COMSAE Phase 1 Form 105 Practice Exam
2026/2027 Test Questions And Correct Verified
Answers Plus Rationales (GUARANTEED PASS)
INSTANT DOWNLOAD PDF
This COMSAE Phase 1 Form 105 Practice Exam is a comprehensive study
resource designed to help osteopathic medical students prepare for their
Phase 1 self-assessment, featuring over 300 questions with detailed
rationales covering core medical topics in physiology, pathology,
pharmacology, and microbiology. The document is specifically tailored for
students taking the NBOME COMSAE Phase 1 Form 105 exam, with verified
answers and explanations that highlight key medical concepts and clinical
presentations. Ideal for students in their pre-clinical years, this resource
helps identify strengths and weaknesses while reinforcing essential
knowledge through scenario-based questions and detailed answer
rationales.
,Musculoskeletal
Question 1
A 24-year-old male presents with acute lower back pain after lifting heavy
boxes. Physical examination reveals a tissue texture abnormality at L3.
The right L3 transverse process is prominent posteriorly. The asymmetry
improves when the patient extends his lumbar spine but worsens during
flexion. What is the correct somatic dysfunction diagnosis?
A. L3 Neutral \(R_{R}S_{L}\)
B. L3 Flexed \(R_{R}S_{R}\)
C. L3 Extended \(R_{R}S_{R}\)
D. L3 Extended \(R_{L}S_{L}\)
E. L3 Flexed \(R_{L}S_{L}\)
ANSWER: C. L3 Extended \(R_{R}S_{R}\)
RATIONALE: The patient's somatic dysfunction improves in extension,
meaning it is an extended dysfunction (E). Type II dysfunctions follow
the rule that rotation and sidebending occur to the same side (\(R\)
and \(S\) match). Because the right transverse process is
prominent posteriorly, the vertebra is rotated to the right
(\(R_{R}\)). Therefore, sidebending must also be to the right
(\(S_{R}\)), yielding E \(R_{R}S_{R}\).
Question 2
,A 45-year-old female presents with severe pain on the plantar aspect of
her right foot, especially during her first steps in the morning.
Examination reveals exquisite tenderness over the medial tubercle of the
calcaneus. A dysfunction is noted at the lateral longitudinal arch of the
foot. Which bone serves as the keystone for this specific arch?
A. Navicular
B. Cuboid
C. Talus
C. Calcaneus
E. Cuneiform
ANSWER: B. Cuboid
RATIONALE: The lateral longitudinal arch of the foot is composed of
the calcaneus, cuboid, and the 4th and 5th metatarsals. The cuboid
acts as the functional keystone of this arch. For the medial
longitudinal arch, the navicular is the keystone. Plantar fasciitis
often correlates with somatic dysfunctions of these structural
arches.
Question 3
A third-year medical student is practicing Muscle Energy Technique (MET)
on a patient diagnosed with a Type I somatic dysfunction of the thoracic
spine involving T5–T9 (\(NR_{L}S_{R}\)). What mechanism best explains
the neurophysiological response during the post-isometric relaxation
phase of MET?
A. Activation of Pacinian corpuscles
, B. Excitation of alpha motor neurons
C. Golgi tendon organ activation causing reflexive muscle lengthening
D. Reciprocal inhibition of antagonist muscle groups
E. Nociceptive pathway downregulation
ANSWER: C. Golgi tendon organ activation causing reflexive muscle
lengthening
RATIONALE: Muscle Energy Technique leveraging post-isometric
relaxation relies on the contraction of the affected agonist muscle.
This active contraction increases tension within the tendon,
activating Golgi tendon organs. This triggers an inhibitory reflex that
dampens alpha motor neuron activity, leading to immediate muscle
relaxation and allowing the operator to meet a new restrictive
barrier.
Question 4
A 35-year-old construction worker presents with pain over the lateral
aspect of his left elbow that radiates down his forearm. He notes the pain
worsens when he screws bolts or uses a screwdriver. Physical
examination demonstrates tenderness distal to the lateral epicondyle and
pain elicited upon resisted wrist extension. Radial head somatic
dysfunction is suspected. Which of the following motions is expected if the
radial head is anterior?
