COMSAE PHASE 1 FORM 114
COMPREHENSIVE MEDICAL
PRACTICE EXAM QUESTIONS AND
ANSWERS
1. A 45-year-old male presents with acute onset chest pain. A viscerosomatic reflex is noted
at the level of T1-T4 on the left. Which of the following organs is most likely associated with
this reflex?
A. Stomach
B. Liver
C. Appendix
D. Heart
Answer: D
Conceptual Explanation: The viscerosomatic reflex for the heart is located at the T1-T4
level, typically on the left side, representing sympathetic innervation to the myocardium.
2. Which mechanism of action is associated with the antibiotic Vancomycin?
A. Binding to the D-ala D-ala terminus of cell wall precursors
B. Inhibition of the 50S ribosomal subunit
,C. Inhibition of the 30S ribosomal subunit
D. Inhibition of DNA gyrase
Answer: A
Conceptual Explanation: Vancomycin inhibits bacterial cell wall synthesis by binding to
the D-alanyl-D-alanine portion of cell wall precursors, preventing peptidoglycan cross-
linking.
3. In Fryette’s Laws of spinal mechanics, which of the following is characteristic of a Type II
somatic dysfunction?
A. Occurs in the neutral position
B. Sidebending and rotation occur to the same side
C. Multiple segments are typically involved
D. Sidebending and rotation occur to opposite sides
Answer: B
Conceptual Explanation: Type II mechanics occur in a non-neutral (flexed or extended)
state, involve a single segment, and rotation and sidebending occur to the same side.
4. A patient presents with a ‘winged scapula’ after a radical mastectomy. Injury to which
nerve is most likely responsible?
A. Long thoracic nerve
B. Thoracodorsal nerve
, C. Axillary nerve
D. Suprascapular nerve
Answer: A
Conceptual Explanation: The long thoracic nerve innervates the serratus anterior muscle.
Damage to this nerve leads to scapular winging.
5. A 24-year-old female presents with flank pain and hematuria. Imaging shows a stone in the
ureter. Where is the Chapman point for the ureter located?
A. Lateral to the pubic symphysis
B. Along the iliotibial band
C. Umbilicus
D. Superior edge of the pubic bone
Answer: D
Conceptual Explanation: The Chapman reflex point for the ureter is located along the
superior edge of the pubic bone, near the pubic tubercle.
6. Which of the following findings is most characteristic of Minimal Change Disease in a child?
A. Spike and dome appearance on EM
B. Linear IgG deposits on IF
C. Effacement of podocyte foot processes
COMPREHENSIVE MEDICAL
PRACTICE EXAM QUESTIONS AND
ANSWERS
1. A 45-year-old male presents with acute onset chest pain. A viscerosomatic reflex is noted
at the level of T1-T4 on the left. Which of the following organs is most likely associated with
this reflex?
A. Stomach
B. Liver
C. Appendix
D. Heart
Answer: D
Conceptual Explanation: The viscerosomatic reflex for the heart is located at the T1-T4
level, typically on the left side, representing sympathetic innervation to the myocardium.
2. Which mechanism of action is associated with the antibiotic Vancomycin?
A. Binding to the D-ala D-ala terminus of cell wall precursors
B. Inhibition of the 50S ribosomal subunit
,C. Inhibition of the 30S ribosomal subunit
D. Inhibition of DNA gyrase
Answer: A
Conceptual Explanation: Vancomycin inhibits bacterial cell wall synthesis by binding to
the D-alanyl-D-alanine portion of cell wall precursors, preventing peptidoglycan cross-
linking.
3. In Fryette’s Laws of spinal mechanics, which of the following is characteristic of a Type II
somatic dysfunction?
A. Occurs in the neutral position
B. Sidebending and rotation occur to the same side
C. Multiple segments are typically involved
D. Sidebending and rotation occur to opposite sides
Answer: B
Conceptual Explanation: Type II mechanics occur in a non-neutral (flexed or extended)
state, involve a single segment, and rotation and sidebending occur to the same side.
4. A patient presents with a ‘winged scapula’ after a radical mastectomy. Injury to which
nerve is most likely responsible?
A. Long thoracic nerve
B. Thoracodorsal nerve
, C. Axillary nerve
D. Suprascapular nerve
Answer: A
Conceptual Explanation: The long thoracic nerve innervates the serratus anterior muscle.
Damage to this nerve leads to scapular winging.
5. A 24-year-old female presents with flank pain and hematuria. Imaging shows a stone in the
ureter. Where is the Chapman point for the ureter located?
A. Lateral to the pubic symphysis
B. Along the iliotibial band
C. Umbilicus
D. Superior edge of the pubic bone
Answer: D
Conceptual Explanation: The Chapman reflex point for the ureter is located along the
superior edge of the pubic bone, near the pubic tubercle.
6. Which of the following findings is most characteristic of Minimal Change Disease in a child?
A. Spike and dome appearance on EM
B. Linear IgG deposits on IF
C. Effacement of podocyte foot processes
