COMSAE PHASE 1 FORM 114 ACTUAL EXAM – 176] QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
CORE DOMAINS
Osteopathic Principles and Practice
Biochemistry and Genetics
Physiology and Pathophysiology
Pharmacology and Therapeutics
Microbiology and Immunology
Anatomy and Embryology
Behavioral Science and Ethics
Pathology and Clinical Diagnostics
INTRODUCTION
The purpose of this examination is to evaluate the clinical readiness and foundational medical knowledge
of candidates for osteopathic practice. This assessment measures mastery of core medical sciences, the
,ability to apply osteopathic principles to clinical scenarios, and proficiency in professional ethics. The
examination consists of high-quality multiple-choice questions designed to test both theoretical
understanding and analytical decision-making skills. By prioritizing real-world application, the assessment
ensures candidates can effectively navigate complex patient presentations and regulatory environments.
Success on this exam demonstrates the critical thinking necessary for safe, effective, and evidence-based
patient care within the osteopathic medical profession.
SECTION ONE: QUESTIONS 1–100
A 45-year-old patient presents with chronic lower back pain. Physical examination reveals a Type II
somatic dysfunction at L3. Which of the following best describes this dysfunction?
A. Flexed, sidebent left, rotated left
B. Extended, sidebent right, rotated right
C. Neutral, sidebent left, rotated right
D. Flexed, sidebent right, rotated left
🟢B
🔴 RATIONALE: Type II somatic dysfunctions involve a single vertebral segment, are non-neutral,
and are characterized by the same side of rotation and sidebending. Option B represents a typical
Type II dysfunction pattern.
A patient with a deficiency in glucose-6-phosphate dehydrogenase is prescribed a medication for a
urinary tract infection. Which drug should be avoided to prevent hemolytic anemia?
A. Amoxicillin
B. Sulfamethoxazole
C. Doxycycline
D. Ciprofloxacin
🟢B
🔴 RATIONALE: Sulfonamides are classic triggers for oxidative stress in patients with G6PD
deficiency, leading to acute hemolysis.
,Which of the following cranial strains is characterized by the greater wings of the sphenoid being
superior on one side and inferior on the other?
A. Torsion
B. Vertical strain
C. Lateral strain
D. Sidebending-rotation
🟢A
🔴 RATIONALE: A cranial torsion is named for the high greater wing of the sphenoid and involves
rotation around an anterior-posterior axis.
A 60-year-old male presents with sudden onset of "crushing" chest pain radiating to the jaw. ECG
shows ST-segment elevation in leads V2-V4. Which coronary artery is most likely occluded?
A. Left circumflex
B. Right coronary artery
C. Left anterior descending
D. Posterior descending
🟢C
🔴 RATIONALE: ST-segment elevation in leads V2-V4 corresponds to the anterior wall of the heart,
which is supplied by the Left Anterior Descending (LAD) artery.
Which of the following ethical principles requires a physician to act in the best interest of the
patient?
A. Autonomy
B. Justice
C. Beneficence
D. Non-maleficence
🟢C
, 🔴 RATIONALE: Beneficence is the ethical obligation to take positive steps to help others and act in
their best interest.
A patient presents with "pill-rolling" tremors and bradykinesia. Which area of the brain is primarily
affected?
A. Substantia nigra
B. Cerebellum
C. Hippocampus
D. Amygdala
🟢A
🔴 RATIONALE: Parkinsonism is caused by the degeneration of dopaminergic neurons in the
substantia nigra pars compacta.
Which osteopathic technique is considered direct and passive?
A. Muscle energy
B. High-velocity, low-amplitude (HVLA)
C. Counterstrain
D. Still technique
🟢B
🔴 RATIONALE: HVLA is classified as a direct technique (moving toward the barrier) and a passive
technique (the physician performs the motion).
