COMSAE FORM 113 PRACTICE EXAM
VERSION 3 QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) P, Exams
of Nursing
The COMSAE (Comprehensive Osteopathic Medical Self-Assessment Examination)
Form 113 is a practice exam designed to assess readiness for the COMLEX-USA Level
1 examination. It evaluates foundational biomedical sciences integrated with
osteopathic principles and practice.
Key Content Areas Tested:
• Osteopathic Principles & Manipulative Treatment (OPP/OMT) – Somatic
dysfunction, treatment modalities, and clinical application
• Foundational Biomedical Sciences – Anatomy, physiology, biochemistry,
microbiology, immunology, pathology, and pharmacology
• Clinical Reasoning & Diagnosis – Differential diagnosis, diagnostic testing, and
clinical decision-making
• Organ Systems – Cardiovascular, respiratory, gastrointestinal, renal, neurologic,
musculoskeletal, endocrine, and reproductive
• Behavioral Sciences & Biostatistics – Epidemiology, study design, and patient
communication
Questions 1–100
,Section I: Osteopathic Principles & Manipulative Medicine
(Questions 1–12)
1. A 45-year-old patient presents with chronic lower back pain. Physical
examination reveals tissue texture abnormality, asymmetry, restriction of motion,
and tenderness in the lumbar spine. This cluster of findings is best described as:
• A) Viscerosomatic reflex
• B) Somatic dysfunction
• C) Myofascial pain syndrome
• D) Radiculopathy
Correct Answer: B) Somatic dysfunction
Rationale: Somatic dysfunction is defined as impaired or altered function of related
components of the somatic system (body framework) including skeletal, arthrodial, and
myofascial structures. The diagnostic criteria are remembered by the acronym TART:
Tissue texture abnormality, Asymmetry, Restriction of motion, and Tenderness.
2. A patient presents with acute low back pain after lifting a heavy object. Which
osteopathic manipulative treatment (OMT) technique is most appropriate for
acute muscle spasm?
• A) High-velocity, low-amplitude (HVLA)
• B) Muscle energy (ME)
• C) Strain-counterstrain
• D) Myofascial release
Correct Answer: C) Strain-counterstrain
,Rationale: Strain-counterstrain is an indirect OMT technique that involves positioning
the patient into a position of comfort (the "counterstrain" position) to reduce muscle
spasm and pain. It is particularly useful for acute muscle spasms and tender points.
HVLA is typically used for joint restrictions, not acute muscle spasm.
3. Which of the following statements best describes the primary function of the
autonomic nervous system in osteopathic medicine?
• A) It controls voluntary skeletal muscle movement
• B) It regulates the function of internal organs and glands
• C) It facilitates the somatic nervous system
• D) It controls the lymphatic system
Correct Answer: B) It regulates the function of internal organs and glands
Rationale: The autonomic nervous system (ANS) regulates the function of internal
organs, glands, and smooth muscle. In osteopathic medicine, the relationship between
the ANS and somatic structures is central to the concept of the viscerosomatic and
somatovisceral reflexes.
4. A patient with asthma is found to have somatic dysfunction at T1–T5. This is
most likely a manifestation of which reflex?
• A) Somatovisceral reflex
• B) Viscerosomatic reflex
• C) Somatosomatic reflex
• D) Viscerovisceral reflex
, Correct Answer: B) Viscerosomatic reflex
Rationale: Viscerosomatic reflexes occur when visceral organ dysfunction (e.g., asthma)
causes somatic changes in corresponding spinal segments (T1–T5 for the lungs). This
can present as paraspinal muscle hypertonicity, tenderness, and tissue texture changes
in those segments.
5. Which OMT technique involves the patient actively contracting muscles against
a counterforce provided by the physician?
• A) High-velocity, low-amplitude (HVLA)
• B) Muscle energy (ME)
• C) Strain-counterstrain
• D) Cranial osteopathy
Correct Answer: B) Muscle energy (ME)
Rationale: Muscle energy (ME) is a direct OMT technique in which the patient actively
contracts specific muscles against a counterforce provided by the physician. This is
followed by a repositioning of the joint into a new position of ease. It is used to improve
joint mobility and reduce muscle spasm.
6. A patient has a sacral base that is rotated to the right and side-bent to the left.
Which somatic dysfunction is this?
