Page 1 of 81
COMSAE PHASE 1 FORM 113 EXAM —QUESTIONS
AND CORRECT ANSWERS WITH RATIONALES
COMSAE PHASE 1 FORM 113 EXAM —PRACTICE QUESTIONS
10 MOST-TESTED EXAM COVERAGE AREAS
1. Osteopathic Principles, OMM & Somatic Dysfunction — Chapman points, viscerosomatic
reflexes, sympathetic and parasympathetic levels, spinal mechanics, Fryette principles, muscle
energy, HVLA, counterstrain, facilitated positional release, myofascial release, lymphatic
techniques, sacral diagnosis, cranial concepts, and common OMM contraindications.
2. Cardiovascular & Hematologic Systems — cardiac physiology, murmurs, ischemic disease, heart
failure, hypertension, arrhythmias, shock, vascular disease, anemia, coagulation disorders,
leukemias, lymphomas, and transfusion-related concepts.
3. Respiratory System — obstructive and restrictive lung disease, pneumonia, tuberculosis,
pulmonary embolism, pleural disease, respiratory physiology, acid-base disorders, neonatal
respiratory disease, and common pulmonary infections.
4. Renal, Genitourinary & Reproductive Systems — nephritic and nephrotic syndromes, acute
kidney injury, electrolyte disorders, acid-base balance, urinary infections, reproductive
physiology, pregnancy complications, sexually transmitted infections, and renal pharmacology.
5. Gastrointestinal & Nutritional Health — liver disease, biliary disease, pancreatic disease,
inflammatory bowel disease, peptic ulcer disease, malabsorption, intestinal obstruction, GI
infections, nutritional deficiencies, and gastrointestinal pathology.
6. Nervous System & Mental Health — neuroanatomy, stroke, seizures, headaches, neuropathies,
spinal cord lesions, movement disorders, psychiatric disorders, neurotransmitters,
neuropharmacology, and behavioral medicine.
7. Endocrine, Metabolism & Genetics — diabetes, thyroid disease, adrenal disorders, pituitary
disorders, calcium regulation, metabolic disease, inherited disorders, genetic mechanisms, and
endocrine pharmacology.
8. Musculoskeletal, Skin & Development — bone and joint disease, fractures, arthritis, muscle
disorders, connective-tissue disease, dermatologic disease, embryology, normal development,
congenital disorders, and pediatric presentations.
9. Microbiology, Immunology, Pharmacology & Pathology — infectious organisms, immune
responses, hypersensitivity, immunodeficiency, antimicrobial drugs, autonomic drugs,
cardiovascular drugs, adverse effects, mechanisms of disease, and laboratory interpretation.
10. Biochemistry, Physiology, Biostatistics, Ethics & Professional Practice — metabolism, molecular
biology, cellular physiology, epidemiology, sensitivity, specificity, predictive values, study design,
informed consent, confidentiality, communication, professionalism, patient safety, and
healthcare systems.
, Page 2 of 81
250 COMSAE PHASE 1–STYLE PRACTICE QUESTIONS
1.
A patient develops weakness of the left arm and leg after a sudden neurologic event. Which brain vessel
is most likely affected?
A. Right middle cerebral artery
B. Left anterior cerebral artery
C. Right posterior cerebral artery
D. Left posterior inferior cerebellar artery
Answer: A
Rationale: The right middle cerebral artery supplies large portions of the lateral frontal and parietal
cortex controlling the opposite face and upper limb, with possible leg involvement.
2.
A patient has low blood pressure, warm skin, and severe infection despite adequate fluid replacement.
Which mechanism best explains this condition?
A. Increased systemic vascular resistance
B. Decreased systemic vascular resistance
C. Increased blood viscosity
D. Increased left ventricular afterload
Answer: B
Rationale: Septic shock causes widespread vasodilation, which lowers systemic vascular resistance and
causes severe hypotension.
3.
A young adult has recurrent episodes of wheezing after exposure to dust and pollen. Which airway
change most directly causes these symptoms?
A. Permanent alveolar destruction
B. Reversible bronchoconstriction
C. Pulmonary vascular obstruction
D. Pleural fluid accumulation
Answer: B
Rationale: Asthma causes reversible airway narrowing from bronchoconstriction, inflammation, and
increased mucus production.
, Page 3 of 81
4.
