COMSAE PHASE 1 (ASA 101i) LEVEL 1 EXAM LATEST 2026/2027 &
HIGH YIELD PRACTICE QUESTIONS ACCURATE TEST APPROVED
QUESTIONS AND CORRECT DETAILED ANSWERS (100% CORRECT
VERIFIED SOLUTIONS) NEWEST UPDATED VERSION 2026 EDITION
|GUARANTEED PASS A+ |ACTUAL COMSAE PHASE (ASA 101i) LEVEL
1 EXAM |JUST RELEASED
1. A 45-year-old male with hypertension presents with acute onset of severe,
tearing chest pain radiating to the back. Blood pressure is 160/90 in the right arm
and 100/70 in the left arm. Which is the most appropriate initial imaging study?
A. Transesophageal echocardiography
B. Chest X-ray
C. CT angiography of the chest
D. MRI of the chest
CORRECT ANSWER: C. CT angiography of the chest
2. A 23-year-old female with dysmenorrhea has had three episodes of pelvic pain
and fever over the past year. Pelvic exam shows cervical motion tenderness and
bilateral adnexal tenderness. Which is the most common causative organism?
A. Escherichia coli
B. Chlamydia trachomatis
C. Bacteroides fragilis
D. Candida albicans
CORRECT ANSWER: B. Chlamydia trachomatis
3. A 68-year-old man with COPD presents with increasing dyspnea and peripheral
edema. Jugular venous pressure is elevated. Which physical exam finding is most
specific for right ventricular failure?
A. Hepatojugular reflux
,B. Pulsus paradoxus
C. Apical impulse displaced laterally
D. Systolic ejection murmur at left sternal border
CORRECT ANSWER: A. Hepatojugular reflux
4. During osteopathic structural exam, a patient has a restricted right sidebending
and rotation of the cervical spine. Which Fryette principle applies to this somatic
dysfunction?
A. Type I dysfunction
B. Type II dysfunction
C. Type III dysfunction
D. Neutral mechanics only
CORRECT ANSWER: B. Type II dysfunction
5. A 55-year-old woman presents with fatigue, weight gain, and cold intolerance.
Labs: TSH 15 µIU/mL (0.4–4.0), free T4 0.5 ng/dL (0.8–1.8). Which is the most
likely diagnosis?
A. Subclinical hypothyroidism
B. Primary hypothyroidism
C. Central hypothyroidism
D. Euthyroid sick syndrome
CORRECT ANSWER: B. Primary hypothyroidism
6. A 30-year-old male has a 3 cm non-tender, mobile mass in the right neck just
below the angle of the mandible. It transilluminates. Which is the most likely
diagnosis?
A. Branchial cleft cyst
,B. Thyroglossal duct cyst
C. Lymphoma
D. Sebaceous cyst
CORRECT ANSWER: A. Branchial cleft cyst
7. A patient with heart failure is on furosemide and develops muscle cramps and
weakness. ECG shows a U wave. Which electrolyte abnormality is most likely?
A. Hypernatremia
B. Hyperkalemia
C. Hypokalemia
D. Hypocalcemia
CORRECT ANSWER: C. Hypokalemia
8. Which rib is most commonly fractured in adults after blunt chest trauma?
A. 1st rib
B. 4th rib
C. 7th rib
D. 10th rib
CORRECT ANSWER: B. 4th rib
9. A 72-year-old with Parkinson’s disease develops progressive dysphagia and
drooling. Which cranial nerve is most directly affected in the bulbar phase?
A. CN V
B. CN VII
C. CN IX and X
D. CN XII
, CORRECT ANSWER: C. CN IX and X
10. A 25-year-old college student reports sudden chest pain and dyspnea after
smoking marijuana. Lung exam shows hyperresonance on the left. Which is the
best initial imaging?
A. Chest X-ray
B. High-resolution CT
C. Ventilation-perfusion scan
D. Ultrasound of the chest
CORRECT ANSWER: A. Chest X-ray
11. A 60-year-old with diabetes presents with painless hematuria. Which risk
factor is most strongly associated with transitional cell carcinoma?
A. Smoking
B. Cyclophosphamide use
C. Schistosoma haematobium infection
D. Chronic catheter use
CORRECT ANSWER: A. Smoking
12. In osteopathic manipulative treatment, which technique is most appropriate for
a patient with an acute, restrictive, painful somatic dysfunction?
