COMSAE PHASE 1 FORM 114 Actual
EXAM –200 QUESTIONS AND ANSWERS |
VERIFIED AND WELL DETAILED
ANSWERS | PLUS RATIONALES |
GUARANTEED PASS | LATEST EXAM
UPDATE | STUVIA VERIFIED | EXAM PREP
| STUDY GUIDE | PRACTICE TEST
EXAM OVERVIEW
COMSAE Phase 1 is the NBOME's self-assessment exam designed to mirror COMLEX-
USA Level 1. It consists of 176 questions (typically 4 blocks of 44) assessing
foundational biomedical sciences and osteopathic principles. The exam covers:
Core Competency Domains:
• Anatomy (10-15%)
• Behavioral Science (5-10%)
• Biochemistry (5-10%)
• Microbiology (10-15%)
• Osteopathic Principles & Practice (15-20%)
• Pathology (15-20%)
• Pharmacology (10-15%)
• Physiology (10-15%)
• Public Health/Biostatistics (5-10%)
,Clinical Presentations: Questions are framed around how patients present for care
across 10 categories (Asymptomatic, Digestion/Metabolism, Respiration/Circulation,
etc.)
EXAM QUESTIONS (200)
SECTION 1: OSTEOPATHIC PRINCIPLES & PRACTICE
(Questions 1-40)
Question 1
A 45-year-old male presents with low back pain. You diagnose a Type II lumbar
dysfunction at L3 in a flexed position. According to Fryette's mechanics, which of
the following best describes this dysfunction?
A) L3 is rotated left and sidebent right
B) L3 is rotated right and sidebent right
C) L3 is rotated left and sidebent left
D) L3 is in neutral position with rotation and sidebending opposite
Answer: B) L3 is rotated right and sidebent right
Rationale: Fryette's Second Principle (Type II mechanics) states that when the spine is in
a non-neutral position (flexed or extended), sidebending and rotation occur to
the same side. This typically involves a single vertebra. Option B describes a right
rotation and right sidebending in a flexed position.
,Why others are wrong:
• A & C: These describe opposite-side rotation/sidebending, which characterizes
Type I mechanics (neutral dysfunction).
• D: This describes Type I mechanics, not Type II.
Question 2
During an OMM session, you perform a muscle energy technique on a patient's
cervical spine. You place the patient's head in sidebending left and rotation left,
then ask the patient to gently push against your resistance. This describes
treatment for which cervical dysfunction?
A) Right rotation, right sidebending restriction
B) Left rotation, left sidebending restriction
C) Right rotation, left sidebending restriction
D) Left rotation, right sidebending restriction
Answer: B) Left rotation, left sidebending restriction
Rationale: Muscle energy technique for cervical dysfunctions uses the principle of
positioning the patient into the restriction. If the restriction is left rotation and left
sidebending, you position the patient into that restricted position and have them
contract against resistance, followed by relaxation and repositioning into the new
barrier.
Why others are wrong:
• A: Would be treated by positioning into right rotation/right sidebending.
• C & D: These are "rotated" dysfunctions treated differently.
, Question 3
A 55-year-old female presents with right upper quadrant pain after a fatty meal.
Physical exam reveals tenderness at the right costochondral junction at T7-T9. This
tenderness represents a viscerosomatic reflex from which organ?
A) Heart
B) Liver/Gallbladder
C) Kidney
D) Stomach
Answer: B) Liver/Gallbladder
Rationale: Viscerosomatic reflexes occur when visceral afferent fibers from an organ
synapse in the spinal cord and cause somatic dysfunction in corresponding myotomes.
The gallbladder and liver (foregut structures) have sympathetic innervation from T5-T9
via the greater splanchnic nerve. Dysfunction presents as tissue texture changes at T5-T9
on the right.
Why others are wrong:
• A (Heart): Referred to T1-T4, typically left-sided.
• C (Kidney): Referred to T10-T11.
• D (Stomach): Also T5-T9 but more midline/epigastric, not typically right-sided at
T7-T9 specifically.
