COMSAE PHASE 1 FORM 117 EXAM TEST BANK –
NEWEST 2026 EDITION | COMPREHENSIVE 160+-
QUESTION SET WITH VERIFIED ANSWERS &
DETAILED RATIONALES
,CORE DOMAINS
• Osteopathic Principles and Manipulative Medicine (OMM/OPP)
• Foundational Biomedical Sciences (Anatomy, Biochemistry,
Physiology)
• Clinical Systems (Cardiovascular, Respiratory, GI, Renal, Endocrine)
• Microbiology and Immunology
• Pharmacology and Pharmacotherapeutics
• Pathology and Laboratory Medicine
• Behavioral Science, Ethics, and Biostatistics
• Musculoskeletal System and Connective Tissue
• Nervous System and Special Senses
• High-Yield Multi-System Clinical Vignettes
INTRODUCTION
The COMSAE Phase 1 Form 117 is a comprehensive self-assessment
examination designed for osteopathic medical students preparing for
COMLEX-USA Level 1. This assessment evaluates foundational biomedical
sciences integrated with osteopathic principles and clinical reasoning. The
examination consists of single-best-answer multiple-choice questions,
including clinical vignettes that mirror the COMLEX-USA blueprint. Questions
emphasize application of basic science knowledge to clinical scenarios,
interpretation of laboratory and imaging findings, and demonstration of
competency in osteopathic manipulative medicine. Success requires mastery of
anatomy, physiology, pathology, pharmacology, and the osteopathic approach
to whole-person care. This resource provides 160 practice questions with
detailed rationales for comprehensive exam preparation.
,Question 1
A 45-year-old female presents with chronic low back pain. On examination,
you find that the L5 vertebra is restricted in flexion, rotates more easily to the
left, and sidebends more easily to the left. According to Fryette's principles,
how should this dysfunction be documented?
A. L5 Flexed RR SR
B. L5 Flexed LR SL
C. L5 Extended RR SR
D. L5 Neutral LR SR
B. L5 Flexed LR SL
RATIONALE: Fryette's principles describe spinal motion mechanics. Type
II (non-neutral) dysfunctions occur in flexion or extension with rotation and
sidebending in the same direction. Since the segment is restricted in flexion
with rotation left (LR) and sidebending left (SL), the correct documentation
is "L5 Flexed LR SL" .
Question 2
A 32-year-old patient with a history of recurrent urinary tract infections has a
tender, nodular region at the tip of the 12th rib on the right. This Chapman
reflex point is associated with dysfunction of which organ?
A. Right kidney
B. Right ureter
C. Appendix
D. Right ovary
A. Right kidney
RATIONALE: Chapman reflexes are small, tender nodules in the deep
fascia that correspond to visceral dysfunction. The kidney reflex points are
, located at the tips of the 12th ribs bilaterally. The ureter reflex is located
medial to the anterior superior iliac spine .
Question 3
A patient presents with a right posterior innominate rotation. Which muscle
energy treatment is most appropriate?
A. Treat the right hip flexors
B. Treat the right hamstrings
C. Treat the left hip flexors
D. Treat the left hamstrings
B. Treat the right hamstrings
RATIONALE: In a posterior innominate rotation, the ilium rotates
posteriorly relative to the sacrum. The hamstrings on the affected side are
shortened and should be treated with muscle energy .
Question 4
A 55-year-old male with chronic asthma has paraspinal tenderness and
restricted motion at T3-T5. This viscerosomatic reflex is most consistent with
dysfunction of which organ?
A. Heart
B. Lungs
C. Stomach
D. Liver
B. Lungs
RATIONALE: Viscerosomatic reflexes occur when visceral disease causes
somatic dysfunction in corresponding spinal segments. The pulmonary reflex
NEWEST 2026 EDITION | COMPREHENSIVE 160+-
QUESTION SET WITH VERIFIED ANSWERS &
DETAILED RATIONALES
,CORE DOMAINS
• Osteopathic Principles and Manipulative Medicine (OMM/OPP)
• Foundational Biomedical Sciences (Anatomy, Biochemistry,
Physiology)
• Clinical Systems (Cardiovascular, Respiratory, GI, Renal, Endocrine)
• Microbiology and Immunology
• Pharmacology and Pharmacotherapeutics
• Pathology and Laboratory Medicine
• Behavioral Science, Ethics, and Biostatistics
• Musculoskeletal System and Connective Tissue
• Nervous System and Special Senses
• High-Yield Multi-System Clinical Vignettes
INTRODUCTION
The COMSAE Phase 1 Form 117 is a comprehensive self-assessment
examination designed for osteopathic medical students preparing for
COMLEX-USA Level 1. This assessment evaluates foundational biomedical
sciences integrated with osteopathic principles and clinical reasoning. The
examination consists of single-best-answer multiple-choice questions,
including clinical vignettes that mirror the COMLEX-USA blueprint. Questions
emphasize application of basic science knowledge to clinical scenarios,
interpretation of laboratory and imaging findings, and demonstration of
competency in osteopathic manipulative medicine. Success requires mastery of
anatomy, physiology, pathology, pharmacology, and the osteopathic approach
to whole-person care. This resource provides 160 practice questions with
detailed rationales for comprehensive exam preparation.
,Question 1
A 45-year-old female presents with chronic low back pain. On examination,
you find that the L5 vertebra is restricted in flexion, rotates more easily to the
left, and sidebends more easily to the left. According to Fryette's principles,
how should this dysfunction be documented?
A. L5 Flexed RR SR
B. L5 Flexed LR SL
C. L5 Extended RR SR
D. L5 Neutral LR SR
B. L5 Flexed LR SL
RATIONALE: Fryette's principles describe spinal motion mechanics. Type
II (non-neutral) dysfunctions occur in flexion or extension with rotation and
sidebending in the same direction. Since the segment is restricted in flexion
with rotation left (LR) and sidebending left (SL), the correct documentation
is "L5 Flexed LR SL" .
Question 2
A 32-year-old patient with a history of recurrent urinary tract infections has a
tender, nodular region at the tip of the 12th rib on the right. This Chapman
reflex point is associated with dysfunction of which organ?
A. Right kidney
B. Right ureter
C. Appendix
D. Right ovary
A. Right kidney
RATIONALE: Chapman reflexes are small, tender nodules in the deep
fascia that correspond to visceral dysfunction. The kidney reflex points are
, located at the tips of the 12th ribs bilaterally. The ureter reflex is located
medial to the anterior superior iliac spine .
Question 3
A patient presents with a right posterior innominate rotation. Which muscle
energy treatment is most appropriate?
A. Treat the right hip flexors
B. Treat the right hamstrings
C. Treat the left hip flexors
D. Treat the left hamstrings
B. Treat the right hamstrings
RATIONALE: In a posterior innominate rotation, the ilium rotates
posteriorly relative to the sacrum. The hamstrings on the affected side are
shortened and should be treated with muscle energy .
Question 4
A 55-year-old male with chronic asthma has paraspinal tenderness and
restricted motion at T3-T5. This viscerosomatic reflex is most consistent with
dysfunction of which organ?
A. Heart
B. Lungs
C. Stomach
D. Liver
B. Lungs
RATIONALE: Viscerosomatic reflexes occur when visceral disease causes
somatic dysfunction in corresponding spinal segments. The pulmonary reflex
