COMSAE 115 High-Yield Practice Exam Prep
COMSAE 115 HIGH-YIELD PRACTICE EXAM PREP NEWEST 2026/2027
ACTUAL EXAM COMPLETE 90 QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) WITH RATIONALES |ALREADY GRADED
A+||BRAND NEW VERSION!!
Structure: 6 sections of 15 questions each
Contents Covered
Topic 1: High-Yield OMM Mechanics & Autonomics............................................... 2
Topic 2: Autonomic Pharmacology & Antimicrobials ............................................ 12
Topic 3: Medical Microbiology & Immunology Variants ....................................... 22
Topic 4: Cardiovascular, Renal & Pulmonary Pathology ........................................ 34
Topic 5: Gastrointestinal, Hepatic & Endocrine Systems ....................................... 46
Topic 6: Musculoskeletal, Rheumatology & Hematology/Oncology ..................... 58
1|Page
, COMSAE 115 High-Yield Practice Exam Prep
Topic 1: High-Yield OMM Mechanics & Autonomics
1. A 28-year-old female presents with mid-back pain after lifting heavy boxes.
Structural examination reveals that the T5 through T8 vertebrae form a group
curve that is sidebent right and rotated left. This structural asymmetry remains
completely unchanged when the patient is evaluated in full spinal flexion and full
spinal extension. What is the correct somatic dysfunction diagnosis for this
patient’s thoracic spine?
A. T5–T8 Neutral S_R R_L
B. T5–T8 Non-neutral S_L R_L
C. T5–T8 Flexed S_R R_R
D. T5–T8 Extended S_L R_L
Correct Answer: A
Rationale: According to Fryette's Principle I, when the thoracic or lumbar spine is in
a neutral baseline state (lacking marked flexion or extension), a group curve of
three or more adjacent vertebrae will sidebend and rotate to opposite sides, and
the structural asymmetry does not change significantly during flexion or extension.
Since the group curve spans T5–T8, is sidebent right (S_R), rotated left (R_L), and
fails to change with sagittal movement, it is a classic Type I neutral group somatic
dysfunction.
2. A 34-year-old male presents with severe lower back pain after a golfing
weekend. Structural examination reveals a positive seated flexion test on the left
side. Palpation demonstrates a deep sacral sulcus on the right and a prominent,
posterior inferior lateral angle (ILA) on the left. A spring test over the lumbosacral
junction demonstrates poor resilience and resists anterior motion (positive spring
test). What is the correct somatic dysfunction diagnosis?
2|Page
, COMSAE 115 High-Yield Practice Exam Prep
A. Right-on-Left backward sacral torsion
B. Left-on-Left forward sacral torsion
C. Right-on-Right forward sacral torsion
D. Left-on-Right backward sacral torsion
Correct Answer: A
Rationale: A positive spring test indicates poor resilience at the lumbosacral
junction, which confirms a backward sacral torsion (where the sacral base as a
whole prefers a posterior position). In all backward sacral torsions, the seated
flexion test is positive on the same side as the oblique axis. Since the test is positive
on the left, the axis is a left oblique axis. Because the axis and the rotation must
occur on opposite sides in a backward torsion, a left axis dictates right rotation,
yielding a Right-on-Left (R-on-L) backward sacral torsion.
3. A 22-year-old soccer player sustains a lateral right ankle sprain during a match.
Structural examination reveals that the right proximal fibular head resists anterior
springing and glides backwards easily. Given the reciprocal motion mechanics of
the fibula, which of the following physical examination findings will also be
present on the patient's right lower extremity?
A. The right foot prefers a position of pure dorsiflexion and eversion
B. The right distal lateral malleolus is displaced posteriorly
C. The right distal lateral malleolus is displaced anteriorly
D. The right proximal fibular head glides anteriorly with ease
Correct Answer: C
Rationale: The fibula functions via strict reciprocal mechanics where the proximal
fibular head and the distal lateral malleolus move in opposite directions along an
oblique axis. This patient has a posterior fibular head somatic dysfunction on the
right, meaning the proximal head glides posteriorly with ease and resists anterior
3|Page
, COMSAE 115 High-Yield Practice Exam Prep
motion. By the rule of reciprocal motion, when the proximal fibular head moves
posteriorly, the distal lateral malleolus moves anteriorly. Additionally, a posterior
fibular head matches a foot that prefers plantarflexion, inversion, and adduction
(supination).
4. A 45-year-old female presents with persistent pelvic pain. Structural
examination demonstrates a positive standing flexion test on the right side. With
the patient supine, the right anterior superior iliac spine (ASIS) is found to be
superior compared to the left, and the right medial malleolus appears
anatomically shorter. Prone evaluation reveals that the right posterior superior
iliac spine (PSIS) is inferior compared to the left. What is the correct somatic
dysfunction diagnosis?
A. Right posterior innominate rotation
B. Right anterior innominate rotation
C. Right superior innominate shear
D. Right inferior innominate shear
Correct Answer: A
Rationale: Innominate somatic dysfunctions are named based on the side of the
positive standing flexion test, which is the right side in this patient. On the
dysfunctional side, the ASIS is found to be superior while the PSIS is inferior. This
structural pairing—where the ASIS moves cephalad and the PSIS moves caudally—
defines a posterior innominate rotation. This rotational dysfunction rotates the
acetabulum anteriorly and superiorly, which functionally shortens the ipsilateral
leg (evidenced by the short right medial malleolus).
