COMSAE Phase 1 Form 115 Practice Exam Complete Study Guide – 200+
Practice Questions with Answers in Bold Italic & Detailed Rationales
Osteopathic Medical Comprehensive Assessment – NBOME Osteopathic
Medical Knowledge Self-Assessment
⭐⭐⭐⭐⭐ "This study guide perfectly mirrors the COMSAE format. The OPP
section was especially helpful for understanding Fryette's mechanics and somatic dysfunctions.
Highly recommend for any DO student.
EXAM OVERVIEW
The COMSAE (Comprehensive Osteopathic Medical Self-Assessment Examination)
Phase 1 Form 115 is a practice examination designed to assess readiness for COMLEX-
USA Level 1. Form 115 is the most current version featuring updated question formats and
clinical presentations.
Component Details
Exam Name COMSAE Phase 1 Form 115
Format Computer-Based, Multiple Choice, NGN-Style Clinical
Presentations
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) 1-25
2 Anatomy & Embryology 26-45
3 Biochemistry & Genetics 46-60
4 Microbiology & Immunology 61-80
5 Pathology 81-105
6 Pharmacology 106-125
7 Physiology 126-140
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. According to Fryette's principles, which of the following correctly describes Type I
mechanics?
A) Neutral position, multiple vertebral segments, side bending and rotation occur in
opposite directions
B) Neutral position, single vertebral segment, side bending and rotation occur in the same
direction
C) Non-neutral position, multiple vertebral segments, side bending and rotation occur in
opposite directions
D) Non-neutral position, single vertebral segment, side bending and rotation occur in the
same direction
, Rationale: Fryette's Type I mechanics occur when the spine is in a neutral position (neither
flexed nor extended). In Type I, multiple vertebral segments are involved, and side bending
and rotation occur in opposite directions. Type II mechanics occur in non-neutral positions
and involve a single segment with side bending and rotation in the same direction.
2. A patient presents with a somatic dysfunction involving multiple vertebral segments in the
lumbar spine. The spine is in a neutral position. Which of the following best describes the
expected motion restriction pattern?
A) Side bending and rotation are restricted in opposite directions
B) Side bending and rotation are restricted in the same direction
C) Only side bending is restricted
D) Only rotation is restricted
Rationale: In Fryette's Type I mechanics (neutral position, multiple segments), side bending
and rotation occur in opposite directions. For example, if the spine is restricted in right side
bending, it will be restricted in left rotation. This is a key diagnostic feature of Type I
dysfunction.
3. According to Fryette's principles, Type II mechanics are characterized by which of the
following?
A) Neutral position, multiple segments, opposite directions
B) Neutral position, single segment, same direction
C) Non-neutral position, single segment, same direction
D) Non-neutral position, multiple segments, opposite directions
Rationale: Fryette's Type II mechanics occur in non-neutral positions (flexion or
extension). They involve a single vertebral segment, and side bending and rotation
occur in the same direction. Type II dysfunctions are typically treated with specific
direct techniques.
, 4. A patient with acute low back pain is found to have a single vertebral segment
dysfunction at L4. The segment is restricted in flexion and extension. This pattern is
characteristic of which Fryette type?
A) Type I
B) Type II
C) Type III
D) Neutral mechanics
Rationale: A single segment dysfunction with restriction in non-neutral positions
(flexion/extension) is characteristic of Fryette's Type II mechanics. Type I involves multiple
segments and neutral position. Type III is a variation of Type II.
5. Which of the following correctly describes the relationship between side bending and
rotation in a Type I somatic dysfunction?
A) They occur in opposite directions
B) They occur in the same direction
C) Side bending occurs without rotation
D) Rotation occurs without side bending
Rationale: In Fryette's Type I mechanics (neutral position, multiple segments), side bending
and rotation occur in opposite directions. This is a fundamental principle of spinal
biomechanics that guides diagnosis and treatment of somatic dysfunction.
6. Which of the following correctly describes the relationship between side bending and
rotation in a Type II somatic dysfunction?