A patient is found to have a pH of 7.30, PCO2 of 50 mmHg, and HCO3 of 24 mEq/L. What is the
acid-base disturbance?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
CORE DOMAINS
Osteopathic Principles and Practice
Biochemistry and Genetics
Physiology and Pathophysiology
Pharmacology and Therapeutics
Microbiology and Immunology
Anatomy and Embryology
Behavioral Science and Ethics
Pathology and Clinical Diagnostics
INTRODUCTION
The purpose of this examination is to evaluate the clinical readiness and foundational medical knowledge
of candidates for osteopathic practice. This assessment measures mastery of core medical sciences, the
,ability to apply osteopathic principles to clinical scenarios, and proficiency in professional ethics. The
examination consists of high-quality multiple-choice questions designed to test both theoretical
understanding and analytical decision-making skills. By prioritizing real-world application, the assessment
ensures candidates can effectively navigate complex patient presentations and regulatory environments.
Success on this exam demonstrates the critical thinking necessary for safe, effective, and evidence-based
patient care within the osteopathic medical profession.
SECTION ONE: QUESTIONS 1–100
A 45-year-old patient presents with chronic lower back pain. Physical examination reveals a Type II
somatic dysfunction at L3. Which of the following best describes this dysfunction?
A. Flexed, sidebent left, rotated left
B. Extended, sidebent right, rotated right
C. Neutral, sidebent left, rotated right
D. Flexed, sidebent right, rotated left
🟢B
🔴 RATIONALE: Type II somatic dysfunctions involve a single vertebral segment, are non-neutral,
and are characterized by the same side of rotation and sidebending. Option B represents a typical
Type II dysfunction pattern.
A patient with a deficiency in glucose-6-phosphate dehydrogenase is prescribed a medication for a
urinary tract infection. Which drug should be avoided to prevent hemolytic anemia?
A. Amoxicillin
B. Sulfamethoxazole
C. Doxycycline
D. Ciprofloxacin
🟢B
🔴 RATIONALE: Sulfonamides are classic triggers for oxidative stress in patients with G6PD
deficiency, leading to acute hemolysis.
,Which of the following cranial strains is characterized by the greater wings of the sphenoid being
superior on one side and inferior on the other?
A. Torsion
B. Vertical strain
C. Lateral strain
D. Sidebending-rotation
🟢A
🔴 RATIONALE: A cranial torsion is named for the high greater wing of the sphenoid and involves
rotation around an anterior-posterior axis.
A 60-year-old male presents with sudden onset of "crushing" chest pain radiating to the jaw. ECG
shows ST-segment elevation in leads V2-V4. Which coronary artery is most likely occluded?
A. Left circumflex
B. Right coronary artery
C. Left anterior descending
D. Posterior descending
🟢C
🔴 RATIONALE: ST-segment elevation in leads V2-V4 corresponds to the anterior wall of the heart,
which is supplied by the Left Anterior Descending (LAD) artery.
Which of the following ethical principles requires a physician to act in the best interest of the
patient?
A. Autonomy
B. Justice
C. Beneficence
D. Non-maleficence
🟢C
, 🔴 RATIONALE: Beneficence is the ethical obligation to take positive steps to help others and act in
their best interest.
A patient presents with "pill-rolling" tremors and bradykinesia. Which area of the brain is primarily
affected?
A. Substantia nigra
B. Cerebellum
C. Hippocampus
D. Amygdala
🟢A
🔴 RATIONALE: Parkinsonism is caused by the degeneration of dopaminergic neurons in the
substantia nigra pars compacta.
Which osteopathic technique is considered direct and passive?
A. Muscle energy
B. High-velocity, low-amplitude (HVLA)
C. Counterstrain
D. Still technique
🟢B
🔴 RATIONALE: HVLA is classified as a direct technique (moving toward the barrier) and a passive
technique (the physician performs the motion).
A patient is found to have a pH of 7.30, PCO2 of 50 mmHg, and HCO3 of 24 mEq/L. What is the
acid-base disturbance?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
