COMSAE PHASE 1 FORM 116 EXAM TEST BANK
– NEWEST 2026 EDITION | COMPREHENSIVE
160-QUESTION SET WITH VERIFIED
ANSWERS & DETAILED RATIONALES
examination assesses the osteopathic
medical student's readiness for COMLEX-USA
Level 1
,Core Domains
• Osteopathic Principles and Manipulative Medicine
• Anatomy and Embryology
• Physiology and Pathophysiology
• Biochemistry and Molecular Biology
• Pharmacology and Pharmacotherapeutics
• Microbiology and Immunology
• Pathology and Laboratory Medicine
• Behavioral Science and Ethics
• Clinical Integration and Systems-Based Practice
• Biostatistics and Epidemiology
Introduction
The COMSAE Phase 1 Form 116 examination assesses the
osteopathic medical student's readiness for COMLEX-USA Level 1
by evaluating foundational biomedical sciences, systems-based
pathology, pharmacology, and osteopathic clinical reasoning. The
exam integrates basic science principles with clinical vignettes to
test critical thinking, application of knowledge to patient
scenarios, and competency in osteopathic manipulative medicine.
Questions emphasize real-world clinical decision-making,
interpretation of laboratory and imaging findings, and the
osteopathic approach to whole-person care. This comprehensive
assessment mirrors the format, difficulty, and content domains of
the official COMSAE Phase 1 examination and is designed to
identify knowledge gaps and strengthen test-taking skills prior to
licensure testing.
,Question 1
A 58-year-old man presents with crushing substernal chest pain
radiating to his left arm. ECG demonstrates ST-segment
elevations in leads II, III, and aVF. Occlusion of which coronary
vessel is most likely responsible?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Left main coronary artery
C. Right coronary artery
RATIONALE: ST-segment elevations in leads II, III, and aVF
indicate an inferior wall myocardial infarction. The right coronary
artery supplies the inferior wall of the heart in approximately
80% of individuals. The left anterior descending artery supplies
the anterior wall (V1–V4), and the left circumflex supplies the
lateral wall (I, aVL, V5–V6).
Question 2
A 22-year-old college student living in a dormitory develops fever,
severe headache, neck stiffness, and photophobia. Cerebrospinal
fluid analysis shows elevated neutrophils, decreased glucose, and
increased protein. Which organism is most likely responsible?
A. Streptococcus pneumoniae
B. Listeria monocytogenes
C. Neisseria meningitidis
D. Herpes simplex virus type 1
C. Neisseria meningitidis
, RATIONALE: Young adults living in close quarters (dormitories,
military barracks) are at increased risk for meningococcal
meningitis caused by Neisseria meningitidis. The CSF findings of
elevated neutrophils, low glucose, and high protein are classic for
bacterial meningitis. N. meningitidis is the most common cause of
bacterial meningitis in adolescents and young adults.
Question 3
A researcher administers a drug that competitively inhibits
angiotensin-converting enzyme (ACE). Which physiological
change is most likely to occur?
A. Increased angiotensin II production
B. Increased aldosterone secretion
C. Increased peripheral vascular resistance
D. Decreased bradykinin degradation
D. Decreased bradykinin degradation
RATIONALE: ACE inhibitors block the conversion of
angiotensin I to angiotensin II and also inhibit the breakdown of
bradykinin. This leads to decreased angiotensin II, decreased
aldosterone secretion, decreased peripheral vascular resistance,
and increased bradykinin levels. The dry cough associated with
ACE inhibitors is due to bradykinin accumulation.
Question 4
A 24-year-old man presents with fever, sore throat, and posterior
cervical lymphadenopathy. A blood smear shows atypical
lymphocytes. Which virus is most likely responsible?
A. Cytomegalovirus
B. Epstein-Barr virus
– NEWEST 2026 EDITION | COMPREHENSIVE
160-QUESTION SET WITH VERIFIED
ANSWERS & DETAILED RATIONALES
examination assesses the osteopathic
medical student's readiness for COMLEX-USA
Level 1
,Core Domains
• Osteopathic Principles and Manipulative Medicine
• Anatomy and Embryology
• Physiology and Pathophysiology
• Biochemistry and Molecular Biology
• Pharmacology and Pharmacotherapeutics
• Microbiology and Immunology
• Pathology and Laboratory Medicine
• Behavioral Science and Ethics
• Clinical Integration and Systems-Based Practice
• Biostatistics and Epidemiology
Introduction
The COMSAE Phase 1 Form 116 examination assesses the
osteopathic medical student's readiness for COMLEX-USA Level 1
by evaluating foundational biomedical sciences, systems-based
pathology, pharmacology, and osteopathic clinical reasoning. The
exam integrates basic science principles with clinical vignettes to
test critical thinking, application of knowledge to patient
scenarios, and competency in osteopathic manipulative medicine.
Questions emphasize real-world clinical decision-making,
interpretation of laboratory and imaging findings, and the
osteopathic approach to whole-person care. This comprehensive
assessment mirrors the format, difficulty, and content domains of
the official COMSAE Phase 1 examination and is designed to
identify knowledge gaps and strengthen test-taking skills prior to
licensure testing.
,Question 1
A 58-year-old man presents with crushing substernal chest pain
radiating to his left arm. ECG demonstrates ST-segment
elevations in leads II, III, and aVF. Occlusion of which coronary
vessel is most likely responsible?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Left main coronary artery
C. Right coronary artery
RATIONALE: ST-segment elevations in leads II, III, and aVF
indicate an inferior wall myocardial infarction. The right coronary
artery supplies the inferior wall of the heart in approximately
80% of individuals. The left anterior descending artery supplies
the anterior wall (V1–V4), and the left circumflex supplies the
lateral wall (I, aVL, V5–V6).
Question 2
A 22-year-old college student living in a dormitory develops fever,
severe headache, neck stiffness, and photophobia. Cerebrospinal
fluid analysis shows elevated neutrophils, decreased glucose, and
increased protein. Which organism is most likely responsible?
A. Streptococcus pneumoniae
B. Listeria monocytogenes
C. Neisseria meningitidis
D. Herpes simplex virus type 1
C. Neisseria meningitidis
, RATIONALE: Young adults living in close quarters (dormitories,
military barracks) are at increased risk for meningococcal
meningitis caused by Neisseria meningitidis. The CSF findings of
elevated neutrophils, low glucose, and high protein are classic for
bacterial meningitis. N. meningitidis is the most common cause of
bacterial meningitis in adolescents and young adults.
Question 3
A researcher administers a drug that competitively inhibits
angiotensin-converting enzyme (ACE). Which physiological
change is most likely to occur?
A. Increased angiotensin II production
B. Increased aldosterone secretion
C. Increased peripheral vascular resistance
D. Decreased bradykinin degradation
D. Decreased bradykinin degradation
RATIONALE: ACE inhibitors block the conversion of
angiotensin I to angiotensin II and also inhibit the breakdown of
bradykinin. This leads to decreased angiotensin II, decreased
aldosterone secretion, decreased peripheral vascular resistance,
and increased bradykinin levels. The dry cough associated with
ACE inhibitors is due to bradykinin accumulation.
Question 4
A 24-year-old man presents with fever, sore throat, and posterior
cervical lymphadenopathy. A blood smear shows atypical
lymphocytes. Which virus is most likely responsible?
A. Cytomegalovirus
B. Epstein-Barr virus
