COMSAE PHASE 1 FORM 116 EXAM | Latest Update 2026/2027 | 200
Questions and Verified Answers | Complete Q&A Guide | A+ Graded
1. A 45yearold female presents with chronic low back pain. On examination, the L5 vertebra is restricted
in flexion, rotates more easily to the left, and sidebends more easily to the left. According to Fryette's
principles, how should this dysfunction be documented?
Answer: B) L5 Flexed LR SL
Explanation: Fryette's Type II (nonneutral) dysfunctions occur in flexion or extension with rotation and
sidebending in the same direction. Since the segment is restricted in flexion with rotation left (LR) and
sidebending left (SL), the correct documentation is "L5 Flexed LR SL".
2. According to Fryette's principles, which of the following describes Type I somatic dysfunction?
Answer: A) Vertebrae in neutral position with rotation and sidebending in opposite directions
Explanation: Fryette's Type I mechanics describe vertebrae in a neutral position where rotation and
sidebending occur in opposite directions, typically involving multiple segments.
3. A patient with chronic neck pain has a restricted C5 segment that rotates more easily to the right and
sidebends more easily to the right. The restriction improves when the patient extends the cervical spine.
According to Fryette's principles, what is the correct diagnosis?
Answer: A) C5 Extended RR SR
Explanation: When a segment improves in extension, it is diagnosed as an Extended dysfunction. In
Type II mechanics, rotation and sidebending occur in the same direction. Thus, rotation right (RR) and
sidebending right (SR) yields "Extended RR SR".
4. A patient with a history of recurrent urinary tract infections has tenderness in the right lower
quadrant at the tip of the 12th rib. This Chapman reflex is associated with which organ?
Answer: B) Right kidney
Explanation: The kidney Chapman reflex is located at the tip of the 12th rib. Chapman reflexes are
small, tender nodules found in the deep fascia that correspond to visceral dysfunction.
5. A patient presents with a left sacral base that is posterior and inferior on the left. The left ILA is
anterior and superior. Which sacral torsion pattern is this?
Answer: Leftonleft sacral torsion
, Explanation: In a leftonleft sacral torsion, the left sacral base is posterior and inferior while the left ILA
(inferior lateral angle) is anterior and superior.
6. A patient presents with an anterior innominate rotation on the right. Which of the following is the
most appropriate muscle energy treatment?
Answer: A) Treat the right hip flexors
Explanation: In an anterior innominate rotation, the ilium rotates anteriorly relative to the sacrum on
the same side. The hip flexors (iliopsoas, rectus femoris) on the affected side are shortened and should
be treated.
7. The gallbladder viscerosomatic reflex is typically found at which spinal level?
Answer: T7T9, right side
Explanation: Viscerosomatic reflexes for the gallbladder are typically found at the T7T9 spinal segments
on the right side.
8. Which of the following is a contraindication to HighVelocity LowAmplitude (HVLA) technique?
Answer: Severe osteoporosis
Explanation: Severe osteoporosis is a contraindication to HVLA due to the risk of fracture.
9. A patient presents with a "slapped cheek" rash. What is the causative organism?
Answer: A) Parvovirus B19
Explanation: Parvovirus B19 causes erythema infectiosum (fifth disease), characterized by slapped
cheek rash and reticular body rash.
10. A 45yearold man presents with chest pain radiating to the left arm. ECG shows STelevation in leads
II, III, and aVF. Which coronary artery is most likely occluded?
Answer: B) Right coronary artery
Explanation: Inferior wall MI (II, III, aVF) is most commonly caused by occlusion of the right coronary
artery, which supplies the AV node and inferior myocardium.
11. Which vitamin deficiency is associated with Wernicke encephalopathy?
Answer: C) Thiamine (Vitamin B1)
, Explanation: Thiamine (Vitamin B1) deficiency causes Wernicke encephalopathy, characterized by
confusion, ataxia, and ophthalmoplegia.
12. A patient presents with fatigue and joint pain. Labs show elevated serum iron and ferritin. Which
gene mutation is most likely responsible?
Answer: HFE gene mutation (hereditary hemochromatosis)
Explanation: Hereditary hemochromatosis is most commonly caused by mutations in the HFE gene
(C282Y and H63D).
13. A patient is diagnosed with Legionella pneumonia. What is the most appropriate diagnostic test?
Answer: A) Urine antigen test
Explanation: The urinary antigen test is highly sensitive and is the most common diagnostic tool for
identifying Legionella pneumophila.
14. What is the primary mechanism of action of sulfonamides?
Answer: B) Inhibition of dihydropteroate synthase
Explanation: Sulfonamides inhibit dihydropteroate synthase, blocking bacterial folate synthesis.
15. DiGeorge syndrome results from a deletion on which chromosome?
Answer: 22q11.2
Explanation: DiGeorge syndrome (22q11.2 deletion) causes developmental failure of the third and
fourth pharyngeal pouches, resulting in absent thymus and parathyroid glands.
16. Which of the following is the most common cause of communityacquired pneumonia in young
adults?
Answer: Mycoplasma pneumoniae
Explanation: Mycoplasma pneumoniae is the most common cause of atypical pneumonia in young
adults.
17. A patient with asthma is prescribed a bronchodilator that acts by stimulating beta2 adrenergic
receptors. Which medication is this?
