COMSAE PHASE 1 (ASA 114) LEVEL 1 EXAM LATEST 2026/2027 &
HIGH YIELD PRACTICE QUESTIONS ACCURATE TEST APPROVED
QUESTIONS AND CORRECT DETAILED ANSWERS (100% CORRECT
VERIFIED SOLUTIONS) NEWEST UPDATED VERSION 2026 EDITION
|GUARANTEED PASS A+ |ACTUAL COMSAE PHASE (ASA 114) LEVEL
1 EXAM |JUST RELEASED
1. A 45-year-old male presents with episodic headache, palpitations, and
diaphoresis. His blood pressure is 180/110 mm Hg. Which receptor is
primarily responsible for the hypertensive response in this condition?
A. Alpha-1 adrenergic receptors
B. Beta-1 adrenergic receptors
C. Dopamine D1 receptors
D. Muscarinic M3 receptors
Correct Answer: A. Alpha-1 adrenergic receptors
2. A patient with blunt abdominal trauma has a positive Focused Assessment
with Sonography in Trauma (FAST) exam in the right upper quadrant.
Which structure is most likely injured?
A. Spleen
B. Liver
C. Kidney
D. Pancreas
Correct Answer: B. Liver
3. During a routine physical exam, a 60-year-old male has a blood pressure of
150/90 mm Hg in the right arm and 120/70 mm Hg in the left arm. Which
condition is most likely?
A. Aortic stenosis
B. Subclavian steal syndrome
,C. Coarctation of the aorta
D. Atherosclerotic plaque in the subclavian artery
Correct Answer: D. Atherosclerotic plaque in the subclavian artery
4. A 25-year-old female presents with acute-onset shortness of breath and
pleuritic chest pain one week after a long flight. She is tachycardic and
hypoxic. Which diagnostic test is most specific for her condition?
A. D-dimer
B. CT pulmonary angiography
C. Ventilation-perfusion scan
D. Chest X-ray
Correct Answer: B. CT pulmonary angiography
5. A 70-year-old male has a new diagnosis of Parkinson’s disease. Which
finding is most likely to improve with levodopa?
A. Postural instability
B. Resting tremor
C. Dementia
D. Dysphagia
Correct Answer: B. Resting tremor
6. During an osteopathic structural exam, a patient has a right posterior
innominate rotation on standing flexion test. Which treatment is most specific
for this somatic dysfunction?
A. Left anterior innominate muscle energy
B. Right posterior innominate muscle energy
C. Bilateral pubic shear
D. Sacral base posterior
Correct Answer: B. Right posterior innominate muscle energy
,7. A 50-year-old chronic alcoholic presents with confusion, ataxia, and
nystagmus. Which vitamin deficiency is most likely?
A. Vitamin A
B. Vitamin B1 (thiamine)
C. Vitamin B12
D. Vitamin D
Correct Answer: B. Vitamin B1 (thiamine)
8. A patient with chest pain has ECG showing ST elevation in leads II, III, and
aVF. Which coronary artery is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Left main coronary artery
Correct Answer: C. Right coronary artery
9. A 34-year-old female has a malar rash, oral ulcers, and arthritis.
Laboratory tests show ANA positive, anti-dsDNA positive. Which renal
finding is most characteristic?
A. Granular subendothelial immune complexes
B. Linear IgG along glomerular basement membrane
C. Pauci-immune glomerulonephritis
D. C3 glomerulopathy
Correct Answer: A. Granular subendothelial immune complexes
, 10. A newborn has a sacral dimple with a tuft of hair. Which structure is most
likely involved?
A. Conus medullaris
B. Filum terminale
C. Cauda equina
D. Spinal cord tethering
Correct Answer: D. Spinal cord tethering
11. A 68-year-old male has difficulty rising from a chair and has a waddling
gait. Creatine kinase is elevated. Which finding is most likely on muscle
biopsy?
A. Ragged red fibers
B. Perifascicular atrophy
C. Inflammation without necrosis
D. Endomysial inflammation
Correct Answer: B. Perifascicular atrophy
12. A patient with chronic kidney disease has calcium 7.5 mg/dL, phosphorus
6.5 mg/dL, PTH elevated. Which bone finding is most expected?
A. Osteomalacia
B. Osteitis fibrosa cystica
C. Osteoporosis
D. Osteopetrosis
Correct Answer: B. Osteitis fibrosa cystica
13. A 55-year-old female has sudden severe headache and vomiting. CT shows
hyperdense area in the Sylvian fissure. Which condition is most likely?
