2026 UPDATED QUESTIONS DOWNLOAD
Ultimate COMSAE Phase 1 (Form 114) Practice Set - 150
High-Yield Questions & Rationales 2026
This comprehensive study resource is specifically designed for osteopathic medical
students preparing for the COMSAE Phase 1 (Form 114) and the COMLEX-USA Level
1. It contains meticulously crafted multiple-choice questions (MCQs) that mirror the
style, difficulty, and content distribution of the actual NBOME assessment.
What’s Included?
• Practice Questions: Covering all major systems (Cardiovascular, GI, Renal,
Respiratory, Reproductive, etc.).
• Heavy OMM Focus: Detailed questions on Cranial strains, Sacral
torsions, Chapman points, Viscerosomatic reflexes, and Fryette’s Laws.
• Bolded Answers: For quick-review and self-testing.
• In-Depth Rationales: Every answer includes an italicized rationale explaining
the underlying physiology, pathology, or osteopathic principle to ensure deep
conceptual understanding.
• High-Yield Topics: Focused on the most "testable" concepts for Form 114,
including Microbiology (gram stains/spores), Pharmacology (MOAs/Antidotes),
and Biochemistry (rate-limiting enzymes).
1. Which cranial nerve is responsible for the sense of smell?
A. CN II
B. CN I
C. CN III
D. CN V
Answer: B. CN I
Rationale: The olfactory nerve (CN I) mediates the sense of smell.
2. Which artery supplies the lateral aspect of the forearm?
,2026 UPDATED QUESTIONS DOWNLOAD
A. Radial artery
B. Ulnar artery
C. Brachial artery
D. Axillary artery
Answer: A. Radial artery
Rationale: The radial artery travels along the lateral forearm to supply blood to the hand.
3. What is the primary action of the gluteus maximus?
A. Hip flexion
B. Hip extension
C. Knee flexion
D. Hip abduction
Answer: B. Hip extension
Rationale: Gluteus maximus extends the thigh at the hip joint and contributes to lateral rotation.
4. Which vitamin deficiency causes rickets in children?
A. Vitamin A
B. Vitamin D
C. Vitamin E
D. Vitamin K
Answer: B. Vitamin D
Rationale: Vitamin D deficiency impairs calcium absorption, leading to defective bone
mineralization.
5. Which bacteria is gram-positive and catalase-positive?
A. Streptococcus pyogenes
B. Staphylococcus aureus
C. Escherichia coli
D. Clostridium perfringens
Answer: B. Staphylococcus aureus
Rationale: Staphylococci are catalase-positive; streptococci are catalase-negative.
,2026 UPDATED QUESTIONS DOWNLOAD
6. Which cranial nerve mediates corneal reflex?
A. CN II
B. CN V (afferent) and CN VII (efferent)
C. CN IX
D. CN XI
Answer: B. CN V (afferent) and CN VII (efferent)
Rationale: Trigeminal nerve senses corneal touch; facial nerve triggers blink.
7. Which hormone is secreted by the anterior pituitary and stimulates adrenal
cortex?
A. ACTH
B. TSH
C. FSH
D. GH
Answer: A. ACTH
Rationale: Adrenocorticotropic hormone stimulates cortisol production in the adrenal cortex.
8. What is the first-line treatment for anaphylaxis?
A. Diphenhydramine
B. Epinephrine
C. Prednisone
D. Albuterol
Answer: B. Epinephrine
Rationale: Epinephrine rapidly reverses hypotension, airway constriction, and shock.
9. Which cardiac valve is affected in rheumatic fever?
A. Tricuspid
B. Mitral
C. Pulmonic
D. Aortic
, 2026 UPDATED QUESTIONS DOWNLOAD
Answer: B. Mitral
Rationale: Rheumatic fever most commonly causes mitral valve stenosis.
10. Which bacteria produces endotoxin?
A. Staphylococcus aureus
B. Escherichia coli
C. Streptococcus pyogenes
D. Clostridium tetani
Answer: B. Escherichia coli
Rationale: Gram-negative bacteria like E. coli release lipopolysaccharide endotoxins.
11. Which neurotransmitter is decreased in Parkinson’s disease?
A. Dopamine
B. Serotonin
C. GABA
D. Acetylcholine
Answer: A. Dopamine
Rationale: Loss of dopaminergic neurons in the substantia nigra leads to motor symptoms.
12. Which is a loop diuretic?
A. Furosemide
B. Spironolactone
C. Hydrochlorothiazide
D. Mannitol
Answer: A. Furosemide
Rationale: Furosemide inhibits Na⁺-K⁺-2Cl⁻ cotransporter in the thick ascending loop of Henle.