5. A 19-year-old male is brought to the clinic after a motor vehicle accident where
his knee struck the dashboard. Structural examination reveals a positive standing
flexion test on the left side. With the patient supine, both the left ASIS and the left
4|Page
COMSAE 115 HIGH-YIELD PRACTICE EXAM PREP NEWEST 2026/2027
ACTUAL EXAM COMPLETE 90 QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) WITH RATIONALES |ALREADY GRADED
A+||BRAND NEW VERSION!!
Structure: 6 sections of 15 questions each
Contents Covered
Topic 1: High-Yield OMM Mechanics & Autonomics............................................... 2
Topic 2: Autonomic Pharmacology & Antimicrobials ............................................ 12
Topic 3: Medical Microbiology & Immunology Variants ....................................... 22
Topic 4: Cardiovascular, Renal & Pulmonary Pathology ........................................ 34
Topic 5: Gastrointestinal, Hepatic & Endocrine Systems ....................................... 46
Topic 6: Musculoskeletal, Rheumatology & Hematology/Oncology ..................... 58
1|Page
, COMSAE 115 High-Yield Practice Exam Prep
Topic 1: High-Yield OMM Mechanics & Autonomics
1. A 28-year-old female presents with mid-back pain after lifting heavy boxes.
Structural examination reveals that the T5 through T8 vertebrae form a group
curve that is sidebent right and rotated left. This structural asymmetry remains
completely unchanged when the patient is evaluated in full spinal flexion and full
spinal extension. What is the correct somatic dysfunction diagnosis for this
patient’s thoracic spine?
A. T5–T8 Neutral S_R R_L
B. T5–T8 Non-neutral S_L R_L
C. T5–T8 Flexed S_R R_R
D. T5–T8 Extended S_L R_L
Correct Answer: A
Rationale: According to Fryette's Principle I, when the thoracic or lumbar spine is in
a neutral baseline state (lacking marked flexion or extension), a group curve of
three or more adjacent vertebrae will sidebend and rotate to opposite sides, and
the structural asymmetry does not change significantly during flexion or extension.
Since the group curve spans T5–T8, is sidebent right (S_R), rotated left (R_L), and
fails to change with sagittal movement, it is a classic Type I neutral group somatic
dysfunction.
2. A 34-year-old male presents with severe lower back pain after a golfing
weekend. Structural examination reveals a positive seated flexion test on the left
side. Palpation demonstrates a deep sacral sulcus on the right and a prominent,
posterior inferior lateral angle (ILA) on the left. A spring test over the lumbosacral
junction demonstrates poor resilience and resists anterior motion (positive spring
test). What is the correct somatic dysfunction diagnosis?
2|Page
, COMSAE 115 High-Yield Practice Exam Prep
A. Right-on-Left backward sacral torsion
B. Left-on-Left forward sacral torsion
C. Right-on-Right forward sacral torsion
D. Left-on-Right backward sacral torsion
Correct Answer: A
Rationale: A positive spring test indicates poor resilience at the lumbosacral
junction, which confirms a backward sacral torsion (where the sacral base as a
whole prefers a posterior position). In all backward sacral torsions, the seated
flexion test is positive on the same side as the oblique axis. Since the test is positive
on the left, the axis is a left oblique axis. Because the axis and the rotation must
occur on opposite sides in a backward torsion, a left axis dictates right rotation,
yielding a Right-on-Left (R-on-L) backward sacral torsion.
3. A 22-year-old soccer player sustains a lateral right ankle sprain during a match.
Structural examination reveals that the right proximal fibular head resists anterior
springing and glides backwards easily. Given the reciprocal motion mechanics of
the fibula, which of the following physical examination findings will also be
present on the patient's right lower extremity?
A. The right foot prefers a position of pure dorsiflexion and eversion
B. The right distal lateral malleolus is displaced posteriorly
C. The right distal lateral malleolus is displaced anteriorly
D. The right proximal fibular head glides anteriorly with ease
Correct Answer: C
Rationale: The fibula functions via strict reciprocal mechanics where the proximal
fibular head and the distal lateral malleolus move in opposite directions along an
oblique axis. This patient has a posterior fibular head somatic dysfunction on the
right, meaning the proximal head glides posteriorly with ease and resists anterior
3|Page
, COMSAE 115 High-Yield Practice Exam Prep
motion. By the rule of reciprocal motion, when the proximal fibular head moves
posteriorly, the distal lateral malleolus moves anteriorly. Additionally, a posterior
fibular head matches a foot that prefers plantarflexion, inversion, and adduction
(supination).
4. A 45-year-old female presents with persistent pelvic pain. Structural
examination demonstrates a positive standing flexion test on the right side. With
the patient supine, the right anterior superior iliac spine (ASIS) is found to be
superior compared to the left, and the right medial malleolus appears
anatomically shorter. Prone evaluation reveals that the right posterior superior
iliac spine (PSIS) is inferior compared to the left. What is the correct somatic
dysfunction diagnosis?
A. Right posterior innominate rotation
B. Right anterior innominate rotation
C. Right superior innominate shear
D. Right inferior innominate shear
Correct Answer: A
Rationale: Innominate somatic dysfunctions are named based on the side of the
positive standing flexion test, which is the right side in this patient. On the
dysfunctional side, the ASIS is found to be superior while the PSIS is inferior. This
structural pairing—where the ASIS moves cephalad and the PSIS moves caudally—
defines a posterior innominate rotation. This rotational dysfunction rotates the
acetabulum anteriorly and superiorly, which functionally shortens the ipsilateral
leg (evidenced by the short right medial malleolus).
5. A 19-year-old male is brought to the clinic after a motor vehicle accident where
his knee struck the dashboard. Structural examination reveals a positive standing
flexion test on the left side. With the patient supine, both the left ASIS and the left
4|Page
