COMSAE 115 Complete Question Bank with
Detailed Rationales
Content Coverage
High-yield domains included
Pathology: necrosis types, inflammation, neoplasia, granulomatous disease
Physiology: cardiac cycle, renal filtration, respiratory drive, acid-base balance
Pharmacology: mechanisms, adverse effects, pregnancy contraindications,
antibiotic classes
Microbiology: bacteria, viruses, fungi, classic presentations and diagnostics
Biochemistry and Metabolism: glycolysis, gluconeogenesis, inborn errors, lipid and
amino acid metabolism
Endocrinology: thyroid, adrenal, diabetes, calcium homeostasis
Cardiology and Pulmonology: ACS, heart failure, arrhythmias, pneumonia, PE
Neurology: stroke, meningitis, neuromuscular disorders, CSF findings
Hematology and Immunology: anemias, coagulation, immunodeficiencies,
autoimmunity
Gastroenterology and Hepatology: hepatitis, pancreatitis, peptic ulcer disease
Renal and Electrolytes: AKI/CKD patterns, diuretics, acid-base disorders
Infectious Disease: empiric therapy, common pathogens, sepsis management
Osteopathic Principles and Practice: somatic dysfunction classification, OMM
techniques (muscle energy, counterstrain, HVLA, lymphatic techniques)
Clinical Integration: multi-system vignettes, diagnostic reasoning, acute
management algorithms
What the simulation gives you
, Representative vignettes that mimic NBOME style and reasoning demands
Answers with concise rationales to explain correct choices and common
distractors
Timing and pacing practice for full-length exam stamina
Targeted weak-area identification to guide focused review
Study and Use Recommendations
Simulate test conditions: do at least one timed 4-hour run.
Block practice: complete 44-question blocks with short breaks between.
Review actively: read rationales for every missed item and summarize the concept
in one sentence.
Drill OMM separately: practice hands-on concepts and classification rules.
Track trends: log missed topics and revisit high-yield resources for those domains.
Block 1 — Questions 1–44 (Pathology, Physiology, Microbiology, Basic Biochemistry)
Q1. A 55‑year‑old man has sudden onset left hemiparesis. CT shows an ischemic infarct in
the right middle cerebral artery territory. Which type of necrosis is most likely in the affected
brain tissue after 48 hours?
A. Coagulative
B. Liquefactive
C. Caseous
D. Fat
Answer: B. Liquefactive
Rationale: CNS infarcts undergo enzymatic digestion producing liquefactive necrosis.
Q2. Which chemokine is the principal mediator of neutrophil chemotaxis in acute
inflammation?
Detailed Rationales
Content Coverage
High-yield domains included
Pathology: necrosis types, inflammation, neoplasia, granulomatous disease
Physiology: cardiac cycle, renal filtration, respiratory drive, acid-base balance
Pharmacology: mechanisms, adverse effects, pregnancy contraindications,
antibiotic classes
Microbiology: bacteria, viruses, fungi, classic presentations and diagnostics
Biochemistry and Metabolism: glycolysis, gluconeogenesis, inborn errors, lipid and
amino acid metabolism
Endocrinology: thyroid, adrenal, diabetes, calcium homeostasis
Cardiology and Pulmonology: ACS, heart failure, arrhythmias, pneumonia, PE
Neurology: stroke, meningitis, neuromuscular disorders, CSF findings
Hematology and Immunology: anemias, coagulation, immunodeficiencies,
autoimmunity
Gastroenterology and Hepatology: hepatitis, pancreatitis, peptic ulcer disease
Renal and Electrolytes: AKI/CKD patterns, diuretics, acid-base disorders
Infectious Disease: empiric therapy, common pathogens, sepsis management
Osteopathic Principles and Practice: somatic dysfunction classification, OMM
techniques (muscle energy, counterstrain, HVLA, lymphatic techniques)
Clinical Integration: multi-system vignettes, diagnostic reasoning, acute
management algorithms
What the simulation gives you
, Representative vignettes that mimic NBOME style and reasoning demands
Answers with concise rationales to explain correct choices and common
distractors
Timing and pacing practice for full-length exam stamina
Targeted weak-area identification to guide focused review
Study and Use Recommendations
Simulate test conditions: do at least one timed 4-hour run.
Block practice: complete 44-question blocks with short breaks between.
Review actively: read rationales for every missed item and summarize the concept
in one sentence.
Drill OMM separately: practice hands-on concepts and classification rules.
Track trends: log missed topics and revisit high-yield resources for those domains.
Block 1 — Questions 1–44 (Pathology, Physiology, Microbiology, Basic Biochemistry)
Q1. A 55‑year‑old man has sudden onset left hemiparesis. CT shows an ischemic infarct in
the right middle cerebral artery territory. Which type of necrosis is most likely in the affected
brain tissue after 48 hours?
A. Coagulative
B. Liquefactive
C. Caseous
D. Fat
Answer: B. Liquefactive
Rationale: CNS infarcts undergo enzymatic digestion producing liquefactive necrosis.
Q2. Which chemokine is the principal mediator of neutrophil chemotaxis in acute
inflammation?
