COMSAE Phase 1 Form 114 Study Guide |
Complete Practice Exam with Questions,
Answers in Bold Italic, and Detailed
Explanations for Osteopathic Medical
Students
Core Domains
Osteopathic Principles and Practice (OPP/OMT)
Cardiovascular System
Respiratory System
Gastrointestinal System and Nutrition
Renal and Genitourinary System
Endocrine and Metabolic System
Neurology and Psychiatry
Musculoskeletal System and Rheumatology
Hematology and Oncology
Infectious Diseases and Immunology
Pharmacology
Biochemistry and Genetics
Behavioral Science and Biostatistics
Clinical Presentation Integration and Diagnostic Reasoning
Introduction
This comprehensive examination assesses the foundational
biomedical science knowledge and osteopathic principles required for
,success on the COMSAE Phase 1 Form 114. It evaluates mastery of
anatomy, physiology, biochemistry, microbiology, immunology,
pathology, pharmacology, and osteopathic manipulative medicine
through single-best-answer, multiple-choice questions organized into
four sections. The exam emphasizes integration of basic science
mechanisms with clinical presentations, laboratory findings, and
diagnostic reasoning. Candidates must demonstrate competency in
identifying disease pathophysiology, interpreting diagnostic studies,
applying osteopathic principles, and understanding pharmacologic
mechanisms. This assessment prepares osteopathic medical students
for the COMLEX-USA Level 1 while reinforcing evidence-based
clinical decision-making.
1. A 45-year-old male presents with low back pain after lifting a
box. On examination, the standing flexion test shows superior
movement of the right PSIS. Which somatic dysfunction is
most likely?
A. Left posterior innominate
B. Right anterior innominate
C. Right sacral torsion on a left oblique axis
D. Bilateral innominate rotation
B. Right anterior innominate
Rationale: A positive standing flexion test on the right suggests
iliosacral dysfunction on that side. For a right anterior innominate,
the right ASIS is positioned anteriorly and inferiorly, creating a
functional short right leg and a positive standing flexion test on the
right.
,2. According to Fryette's first principle (Type I mechanics),
when the spine is in a neutral position, sidebending and
rotation occur:
A. To the same side
B. To opposite sides
C. Without rotation
D. Only in the lumbar spine
B. To opposite sides
Rationale: Fryette's first principle states that in a neutral spine
(neither flexed nor extended), sidebending and rotation occur to
opposite sides. For example, sidebending right is accompanied by
rotation left.
3. Which cranial technique is specifically designed to enhance
the amplitude of the cranial rhythmic impulse (CRI)?
A. Venous sinus traction
B. Bulb compression (CV4)
C. V-spread technique
D. Frontal lift
B. Bulb compression (CV4)
Rationale: Compression of the fourth ventricle (CV4) is explicitly
utilized to encourage fluid movement, enhance the amplitude of the
CRI, and assist with autonomic nervous system balancing. Other
techniques target specific sutural restrictions or venous drainage.
4. A 45-year-old female presents with pain along the medial
aspect of her right knee. Palpation reveals a tender point on
, the medial surface of the tibia, approximately 2 cm below the
joint line, at the insertion of the pes anserinus. Which
position is used for counterstrain treatment?
A. Flexion, Abduction, External Rotation
B. Flexion, Adduction, Internal Rotation
C. Extension, Abduction, External Rotation
D. Extension, Adduction, Internal Rotation
B. Flexion, Adduction, Internal Rotation
Rationale: The medial knee tender point (often associated with the
medial meniscus or pes anserinus) is treated with hip/knee flexion,
adduction, and internal rotation of the tibia. Other positions will
stretch the tissue rather than shorten it, worsening the tender point.
5. A 28-year-old female presents with a distinct, migratory,
butterfly-shaped rash across her cheeks and nasal bridge that
worsens after sun exposure. Laboratory testing reveals
positive antinuclear antibodies (ANA) and anti-double-
stranded DNA (anti-dsDNA) antibodies. What is the most
likely diagnosis?
