COMSAE BUNDLED EXAM STUDY GUIDE
2026 – COMPLETE CONCEPT REVIEW &
PRACTICE MATERIALS (LATEST EDITION)
Description: This guide serves as a comprehensive review tool for the COMSAE (Comprehensive
Osteopathic Medical Self-Assessment Examination), aligned with the latest 2026 blueprint. It
integrates fundamental medical science concepts with clinical applications, emphasizing
osteopathic principles and practice. The materials are designed to mirror the actual exam's
structure, providing detailed concept explanations, system-based review, and extensive practice
questions to identify knowledge gaps and improve test-taking strategy for osteopathic medical
students preparing for COMLEX-USA.
Keywords: Osteopathic Principles, System-Based Review, Clinical Application, Test-Taking
Strategy, COMLEX-USA Preparation.
Question 1: A 24-year-old female presents with fatigue, cold intolerance, and constipation.
Physical exam reveals dry skin, delayed deep tendon reflexes, and a painless, diffuse
enlargement of the thyroid gland. Laboratory studies show elevated TSH and low free T4. Which
of the following autoantibodies is most likely to be involved in the pathogenesis of this
condition?
A. Anti-thyroglobulin antibodies
B. Anti-thyroid peroxidase antibodies
C. Anti-TSH receptor stimulating antibodies
D. Anti-TSH receptor blocking antibodies
E. Anti-sodium-iodide symporter antibodies
Question 2: During a pre-participation physical, a 20-year-old college basketball player is found
to have a systolic murmur that increases with the Valsalva maneuver and decreases with
squatting. He is asymptomatic. What is the most likely diagnosis?
A. Atrial septal defect
B. Mitral valve prolapse
C. Hypertrophic cardiomyopathy
D. Aortic stenosis
E. Patent ductus arteriosus
, Question 3: A 55-year-old male with a history of chronic alcohol use presents with confusion,
ataxia, and ophthalmoplegia. Which of the following vitamin deficiencies is most directly
responsible for this clinical triad?
A. Vitamin B1 (Thiamine)
B. Vitamin B3 (Niacin)
C. Vitamin B6 (Pyridoxine)
D. Vitamin B9 (Folate)
E. Vitamin B12 (Cobalamin)
Question 4: A 65-year-old male with a 50-pack-year smoking history presents with hemoptysis,
weight loss, and a right apical lung mass on chest X-ray. Biopsy reveals a non-small cell
carcinoma. Which of the following paraneoplastic syndromes is most specifically associated with
this tumor location?
A. Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
B. Cushing syndrome
C. Hypercalcemia
D. Lambert-Eaton myasthenic syndrome
E. Pancoast tumor (shoulder pain, Horner syndrome)
Question 5: A physician notes that a patient's sacrum moves anteriorly during inhalation. Which
osteopathic somatic dysfunction terminology correctly describes this finding?
A. Sacral extension
B. Sacral flexion
C. Left rotation on a left oblique axis
D. Right rotation on a right oblique axis
E. Torsion
COMSAE BUNDLED EXAM STUDY GUIDE 2026 – COMPLETE CONCEPT REVIEW & PRACTICE
MATERIALS (LATEST EDITION)
Description: This guide serves as a comprehensive review tool for the COMSAE (Comprehensive
Osteopathic Medical Self-Assessment Examination), aligned with the latest 2026 blueprint. It
integrates fundamental medical science concepts with clinical applications, emphasizing
osteopathic principles and practice. The materials are designed to mirror the actual exam's
structure, providing detailed concept explanations, system-based review, and extensive practice
questions to identify knowledge gaps and improve test-taking strategy for osteopathic medical
students preparing for COMLEX-USA.
Keywords: Osteopathic Principles, System-Based Review, Clinical Application, Test-Taking
Strategy, COMLEX-USA Preparation.
2026 – COMPLETE CONCEPT REVIEW &
PRACTICE MATERIALS (LATEST EDITION)
Description: This guide serves as a comprehensive review tool for the COMSAE (Comprehensive
Osteopathic Medical Self-Assessment Examination), aligned with the latest 2026 blueprint. It
integrates fundamental medical science concepts with clinical applications, emphasizing
osteopathic principles and practice. The materials are designed to mirror the actual exam's
structure, providing detailed concept explanations, system-based review, and extensive practice
questions to identify knowledge gaps and improve test-taking strategy for osteopathic medical
students preparing for COMLEX-USA.
Keywords: Osteopathic Principles, System-Based Review, Clinical Application, Test-Taking
Strategy, COMLEX-USA Preparation.
Question 1: A 24-year-old female presents with fatigue, cold intolerance, and constipation.
Physical exam reveals dry skin, delayed deep tendon reflexes, and a painless, diffuse
enlargement of the thyroid gland. Laboratory studies show elevated TSH and low free T4. Which
of the following autoantibodies is most likely to be involved in the pathogenesis of this
condition?
A. Anti-thyroglobulin antibodies
B. Anti-thyroid peroxidase antibodies
C. Anti-TSH receptor stimulating antibodies
D. Anti-TSH receptor blocking antibodies
E. Anti-sodium-iodide symporter antibodies
Question 2: During a pre-participation physical, a 20-year-old college basketball player is found
to have a systolic murmur that increases with the Valsalva maneuver and decreases with
squatting. He is asymptomatic. What is the most likely diagnosis?
A. Atrial septal defect
B. Mitral valve prolapse
C. Hypertrophic cardiomyopathy
D. Aortic stenosis
E. Patent ductus arteriosus
, Question 3: A 55-year-old male with a history of chronic alcohol use presents with confusion,
ataxia, and ophthalmoplegia. Which of the following vitamin deficiencies is most directly
responsible for this clinical triad?
A. Vitamin B1 (Thiamine)
B. Vitamin B3 (Niacin)
C. Vitamin B6 (Pyridoxine)
D. Vitamin B9 (Folate)
E. Vitamin B12 (Cobalamin)
Question 4: A 65-year-old male with a 50-pack-year smoking history presents with hemoptysis,
weight loss, and a right apical lung mass on chest X-ray. Biopsy reveals a non-small cell
carcinoma. Which of the following paraneoplastic syndromes is most specifically associated with
this tumor location?
A. Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
B. Cushing syndrome
C. Hypercalcemia
D. Lambert-Eaton myasthenic syndrome
E. Pancoast tumor (shoulder pain, Horner syndrome)
Question 5: A physician notes that a patient's sacrum moves anteriorly during inhalation. Which
osteopathic somatic dysfunction terminology correctly describes this finding?
A. Sacral extension
B. Sacral flexion
C. Left rotation on a left oblique axis
D. Right rotation on a right oblique axis
E. Torsion
COMSAE BUNDLED EXAM STUDY GUIDE 2026 – COMPLETE CONCEPT REVIEW & PRACTICE
MATERIALS (LATEST EDITION)
Description: This guide serves as a comprehensive review tool for the COMSAE (Comprehensive
Osteopathic Medical Self-Assessment Examination), aligned with the latest 2026 blueprint. It
integrates fundamental medical science concepts with clinical applications, emphasizing
osteopathic principles and practice. The materials are designed to mirror the actual exam's
structure, providing detailed concept explanations, system-based review, and extensive practice
questions to identify knowledge gaps and improve test-taking strategy for osteopathic medical
students preparing for COMLEX-USA.
Keywords: Osteopathic Principles, System-Based Review, Clinical Application, Test-Taking
Strategy, COMLEX-USA Preparation.
