COMSAE PHASE 1 FORM 114 ACTUAL EXAM QUESTIONS AND ANSWERS ALREADY GRADED A+|
100% VERIFIED SOLUTIONS………...
CORE DOMAINS
Osteopathic Principles and Practice (OPP/OMT)
Anatomy and Embryology
Physiology and Pathophysiology
Biochemistry and Molecular Biology
Microbiology and Immunology
Pharmacology
Pathology
Behavioral Science and Biostatistics
Public Health and Health Promotion
INTRODUCTION
This comprehensive examination is designed to assess the foundational biomedical science
knowledge and osteopathic clinical reasoning skills essential for success on the COMSAE Phase 1
,assessment. The examination covers the core disciplines tested on COMLEX-USA Level 1, including
anatomy, physiology, biochemistry, microbiology, pharmacology, pathology, and osteopathic
principles and practice. Utilizing a multiple-choice and scenario-based structure, this assessment
emphasizes the application of foundational sciences to real-world clinical presentations. It aims to
prepare candidates for the rigor of osteopathic medical board examinations by testing the synthesis
of scientific knowledge, clinical decision-making, and osteopathic philosophy necessary for safe and
effective patient care.
SECTION ONE: QUESTIONS 1–100
1. A 45-year-old man presents with acute onset of severe low back pain after lifting a heavy box.
Osteopathic structural examination reveals a right rotated lumbar vertebra at L3 with restricted
motion. Which counterstrain point would most likely be tender?
A. Anterior Chapman point for the lumbar spine
B. Posterior Chapman point for the lumbar spine
C. Anterior tender point at the level of the dysfunction
D. Posterior tender point at the level of the dysfunction
🟢 D. Posterior tender point at the level of the dysfunction
🔴 RATIONALE: Counterstrain tender points for somatic dysfunction of the lumbar spine are
typically located posteriorly, near the transverse processes of the involved vertebra. These points
are used in the counterstrain technique to relieve the dysfunction.
2. A 28-year-old woman presents with a headache that is worse in the morning and associated
with nausea. She has a history of migraine headaches. Which cranial nerve is most likely
involved in the pathophysiology of her migraine?
, A. Olfactory nerve (CN I)
B. Optic nerve (CN II)
C. Trigeminal nerve (CN V)
D. Vagus nerve (CN X)
🟢 C. Trigeminal nerve (CN V)
🔴 RATIONALE: Migraine headaches involve activation of the trigeminovascular system, which
includes the trigeminal nerve (CN V). This leads to release of vasoactive neuropeptides and
inflammation, causing the characteristic pain.
3. A 65-year-old man presents with sudden-onset right-sided weakness and aphasia. CT scan
shows a left middle cerebral artery infarction. Which area of the brain is most likely affected?
A. Frontal lobe
B. Parietal lobe
C. Temporal lobe
D. Occipital lobe
🟢 A. Frontal lobe
🔴 RATIONALE: The middle cerebral artery supplies the lateral aspect of the cerebral
hemisphere, including the frontal, parietal, and temporal lobes. Aphasia (language impairment) is
associated with damage to Broca's area (frontal lobe) or Wernicke's area (temporal lobe). Right-
sided weakness indicates left hemisphere involvement, affecting the frontal lobe's motor cortex.
4. A 2-year-old child presents with fever, cough, and conjunctivitis followed by a maculopapular
rash starting on the face. What is the most likely diagnosis?
A. Rubella
, B. Measles
C. Roseola
D. Scarlet fever
🟢 B. Measles
🔴 RATIONALE: Measles (rubeola) presents with the classic triad of cough, coryza, and
conjunctivitis, followed by a maculopapular rash that starts on the face and spreads downward.
Koplik spots may be seen on the buccal mucosa.
5. A 55-year-old man with a history of smoking presents with hemoptysis and weight loss. Chest
X-ray shows a central mass. Which type of lung cancer is most likely?
A. Adenocarcinoma
B. Squamous cell carcinoma
C. Small cell carcinoma
D. Large cell carcinoma
🟢 B. Squamous cell carcinoma
🔴 RATIONALE: Squamous cell carcinoma is the most common type of lung cancer associated
with smoking and typically presents as a central mass. Adenocarcinoma is more common in non-
smokers and presents peripherally.
6. A 45-year-old woman presents with fatigue, weight gain, and cold intolerance. TSH is elevated
and free T4 is low. What is the most likely diagnosis?
