COMSAE Phase 1 Form 116 Practice Exam
250 Questions with Verified Answers & Detailed Rationales
SECTION 1: OSTEOPATHIC PRINCIPLES & OMM (Questions 1-40)
Question 1
A 32-year-old female presents with chronic headaches and neck pain.
On structural exam, you find a Type I dysfunction at C3-C5. According to
Fryette's principles, which of the following best describes this
dysfunction?
A. Neutral position, rotation and sidebending opposite directions
B. Flexed position, rotation and sidebending same direction
C. Extended position, rotation and sidebending opposite directions
D. Neutral position, rotation and sidebending same direction
Correct Answer: A
Rationale: Fryette's Type I mechanics occur in the neutral position,
where rotation and sidebending occur in opposite directions. This
typically involves multiple segments and is the most common pattern of
somatic dysfunction.
,Question 2
A 55-year-old male with a history of COPD presents with low back pain.
On examination, you note a right-sided short leg and a positive standing
flexion test on the right. In the prone position, the right ILA is more
anterior than the left. What is the most likely sacral diagnosis?
A. Right on right sacral torsion
B. Left on left sacral torsion
C. Right unilateral sacral extension
D. Left unilateral sacral flexion
Correct Answer: C
Rationale: In unilateral sacral extension, the ILA on the affected side is
more anterior and superior, with a positive flexion test on the same
side. The short leg on the right further supports a right-sided
dysfunction.
Question 3
A 45-year-old woman 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?
A. L5 Extended RR SR
B. L5 Flexed LR SL
C. L5 Neutral LR SL
D. L5 Extended LR SL
Correct Answer: B
Rationale: 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."
Question 4
According to Fryette's principles, which of the following describes Type
I somatic dysfunction?
A. Vertebrae in neutral position with rotation and sidebending in
opposite directions
B. Vertebrae in neutral position with rotation and sidebending in same
direction
C. Vertebrae in flexed position with rotation and sidebending in
opposite directions
D. Vertebrae in extended position with rotation and sidebending in
same direction
Correct Answer: A
Rationale: Fryette's Type I mechanics describe vertebrae in a neutral
position where rotation and sidebending occur in opposite directions,
typically involving multiple segments.
Question 5
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?
, A. C5 Extended RR SR
B. C5 Flexed RR SR
C. C5 Extended RL SL
D. C5 Neutral RR SR
Correct Answer: A
Rationale: 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."
Question 6
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?
A. Left kidney
B. Right kidney
C. Liver
D. Gallbladder
Correct Answer: B
Rationale: 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.
250 Questions with Verified Answers & Detailed Rationales
SECTION 1: OSTEOPATHIC PRINCIPLES & OMM (Questions 1-40)
Question 1
A 32-year-old female presents with chronic headaches and neck pain.
On structural exam, you find a Type I dysfunction at C3-C5. According to
Fryette's principles, which of the following best describes this
dysfunction?
A. Neutral position, rotation and sidebending opposite directions
B. Flexed position, rotation and sidebending same direction
C. Extended position, rotation and sidebending opposite directions
D. Neutral position, rotation and sidebending same direction
Correct Answer: A
Rationale: Fryette's Type I mechanics occur in the neutral position,
where rotation and sidebending occur in opposite directions. This
typically involves multiple segments and is the most common pattern of
somatic dysfunction.
,Question 2
A 55-year-old male with a history of COPD presents with low back pain.
On examination, you note a right-sided short leg and a positive standing
flexion test on the right. In the prone position, the right ILA is more
anterior than the left. What is the most likely sacral diagnosis?
A. Right on right sacral torsion
B. Left on left sacral torsion
C. Right unilateral sacral extension
D. Left unilateral sacral flexion
Correct Answer: C
Rationale: In unilateral sacral extension, the ILA on the affected side is
more anterior and superior, with a positive flexion test on the same
side. The short leg on the right further supports a right-sided
dysfunction.
Question 3
A 45-year-old woman 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?
A. L5 Extended RR SR
B. L5 Flexed LR SL
C. L5 Neutral LR SL
D. L5 Extended LR SL
Correct Answer: B
Rationale: 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."
Question 4
According to Fryette's principles, which of the following describes Type
I somatic dysfunction?
A. Vertebrae in neutral position with rotation and sidebending in
opposite directions
B. Vertebrae in neutral position with rotation and sidebending in same
direction
C. Vertebrae in flexed position with rotation and sidebending in
opposite directions
D. Vertebrae in extended position with rotation and sidebending in
same direction
Correct Answer: A
Rationale: Fryette's Type I mechanics describe vertebrae in a neutral
position where rotation and sidebending occur in opposite directions,
typically involving multiple segments.
Question 5
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?
, A. C5 Extended RR SR
B. C5 Flexed RR SR
C. C5 Extended RL SL
D. C5 Neutral RR SR
Correct Answer: A
Rationale: 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."
Question 6
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?
A. Left kidney
B. Right kidney
C. Liver
D. Gallbladder
Correct Answer: B
Rationale: 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.