A patient has severe diarrhea and develops metabolic acidosis. Which renal response normally helps
correct this acid-base problem?
A. Decreased hydrogen ion secretion
B. Increased bicarbonate loss
C. Increased hydrogen ion secretion
D. Decreased ammonium production
Answer: C
Rationale: The kidneys compensate for metabolic acidosis by increasing hydrogen ion secretion and
generating additional bicarbonate.
5.
A patient has fever, painful urination, and urinary frequency without flank pain. Which diagnosis is most
likely based on these findings?
A. Cystitis
B. Pyelonephritis
C. Nephrotic syndrome
D. Renal cell carcinoma
Answer: A
Rationale: Dysuria and urinary frequency without systemic or flank symptoms are typical of lower
urinary tract infection.
6.
A patient has a resting tremor, rigidity, and slow movement. Which neurotransmitter deficiency is most
strongly associated with this disorder?
A. Dopamine
B. Serotonin
C. GABA
D. Acetylcholine
Answer: A
Rationale: Parkinson disease is associated with degeneration of dopaminergic neurons in the substantia
nigra.
, Page 4 of 81
7.
A patient has excessive thirst, frequent urination, weight loss, and very high blood glucose. Which
hormone is deficient or ineffective?
A. Insulin
B. Cortisol
C. Aldosterone
D. Growth hormone
Answer: A
Rationale: Insulin deficiency or ineffective insulin action causes hyperglycemia and the classic symptoms
of diabetes mellitus.
8.
A patient has fatigue, pale skin, and microcytic red blood cells. Which laboratory finding most strongly
supports iron deficiency?
A. Increased ferritin
B. Increased serum iron
C. Decreased ferritin
D. Increased vitamin B12
Answer: C
Rationale: Low ferritin reflects reduced iron stores and strongly supports iron deficiency anemia.
9.
A patient develops facial swelling and difficulty breathing immediately after receiving a medication.
Which immune mechanism is most likely responsible?
A. IgE-mediated hypersensitivity
B. IgG-mediated cytotoxicity
C. Immune complex deposition
D. Delayed T-cell response
Answer: A
Rationale: Rapid anaphylactic reactions are type I hypersensitivity reactions mediated by IgE and mast-
cell activation.
10.
COMSAE PHASE 1 FORM 113 EXAM —QUESTIONS
AND CORRECT ANSWERS WITH RATIONALES
COMSAE PHASE 1 FORM 113 EXAM —PRACTICE QUESTIONS
10 MOST-TESTED EXAM COVERAGE AREAS
1. Osteopathic Principles, OMM & Somatic Dysfunction — Chapman points, viscerosomatic
reflexes, sympathetic and parasympathetic levels, spinal mechanics, Fryette principles, muscle
energy, HVLA, counterstrain, facilitated positional release, myofascial release, lymphatic
techniques, sacral diagnosis, cranial concepts, and common OMM contraindications.
2. Cardiovascular & Hematologic Systems — cardiac physiology, murmurs, ischemic disease, heart
failure, hypertension, arrhythmias, shock, vascular disease, anemia, coagulation disorders,
leukemias, lymphomas, and transfusion-related concepts.
3. Respiratory System — obstructive and restrictive lung disease, pneumonia, tuberculosis,
pulmonary embolism, pleural disease, respiratory physiology, acid-base disorders, neonatal
respiratory disease, and common pulmonary infections.
4. Renal, Genitourinary & Reproductive Systems — nephritic and nephrotic syndromes, acute
kidney injury, electrolyte disorders, acid-base balance, urinary infections, reproductive
physiology, pregnancy complications, sexually transmitted infections, and renal pharmacology.
5. Gastrointestinal & Nutritional Health — liver disease, biliary disease, pancreatic disease,
inflammatory bowel disease, peptic ulcer disease, malabsorption, intestinal obstruction, GI
infections, nutritional deficiencies, and gastrointestinal pathology.
6. Nervous System & Mental Health — neuroanatomy, stroke, seizures, headaches, neuropathies,
spinal cord lesions, movement disorders, psychiatric disorders, neurotransmitters,
neuropharmacology, and behavioral medicine.
7. Endocrine, Metabolism & Genetics — diabetes, thyroid disease, adrenal disorders, pituitary
disorders, calcium regulation, metabolic disease, inherited disorders, genetic mechanisms, and
endocrine pharmacology.
