ACCURATE TEST APPROVED QUESTIONS AND CORRECT
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|ACTUAL COMSAE PHASE (ASA 110 i ) LEVEL 1 EXAM |JUST
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COMSAE Phase 1 (ASA 110i) – Level 1 Exam
Total Questions: 100
Time Limit: 4 hours
1. A 45-year-old male presents with sudden onset of severe, tearing chest pain
radiating to the back. Blood pressure is 160/90 in the right arm and 110/70 in the
left arm. What is the most likely diagnosis?
A) Acute myocardial infarction
B) Pulmonary embolism
C) Aortic dissection – CORRECT ANSWER
D) Pericarditis
2. A 65-year-old with chronic obstructive pulmonary disease (COPD) presents
with worsening dyspnea and a new right-sided pneumothorax. Which physical
examination finding is expected on the right side?
A) Hyperresonance to percussion – CORRECT ANSWER
B) Egophony
C) Bronchial breath sounds
D) Dullness to percussion
3. Which of the following is the most common causative agent of community-
acquired pneumonia in a previously healthy 22-year-old?
A) Mycoplasma pneumoniae – CORRECT ANSWER
B) Klebsiella pneumoniae
C) Staphylococcus aureus
D) Moraxella catarrhalis
,4. A 55-year-old woman with hypertension presents with palpitations. ECG shows
narrow-complex tachycardia with a regular rhythm at 180 bpm and no visible P
waves. After carotid massage, the rhythm abruptly terminates. What is the most
likely diagnosis?
A) Atrial fibrillation
B) Multifocal atrial tachycardia
C) Atrioventricular nodal reentrant tachycardia (AVNRT) – CORRECT
ANSWER
D) Sinus tachycardia
5. In osteopathic structural examination, a patient has a right posterior innominate
rotation. What somatic dysfunction is most likely found on standing flexion test?
A) Right PSIS moves superior and posterior earlier than left – CORRECT
ANSWER
B) Left PSIS moves superior and posterior earlier than right
C) Bilateral PSIS move equally
D) Right PSIS moves inferior and anterior earlier than left
6. A 32-year-old man with HIV (CD4 count 180 cells/mm³) presents with
headache, fever, and confusion. MRI shows ring-enhancing lesions. What is the
most likely diagnosis?
A) Primary CNS lymphoma
B) Cryptococcal meningitis
C) Toxoplasmosis – CORRECT ANSWER
D) Progressive multifocal leukoencephalopathy
7. A 67-year-old man with a 30-pack-year smoking history presents with
hemoptysis and weight loss. Chest X-ray shows a right hilar mass. What is the next
best step?
A) PET scan
B) CT chest – CORRECT ANSWER
, C) Bronchoscopy
D) Sputum cytology
8. Which of the following is the hallmark of the direct, or “common,” pathway of
the basal ganglia?
A) D1 receptor activation facilitating movement – CORRECT ANSWER
B) D2 receptor activation inhibiting movement
C) Subthalamic nucleus excitation of globus pallidus externa
D) Loss of dopaminergic input to substantia nigra pars compacta
9. A patient with heart failure with reduced ejection fraction (HFrEF) is on
lisinopril, metoprolol, and furosemide. Which medication added next has the
greatest mortality benefit?
A) Digoxin
B) Spironolactone – CORRECT ANSWER
C) Hydralazine
D) Diltiazem
10. A 23-year-old woman presents with painful menstruation, dyspareunia, and
chronic pelvic pain. Transvaginal ultrasound is normal. What is the next best step?
A) CA-125 level
B) Diagnostic laparoscopy – CORRECT ANSWER
C) Endometrial biopsy
D) Hysterosalpingography
11. During an osteopathic manipulative treatment (OMT) session, a patient
exhibits a T5 flexed, rotated right, and sidebent left dysfunction. What is the
correct diagnosis using the Fryette type I or II model?