Answer: Albuterol
Questions and Verified Answers | Complete Q&A Guide | A+ Graded
1. A 45yearold female presents with chronic low back pain. On examination, the L5 vertebra is restricted
in flexion, rotates more easily to the left, and sidebends more easily to the left. According to Fryette's
principles, how should this dysfunction be documented?
Answer: B) L5 Flexed LR SL
Explanation: Fryette's Type II (nonneutral) dysfunctions occur in flexion or extension with rotation and
sidebending in the same direction. Since the segment is restricted in flexion with rotation left (LR) and
sidebending left (SL), the correct documentation is "L5 Flexed LR SL".
2. According to Fryette's principles, which of the following describes Type I somatic dysfunction?
Answer: A) Vertebrae in neutral position with rotation and sidebending in opposite directions
Explanation: Fryette's Type I mechanics describe vertebrae in a neutral position where rotation and
sidebending occur in opposite directions, typically involving multiple segments.
3. A patient with chronic neck pain has a restricted C5 segment that rotates more easily to the right and
sidebends more easily to the right. The restriction improves when the patient extends the cervical spine.
According to Fryette's principles, what is the correct diagnosis?
Answer: A) C5 Extended RR SR
Explanation: When a segment improves in extension, it is diagnosed as an Extended dysfunction. In
Type II mechanics, rotation and sidebending occur in the same direction. Thus, rotation right (RR) and
sidebending right (SR) yields "Extended RR SR".
4. A patient with a history of recurrent urinary tract infections has tenderness in the right lower
quadrant at the tip of the 12th rib. This Chapman reflex is associated with which organ?
Answer: B) Right kidney
Explanation: The kidney Chapman reflex is located at the tip of the 12th rib. Chapman reflexes are
small, tender nodules found in the deep fascia that correspond to visceral dysfunction.
5. A patient presents with a left sacral base that is posterior and inferior on the left. The left ILA is
anterior and superior. Which sacral torsion pattern is this?
Answer: Leftonleft sacral torsion
, Explanation: In a leftonleft sacral torsion, the left sacral base is posterior and inferior while the left ILA
(inferior lateral angle) is anterior and superior.
6. A patient presents with an anterior innominate rotation on the right. Which of the following is the
most appropriate muscle energy treatment?
Answer: A) Treat the right hip flexors
Explanation: In an anterior innominate rotation, the ilium rotates anteriorly relative to the sacrum on
the same side. The hip flexors (iliopsoas, rectus femoris) on the affected side are shortened and should
be treated.
7. The gallbladder viscerosomatic reflex is typically found at which spinal level?
Answer: T7T9, right side
Explanation: Viscerosomatic reflexes for the gallbladder are typically found at the T7T9 spinal segments
on the right side.
8. Which of the following is a contraindication to HighVelocity LowAmplitude (HVLA) technique?
Answer: Severe osteoporosis
Explanation: Severe osteoporosis is a contraindication to HVLA due to the risk of fracture.
9. A patient presents with a "slapped cheek" rash. What is the causative organism?
Answer: A) Parvovirus B19
Explanation: Parvovirus B19 causes erythema infectiosum (fifth disease), characterized by slapped
cheek rash and reticular body rash.
10. A 45yearold man presents with chest pain radiating to the left arm. ECG shows STelevation in leads
II, III, and aVF. Which coronary artery is most likely occluded?
Answer: B) Right coronary artery
Explanation: Inferior wall MI (II, III, aVF) is most commonly caused by occlusion of the right coronary
artery, which supplies the AV node and inferior myocardium.
11. Which vitamin deficiency is associated with Wernicke encephalopathy?
Answer: C) Thiamine (Vitamin B1)
, Explanation: Thiamine (Vitamin B1) deficiency causes Wernicke encephalopathy, characterized by
confusion, ataxia, and ophthalmoplegia.
12. A patient presents with fatigue and joint pain. Labs show elevated serum iron and ferritin. Which
gene mutation is most likely responsible?
Answer: HFE gene mutation (hereditary hemochromatosis)
Explanation: Hereditary hemochromatosis is most commonly caused by mutations in the HFE gene
(C282Y and H63D).
13. A patient is diagnosed with Legionella pneumonia. What is the most appropriate diagnostic test?
Answer: A) Urine antigen test
Explanation: The urinary antigen test is highly sensitive and is the most common diagnostic tool for
identifying Legionella pneumophila.
14. What is the primary mechanism of action of sulfonamides?
Answer: B) Inhibition of dihydropteroate synthase
Explanation: Sulfonamides inhibit dihydropteroate synthase, blocking bacterial folate synthesis.
15. DiGeorge syndrome results from a deletion on which chromosome?
Answer: 22q11.2
Explanation: DiGeorge syndrome (22q11.2 deletion) causes developmental failure of the third and
fourth pharyngeal pouches, resulting in absent thymus and parathyroid glands.
16. Which of the following is the most common cause of communityacquired pneumonia in young
adults?
Answer: Mycoplasma pneumoniae
Explanation: Mycoplasma pneumoniae is the most common cause of atypical pneumonia in young
adults.
17. A patient with asthma is prescribed a bronchodilator that acts by stimulating beta2 adrenergic
receptors. Which medication is this?
Answer: Albuterol