A. Dermatomyositis
B. Systemic lupus erythematosus
C. Rosacea
D. Seborrheic dermatitis
B. Systemic lupus erythematosus
Rationale: Systemic lupus erythematosus (SLE) is a chronic
autoimmune disease characterized by a malar (butterfly) rash that
exhibits photosensitivity. The presence of highly specific antibodies
Complete Practice Exam with Questions,
Answers in Bold Italic, and Detailed
Explanations for Osteopathic Medical
Students
Core Domains
Osteopathic Principles and Practice (OPP/OMT)
Cardiovascular System
Respiratory System
Gastrointestinal System and Nutrition
Renal and Genitourinary System
Endocrine and Metabolic System
Neurology and Psychiatry
Musculoskeletal System and Rheumatology
Hematology and Oncology
Infectious Diseases and Immunology
Pharmacology
Biochemistry and Genetics
Behavioral Science and Biostatistics
Clinical Presentation Integration and Diagnostic Reasoning
Introduction
This comprehensive examination assesses the foundational
biomedical science knowledge and osteopathic principles required for
,success on the COMSAE Phase 1 Form 114. It evaluates mastery of
anatomy, physiology, biochemistry, microbiology, immunology,
pathology, pharmacology, and osteopathic manipulative medicine
through single-best-answer, multiple-choice questions organized into
four sections. The exam emphasizes integration of basic science
mechanisms with clinical presentations, laboratory findings, and
diagnostic reasoning. Candidates must demonstrate competency in
identifying disease pathophysiology, interpreting diagnostic studies,
applying osteopathic principles, and understanding pharmacologic
mechanisms. This assessment prepares osteopathic medical students
for the COMLEX-USA Level 1 while reinforcing evidence-based
clinical decision-making.
1. A 45-year-old male presents with low back pain after lifting a
box. On examination, the standing flexion test shows superior
movement of the right PSIS. Which somatic dysfunction is
most likely?
A. Left posterior innominate
B. Right anterior innominate
C. Right sacral torsion on a left oblique axis
D. Bilateral innominate rotation
B. Right anterior innominate
Rationale: A positive standing flexion test on the right suggests
iliosacral dysfunction on that side. For a right anterior innominate,
the right ASIS is positioned anteriorly and inferiorly, creating a
functional short right leg and a positive standing flexion test on the
right.
,2. According to Fryette's first principle (Type I mechanics),
when the spine is in a neutral position, sidebending and
rotation occur:
A. To the same side
B. To opposite sides
C. Without rotation
D. Only in the lumbar spine
B. To opposite sides
Rationale: Fryette's first principle states that in a neutral spine
(neither flexed nor extended), sidebending and rotation occur to
opposite sides. For example, sidebending right is accompanied by
rotation left.
3. Which cranial technique is specifically designed to enhance
the amplitude of the cranial rhythmic impulse (CRI)?
A. Venous sinus traction
B. Bulb compression (CV4)
C. V-spread technique
D. Frontal lift
B. Bulb compression (CV4)
Rationale: Compression of the fourth ventricle (CV4) is explicitly
utilized to encourage fluid movement, enhance the amplitude of the
CRI, and assist with autonomic nervous system balancing. Other
techniques target specific sutural restrictions or venous drainage.
4. A 45-year-old female presents with pain along the medial
aspect of her right knee. Palpation reveals a tender point on
, the medial surface of the tibia, approximately 2 cm below the
joint line, at the insertion of the pes anserinus. Which
position is used for counterstrain treatment?
A. Flexion, Abduction, External Rotation
B. Flexion, Adduction, Internal Rotation
C. Extension, Abduction, External Rotation
D. Extension, Adduction, Internal Rotation
B. Flexion, Adduction, Internal Rotation
Rationale: The medial knee tender point (often associated with the
medial meniscus or pes anserinus) is treated with hip/knee flexion,
adduction, and internal rotation of the tibia. Other positions will
stretch the tissue rather than shorten it, worsening the tender point.
5. A 28-year-old female presents with a distinct, migratory,
butterfly-shaped rash across her cheeks and nasal bridge that
worsens after sun exposure. Laboratory testing reveals
positive antinuclear antibodies (ANA) and anti-double-
stranded DNA (anti-dsDNA) antibodies. What is the most
likely diagnosis?
A. Dermatomyositis
B. Systemic lupus erythematosus
C. Rosacea
D. Seborrheic dermatitis
B. Systemic lupus erythematosus
Rationale: Systemic lupus erythematosus (SLE) is a chronic
autoimmune disease characterized by a malar (butterfly) rash that
exhibits photosensitivity. The presence of highly specific antibodies