• A) Right-on-right
• B) Left-on-left
• C) Right-on-left
VERSION 3 QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) P, Exams
of Nursing
The COMSAE (Comprehensive Osteopathic Medical Self-Assessment Examination)
Form 113 is a practice exam designed to assess readiness for the COMLEX-USA Level
1 examination. It evaluates foundational biomedical sciences integrated with
osteopathic principles and practice.
Key Content Areas Tested:
• Osteopathic Principles & Manipulative Treatment (OPP/OMT) – Somatic
dysfunction, treatment modalities, and clinical application
• Foundational Biomedical Sciences – Anatomy, physiology, biochemistry,
microbiology, immunology, pathology, and pharmacology
• Clinical Reasoning & Diagnosis – Differential diagnosis, diagnostic testing, and
clinical decision-making
• Organ Systems – Cardiovascular, respiratory, gastrointestinal, renal, neurologic,
musculoskeletal, endocrine, and reproductive
• Behavioral Sciences & Biostatistics – Epidemiology, study design, and patient
communication
Questions 1–100
,Section I: Osteopathic Principles & Manipulative Medicine
(Questions 1–12)
1. A 45-year-old patient presents with chronic lower back pain. Physical
examination reveals tissue texture abnormality, asymmetry, restriction of motion,
and tenderness in the lumbar spine. This cluster of findings is best described as:
• A) Viscerosomatic reflex
• B) Somatic dysfunction
• C) Myofascial pain syndrome
• D) Radiculopathy
Correct Answer: B) Somatic dysfunction
Rationale: Somatic dysfunction is defined as impaired or altered function of related
components of the somatic system (body framework) including skeletal, arthrodial, and
myofascial structures. The diagnostic criteria are remembered by the acronym TART:
Tissue texture abnormality, Asymmetry, Restriction of motion, and Tenderness.
2. A patient presents with acute low back pain after lifting a heavy object. Which
osteopathic manipulative treatment (OMT) technique is most appropriate for
acute muscle spasm?
• A) High-velocity, low-amplitude (HVLA)
• B) Muscle energy (ME)
• C) Strain-counterstrain
• D) Myofascial release
Correct Answer: C) Strain-counterstrain
,Rationale: Strain-counterstrain is an indirect OMT technique that involves positioning
the patient into a position of comfort (the "counterstrain" position) to reduce muscle
spasm and pain. It is particularly useful for acute muscle spasms and tender points.
HVLA is typically used for joint restrictions, not acute muscle spasm.
3. Which of the following statements best describes the primary function of the
autonomic nervous system in osteopathic medicine?
• A) It controls voluntary skeletal muscle movement
• B) It regulates the function of internal organs and glands
• C) It facilitates the somatic nervous system
• D) It controls the lymphatic system
Correct Answer: B) It regulates the function of internal organs and glands
Rationale: The autonomic nervous system (ANS) regulates the function of internal
organs, glands, and smooth muscle. In osteopathic medicine, the relationship between
the ANS and somatic structures is central to the concept of the viscerosomatic and
somatovisceral reflexes.
4. A patient with asthma is found to have somatic dysfunction at T1–T5. This is
most likely a manifestation of which reflex?
• A) Somatovisceral reflex
• B) Viscerosomatic reflex
• C) Somatosomatic reflex
• D) Viscerovisceral reflex
, Correct Answer: B) Viscerosomatic reflex
Rationale: Viscerosomatic reflexes occur when visceral organ dysfunction (e.g., asthma)
causes somatic changes in corresponding spinal segments (T1–T5 for the lungs). This
can present as paraspinal muscle hypertonicity, tenderness, and tissue texture changes
in those segments.
5. Which OMT technique involves the patient actively contracting muscles against
a counterforce provided by the physician?
• A) High-velocity, low-amplitude (HVLA)
• B) Muscle energy (ME)
• C) Strain-counterstrain
• D) Cranial osteopathy
Correct Answer: B) Muscle energy (ME)
Rationale: Muscle energy (ME) is a direct OMT technique in which the patient actively
contracts specific muscles against a counterforce provided by the physician. This is
followed by a repositioning of the joint into a new position of ease. It is used to improve
joint mobility and reduce muscle spasm.
6. A patient has a sacral base that is rotated to the right and side-bent to the left.
Which somatic dysfunction is this?
• A) Right-on-right
• B) Left-on-left
• C) Right-on-left