A. Subdural hematoma
B. Subarachnoid hemorrhage
HIGH YIELD PRACTICE QUESTIONS ACCURATE TEST APPROVED
QUESTIONS AND CORRECT DETAILED ANSWERS (100% CORRECT
VERIFIED SOLUTIONS) NEWEST UPDATED VERSION 2026 EDITION
|GUARANTEED PASS A+ |ACTUAL COMSAE PHASE (ASA 114) LEVEL
1 EXAM |JUST RELEASED
1. A 45-year-old male presents with episodic headache, palpitations, and
diaphoresis. His blood pressure is 180/110 mm Hg. Which receptor is
primarily responsible for the hypertensive response in this condition?
A. Alpha-1 adrenergic receptors
B. Beta-1 adrenergic receptors
C. Dopamine D1 receptors
D. Muscarinic M3 receptors
Correct Answer: A. Alpha-1 adrenergic receptors
2. A patient with blunt abdominal trauma has a positive Focused Assessment
with Sonography in Trauma (FAST) exam in the right upper quadrant.
Which structure is most likely injured?
A. Spleen
B. Liver
C. Kidney
D. Pancreas
Correct Answer: B. Liver
3. During a routine physical exam, a 60-year-old male has a blood pressure of
150/90 mm Hg in the right arm and 120/70 mm Hg in the left arm. Which
condition is most likely?
A. Aortic stenosis
B. Subclavian steal syndrome
,C. Coarctation of the aorta
D. Atherosclerotic plaque in the subclavian artery
Correct Answer: D. Atherosclerotic plaque in the subclavian artery
4. A 25-year-old female presents with acute-onset shortness of breath and
pleuritic chest pain one week after a long flight. She is tachycardic and
hypoxic. Which diagnostic test is most specific for her condition?
A. D-dimer
B. CT pulmonary angiography
C. Ventilation-perfusion scan
D. Chest X-ray
Correct Answer: B. CT pulmonary angiography
5. A 70-year-old male has a new diagnosis of Parkinson’s disease. Which
finding is most likely to improve with levodopa?
A. Postural instability
B. Resting tremor
C. Dementia
D. Dysphagia
Correct Answer: B. Resting tremor
6. During an osteopathic structural exam, a patient has a right posterior
innominate rotation on standing flexion test. Which treatment is most specific
for this somatic dysfunction?
A. Left anterior innominate muscle energy
B. Right posterior innominate muscle energy
C. Bilateral pubic shear
D. Sacral base posterior
Correct Answer: B. Right posterior innominate muscle energy
,7. A 50-year-old chronic alcoholic presents with confusion, ataxia, and
nystagmus. Which vitamin deficiency is most likely?
A. Vitamin A
B. Vitamin B1 (thiamine)
C. Vitamin B12
D. Vitamin D
Correct Answer: B. Vitamin B1 (thiamine)
8. A patient with chest pain has ECG showing ST elevation in leads II, III, and
aVF. Which coronary artery is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Left main coronary artery
Correct Answer: C. Right coronary artery
9. A 34-year-old female has a malar rash, oral ulcers, and arthritis.
Laboratory tests show ANA positive, anti-dsDNA positive. Which renal
finding is most characteristic?
A. Granular subendothelial immune complexes
B. Linear IgG along glomerular basement membrane
C. Pauci-immune glomerulonephritis
D. C3 glomerulopathy
Correct Answer: A. Granular subendothelial immune complexes
, 10. A newborn has a sacral dimple with a tuft of hair. Which structure is most
likely involved?
A. Conus medullaris
B. Filum terminale
C. Cauda equina
D. Spinal cord tethering
Correct Answer: D. Spinal cord tethering
11. A 68-year-old male has difficulty rising from a chair and has a waddling
gait. Creatine kinase is elevated. Which finding is most likely on muscle
biopsy?
A. Ragged red fibers
B. Perifascicular atrophy
C. Inflammation without necrosis
D. Endomysial inflammation
Correct Answer: B. Perifascicular atrophy
12. A patient with chronic kidney disease has calcium 7.5 mg/dL, phosphorus
6.5 mg/dL, PTH elevated. Which bone finding is most expected?
A. Osteomalacia
B. Osteitis fibrosa cystica
C. Osteoporosis
D. Osteopetrosis
Correct Answer: B. Osteitis fibrosa cystica
13. A 55-year-old female has sudden severe headache and vomiting. CT shows
hyperdense area in the Sylvian fissure. Which condition is most likely?
A. Subdural hematoma
B. Subarachnoid hemorrhage