13. Which structure separates the atria from ventricles?
A. AV node
B. Atrioventricular valves
Ultimate COMSAE Phase 1 (Form 114) Practice Set - 150
High-Yield Questions & Rationales 2026
This comprehensive study resource is specifically designed for osteopathic medical
students preparing for the COMSAE Phase 1 (Form 114) and the COMLEX-USA Level
1. It contains meticulously crafted multiple-choice questions (MCQs) that mirror the
style, difficulty, and content distribution of the actual NBOME assessment.
What’s Included?
• Practice Questions: Covering all major systems (Cardiovascular, GI, Renal,
Respiratory, Reproductive, etc.).
• Heavy OMM Focus: Detailed questions on Cranial strains, Sacral
torsions, Chapman points, Viscerosomatic reflexes, and Fryette’s Laws.
• Bolded Answers: For quick-review and self-testing.
• In-Depth Rationales: Every answer includes an italicized rationale explaining
the underlying physiology, pathology, or osteopathic principle to ensure deep
conceptual understanding.
• High-Yield Topics: Focused on the most "testable" concepts for Form 114,
including Microbiology (gram stains/spores), Pharmacology (MOAs/Antidotes),
and Biochemistry (rate-limiting enzymes).
1. Which cranial nerve is responsible for the sense of smell?
A. CN II
B. CN I
C. CN III
D. CN V
Answer: B. CN I
Rationale: The olfactory nerve (CN I) mediates the sense of smell.
2. Which artery supplies the lateral aspect of the forearm?
,2026 UPDATED QUESTIONS DOWNLOAD
A. Radial artery
B. Ulnar artery
C. Brachial artery
D. Axillary artery
Answer: A. Radial artery
Rationale: The radial artery travels along the lateral forearm to supply blood to the hand.
3. What is the primary action of the gluteus maximus?
A. Hip flexion
B. Hip extension
C. Knee flexion
D. Hip abduction
Answer: B. Hip extension
Rationale: Gluteus maximus extends the thigh at the hip joint and contributes to lateral rotation.
4. Which vitamin deficiency causes rickets in children?
A. Vitamin A
B. Vitamin D
C. Vitamin E
D. Vitamin K
Answer: B. Vitamin D
Rationale: Vitamin D deficiency impairs calcium absorption, leading to defective bone
mineralization.
5. Which bacteria is gram-positive and catalase-positive?
A. Streptococcus pyogenes
B. Staphylococcus aureus
C. Escherichia coli
D. Clostridium perfringens
Answer: B. Staphylococcus aureus
Rationale: Staphylococci are catalase-positive; streptococci are catalase-negative.
,2026 UPDATED QUESTIONS DOWNLOAD
6. Which cranial nerve mediates corneal reflex?
A. CN II
B. CN V (afferent) and CN VII (efferent)
C. CN IX
D. CN XI
Answer: B. CN V (afferent) and CN VII (efferent)
Rationale: Trigeminal nerve senses corneal touch; facial nerve triggers blink.
7. Which hormone is secreted by the anterior pituitary and stimulates adrenal
cortex?
A. ACTH
B. TSH
C. FSH
D. GH
Answer: A. ACTH
Rationale: Adrenocorticotropic hormone stimulates cortisol production in the adrenal cortex.
8. What is the first-line treatment for anaphylaxis?
A. Diphenhydramine
B. Epinephrine
C. Prednisone
D. Albuterol
Answer: B. Epinephrine
Rationale: Epinephrine rapidly reverses hypotension, airway constriction, and shock.
9. Which cardiac valve is affected in rheumatic fever?
A. Tricuspid
B. Mitral
C. Pulmonic
D. Aortic
, 2026 UPDATED QUESTIONS DOWNLOAD
Answer: B. Mitral
Rationale: Rheumatic fever most commonly causes mitral valve stenosis.
10. Which bacteria produces endotoxin?
A. Staphylococcus aureus
B. Escherichia coli
C. Streptococcus pyogenes
D. Clostridium tetani
Answer: B. Escherichia coli
Rationale: Gram-negative bacteria like E. coli release lipopolysaccharide endotoxins.
11. Which neurotransmitter is decreased in Parkinson’s disease?
A. Dopamine
B. Serotonin
C. GABA
D. Acetylcholine
Answer: A. Dopamine
Rationale: Loss of dopaminergic neurons in the substantia nigra leads to motor symptoms.
12. Which is a loop diuretic?
A. Furosemide
B. Spironolactone
C. Hydrochlorothiazide
D. Mannitol
Answer: A. Furosemide
Rationale: Furosemide inhibits Na⁺-K⁺-2Cl⁻ cotransporter in the thick ascending loop of Henle.
13. Which structure separates the atria from ventricles?
A. AV node
B. Atrioventricular valves
