COMSAE PHASE 1 ADVANCED
COMPREHENSIVE ASSESSMENT
QUESTIONS AND ANSWERS
1. A 45-year-old male presents with epigastric pain. Palpation reveals a gangliform
contraction at the 5th intercostal space on the left, between the midclavicular and
parasternal lines. Which organ is most likely associated with this finding?
A. Liver
B. Spleen
C. Stomach (Acidity)
D. Appendix
Answer: C
Conceptual Explanation: The anterior Chapman point for stomach acidity is located in the
left 5th intercostal space between the midclavicular line and the sternum.
2. Which of the following cranial strains is characterized by the base of the sphenoid and the
base of the occiput rotating in the same direction about two transverse axes?
A. Sidebending-Rotation
B. Torsion
,C. Lateral Strain
D. Vertical Strain
Answer: D
Conceptual Explanation: In a vertical strain, the sphenoid and occiput rotate in the same
direction about two parallel transverse axes, resulting in the base of the sphenoid moving
superiorly (superior strain) or inferiorly (inferior strain) relative to the occiput.
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 most likely diagnosis?
A. Right-on-Right Forward Torsion
B. Left-on-Left Forward Torsion
C. Right-on-Left Backward Torsion
D. Left-on-Right Backward Torsion
Answer: D
Conceptual Explanation: A positive seated flexion test on the right indicates a right-sided
axis or restriction. A deep left sulcus and posterior right ILA indicate rotation to the left.
Since the findings are opposite (Right axis, Left rotation), it is a backward torsion,
specifically Left-on-Right.
, 4. A 62-year-old female with a history of chronic kidney disease presents with profound
muscle weakness. EKG shows peaked T-waves and a widened QRS complex. Which of the
following is the most appropriate next step to stabilize the cardiac membrane?
A. Insulin and Glucose
B. Sodium Polystyrene Sulfonate
C. Furosemide
D. Calcium Gluconate
Answer: D
Conceptual Explanation: In severe hyperkalemia with EKG changes, intravenous calcium
(gluconate or chloride) is administered first to stabilize the cardiac myocyte membrane
and prevent arrhythmias.
5. Which rib motion is primarily assessed when the patient is asked to reach for their
opposite knee during muscle energy treatment of ribs 3-5?
A. Caliper
B. Bucket handle
C. Pump handle
D. Inhalation
Answer: C
COMPREHENSIVE ASSESSMENT
QUESTIONS AND ANSWERS
1. A 45-year-old male presents with epigastric pain. Palpation reveals a gangliform
contraction at the 5th intercostal space on the left, between the midclavicular and
parasternal lines. Which organ is most likely associated with this finding?
A. Liver
B. Spleen
C. Stomach (Acidity)
D. Appendix
Answer: C
Conceptual Explanation: The anterior Chapman point for stomach acidity is located in the
left 5th intercostal space between the midclavicular line and the sternum.
2. Which of the following cranial strains is characterized by the base of the sphenoid and the
base of the occiput rotating in the same direction about two transverse axes?
A. Sidebending-Rotation
B. Torsion
,C. Lateral Strain
D. Vertical Strain
Answer: D
Conceptual Explanation: In a vertical strain, the sphenoid and occiput rotate in the same
direction about two parallel transverse axes, resulting in the base of the sphenoid moving
superiorly (superior strain) or inferiorly (inferior strain) relative to the occiput.
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 most likely diagnosis?
A. Right-on-Right Forward Torsion
B. Left-on-Left Forward Torsion
C. Right-on-Left Backward Torsion
D. Left-on-Right Backward Torsion
Answer: D
Conceptual Explanation: A positive seated flexion test on the right indicates a right-sided
axis or restriction. A deep left sulcus and posterior right ILA indicate rotation to the left.
Since the findings are opposite (Right axis, Left rotation), it is a backward torsion,
specifically Left-on-Right.
, 4. A 62-year-old female with a history of chronic kidney disease presents with profound
muscle weakness. EKG shows peaked T-waves and a widened QRS complex. Which of the
following is the most appropriate next step to stabilize the cardiac membrane?
A. Insulin and Glucose
B. Sodium Polystyrene Sulfonate
C. Furosemide
D. Calcium Gluconate
Answer: D
Conceptual Explanation: In severe hyperkalemia with EKG changes, intravenous calcium
(gluconate or chloride) is administered first to stabilize the cardiac myocyte membrane
and prevent arrhythmias.
5. Which rib motion is primarily assessed when the patient is asked to reach for their
opposite knee during muscle energy treatment of ribs 3-5?
A. Caliper
B. Bucket handle
C. Pump handle
D. Inhalation
Answer: C
