COMSAE PHASE 1 FORM 114 HIGH-
YIELD PRACTICE EXAM QUESTIONS
AND ANSWERS
1. A 24-year-old female presents with a headache. Physical exam reveals that during the
cranial rhythmic impulse, the base of the sphenoid moves superiorly relative to the base of
the occiput. What is the most likely diagnosis?
A. Sidebending rotation
B. Inferior vertical strain
C. Torsion
D. Superior vertical strain
Answer: D
Conceptual Explanation: In a superior vertical strain, the base of the sphenoid moves
superiorly relative to the base of the occiput. This occurs at the sphenobasilar
synchondrosis around two transverse axes.
2. A 65-year-old male with a history of chronic kidney disease presents with fatigue. Lab
results show a normocytic anemia and low erythropoietin levels. Which of the following is
the most likely site of erythropoietin production in this patient?
A. Peritubular interstitial cells
,B. Juxtaglomerular cells
C. Macula densa
D. Hepatocytes
Answer: A
Conceptual Explanation: Erythropoietin (EPO) is primarily produced by the peritubular
interstitial cells of the renal cortex in response to hypoxia.
3. A patient presents with a positive seated flexion test on the right, a deep sacral sulcus on
the left, and a posterior inferior ILA on the right. What is the sacral diagnosis?
A. Left-on-left forward torsion
B. Right-on-right forward torsion
C. Left-on-right backward torsion
D. Right-on-left backward torsion
Answer: D
Conceptual Explanation: A positive seated flexion test on the right indicates a right-sided
restriction. A deep left sulcus and posterior right ILA suggest a backward torsion (Right-on-
left) where the L5 rotates opposite to the sacrum.
, 4. A 45-year-old male presents with severe epigastric pain radiating to the back. Lipase is
significantly elevated. Which of the following is the most common cause of this condition in
the United States?
A. Alcohol consumption
B. Hypertriglyceridemia
C. Gallstones
D. Hypercalcemia
Answer: C
Conceptual Explanation: Gallstones (biliary tract disease) and alcohol are the two most
common causes of acute pancreatitis, with gallstones being the most frequent cause in the
US.
5. A 30-year-old female presents with palpitations and heat intolerance. Her TSH is low and
Free T4 is high. Examination reveals a diffuse, nontender goiter and exophthalmos. Which
antibody is most likely present?
A. Anti-thyroid peroxidase
B. Anti-thyroglobulin
C. Thyroid-stimulating immunoglobulin
D. TSH receptor blocking antibody
Answer: C
YIELD PRACTICE EXAM QUESTIONS
AND ANSWERS
1. A 24-year-old female presents with a headache. Physical exam reveals that during the
cranial rhythmic impulse, the base of the sphenoid moves superiorly relative to the base of
the occiput. What is the most likely diagnosis?
A. Sidebending rotation
B. Inferior vertical strain
C. Torsion
D. Superior vertical strain
Answer: D
Conceptual Explanation: In a superior vertical strain, the base of the sphenoid moves
superiorly relative to the base of the occiput. This occurs at the sphenobasilar
synchondrosis around two transverse axes.
2. A 65-year-old male with a history of chronic kidney disease presents with fatigue. Lab
results show a normocytic anemia and low erythropoietin levels. Which of the following is
the most likely site of erythropoietin production in this patient?
A. Peritubular interstitial cells
,B. Juxtaglomerular cells
C. Macula densa
D. Hepatocytes
Answer: A
Conceptual Explanation: Erythropoietin (EPO) is primarily produced by the peritubular
interstitial cells of the renal cortex in response to hypoxia.
3. A patient presents with a positive seated flexion test on the right, a deep sacral sulcus on
the left, and a posterior inferior ILA on the right. What is the sacral diagnosis?
A. Left-on-left forward torsion
B. Right-on-right forward torsion
C. Left-on-right backward torsion
D. Right-on-left backward torsion
Answer: D
Conceptual Explanation: A positive seated flexion test on the right indicates a right-sided
restriction. A deep left sulcus and posterior right ILA suggest a backward torsion (Right-on-
left) where the L5 rotates opposite to the sacrum.
, 4. A 45-year-old male presents with severe epigastric pain radiating to the back. Lipase is
significantly elevated. Which of the following is the most common cause of this condition in
the United States?
A. Alcohol consumption
B. Hypertriglyceridemia
C. Gallstones
D. Hypercalcemia
Answer: C
Conceptual Explanation: Gallstones (biliary tract disease) and alcohol are the two most
common causes of acute pancreatitis, with gallstones being the most frequent cause in the
US.
5. A 30-year-old female presents with palpitations and heat intolerance. Her TSH is low and
Free T4 is high. Examination reveals a diffuse, nontender goiter and exophthalmos. Which
antibody is most likely present?
A. Anti-thyroid peroxidase
B. Anti-thyroglobulin
C. Thyroid-stimulating immunoglobulin
D. TSH receptor blocking antibody
Answer: C
