COMSAE PHASE 1 FORM 114 PRACTICE TEST QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Anatomy
Behavioral Science
Biochemistry
Microbiology
Osteopathic Principles and Practice
Pathology
Pharmacology
Physiology
,Introduction
This practice examination is designed to assess foundational biomedical sciences knowledge and osteopathic
principles essential for clinical practice. The exam evaluates critical competencies including diagnostic
reasoning, therapeutic decision-making, regulatory compliance, and professional ethics. All questions follow a
multiple-choice format with scenario-based stems that emphasize real-world application of medical knowledge.
Candidates will encounter clinical presentations requiring integration of basic science principles with
osteopathic manipulative medicine, pathophysiology, and pharmacological management. This assessment
mirrors the structure and difficulty of the official COMSAE Phase 1 examination, providing valuable preparation
for board readiness.
SECTION ONE: QUESTIONS 1–100
Question 1
A 45-year-old patient presents with chronic low back pain and somatic dysfunction noted in the lumbar region.
During osteopathic manipulation, the physician identifies a viscerosomatic reflex at the T10–L2 spinal levels.
Which organ system is most likely associated with this finding?
A. Cardiac system
B. Gastrointestinal system
C. Pulmonary system
D. Renal system
🟢 D. Renal system
🔴 RATIONALE: The T10–L2 spinal levels correspond to viscerosomatic reflexes for the kidneys and urinary
tract. Cardiac reflexes are at T1–T4, pulmonary at T2–T7, and gastrointestinal varies by region but lower GI is
at T10–L2.
,Question 2
Which of the following amino acids is exclusively ketogenic and cannot be converted to glucose?
A. Alanine
B. Isoleucine
C. Leucine
D. Phenylalanine
🟢 C. Leucine
🔴 RATIONALE: Leucine is the only amino acid that is exclusively ketogenic. Isoleucine and phenylalanine are
both ketogenic and glucogenic, while alanine is exclusively glucogenic.
Question 3
A newborn presents with a midline neck mass that moves with swallowing. Ultrasound reveals a connection to
the thyroid gland. Which embryological structure is most likely responsible for this finding?
A. First pharyngeal pouch
B. Second pharyngeal arch
C. Thyroglossal duct
D. Parathyroid gland
, 🟢 C. Thyroglossal duct
🔴 RATIONALE: A thyroglossal duct cyst presents as a midline neck mass that moves with swallowing and is
connected to the thyroid gland. This results from incomplete obliteration of the thyroglossal duct during
embryological development.
Question 4
Which of the following bacteria produces an exotoxin that inhibits protein synthesis by inactivating elongation
factor-2 (EF-2)?
A. Bordetella pertussis
B. Clostridium tetani
C. Pseudomonas aeruginosa
D. Corynebacterium diphtheriae
🟢 D. Corynebacterium diphtheriae
🔴 RATIONALE: Diphtheria toxin from Corynebacterium diphtheriae inhibits protein synthesis by inactivating
EF-2 through ADP-ribosylation. Pseudomonas produces a similar toxin, but diphtheria is the classic answer for
this mechanism.
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Anatomy
Behavioral Science
Biochemistry
Microbiology
Osteopathic Principles and Practice
Pathology
Pharmacology
Physiology
,Introduction
This practice examination is designed to assess foundational biomedical sciences knowledge and osteopathic
principles essential for clinical practice. The exam evaluates critical competencies including diagnostic
reasoning, therapeutic decision-making, regulatory compliance, and professional ethics. All questions follow a
multiple-choice format with scenario-based stems that emphasize real-world application of medical knowledge.
Candidates will encounter clinical presentations requiring integration of basic science principles with
osteopathic manipulative medicine, pathophysiology, and pharmacological management. This assessment
mirrors the structure and difficulty of the official COMSAE Phase 1 examination, providing valuable preparation
for board readiness.
SECTION ONE: QUESTIONS 1–100
Question 1
A 45-year-old patient presents with chronic low back pain and somatic dysfunction noted in the lumbar region.
During osteopathic manipulation, the physician identifies a viscerosomatic reflex at the T10–L2 spinal levels.
Which organ system is most likely associated with this finding?
A. Cardiac system
B. Gastrointestinal system
C. Pulmonary system
D. Renal system
🟢 D. Renal system
🔴 RATIONALE: The T10–L2 spinal levels correspond to viscerosomatic reflexes for the kidneys and urinary
tract. Cardiac reflexes are at T1–T4, pulmonary at T2–T7, and gastrointestinal varies by region but lower GI is
at T10–L2.
,Question 2
Which of the following amino acids is exclusively ketogenic and cannot be converted to glucose?
A. Alanine
B. Isoleucine
C. Leucine
D. Phenylalanine
🟢 C. Leucine
🔴 RATIONALE: Leucine is the only amino acid that is exclusively ketogenic. Isoleucine and phenylalanine are
both ketogenic and glucogenic, while alanine is exclusively glucogenic.
Question 3
A newborn presents with a midline neck mass that moves with swallowing. Ultrasound reveals a connection to
the thyroid gland. Which embryological structure is most likely responsible for this finding?
A. First pharyngeal pouch
B. Second pharyngeal arch
C. Thyroglossal duct
D. Parathyroid gland
, 🟢 C. Thyroglossal duct
🔴 RATIONALE: A thyroglossal duct cyst presents as a midline neck mass that moves with swallowing and is
connected to the thyroid gland. This results from incomplete obliteration of the thyroglossal duct during
embryological development.
Question 4
Which of the following bacteria produces an exotoxin that inhibits protein synthesis by inactivating elongation
factor-2 (EF-2)?
A. Bordetella pertussis
B. Clostridium tetani
C. Pseudomonas aeruginosa
D. Corynebacterium diphtheriae
🟢 D. Corynebacterium diphtheriae
🔴 RATIONALE: Diphtheria toxin from Corynebacterium diphtheriae inhibits protein synthesis by inactivating
EF-2 through ADP-ribosylation. Pseudomonas produces a similar toxin, but diphtheria is the classic answer for
this mechanism.