A. High-velocity low-amplitude (HVLA)
B. Muscle energy (ME)
C. Counterstrain
D. Myofascial release
CORRECT ANSWER: C. Counterstrain
HIGH YIELD PRACTICE QUESTIONS ACCURATE TEST APPROVED
QUESTIONS AND CORRECT DETAILED ANSWERS (100% CORRECT
VERIFIED SOLUTIONS) NEWEST UPDATED VERSION 2026 EDITION
|GUARANTEED PASS A+ |ACTUAL COMSAE PHASE (ASA 101i) LEVEL
1 EXAM |JUST RELEASED
1. A 45-year-old male with hypertension presents with acute onset of severe,
tearing chest pain radiating to the back. Blood pressure is 160/90 in the right arm
and 100/70 in the left arm. Which is the most appropriate initial imaging study?
A. Transesophageal echocardiography
B. Chest X-ray
C. CT angiography of the chest
D. MRI of the chest
CORRECT ANSWER: C. CT angiography of the chest
2. A 23-year-old female with dysmenorrhea has had three episodes of pelvic pain
and fever over the past year. Pelvic exam shows cervical motion tenderness and
bilateral adnexal tenderness. Which is the most common causative organism?
A. Escherichia coli
B. Chlamydia trachomatis
C. Bacteroides fragilis
D. Candida albicans
CORRECT ANSWER: B. Chlamydia trachomatis
3. A 68-year-old man with COPD presents with increasing dyspnea and peripheral
edema. Jugular venous pressure is elevated. Which physical exam finding is most
specific for right ventricular failure?
A. Hepatojugular reflux
,B. Pulsus paradoxus
C. Apical impulse displaced laterally
D. Systolic ejection murmur at left sternal border
CORRECT ANSWER: A. Hepatojugular reflux
4. During osteopathic structural exam, a patient has a restricted right sidebending
and rotation of the cervical spine. Which Fryette principle applies to this somatic
dysfunction?
A. Type I dysfunction
B. Type II dysfunction
C. Type III dysfunction
D. Neutral mechanics only
CORRECT ANSWER: B. Type II dysfunction
5. A 55-year-old woman presents with fatigue, weight gain, and cold intolerance.
Labs: TSH 15 µIU/mL (0.4–4.0), free T4 0.5 ng/dL (0.8–1.8). Which is the most
likely diagnosis?
A. Subclinical hypothyroidism
B. Primary hypothyroidism
C. Central hypothyroidism
D. Euthyroid sick syndrome
CORRECT ANSWER: B. Primary hypothyroidism
6. A 30-year-old male has a 3 cm non-tender, mobile mass in the right neck just
below the angle of the mandible. It transilluminates. Which is the most likely
diagnosis?
A. Branchial cleft cyst
,B. Thyroglossal duct cyst
C. Lymphoma
D. Sebaceous cyst
CORRECT ANSWER: A. Branchial cleft cyst
7. A patient with heart failure is on furosemide and develops muscle cramps and
weakness. ECG shows a U wave. Which electrolyte abnormality is most likely?
A. Hypernatremia
B. Hyperkalemia
C. Hypokalemia
D. Hypocalcemia
CORRECT ANSWER: C. Hypokalemia
8. Which rib is most commonly fractured in adults after blunt chest trauma?
A. 1st rib
B. 4th rib
C. 7th rib
D. 10th rib
CORRECT ANSWER: B. 4th rib
9. A 72-year-old with Parkinson’s disease develops progressive dysphagia and
drooling. Which cranial nerve is most directly affected in the bulbar phase?
A. CN V
B. CN VII
C. CN IX and X
D. CN XII
, CORRECT ANSWER: C. CN IX and X
10. A 25-year-old college student reports sudden chest pain and dyspnea after
smoking marijuana. Lung exam shows hyperresonance on the left. Which is the
best initial imaging?
A. Chest X-ray
B. High-resolution CT
C. Ventilation-perfusion scan
D. Ultrasound of the chest
CORRECT ANSWER: A. Chest X-ray
11. A 60-year-old with diabetes presents with painless hematuria. Which risk
factor is most strongly associated with transitional cell carcinoma?
A. Smoking
B. Cyclophosphamide use
C. Schistosoma haematobium infection
D. Chronic catheter use
CORRECT ANSWER: A. Smoking
12. In osteopathic manipulative treatment, which technique is most appropriate for
a patient with an acute, restrictive, painful somatic dysfunction?
A. High-velocity low-amplitude (HVLA)
B. Muscle energy (ME)
C. Counterstrain
D. Myofascial release
CORRECT ANSWER: C. Counterstrain
