COMSAE Phase 1 Form ASA 103 Intensive Review
Actual Exam 2026 Practice Questions And Verified
Answers With Rationales (Guaranteed Pass)
INSTANT DOWNLOAD PDF
This comprehensive COMSAE Phase 1 study companion features 300
premium, high-yield practice questions meticulously structured to reflect
the official NBOME exam blueprint. Every clinical scenario includes its own
verified answer key and exhaustive, step-by-step rationales that
thoroughly explain foundational biomedical sciences and osteopathic
principles. It serves as an indispensable, high-conversion resource
engineered to build testing stamina and maximize diagnostic accuracy for
top-tier board scores.
Question 1
A 62-year-old male presents to the emergency department with severe,
crushing substernal chest pain that radiates to his left jaw and arm,
accompanied by diaphoresis and nausea. An electrocardiogram (ECG)
reveals ST-segment 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) Marginal artery
E) Left main coronary artery
Answer: C
Rationale: ST-segment elevation in leads II, III, and aVF indicates an
acute transmural myocardial infarction affecting the inferior wall of
the heart. The right coronary artery (RCA) supplies the inferior wall
of the left ventricle in dominant systems, making it the most likely
site of occlusion. Occlusion of the left anterior descending artery
would cause changes in anterior/septal leads (V1-V4), while the left
circumflex artery affects lateral leads (I, aVL, V5-V6).
Question 2
A 24-year-old female presents with sharp, localized chest pain that
worsens with deep inspiration and improves when leaning forward. A
pericardial friction rub is heard on auscultation. Which of the following
ECG findings is most characteristic of this patient's condition?
A) Isolated ST-segment depression in V1-V3
B) Diffuse ST-segment elevation with PR-segment depression
C) Prominent U waves
D) Prolonged QT interval
E) Delta waves
,Answer: B
Rationale: The clinical presentation is classic for acute pericarditis
(pleuritic chest pain relieved by sitting up/leaning forward, plus a
friction rub). The pathognomonic ECG findings for acute pericarditis
are widespread/diffuse ST-segment elevation alongside widespread
PR-segment depression (especially notable in lead II), along with PR
elevation in lead aVR. Prominent U waves indicate hypokalemia, delta
waves indicate Wolff-Parkinson-White syndrome, and a prolonged
QT interval predisposes to Torsades de Pointes.
Question 3
A 48-year-old female undergoes an osteopathic structural examination.
The physician notes that her T4 vertebra is rotated right and sidebent
right in a flexed position. Which of the following describes the correct
setup for a direct, muscle energy technique to treat this somatic
dysfunction?
A) Flexion, sidebend right, rotate right
B) Extension, sidebend left, rotate left
C) Extension, sidebend right, rotate left
D) Flexion, sidebend left, rotate right
E) Neutral, sidebend left, rotate left
Answer: B
Rationale: The patient's somatic dysfunction is T4 Flexed, Sidebent
Right, Rotated Right (T4 F \(S_{R}R_{R}\)). Because Muscle Energy
, is a direct technique, the operator must engage the restrictive
barrier by positioning the patient into the exact opposite directions
of the dysfunction. The restrictive barriers for this segment are
Extension, Sidebending Left, and Rotation Left.
Question 4
A 19-year-old college student presents with a high fever, severe
headache, and neck stiffness. Physical examination reveals a positive
Brudzinski sign. A lumbar puncture is performed, and cerebrospinal fluid
(CSF) analysis shows high neutrophils, low glucose, and high protein. What
is the most likely causative organism?
