Page 1 of 137
COMSAE Phase 1 Form 112 — exam COMPLETE
QUESTIONS AND DETAILED SOLUTIONS LATEST
UPDATE THIS YEAR-JUST RELEASED
Exam covarage
1. Osteopathic Principles & OMM: TART diagnosis, viscerosomatic reflexes, autonomics, Chapman
points, muscle energy, counterstrain, HVLA contraindications, MFR, rib dysfunctions, Fryette laws,
sacral/innominate dysfunctions, lymphatics, cranial SBS strains, clinical OMM applications.
2. Biostatistics & Epidemiology: Sensitivity/specificity/PPV/NPV, RR vs OR, ARR/NNT, likelihood ratios,
CI/p-values, Type I/II errors and power, study designs, bias/confounding, screening concepts.
3. Ethics & Professionalism: Consent/refusal, capacity vs competency, confidentiality/reporting,
surrogate hierarchy, DNR/advance directives, error disclosure, boundaries/conflicts, physician
impairment duties.
4. Cardiovascular System: PV loops/hemodynamics, heart failure, murmurs, arrhythmias/AV blocks,
shock, hypertension treatment, atherosclerosis/MI pathogenesis, MI complication timeline,
endocarditis/rheumatic/pericarditis.
5. Pulmonary & Critical Care: Obstructive vs restrictive, PFTs/DLCO, V/Q mismatch/shunt/dead space,
ARDS, pneumonia organisms, PE diagnosis, pleural effusions, pulmonary acid-base disorders.
6. Renal/Electrolytes/Acid-Base: GFR/RPF/clearance, AKI types, nephritic vs nephrotic, tubular
disorders, diuretics, anion gap vs non-gap acidosis, respiratory compensation, potassium/ECG, SIADH vs
DI.
7. Endocrine System: Diabetes/DKA/HHS, thyroid disorders, adrenal disorders, aldosteronism,
pituitary axes, MEN syndromes, calcium/PTH disorders.
8. GI & Hepatobiliary: Hepatitis serology, liver enzyme patterns, cirrhosis complications, pancreatitis,
PUD/H. pylori, malabsorption/IBD, gallstones/biliary disease, GI bleed-anemia links.
9. Hematology & Oncology: RBC indices/anemia types, hemolysis labs, coagulation/anticoagulants,
DIC vs TTP vs HUS, leukemias/lymphomas, multiple myeloma, paraneoplastic syndromes/tumor
markers.
10. Neurology & Psychiatry: Stroke territories, brainstem/CN lesions, spinal cord syndromes,
seizures/drugs, MS/GBS, neurodegeneration, neurotransmitters/psych drugs, psychiatric disorders,
intoxication/withdrawal.
11. MSK/Derm/Rheumatology: OA vs RA, gout/pseudogout, SLE antibodies, Sjogren, vasculitis
syndromes, osteomyelitis, bone tumors, skin cancers, psoriasis.
12. Reproductive/Embryology/Genetics: Embryology derivatives, pregnancy hormones, menstrual
cycle, STIs, HPV/cervical cancer, ovarian/testicular tumor markers, inheritance/pedigrees, chromosomal
disorders.
13. Microbiology: Gram ID, catalase/coagulase/hemolysis, CNS infections by age, respiratory/GI
pathogens, toxin-mediated disease, STIs, opportunistic infections, fungi/dimorphic fungi, viral
replication, parasites.
14. Immunology: Innate/adaptive immunity, antibody classes, MHC I/II, complement deficiencies,
hypersensitivity I–IV, immunodeficiencies, autoimmune disease, transplant rejection/GVHD, vaccine
response.
15. Pharmacology: Autonomic/cholinergic drugs, antibiotics resistance/toxicities,
antivirals/antifungals, CV drugs, CNS drugs, endocrine drugs, chemotherapy toxicities, CYP450
interactions, teratogens.
, Page 2 of 137
16. Biochemistry & Metabolism: Enzyme kinetics, glycolysis/gluconeogenesis/glycogen storage,
TCA/OXPHOS, fatty acids/ketones, amino acid disorders, urea cycle defects, porphyrias/heme synthesis,
vitamin deficiencies.
