1-20
2 Anatomy & Embryology 21-40
3 Biochemistry & Genetics 41-55
4 Microbiology & Immunology 56-75
5 Pathology 76-100
6 Pharmacology 101-120
7 Physiology 121-140
8 Behavioral Science & Ethics 141-155
9 Clinical Presentation & Diagnosis 156-180
10 Clinical Decision-Making & Management 181-200
SECTION 1: OSTEOPATHIC PRINCIPLES & PRACTICE (OPP)
1. A 45-year-old male presents with chronic low back pain. On examination, you find
restricted motion of the L5 vertebral segment on flexion and extension. The patient reports
that the pain worsens with prolonged sitting. Which of the following somatic dysfunctions is
most consistent with these findings?
A) Type I somatic dysfunction
B) Type II somatic dysfunction
C) Fryette's Type I mechanics
D) Neutral mechanics
*Rationale: Fryette's Type II mechanics occur when the spine is in a non-neutral position
(flexion or extension), with dysfunction in a single vertebral segment. Type II dysfunctions
are characterized by a single vertebral segment that is restricted in the opposite direction of
, side bending and rotation. The description of L5 restricted on flexion and extension
suggests a non-neutral dysfunction.*
2. A patient presents with a diagnosis of acute bronchitis. The physician performs lymphatic
pump techniques to enhance immune function. Which of the following best describes the
physiological mechanism of the lymphatic pump?
A) Increases lymphatic flow and enhances immune surveillance
B) Decreases lymphatic flow to reduce inflammation
C) Directly stimulates antibody production
D) Increases sympathetic tone to fight infection
Rationale: The lymphatic pump (thoracic or pedal) increases lymphatic flow through
mechanical compression and release, enhancing lymphatic circulation and immune
surveillance. This technique is used in osteopathic manipulative medicine (OMM) to support
the immune system, particularly in patients with respiratory infections.
3. A patient presents with a diagnosis of tension headache. On examination, you find
restricted motion of the occipitoatlantal (OA) joint. The patient reports pain with rotation and
side bending. Which of the following is the correct diagnosis for this somatic dysfunction?
A) OA flexion dysfunction
B) OA extension dysfunction
C) OA rotation dysfunction
D) OA side bending dysfunction
, *Rationale: The occipitoatlantal joint is a modified condyloid joint that allows for flexion,
extension, and side bending. Rotation at the OA joint is minimal; most rotation occurs at C1-
C2. However, OA dysfunction can present with rotation restriction. The diagnosis is based
on restriction patterns identified during motion testing.*
4. A 30-year-old female presents with right-sided rib pain after a motor vehicle accident. On
examination, you find tenderness over the right 5th rib with restricted motion on inspiration.
The rib is positioned superiorly compared to the left. Which of the following rib dysfunctions
is most likely?
A) Inhalation rib dysfunction
B) Exhalation rib dysfunction
C) Bucket handle dysfunction
D) Pump handle dysfunction
Rationale: Inhalation rib dysfunction occurs when the rib is stuck in an elevated position
(superior) and has restricted motion on exhalation. This is commonly seen after trauma.
Exhalation rib dysfunction presents with the rib depressed (inferior) and restricted on
inhalation.
5. A patient presents with a diagnosis of chronic obstructive pulmonary disease (COPD).
The physician performs thoracic inlet myofascial release to improve respiratory function.
Which of the following anatomical structures is the primary target of this technique?
A) Scalene muscles
B) Pectoralis major
C) Thoracic inlet fascia and surrounding structures
Questions with Bold Italic Answers & Rationales –
NBOME Osteopathic Medical Knowledge Self-
Assessment Prep
⭐⭐⭐⭐⭐ *"I passed my COMSAE Phase 1 Form 114 on the first attempt! The
bold italic answers made it easy to review, and the rationales helped me understand the
concepts, not just memorize answers. This was essential for my COMLEX-USA Level 1
prep."* – Sarah M., OMS-II
EXAM OVERVIEW
The COMSAE (Comprehensive Osteopathic Medical Self-Assessment Examination)
Phase 1 Form 114 is a practice examination designed to assess readiness for the
COMLEX-USA Level 1. This guide provides comprehensive practice questions aligned with
the NBOME blueprint.