8. Musculoskeletal, Skin & Development — bone and joint disease, fractures, arthritis, muscle
disorders, connective-tissue disease, dermatologic disease, embryology, normal development,
congenital disorders, and pediatric presentations.
9. Microbiology, Immunology, Pharmacology & Pathology — infectious organisms, immune
responses, hypersensitivity, immunodeficiency, antimicrobial drugs, autonomic drugs,
cardiovascular drugs, adverse effects, mechanisms of disease, and laboratory interpretation.
10. Biochemistry, Physiology, Biostatistics, Ethics & Professional Practice — metabolism, molecular
biology, cellular physiology, epidemiology, sensitivity, specificity, predictive values, study design,
informed consent, confidentiality, communication, professionalism, patient safety, and
healthcare systems.
, Page 2 of 81
250 COMSAE PHASE 1–STYLE PRACTICE QUESTIONS
1.
A patient develops weakness of the left arm and leg after a sudden neurologic event. Which brain vessel
is most likely affected?
A. Right middle cerebral artery
B. Left anterior cerebral artery
C. Right posterior cerebral artery
D. Left posterior inferior cerebellar artery
Answer: A
Rationale: The right middle cerebral artery supplies large portions of the lateral frontal and parietal
cortex controlling the opposite face and upper limb, with possible leg involvement.
2.
A patient has low blood pressure, warm skin, and severe infection despite adequate fluid replacement.
Which mechanism best explains this condition?
A. Increased systemic vascular resistance
B. Decreased systemic vascular resistance
C. Increased blood viscosity
D. Increased left ventricular afterload
Answer: B
Rationale: Septic shock causes widespread vasodilation, which lowers systemic vascular resistance and
causes severe hypotension.
3.
A young adult has recurrent episodes of wheezing after exposure to dust and pollen. Which airway
change most directly causes these symptoms?
A. Permanent alveolar destruction
B. Reversible bronchoconstriction
C. Pulmonary vascular obstruction
D. Pleural fluid accumulation
Answer: B
Rationale: Asthma causes reversible airway narrowing from bronchoconstriction, inflammation, and
increased mucus production.
, Page 3 of 81
4.
A patient has severe diarrhea and develops metabolic acidosis. Which renal response normally helps
correct this acid-base problem?
A. Decreased hydrogen ion secretion
B. Increased bicarbonate loss
C. Increased hydrogen ion secretion
D. Decreased ammonium production
Answer: C
Rationale: The kidneys compensate for metabolic acidosis by increasing hydrogen ion secretion and
generating additional bicarbonate.
5.
A patient has fever, painful urination, and urinary frequency without flank pain. Which diagnosis is most
likely based on these findings?
A. Cystitis
B. Pyelonephritis
C. Nephrotic syndrome
D. Renal cell carcinoma
Answer: A
Rationale: Dysuria and urinary frequency without systemic or flank symptoms are typical of lower
urinary tract infection.
6.
A patient has a resting tremor, rigidity, and slow movement. Which neurotransmitter deficiency is most
strongly associated with this disorder?
A. Dopamine
B. Serotonin
C. GABA
D. Acetylcholine
Answer: A
Rationale: Parkinson disease is associated with degeneration of dopaminergic neurons in the substantia
nigra.
, Page 4 of 81
7.
A patient has excessive thirst, frequent urination, weight loss, and very high blood glucose. Which
hormone is deficient or ineffective?
A. Insulin
B. Cortisol
C. Aldosterone
D. Growth hormone
Answer: A
Rationale: Insulin deficiency or ineffective insulin action causes hyperglycemia and the classic symptoms
of diabetes mellitus.
8.
A patient has fatigue, pale skin, and microcytic red blood cells. Which laboratory finding most strongly
supports iron deficiency?
A. Increased ferritin
B. Increased serum iron
C. Decreased ferritin
D. Increased vitamin B12
Answer: C
Rationale: Low ferritin reflects reduced iron stores and strongly supports iron deficiency anemia.
9.
A patient develops facial swelling and difficulty breathing immediately after receiving a medication.
Which immune mechanism is most likely responsible?
A. IgE-mediated hypersensitivity
B. IgG-mediated cytotoxicity
C. Immune complex deposition
D. Delayed T-cell response
Answer: A
Rationale: Rapid anaphylactic reactions are type I hypersensitivity reactions mediated by IgE and mast-
cell activation.
10.