A. Hashimoto's thyroiditis
B. Graves' disease
100% VERIFIED SOLUTIONS………...
CORE DOMAINS
Osteopathic Principles and Practice (OPP/OMT)
Anatomy and Embryology
Physiology and Pathophysiology
Biochemistry and Molecular Biology
Microbiology and Immunology
Pharmacology
Pathology
Behavioral Science and Biostatistics
Public Health and Health Promotion
INTRODUCTION
This comprehensive examination is designed to assess the foundational biomedical science
knowledge and osteopathic clinical reasoning skills essential for success on the COMSAE Phase 1
,assessment. The examination covers the core disciplines tested on COMLEX-USA Level 1, including
anatomy, physiology, biochemistry, microbiology, pharmacology, pathology, and osteopathic
principles and practice. Utilizing a multiple-choice and scenario-based structure, this assessment
emphasizes the application of foundational sciences to real-world clinical presentations. It aims to
prepare candidates for the rigor of osteopathic medical board examinations by testing the synthesis
of scientific knowledge, clinical decision-making, and osteopathic philosophy necessary for safe and
effective patient care.
SECTION ONE: QUESTIONS 1–100
1. A 45-year-old man presents with acute onset of severe low back pain after lifting a heavy box.
Osteopathic structural examination reveals a right rotated lumbar vertebra at L3 with restricted
motion. Which counterstrain point would most likely be tender?
A. Anterior Chapman point for the lumbar spine
B. Posterior Chapman point for the lumbar spine
C. Anterior tender point at the level of the dysfunction
D. Posterior tender point at the level of the dysfunction
🟢 D. Posterior tender point at the level of the dysfunction
🔴 RATIONALE: Counterstrain tender points for somatic dysfunction of the lumbar spine are
typically located posteriorly, near the transverse processes of the involved vertebra. These points
are used in the counterstrain technique to relieve the dysfunction.
2. A 28-year-old woman presents with a headache that is worse in the morning and associated
with nausea. She has a history of migraine headaches. Which cranial nerve is most likely
involved in the pathophysiology of her migraine?
, A. Olfactory nerve (CN I)
B. Optic nerve (CN II)
C. Trigeminal nerve (CN V)
D. Vagus nerve (CN X)
🟢 C. Trigeminal nerve (CN V)
🔴 RATIONALE: Migraine headaches involve activation of the trigeminovascular system, which
includes the trigeminal nerve (CN V). This leads to release of vasoactive neuropeptides and
inflammation, causing the characteristic pain.
3. A 65-year-old man presents with sudden-onset right-sided weakness and aphasia. CT scan
shows a left middle cerebral artery infarction. Which area of the brain is most likely affected?
A. Frontal lobe
B. Parietal lobe
C. Temporal lobe
D. Occipital lobe
🟢 A. Frontal lobe
🔴 RATIONALE: The middle cerebral artery supplies the lateral aspect of the cerebral
hemisphere, including the frontal, parietal, and temporal lobes. Aphasia (language impairment) is
associated with damage to Broca's area (frontal lobe) or Wernicke's area (temporal lobe). Right-
sided weakness indicates left hemisphere involvement, affecting the frontal lobe's motor cortex.
4. A 2-year-old child presents with fever, cough, and conjunctivitis followed by a maculopapular
rash starting on the face. What is the most likely diagnosis?
A. Rubella
, B. Measles
C. Roseola
D. Scarlet fever
🟢 B. Measles
🔴 RATIONALE: Measles (rubeola) presents with the classic triad of cough, coryza, and
conjunctivitis, followed by a maculopapular rash that starts on the face and spreads downward.
Koplik spots may be seen on the buccal mucosa.
5. A 55-year-old man with a history of smoking presents with hemoptysis and weight loss. Chest
X-ray shows a central mass. Which type of lung cancer is most likely?
A. Adenocarcinoma
B. Squamous cell carcinoma
C. Small cell carcinoma
D. Large cell carcinoma
🟢 B. Squamous cell carcinoma
🔴 RATIONALE: Squamous cell carcinoma is the most common type of lung cancer associated
with smoking and typically presents as a central mass. Adenocarcinoma is more common in non-
smokers and presents peripherally.
6. A 45-year-old woman presents with fatigue, weight gain, and cold intolerance. TSH is elevated
and free T4 is low. What is the most likely diagnosis?
A. Hashimoto's thyroiditis
B. Graves' disease