Component Details
Exam Name COMSAE Phase 1 Form 114
Format Computer-Based, Multiple Choice
Questions Approximately 200-250 items
Time Limit 4 hours 30 minutes (approximately 4 blocks)
Content Osteopathic Principles & Practice, Anatomy,
Areas Biochemistry, Microbiology, Pathology, Pharmacology,
Physiology, Behavioral Science, Clinical Presentation
Purpose Self-assessment for COMLEX-USA Level 1 readiness
, TABLE OF CONTENTS
Section Topic Questions
1 Osteopathic Principles & Practice (OPP) 1-20
2 Anatomy & Embryology 21-40
3 Biochemistry & Genetics 41-55
4 Microbiology & Immunology 56-75
5 Pathology 76-100
6 Pharmacology 101-120
7 Physiology 121-140
8 Behavioral Science & Ethics 141-155
9 Clinical Presentation & Diagnosis 156-180
10 Clinical Decision-Making & Management 181-200
SECTION 1: OSTEOPATHIC PRINCIPLES & PRACTICE (OPP)
1. A 45-year-old male presents with chronic low back pain. On examination, you find
restricted motion of the L5 vertebral segment on flexion and extension. The patient reports
that the pain worsens with prolonged sitting. Which of the following somatic dysfunctions is
most consistent with these findings?
A) Type I somatic dysfunction
B) Type II somatic dysfunction
C) Fryette's Type I mechanics
D) Neutral mechanics
*Rationale: Fryette's Type II mechanics occur when the spine is in a non-neutral position
(flexion or extension), with dysfunction in a single vertebral segment. Type II dysfunctions
are characterized by a single vertebral segment that is restricted in the opposite direction of
, side bending and rotation. The description of L5 restricted on flexion and extension
suggests a non-neutral dysfunction.*
2. A patient presents with a diagnosis of acute bronchitis. The physician performs lymphatic
pump techniques to enhance immune function. Which of the following best describes the
physiological mechanism of the lymphatic pump?
A) Increases lymphatic flow and enhances immune surveillance
B) Decreases lymphatic flow to reduce inflammation
C) Directly stimulates antibody production
D) Increases sympathetic tone to fight infection
Rationale: The lymphatic pump (thoracic or pedal) increases lymphatic flow through
mechanical compression and release, enhancing lymphatic circulation and immune
surveillance. This technique is used in osteopathic manipulative medicine (OMM) to support
the immune system, particularly in patients with respiratory infections.
3. A patient presents with a diagnosis of tension headache. On examination, you find
restricted motion of the occipitoatlantal (OA) joint. The patient reports pain with rotation and
side bending. Which of the following is the correct diagnosis for this somatic dysfunction?
A) OA flexion dysfunction
B) OA extension dysfunction
C) OA rotation dysfunction
D) OA side bending dysfunction
, *Rationale: The occipitoatlantal joint is a modified condyloid joint that allows for flexion,
extension, and side bending. Rotation at the OA joint is minimal; most rotation occurs at C1-
C2. However, OA dysfunction can present with rotation restriction. The diagnosis is based
on restriction patterns identified during motion testing.*
4. A 30-year-old female presents with right-sided rib pain after a motor vehicle accident. On
examination, you find tenderness over the right 5th rib with restricted motion on inspiration.
The rib is positioned superiorly compared to the left. Which of the following rib dysfunctions
is most likely?
A) Inhalation rib dysfunction
B) Exhalation rib dysfunction
C) Bucket handle dysfunction
D) Pump handle dysfunction
Rationale: Inhalation rib dysfunction occurs when the rib is stuck in an elevated position
(superior) and has restricted motion on exhalation. This is commonly seen after trauma.
Exhalation rib dysfunction presents with the rib depressed (inferior) and restricted on
inhalation.
5. A patient presents with a diagnosis of chronic obstructive pulmonary disease (COPD).
The physician performs thoracic inlet myofascial release to improve respiratory function.
Which of the following anatomical structures is the primary target of this technique?
A) Scalene muscles
B) Pectoralis major
C) Thoracic inlet fascia and surrounding structures