17. General Pathology & Cell Biology: Cellular adaptation/injury, free radicals/reperfusion,
inflammation/leukocyte migration, wound healing/collagen, carcinogenesis,
thrombosis/embolism/edema, amyloidosis.
18. Systems Integration/Reasoning: Integrated vignettes (micro/pharm/path), lab interpretation,
next-step management, ABC stabilization, classic board pattern recognition, OMM integration with
clinical disease.
COMSAE Phase 1 Form 112 —
1.
A 42-year-old man with acute bronchitis has tissue texture changes, asymmetry, restriction of motion,
and tenderness over the thoracic spine. These findings are collectively referred to as which osteopathic
concept?
A. Fryette mechanics
B. TART findings
C. Chapman points
D. Viscerosomatic reflexes
Answer: B. TART findings
, Page 3 of 137
Rationale: TART stands for Tissue texture changes, Asymmetry, Restriction of motion, and Tenderness,
which are used to diagnose somatic dysfunction.
2.
A patient with gallbladder disease is most likely to exhibit viscerosomatic reflexes at which spinal levels?
A. T1–T4
B. T5–T9
C. T10–L2
D. S2–S4
Answer: B. T5–T9
Rationale: The gallbladder is a foregut structure with sympathetic innervation primarily from T5–T9.
3.
, Page 4 of 137
A physician performs HVLA treatment on a patient with severe osteoporosis. Which statement best
describes this situation?
A. HVLA is first-line therapy
B. Osteoporosis is a contraindication to HVLA
C. Muscle energy is contraindicated instead
D. Counterstrain worsens osteoporosis
Answer: B. Osteoporosis is a contraindication to HVLA
Rationale: HVLA should be avoided in patients with weakened bone due to fracture risk.
4.
A study evaluates how well a screening test correctly identifies healthy individuals. Which statistic is
being measured?
A. Sensitivity
B. Positive predictive value
COMSAE Phase 1 Form 112 — exam COMPLETE
QUESTIONS AND DETAILED SOLUTIONS LATEST
UPDATE THIS YEAR-JUST RELEASED
Exam covarage
1. Osteopathic Principles & OMM: TART diagnosis, viscerosomatic reflexes, autonomics, Chapman
points, muscle energy, counterstrain, HVLA contraindications, MFR, rib dysfunctions, Fryette laws,
sacral/innominate dysfunctions, lymphatics, cranial SBS strains, clinical OMM applications.
2. Biostatistics & Epidemiology: Sensitivity/specificity/PPV/NPV, RR vs OR, ARR/NNT, likelihood ratios,
CI/p-values, Type I/II errors and power, study designs, bias/confounding, screening concepts.
3. Ethics & Professionalism: Consent/refusal, capacity vs competency, confidentiality/reporting,
surrogate hierarchy, DNR/advance directives, error disclosure, boundaries/conflicts, physician
impairment duties.
4. Cardiovascular System: PV loops/hemodynamics, heart failure, murmurs, arrhythmias/AV blocks,
shock, hypertension treatment, atherosclerosis/MI pathogenesis, MI complication timeline,
endocarditis/rheumatic/pericarditis.
5. Pulmonary & Critical Care: Obstructive vs restrictive, PFTs/DLCO, V/Q mismatch/shunt/dead space,
ARDS, pneumonia organisms, PE diagnosis, pleural effusions, pulmonary acid-base disorders.
6. Renal/Electrolytes/Acid-Base: GFR/RPF/clearance, AKI types, nephritic vs nephrotic, tubular
disorders, diuretics, anion gap vs non-gap acidosis, respiratory compensation, potassium/ECG, SIADH vs
DI.
7. Endocrine System: Diabetes/DKA/HHS, thyroid disorders, adrenal disorders, aldosteronism,
pituitary axes, MEN syndromes, calcium/PTH disorders.
