COMSAE PHASE 1 FORM 113
EXAMINATION COMPLETE QUESTIONS
AND DETAILED SOLUTIONS LATEST
UPDATE THIS YEAR-JUST RELEASED
COMSAE Phase 1 Form 113 is a self-assessment
examination developed by the National Board of
Osteopathic Medical Examiners to evaluate readiness for
COMLEX-USA Level 1. Form 113 contains 176 single-
best-answer questions divided into four blocks of 44
questions and assesses foundational biomedical sciences,
osteopathic principles, clinical reasoning, ethics,
communication, and patient care competencies.
Exam Coverage
Osteopathic Principles and Manipulative Medicine
Anatomy and Embryology
Physiology
Pathology
Pharmacology
Microbiology and Immunology
Biochemistry and Genetics
, Neurology and Psychiatry
Cardiovascular Medicine
Respiratory Medicine
Gastrointestinal Medicine
Endocrinology
Renal Medicine
Musculoskeletal Disorders
Behavioral Science and Ethics
Epidemiology and Public Health
Clinical Reasoning and Patient Safety
Preventive Medicine
Communication and Professionalism
Multisystem Integration and Clinical Applications
Question 1
A 62-year-old man develops exertional chest discomfort
relieved by rest, and coronary angiography demonstrates
significant atherosclerotic narrowing of a major coronary
artery. Which pathologic process most directly initiated
plaque formation?
,A. Neutrophil degranulation within vessel lumen
B. Endothelial injury causing lipid infiltration
C. Platelet deficiency causing hemorrhage
D. Smooth muscle apoptosis alone
Answer: B
Rationale: Endothelial dysfunction allows LDL infiltration
and initiates atherosclerotic plaque development.
Question 2
A medical student performs osteopathic evaluation and
identifies a thoracic segment that rotates right and
sidebends right during flexion testing. Which dysfunction
pattern is most likely present?
A. Type I neutral dysfunction
B. Type II flexed dysfunction
C. Bilateral extension dysfunction
D. Sacral torsion
Answer: B
Rationale: Type II dysfunction involves a single vertebral
segment with rotation and sidebending toward the same
side.
Question 3
, A child presents with recurrent respiratory infections,
absent thymic shadow, and hypocalcemia shortly after
birth. Failure of development of which embryologic
structure best explains these findings?
A. First pharyngeal pouch
B. Second pharyngeal arch
C. Third and fourth pharyngeal pouches
D. Neural crest migration to kidneys
Answer: C
Rationale: DiGeorge syndrome results from abnormal
development of the third and fourth pharyngeal pouches.
Question 4
A patient with severe vomiting develops metabolic
alkalosis. Which renal response helps compensate for this
disturbance?
A. Increased bicarbonate reabsorption exclusively
B. Increased hydrogen ion secretion
C. Enhanced bicarbonate excretion
D. Increased ammonium production only
Answer: C
Rationale: Kidneys compensate by eliminating excess
bicarbonate when volume status permits.
EXAMINATION COMPLETE QUESTIONS
AND DETAILED SOLUTIONS LATEST
UPDATE THIS YEAR-JUST RELEASED
COMSAE Phase 1 Form 113 is a self-assessment
examination developed by the National Board of
Osteopathic Medical Examiners to evaluate readiness for
COMLEX-USA Level 1. Form 113 contains 176 single-
best-answer questions divided into four blocks of 44
questions and assesses foundational biomedical sciences,
osteopathic principles, clinical reasoning, ethics,
communication, and patient care competencies.
Exam Coverage
Osteopathic Principles and Manipulative Medicine
Anatomy and Embryology
Physiology
Pathology
Pharmacology
Microbiology and Immunology
Biochemistry and Genetics
, Neurology and Psychiatry
Cardiovascular Medicine
Respiratory Medicine
Gastrointestinal Medicine
Endocrinology
Renal Medicine
Musculoskeletal Disorders
Behavioral Science and Ethics
Epidemiology and Public Health
Clinical Reasoning and Patient Safety
Preventive Medicine
Communication and Professionalism
Multisystem Integration and Clinical Applications
Question 1
A 62-year-old man develops exertional chest discomfort
relieved by rest, and coronary angiography demonstrates
significant atherosclerotic narrowing of a major coronary
artery. Which pathologic process most directly initiated
plaque formation?
,A. Neutrophil degranulation within vessel lumen
B. Endothelial injury causing lipid infiltration
C. Platelet deficiency causing hemorrhage
D. Smooth muscle apoptosis alone
Answer: B
Rationale: Endothelial dysfunction allows LDL infiltration
and initiates atherosclerotic plaque development.
Question 2
A medical student performs osteopathic evaluation and
identifies a thoracic segment that rotates right and
sidebends right during flexion testing. Which dysfunction
pattern is most likely present?
A. Type I neutral dysfunction
B. Type II flexed dysfunction
C. Bilateral extension dysfunction
D. Sacral torsion
Answer: B
Rationale: Type II dysfunction involves a single vertebral
segment with rotation and sidebending toward the same
side.
Question 3
, A child presents with recurrent respiratory infections,
absent thymic shadow, and hypocalcemia shortly after
birth. Failure of development of which embryologic
structure best explains these findings?
A. First pharyngeal pouch
B. Second pharyngeal arch
C. Third and fourth pharyngeal pouches
D. Neural crest migration to kidneys
Answer: C
Rationale: DiGeorge syndrome results from abnormal
development of the third and fourth pharyngeal pouches.
Question 4
A patient with severe vomiting develops metabolic
alkalosis. Which renal response helps compensate for this
disturbance?
A. Increased bicarbonate reabsorption exclusively
B. Increased hydrogen ion secretion
C. Enhanced bicarbonate excretion
D. Increased ammonium production only
Answer: C
Rationale: Kidneys compensate by eliminating excess
bicarbonate when volume status permits.