COMSAE 114 (COMSAE PHASE 1 ASA
114) EXAMINATION COMPLETE
QUESTIONS AND DETAILED
SOLUTIONS LATEST UPDATE THIS
YEAR-JUST RELEASED
The COMSAE (Comprehensive Osteopathic Medical Self-
Assessment Examination) Phase 1 Form 114 is a
computer-based self-assessment developed by the National
Board of Osteopathic Medical Examiners to evaluate
readiness for COMLEX-USA Level 1. The examination
follows the COMLEX blueprint and assesses foundational
biomedical sciences, osteopathic principles, clinical
reasoning, patient care, professionalism, and systems-
based practice. Form 114 contains 176 single-best-answer
multiple-choice questions divided into four sections of 44
questions.
Exam Coverage
Osteopathic Principles, Practice, and Manipulative
Medicine (≈12%)
Osteopathic Patient Care and Procedural Skills
, Foundational Biomedical Sciences
Anatomy and Embryology
Physiology
Pathology
Pharmacology
Microbiology and Immunology
Biochemistry and Genetics
Behavioral Science and Ethics
Public Health and Epidemiology
Nervous System Disorders
Musculoskeletal Disorders
Cardiovascular Disorders
Respiratory Disorders
Gastrointestinal Disorders
Endocrine Disorders
Renal and Genitourinary Disorders
Reproductive Medicine
Dermatology
Clinical Reasoning and Diagnostic Interpretation
, Health Promotion and Preventive Medicine
(NBOME)
COMSAE 114 Practice Questions (Batch 1: Questions 1–50)
1.
A first-year osteopathic medical student reviews a
patient's spinal findings and notes T5 is rotated right, side-
bent right, and flexed; which Fryette dysfunction
classification best describes this vertebral segment?
A. Type I dysfunction
B. Type II dysfunction
C. Neutral dysfunction
D. Physiologic motion
Answer: B
Rationale: Type II dysfunction involves rotation and side-
bending to the same side in a flexed or extended segment.
2.
A 62-year-old patient develops crushing substernal chest
pain, diaphoresis, and elevated troponin levels after
exertion; which cellular process most directly causes
myocardial necrosis?
A. Increased ATP production
B. Mitochondrial oxidative phosphorylation
, C. Prolonged ischemia causing irreversible membrane
injury
D. Enhanced glycogen storage
Answer: C
Rationale: Irreversible ischemia damages cellular
membranes leading to necrosis.
3.
A patient with hyperthyroidism experiences tachycardia,
tremor, and heat intolerance; which receptor activity
primarily mediates these symptoms?
A. Alpha-2 receptor inhibition
B. Beta-1 receptor sensitization
C. Muscarinic receptor activation
D. Dopamine receptor blockade
Answer: B
Rationale: Thyroid hormone increases beta-adrenergic
receptor sensitivity.
4.
114) EXAMINATION COMPLETE
QUESTIONS AND DETAILED
SOLUTIONS LATEST UPDATE THIS
YEAR-JUST RELEASED
The COMSAE (Comprehensive Osteopathic Medical Self-
Assessment Examination) Phase 1 Form 114 is a
computer-based self-assessment developed by the National
Board of Osteopathic Medical Examiners to evaluate
readiness for COMLEX-USA Level 1. The examination
follows the COMLEX blueprint and assesses foundational
biomedical sciences, osteopathic principles, clinical
reasoning, patient care, professionalism, and systems-
based practice. Form 114 contains 176 single-best-answer
multiple-choice questions divided into four sections of 44
questions.
Exam Coverage
Osteopathic Principles, Practice, and Manipulative
Medicine (≈12%)
Osteopathic Patient Care and Procedural Skills
, Foundational Biomedical Sciences
Anatomy and Embryology
Physiology
Pathology
Pharmacology
Microbiology and Immunology
Biochemistry and Genetics
Behavioral Science and Ethics
Public Health and Epidemiology
Nervous System Disorders
Musculoskeletal Disorders
Cardiovascular Disorders
Respiratory Disorders
Gastrointestinal Disorders
Endocrine Disorders
Renal and Genitourinary Disorders
Reproductive Medicine
Dermatology
Clinical Reasoning and Diagnostic Interpretation
, Health Promotion and Preventive Medicine
(NBOME)
COMSAE 114 Practice Questions (Batch 1: Questions 1–50)
1.
A first-year osteopathic medical student reviews a
patient's spinal findings and notes T5 is rotated right, side-
bent right, and flexed; which Fryette dysfunction
classification best describes this vertebral segment?
A. Type I dysfunction
B. Type II dysfunction
C. Neutral dysfunction
D. Physiologic motion
Answer: B
Rationale: Type II dysfunction involves rotation and side-
bending to the same side in a flexed or extended segment.
2.
A 62-year-old patient develops crushing substernal chest
pain, diaphoresis, and elevated troponin levels after
exertion; which cellular process most directly causes
myocardial necrosis?
A. Increased ATP production
B. Mitochondrial oxidative phosphorylation
, C. Prolonged ischemia causing irreversible membrane
injury
D. Enhanced glycogen storage
Answer: C
Rationale: Irreversible ischemia damages cellular
membranes leading to necrosis.
3.
A patient with hyperthyroidism experiences tachycardia,
tremor, and heat intolerance; which receptor activity
primarily mediates these symptoms?
A. Alpha-2 receptor inhibition
B. Beta-1 receptor sensitization
C. Muscarinic receptor activation
D. Dopamine receptor blockade
Answer: B
Rationale: Thyroid hormone increases beta-adrenergic
receptor sensitivity.
4.