Question 4
EXAM –200 QUESTIONS AND ANSWERS |
VERIFIED AND WELL DETAILED
ANSWERS | PLUS RATIONALES |
GUARANTEED PASS | LATEST EXAM
UPDATE | STUVIA VERIFIED | EXAM PREP
| STUDY GUIDE | PRACTICE TEST
EXAM OVERVIEW
COMSAE Phase 1 is the NBOME's self-assessment exam designed to mirror COMLEX-
USA Level 1. It consists of 176 questions (typically 4 blocks of 44) assessing
foundational biomedical sciences and osteopathic principles. The exam covers:
Core Competency Domains:
• Anatomy (10-15%)
• Behavioral Science (5-10%)
• Biochemistry (5-10%)
• Microbiology (10-15%)
• Osteopathic Principles & Practice (15-20%)
• Pathology (15-20%)
• Pharmacology (10-15%)
• Physiology (10-15%)
• Public Health/Biostatistics (5-10%)
,Clinical Presentations: Questions are framed around how patients present for care
across 10 categories (Asymptomatic, Digestion/Metabolism, Respiration/Circulation,
etc.)
EXAM QUESTIONS (200)
SECTION 1: OSTEOPATHIC PRINCIPLES & PRACTICE
(Questions 1-40)
Question 1
A 45-year-old male presents with low back pain. You diagnose a Type II lumbar
dysfunction at L3 in a flexed position. According to Fryette's mechanics, which of
the following best describes this dysfunction?
A) L3 is rotated left and sidebent right
B) L3 is rotated right and sidebent right
C) L3 is rotated left and sidebent left
D) L3 is in neutral position with rotation and sidebending opposite
Answer: B) L3 is rotated right and sidebent right
Rationale: Fryette's Second Principle (Type II mechanics) states that when the spine is in
a non-neutral position (flexed or extended), sidebending and rotation occur to
the same side. This typically involves a single vertebra. Option B describes a right
rotation and right sidebending in a flexed position.
,Why others are wrong:
• A & C: These describe opposite-side rotation/sidebending, which characterizes
Type I mechanics (neutral dysfunction).
• D: This describes Type I mechanics, not Type II.
Question 2
During an OMM session, you perform a muscle energy technique on a patient's
cervical spine. You place the patient's head in sidebending left and rotation left,
then ask the patient to gently push against your resistance. This describes
treatment for which cervical dysfunction?
A) Right rotation, right sidebending restriction
B) Left rotation, left sidebending restriction
C) Right rotation, left sidebending restriction
D) Left rotation, right sidebending restriction
Answer: B) Left rotation, left sidebending restriction
Rationale: Muscle energy technique for cervical dysfunctions uses the principle of
positioning the patient into the restriction. If the restriction is left rotation and left
sidebending, you position the patient into that restricted position and have them
contract against resistance, followed by relaxation and repositioning into the new
barrier.
Why others are wrong:
• A: Would be treated by positioning into right rotation/right sidebending.
• C & D: These are "rotated" dysfunctions treated differently.
, Question 3
A 55-year-old female presents with right upper quadrant pain after a fatty meal.
Physical exam reveals tenderness at the right costochondral junction at T7-T9. This
tenderness represents a viscerosomatic reflex from which organ?
A) Heart
B) Liver/Gallbladder
C) Kidney
D) Stomach
Answer: B) Liver/Gallbladder
Rationale: Viscerosomatic reflexes occur when visceral afferent fibers from an organ
synapse in the spinal cord and cause somatic dysfunction in corresponding myotomes.
The gallbladder and liver (foregut structures) have sympathetic innervation from T5-T9
via the greater splanchnic nerve. Dysfunction presents as tissue texture changes at T5-T9
on the right.
Why others are wrong:
• A (Heart): Referred to T1-T4, typically left-sided.
• C (Kidney): Referred to T10-T11.
• D (Stomach): Also T5-T9 but more midline/epigastric, not typically right-sided at
T7-T9 specifically.
Question 4
