COMSAE PHASE 1 FORM 115 PRACTICE EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
,Core Domains
Anatomy and Embryology
Biochemistry and Molecular Biology
Microbiology and Immunology
Osteopathic Principles and Manipulative Medicine (OMM)
Pathology and Pathophysiology
Pharmacology
Physiology and Systems Function
Behavioral Science and Ethics
, Public Health and Preventive Medicine
*
Introduction
This comprehensive practice examination is designed to assess foundational knowledge and clinical
application skills essential for osteopathic medical students preparing for the COMLEX Level 1 examination.
The exam evaluates mastery across core medical sciences, osteopathic principles, and clinical decision-making
competencies. Questions are presented in multiple-choice format with integrated clinical scenarios that
emphasize real-world application, diagnostic reasoning, and professional judgment. The assessment prioritizes
ability to integrate basic science knowledge with patient care decisions, apply osteopathic distinctive
approaches, and demonstrate understanding of regulatory standards, ethics, and evidence-based practice.
Success on this exam indicates readiness for advanced clinical training and competence in osteopathic patient
care management.
*
Section One: Questions 1–100
A 45-year-old male presents with epigastric pain radiating to the back, nausea, and vomiting. Laboratory
studies show elevated serum amylase and lipase. CT imaging reveals pancreatic enlargement with
peripancreatic fluid. What is the most likely diagnosis?
A. Cholecystitis
B. Acute pancreatitis
C. Peptic ulcer disease
D. Gastroesophageal reflux disease
, 🟢 Correct answer: B
🔴 RATIONALE: Acute pancreatitis is characterized by epigastric pain radiating to the back, elevated
amylase/lipase (diagnostic when >3x normal), and CT findings of pancreatic enlargement with peripancreatic
fluid. Cholecystitis presents with right upper quadrant pain, peptic ulcer disease lacks enzyme elevation, and
GERD does not cause these severe findings.
A 23-year-old woman develops right lower quadrant pain, fever, and leukocytosis. Physical exam reveals
tenderness at McBurney's point. What is the most appropriate initial diagnostic test?
A. Upper endoscopy
B. CT abdomen/pelvis
C. Colonoscopy
D. Barium swallow
🟢 Correct answer: B
🔴 RATIONALE: CT abdomen/pelvis is the gold initial diagnostic test for suspected acute appendicitis,
showing bowel wall thickening, pericecal inflammation, and potential abscess. The clinical presentation (RLQ
pain, fever, leukocytosis, McBurney's point tenderness) is classic for appendicitis. Endoscopy, colonoscopy, and
barium swallow are inappropriate for this acute presentation.
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
,Core Domains
Anatomy and Embryology
Biochemistry and Molecular Biology
Microbiology and Immunology
Osteopathic Principles and Manipulative Medicine (OMM)
Pathology and Pathophysiology
Pharmacology
Physiology and Systems Function
Behavioral Science and Ethics
, Public Health and Preventive Medicine
*
Introduction
This comprehensive practice examination is designed to assess foundational knowledge and clinical
application skills essential for osteopathic medical students preparing for the COMLEX Level 1 examination.
The exam evaluates mastery across core medical sciences, osteopathic principles, and clinical decision-making
competencies. Questions are presented in multiple-choice format with integrated clinical scenarios that
emphasize real-world application, diagnostic reasoning, and professional judgment. The assessment prioritizes
ability to integrate basic science knowledge with patient care decisions, apply osteopathic distinctive
approaches, and demonstrate understanding of regulatory standards, ethics, and evidence-based practice.
Success on this exam indicates readiness for advanced clinical training and competence in osteopathic patient
care management.
*
Section One: Questions 1–100
A 45-year-old male presents with epigastric pain radiating to the back, nausea, and vomiting. Laboratory
studies show elevated serum amylase and lipase. CT imaging reveals pancreatic enlargement with
peripancreatic fluid. What is the most likely diagnosis?
A. Cholecystitis
B. Acute pancreatitis
C. Peptic ulcer disease
D. Gastroesophageal reflux disease
, 🟢 Correct answer: B
🔴 RATIONALE: Acute pancreatitis is characterized by epigastric pain radiating to the back, elevated
amylase/lipase (diagnostic when >3x normal), and CT findings of pancreatic enlargement with peripancreatic
fluid. Cholecystitis presents with right upper quadrant pain, peptic ulcer disease lacks enzyme elevation, and
GERD does not cause these severe findings.
A 23-year-old woman develops right lower quadrant pain, fever, and leukocytosis. Physical exam reveals
tenderness at McBurney's point. What is the most appropriate initial diagnostic test?
A. Upper endoscopy
B. CT abdomen/pelvis
C. Colonoscopy
D. Barium swallow
🟢 Correct answer: B
🔴 RATIONALE: CT abdomen/pelvis is the gold initial diagnostic test for suspected acute appendicitis,
showing bowel wall thickening, pericecal inflammation, and potential abscess. The clinical presentation (RLQ
pain, fever, leukocytosis, McBurney's point tenderness) is classic for appendicitis. Endoscopy, colonoscopy, and
barium swallow are inappropriate for this acute presentation.