8. GI & Hepatobiliary: Hepatitis serology, liver enzyme patterns, cirrhosis complications, pancreatitis,
PUD/H. pylori, malabsorption/IBD, gallstones/biliary disease, GI bleed-anemia links.
9. Hematology & Oncology: RBC indices/anemia types, hemolysis labs, coagulation/anticoagulants,
DIC vs TTP vs HUS, leukemias/lymphomas, multiple myeloma, paraneoplastic syndromes/tumor
markers.
10. Neurology & Psychiatry: Stroke territories, brainstem/CN lesions, spinal cord syndromes,
seizures/drugs, MS/GBS, neurodegeneration, neurotransmitters/psych drugs, psychiatric disorders,
intoxication/withdrawal.
11. MSK/Derm/Rheumatology: OA vs RA, gout/pseudogout, SLE antibodies, Sjogren, vasculitis
syndromes, osteomyelitis, bone tumors, skin cancers, psoriasis.
12. Reproductive/Embryology/Genetics: Embryology derivatives, pregnancy hormones, menstrual
cycle, STIs, HPV/cervical cancer, ovarian/testicular tumor markers, inheritance/pedigrees, chromosomal
disorders.
13. Microbiology: Gram ID, catalase/coagulase/hemolysis, CNS infections by age, respiratory/GI
pathogens, toxin-mediated disease, STIs, opportunistic infections, fungi/dimorphic fungi, viral
replication, parasites.
14. Immunology: Innate/adaptive immunity, antibody classes, MHC I/II, complement deficiencies,
hypersensitivity I–IV, immunodeficiencies, autoimmune disease, transplant rejection/GVHD, vaccine
response.
15. Pharmacology: Autonomic/cholinergic drugs, antibiotics resistance/toxicities,
antivirals/antifungals, CV drugs, CNS drugs, endocrine drugs, chemotherapy toxicities, CYP450
interactions, teratogens.
, Page 2 of 137
16. Biochemistry & Metabolism: Enzyme kinetics, glycolysis/gluconeogenesis/glycogen storage,
TCA/OXPHOS, fatty acids/ketones, amino acid disorders, urea cycle defects, porphyrias/heme synthesis,
vitamin deficiencies.
17. General Pathology & Cell Biology: Cellular adaptation/injury, free radicals/reperfusion,
inflammation/leukocyte migration, wound healing/collagen, carcinogenesis,
thrombosis/embolism/edema, amyloidosis.
18. Systems Integration/Reasoning: Integrated vignettes (micro/pharm/path), lab interpretation,
next-step management, ABC stabilization, classic board pattern recognition, OMM integration with
clinical disease.
COMSAE Phase 1 Form 112 —
1.
A 42-year-old man with acute bronchitis has tissue texture changes, asymmetry, restriction of motion,
and tenderness over the thoracic spine. These findings are collectively referred to as which osteopathic
concept?
A. Fryette mechanics
B. TART findings
C. Chapman points
D. Viscerosomatic reflexes
Answer: B. TART findings
, Page 3 of 137
Rationale: TART stands for Tissue texture changes, Asymmetry, Restriction of motion, and Tenderness,
which are used to diagnose somatic dysfunction.
2.
A patient with gallbladder disease is most likely to exhibit viscerosomatic reflexes at which spinal levels?
A. T1–T4
B. T5–T9
C. T10–L2
D. S2–S4
Answer: B. T5–T9
Rationale: The gallbladder is a foregut structure with sympathetic innervation primarily from T5–T9.
3.
, Page 4 of 137
A physician performs HVLA treatment on a patient with severe osteoporosis. Which statement best
describes this situation?
A. HVLA is first-line therapy
B. Osteoporosis is a contraindication to HVLA
C. Muscle energy is contraindicated instead
D. Counterstrain worsens osteoporosis
Answer: B. Osteoporosis is a contraindication to HVLA
Rationale: HVLA should be avoided in patients with weakened bone due to fracture risk.
4.
A study evaluates how well a screening test correctly identifies healthy individuals. Which statistic is
being measured?
A. Sensitivity
B. Positive predictive value