A) Coxsackievirus
B) Cryptococcus neoformans
C) Neisseria meningitidis
D) Streptococcus pneumoniae
E) Listeria monocytogenes
Answer: C
Rationale: The clinical picture describes acute bacterial meningitis,
further confirmed by a CSF profile showing elevated neutrophils,
depressed glucose, and elevated protein. In young adults living in
close quarters like college dormitories, Neisseria meningitidis is a
highly prevalent causative pathogen. Streptococcus pneumoniae is
more common across the general adult population, but the age
Actual Exam 2026 Practice Questions And Verified
Answers With Rationales (Guaranteed Pass)
INSTANT DOWNLOAD PDF
This comprehensive COMSAE Phase 1 study companion features 300
premium, high-yield practice questions meticulously structured to reflect
the official NBOME exam blueprint. Every clinical scenario includes its own
verified answer key and exhaustive, step-by-step rationales that
thoroughly explain foundational biomedical sciences and osteopathic
principles. It serves as an indispensable, high-conversion resource
engineered to build testing stamina and maximize diagnostic accuracy for
top-tier board scores.
Question 1
A 62-year-old male presents to the emergency department with severe,
crushing substernal chest pain that radiates to his left jaw and arm,
accompanied by diaphoresis and nausea. An electrocardiogram (ECG)
reveals ST-segment 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) Marginal artery
E) Left main coronary artery
Answer: C
Rationale: ST-segment elevation in leads II, III, and aVF indicates an
acute transmural myocardial infarction affecting the inferior wall of
the heart. The right coronary artery (RCA) supplies the inferior wall
of the left ventricle in dominant systems, making it the most likely
site of occlusion. Occlusion of the left anterior descending artery
would cause changes in anterior/septal leads (V1-V4), while the left
circumflex artery affects lateral leads (I, aVL, V5-V6).
Question 2
A 24-year-old female presents with sharp, localized chest pain that
worsens with deep inspiration and improves when leaning forward. A
pericardial friction rub is heard on auscultation. Which of the following
ECG findings is most characteristic of this patient's condition?
A) Isolated ST-segment depression in V1-V3
B) Diffuse ST-segment elevation with PR-segment depression
C) Prominent U waves
D) Prolonged QT interval
E) Delta waves
,Answer: B
Rationale: The clinical presentation is classic for acute pericarditis
(pleuritic chest pain relieved by sitting up/leaning forward, plus a
friction rub). The pathognomonic ECG findings for acute pericarditis
are widespread/diffuse ST-segment elevation alongside widespread
PR-segment depression (especially notable in lead II), along with PR
elevation in lead aVR. Prominent U waves indicate hypokalemia, delta
waves indicate Wolff-Parkinson-White syndrome, and a prolonged
QT interval predisposes to Torsades de Pointes.
Question 3
A 48-year-old female undergoes an osteopathic structural examination.
The physician notes that her T4 vertebra is rotated right and sidebent
right in a flexed position. Which of the following describes the correct
setup for a direct, muscle energy technique to treat this somatic
dysfunction?
A) Flexion, sidebend right, rotate right
B) Extension, sidebend left, rotate left
C) Extension, sidebend right, rotate left
D) Flexion, sidebend left, rotate right
E) Neutral, sidebend left, rotate left
Answer: B
Rationale: The patient's somatic dysfunction is T4 Flexed, Sidebent
Right, Rotated Right (T4 F \(S_{R}R_{R}\)). Because Muscle Energy
, is a direct technique, the operator must engage the restrictive
barrier by positioning the patient into the exact opposite directions
of the dysfunction. The restrictive barriers for this segment are
Extension, Sidebending Left, and Rotation Left.
Question 4
A 19-year-old college student presents with a high fever, severe
headache, and neck stiffness. Physical examination reveals a positive
Brudzinski sign. A lumbar puncture is performed, and cerebrospinal fluid
(CSF) analysis shows high neutrophils, low glucose, and high protein. What
is the most likely causative organism?
A) Coxsackievirus
B) Cryptococcus neoformans
C) Neisseria meningitidis
D) Streptococcus pneumoniae
E) Listeria monocytogenes
Answer: C
Rationale: The clinical picture describes acute bacterial meningitis,
further confirmed by a CSF profile showing elevated neutrophils,
depressed glucose, and elevated protein. In young adults living in
close quarters like college dormitories, Neisseria meningitidis is a
highly prevalent causative pathogen. Streptococcus pneumoniae is
more common across the general adult population, but the age