A. Restriction in anterior glide
B. Restriction in supination
C. Ease of pronation
2026/2027 Test Questions And Correct Verified
Answers Plus Rationales (GUARANTEED PASS)
INSTANT DOWNLOAD PDF
This COMSAE Phase 1 Form 105 Practice Exam is a comprehensive study
resource designed to help osteopathic medical students prepare for their
Phase 1 self-assessment, featuring over 300 questions with detailed
rationales covering core medical topics in physiology, pathology,
pharmacology, and microbiology. The document is specifically tailored for
students taking the NBOME COMSAE Phase 1 Form 105 exam, with verified
answers and explanations that highlight key medical concepts and clinical
presentations. Ideal for students in their pre-clinical years, this resource
helps identify strengths and weaknesses while reinforcing essential
knowledge through scenario-based questions and detailed answer
rationales.
,Musculoskeletal
Question 1
A 24-year-old male presents with acute lower back pain after lifting heavy
boxes. Physical examination reveals a tissue texture abnormality at L3.
The right L3 transverse process is prominent posteriorly. The asymmetry
improves when the patient extends his lumbar spine but worsens during
flexion. What is the correct somatic dysfunction diagnosis?
A. L3 Neutral \(R_{R}S_{L}\)
B. L3 Flexed \(R_{R}S_{R}\)
C. L3 Extended \(R_{R}S_{R}\)
D. L3 Extended \(R_{L}S_{L}\)
E. L3 Flexed \(R_{L}S_{L}\)
ANSWER: C. L3 Extended \(R_{R}S_{R}\)
RATIONALE: The patient's somatic dysfunction improves in extension,
meaning it is an extended dysfunction (E). Type II dysfunctions follow
the rule that rotation and sidebending occur to the same side (\(R\)
and \(S\) match). Because the right transverse process is
prominent posteriorly, the vertebra is rotated to the right
(\(R_{R}\)). Therefore, sidebending must also be to the right
(\(S_{R}\)), yielding E \(R_{R}S_{R}\).
Question 2
,A 45-year-old female presents with severe pain on the plantar aspect of
her right foot, especially during her first steps in the morning.
Examination reveals exquisite tenderness over the medial tubercle of the
calcaneus. A dysfunction is noted at the lateral longitudinal arch of the
foot. Which bone serves as the keystone for this specific arch?
A. Navicular
B. Cuboid
C. Talus
C. Calcaneus
E. Cuneiform
ANSWER: B. Cuboid
RATIONALE: The lateral longitudinal arch of the foot is composed of
the calcaneus, cuboid, and the 4th and 5th metatarsals. The cuboid
acts as the functional keystone of this arch. For the medial
longitudinal arch, the navicular is the keystone. Plantar fasciitis
often correlates with somatic dysfunctions of these structural
arches.
Question 3
A third-year medical student is practicing Muscle Energy Technique (MET)
on a patient diagnosed with a Type I somatic dysfunction of the thoracic
spine involving T5–T9 (\(NR_{L}S_{R}\)). What mechanism best explains
the neurophysiological response during the post-isometric relaxation
phase of MET?
A. Activation of Pacinian corpuscles
, B. Excitation of alpha motor neurons
C. Golgi tendon organ activation causing reflexive muscle lengthening
D. Reciprocal inhibition of antagonist muscle groups
E. Nociceptive pathway downregulation
ANSWER: C. Golgi tendon organ activation causing reflexive muscle
lengthening
RATIONALE: Muscle Energy Technique leveraging post-isometric
relaxation relies on the contraction of the affected agonist muscle.
This active contraction increases tension within the tendon,
activating Golgi tendon organs. This triggers an inhibitory reflex that
dampens alpha motor neuron activity, leading to immediate muscle
relaxation and allowing the operator to meet a new restrictive
barrier.
Question 4
A 35-year-old construction worker presents with pain over the lateral
aspect of his left elbow that radiates down his forearm. He notes the pain
worsens when he screws bolts or uses a screwdriver. Physical
examination demonstrates tenderness distal to the lateral epicondyle and
pain elicited upon resisted wrist extension. Radial head somatic
dysfunction is suspected. Which of the following motions is expected if the
radial head is anterior?
A. Restriction in anterior glide
B. Restriction in supination
C. Ease of pronation
