Page 1 of 72
COMSAE Phase 1 Form 110 exam QUESTIONS AND
VERIFIED ANSWERS WITH RATIONALES JUST
RELEASED
COMSAE Phase 1 - Form 110
This content is designed to assess your readiness for COMLEX-USA Level 1, integrating foundational
biomedical sciences with osteopathic principles.
study aids compiled by third-party sources to reflect the exam's content and style.
COMSAE Phase 1 - Form 110: Exam Overview
The COMSAE Phase 1 exam is a self-assessment tool that mirrors the COMLEX-USA Level 1 blueprint. It is
designed to help you gauge your readiness before taking the licensure exam.
• Exam Structure: The examination contains 176 items, divided into four sections of 44 questions
each.
• Question Format: All questions are single-best-answer, multiple-choice. Some questions may
include images, exhibits, or videos.
• Scoring & Reporting: The NBOME provides a three-digit standard score (400-649 is average,
>649 is higher performance) and a Performance Profile breaking down your results by
competency domain and clinical presentation. For individually purchased student exams, an
answer key is provided with the score report to help identify areas for improvement.
1. A 45-year-old male presents with a painful, swollen right great toe. Synovial fluid analysis under
polarized light microscopy demonstrates negatively birefringent, needle-shaped crystals. What is the
most appropriate first-line medical therapy for this acute flare?
A) Allopurinol
B) Febuxostat
C) Indomethacin
D) Probenecid
, Page 2 of 72
Answer: C) Indomethacin
Rationale: Acute gouty arthritis flares are treated first-line with Nonsteroidal Anti-inflammatory Drugs
(NSAIDs) like indomethacin, or alternatives such as colchicine and glucocorticoids. Urate-lowering
therapies like allopurinol or febuxostat should not be initiated during an acute flare, as sudden shifts in
serum uric acid can worsen or prolong the attack.
2. An osteopathic physician diagnoses a patient with a T4-T8 Type I somatic dysfunction. According to
Fryette's laws, in which relative directions do sidebending and rotation occur for this type of
dysfunction?
A) Same direction, in a non-neutral position
B) Opposite directions, in a neutral position
C) Same direction, in a neutral position
D) Opposite directions, in a flexed position
Answer: B) Opposite directions, in a neutral position
Rationale: Fryette's Principle I states that when the thoracic or lumbar spine is in a neutral position
(neither flexed nor extended), sidebending and rotation occur in opposite directions. This typically
involves a group of segments.
, Page 3 of 72
3. A patient with chronic alcoholism develops confusion, ophthalmoplegia, and ataxia. Which vitamin
deficiency is most likely responsible?
A) Vitamin B12
B) Vitamin C
C) Vitamin B1 (thiamine)
D) Vitamin K
Answer: C) Vitamin B1 (thiamine)
Rationale: The triad of confusion, ophthalmoplegia, and ataxia is classic for Wernicke encephalopathy,
which is caused by thiamine (Vitamin B1) deficiency, commonly seen in chronic alcohol use disorder.
Prompt treatment is essential to prevent progression to Korsakoff syndrome.
4. A 65-year-old woman develops crushing substernal chest pain radiating to her jaw. ECG reveals ST-
segment elevations in leads II, III, and aVF. Which coronary artery is most likely occluded?
A) Left anterior descending artery
B) Circumflex artery
C) Right coronary artery
D) Left main coronary artery
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Answer: C) Right coronary artery
Rationale: ST elevation in leads II, III, and aVF localizes an inferior wall myocardial infarction, which is
most commonly due to occlusion of the right coronary artery (RCA).
5. A 62-year-old male with a history of chronic smoking presents with a cough and unintended weight
loss. Lab results show severe hyponatremia. A chest X-ray reveals a central hilar mass. What tumor
cell origin is most strongly associated with this clinical picture?
A) Squamous cell carcinoma
B) Adenocarcinoma
C) Large cell carcinoma
D) Small cell carcinoma
Answer: D) Small cell carcinoma
Rationale: Small cell lung carcinoma is a neuroendocrine tumor highly associated with smoking and
centrally located lesions. The severe hyponatremia is caused by ectopic SIADH (Syndrome of
Inappropriate Antidiuretic Hormone) secretion.