A) They occur in opposite directions
B) They occur in the same direction
C) Side bending occurs without rotation
D) Rotation occurs without side bending
Practice Questions with Answers in Bold Italic & Detailed Rationales
Osteopathic Medical Comprehensive Assessment – NBOME Osteopathic
Medical Knowledge Self-Assessment
⭐⭐⭐⭐⭐ "This study guide perfectly mirrors the COMSAE format. The OPP
section was especially helpful for understanding Fryette's mechanics and somatic dysfunctions.
Highly recommend for any DO student.
EXAM OVERVIEW
The COMSAE (Comprehensive Osteopathic Medical Self-Assessment Examination)
Phase 1 Form 115 is a practice examination designed to assess readiness for COMLEX-
USA Level 1. Form 115 is the most current version featuring updated question formats and
clinical presentations.
Component Details
Exam Name COMSAE Phase 1 Form 115
Format Computer-Based, Multiple Choice, NGN-Style Clinical
Presentations
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) 1-25
2 Anatomy & Embryology 26-45
3 Biochemistry & Genetics 46-60
4 Microbiology & Immunology 61-80
5 Pathology 81-105
6 Pharmacology 106-125
7 Physiology 126-140
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. According to Fryette's principles, which of the following correctly describes Type I
mechanics?
A) Neutral position, multiple vertebral segments, side bending and rotation occur in
opposite directions
B) Neutral position, single vertebral segment, side bending and rotation occur in the same
direction
C) Non-neutral position, multiple vertebral segments, side bending and rotation occur in
opposite directions
D) Non-neutral position, single vertebral segment, side bending and rotation occur in the
same direction
, Rationale: Fryette's Type I mechanics occur when the spine is in a neutral position (neither
flexed nor extended). In Type I, multiple vertebral segments are involved, and side bending
and rotation occur in opposite directions. Type II mechanics occur in non-neutral positions
and involve a single segment with side bending and rotation in the same direction.
2. A patient presents with a somatic dysfunction involving multiple vertebral segments in the
lumbar spine. The spine is in a neutral position. Which of the following best describes the
expected motion restriction pattern?
A) Side bending and rotation are restricted in opposite directions
B) Side bending and rotation are restricted in the same direction
C) Only side bending is restricted
D) Only rotation is restricted
Rationale: In Fryette's Type I mechanics (neutral position, multiple segments), side bending
and rotation occur in opposite directions. For example, if the spine is restricted in right side
bending, it will be restricted in left rotation. This is a key diagnostic feature of Type I
dysfunction.
3. According to Fryette's principles, Type II mechanics are characterized by which of the
following?
A) Neutral position, multiple segments, opposite directions
B) Neutral position, single segment, same direction
C) Non-neutral position, single segment, same direction
D) Non-neutral position, multiple segments, opposite directions
Rationale: Fryette's Type II mechanics occur in non-neutral positions (flexion or
extension). They involve a single vertebral segment, and side bending and rotation
occur in the same direction. Type II dysfunctions are typically treated with specific
direct techniques.
, 4. A patient with acute low back pain is found to have a single vertebral segment
dysfunction at L4. The segment is restricted in flexion and extension. This pattern is
characteristic of which Fryette type?
A) Type I
B) Type II
C) Type III
D) Neutral mechanics
Rationale: A single segment dysfunction with restriction in non-neutral positions
(flexion/extension) is characteristic of Fryette's Type II mechanics. Type I involves multiple
segments and neutral position. Type III is a variation of Type II.
5. Which of the following correctly describes the relationship between side bending and
rotation in a Type I somatic dysfunction?
A) They occur in opposite directions
B) They occur in the same direction
C) Side bending occurs without rotation
D) Rotation occurs without side bending
Rationale: In Fryette's Type I mechanics (neutral position, multiple segments), side bending
and rotation occur in opposite directions. This is a fundamental principle of spinal
biomechanics that guides diagnosis and treatment of somatic dysfunction.
6. Which of the following correctly describes the relationship between side bending and
rotation in a Type II somatic dysfunction?
A) They occur in opposite directions
B) They occur in the same direction
C) Side bending occurs without rotation
D) Rotation occurs without side bending