COMSAE Phase 1 Form 110 exam QUESTIONS AND
VERIFIED ANSWERS WITH RATIONALES JUST
RELEASED
COMSAE Phase 1 - Form 110
This content is designed to assess your readiness for COMLEX-USA Level 1, integrating foundational
biomedical sciences with osteopathic principles.
study aids compiled by third-party sources to reflect the exam's content and style.
COMSAE Phase 1 - Form 110: Exam Overview
The COMSAE Phase 1 exam is a self-assessment tool that mirrors the COMLEX-USA Level 1 blueprint. It is
designed to help you gauge your readiness before taking the licensure exam.
• Exam Structure: The examination contains 176 items, divided into four sections of 44 questions
each.
• Question Format: All questions are single-best-answer, multiple-choice. Some questions may
include images, exhibits, or videos.
• Scoring & Reporting: The NBOME provides a three-digit standard score (400-649 is average,
>649 is higher performance) and a Performance Profile breaking down your results by
competency domain and clinical presentation. For individually purchased student exams, an
answer key is provided with the score report to help identify areas for improvement.
1. A 45-year-old male presents with a painful, swollen right great toe. Synovial fluid analysis under
polarized light microscopy demonstrates negatively birefringent, needle-shaped crystals. What is the
most appropriate first-line medical therapy for this acute flare?
A) Allopurinol
B) Febuxostat
C) Indomethacin
D) Probenecid
, Page 2 of 72
Answer: C) Indomethacin
Rationale: Acute gouty arthritis flares are treated first-line with Nonsteroidal Anti-inflammatory Drugs
(NSAIDs) like indomethacin, or alternatives such as colchicine and glucocorticoids. Urate-lowering
therapies like allopurinol or febuxostat should not be initiated during an acute flare, as sudden shifts in
serum uric acid can worsen or prolong the attack.
2. An osteopathic physician diagnoses a patient with a T4-T8 Type I somatic dysfunction. According to
Fryette's laws, in which relative directions do sidebending and rotation occur for this type of
dysfunction?
A) Same direction, in a non-neutral position
B) Opposite directions, in a neutral position
C) Same direction, in a neutral position
D) Opposite directions, in a flexed position
Answer: B) Opposite directions, in a neutral position
Rationale: Fryette's Principle I states that when the thoracic or lumbar spine is in a neutral position
(neither flexed nor extended), sidebending and rotation occur in opposite directions. This typically
involves a group of segments.
, Page 3 of 72
3. A patient with chronic alcoholism develops confusion, ophthalmoplegia, and ataxia. Which vitamin
deficiency is most likely responsible?
A) Vitamin B12
B) Vitamin C
C) Vitamin B1 (thiamine)
D) Vitamin K
Answer: C) Vitamin B1 (thiamine)
Rationale: The triad of confusion, ophthalmoplegia, and ataxia is classic for Wernicke encephalopathy,
which is caused by thiamine (Vitamin B1) deficiency, commonly seen in chronic alcohol use disorder.
Prompt treatment is essential to prevent progression to Korsakoff syndrome.
4. A 65-year-old woman develops crushing substernal chest pain radiating to her jaw. ECG reveals ST-
segment elevations in leads II, III, and aVF. Which coronary artery is most likely occluded?
A) Left anterior descending artery
B) Circumflex artery
C) Right coronary artery
D) Left main coronary artery
, Page 4 of 72
Answer: C) Right coronary artery
Rationale: ST elevation in leads II, III, and aVF localizes an inferior wall myocardial infarction, which is
most commonly due to occlusion of the right coronary artery (RCA).
5. A 62-year-old male with a history of chronic smoking presents with a cough and unintended weight
loss. Lab results show severe hyponatremia. A chest X-ray reveals a central hilar mass. What tumor
cell origin is most strongly associated with this clinical picture?
A) Squamous cell carcinoma
B) Adenocarcinoma
C) Large cell carcinoma
D) Small cell carcinoma
Answer: D) Small cell carcinoma
Rationale: Small cell lung carcinoma is a neuroendocrine tumor highly associated with smoking and
centrally located lesions. The severe hyponatremia is caused by ectopic SIADH (Syndrome of
Inappropriate Antidiuretic Hormone) secretion.
