Page 1 of 139
COMSAE Phase 1 Form 111 — exam COMPLETE
QUESTIONS AND DETAILED SOLUTIONS LATEST
UPDATE THIS YEAR-JUST RELEASED
COMSAE Phase 1 Form 111 — covarage
1. Osteopathic Principles & OMM: TART, autonomics/viscerosomatic reflexes, Chapman points,
counterstrain, muscle energy, HVLA contraindications, MFR, ribs, Fryette laws,
sacral/innominate dysfunctions, lymphatics, cranial SBS strain patterns.
2. Biostatistics & Epidemiology: Sensitivity/specificity/PPV/NPV, RR vs OR, CI/p-values, Type I/II
errors and power, study designs, bias/confounding, screening vs diagnostic tests, ARR/NNT.
3. Ethics & Professionalism: Consent/autonomy, capacity vs competency,
confidentiality/reporting, DNR/advance directives, surrogate hierarchy, error disclosure,
boundaries/conflicts, impaired physician reporting.
4. Cardiovascular: Preload/afterload/contractility, murmurs, heart failure, arrhythmias/AV blocks,
shock, hypertension drugs, MI pathology/complications, atherosclerosis, endocarditis/rheumatic
fever.
5. Pulmonary & Critical Care: Obstructive vs restrictive, PFTs, V/Q mismatch/shunt/dead space,
ARDS, pneumonia organisms, PE diagnosis, pleural effusions, respiratory acid-base disorders.
6. Renal/Electrolytes/Acid-Base: GFR/clearance, AKI types, nephritic vs nephrotic, diuretics, acid-
base compensation, anion gap causes, potassium/ECG changes, SIADH vs DI.
7. Endocrine: Diabetes/DKA/HHS, thyroid disorders, adrenal disorders, aldosteronism, pituitary
axes, MEN syndromes, calcium/parathyroid disorders.
8. GI & Hepatobiliary: Hepatitis serology, cirrhosis complications, pancreatitis, gallstones/biliary
disease, PUD/H. pylori, malabsorption/IBD, GI bleeding causes.
9. Heme/Onc: Anemia types, hemolysis labs, coagulation/anticoagulants, DIC vs TTP vs HUS,
leukemia/lymphoma, multiple myeloma, tumor markers/paraneoplastic syndromes.
10. Neurology & Psychiatry: Stroke territories, brainstem/CN deficits, spinal cord syndromes,
seizures/drugs, MS/GBS, neurodegeneration, neurotransmitters, mood/psychotic disorders,
intoxication/withdrawal.
11. MSK/Derm/Rheum: OA vs RA, gout/pseudogout, SLE/Sjogren antibodies, vasculitis syndromes,
bone tumors, osteomyelitis, skin cancers, psoriasis.
12. Reproductive/Embryology/Genetics: Embryologic derivatives, pregnancy hormones, menstrual
cycle, STIs, gynecologic cancers/HPV, testicular tumors, inheritance/chromosomal disorders.
13. Microbiology: Gram ID and lab tests, meningitis organisms by age, respiratory pathogens, GI
pathogens/toxins, STIs, opportunistic infections, fungi/dimorphic fungi, viral
classification/hepatitis.
14. Immunology: Innate/adaptive immunity, immunoglobulins, MHC presentation, hypersensitivity
I–IV, complement deficiencies, immunodeficiencies, autoimmune mechanisms, vaccine
response.
15. Pharmacology: Autonomics, antibiotics/antivirals/antifungals, CV drugs, CNS drugs, endocrine
drugs, chemotherapy toxicity, CYP450 interactions, teratogens.
16. Biochemistry & Metabolism: Enzyme kinetics, glycolysis/gluconeogenesis/glycogen,
TCA/OXPHOS, fatty acids/ketogenesis, urea cycle defects, amino acid disorders, heme synthesis,
vitamin deficiencies.
, Page 2 of 139
17. General Pathology/Cell Biology: Adaptation/injury, free radicals/reperfusion, inflammation
mediators, wound healing/collagen, carcinogenesis, thrombosis/embolism/infarction,
amyloidosis.
18. Systems Integration/Reasoning: Mixed-topic vignettes, lab interpretation, next-step
diagnosis/management, mechanism-based drug questions, ABC stabilization, classic board
pattern recognition.
1.
A 32-year-old woman with asthma has increased sympathetic activity to the lungs identified during
osteopathic examination. Which spinal levels are most associated with sympathetic innervation to the
lungs?
A. T1–T4
B. T5–T9
C. T10–L2
D. S2–S4
Answer: A. T1–T4
Rationale: Pulmonary sympathetic innervation originates primarily from T1–T4 spinal segments.
2.
, Page 3 of 139
A patient with rib dysfunction demonstrates a rib that prefers inhalation and resists exhalation. What
type of rib dysfunction is present?
A. Exhalation dysfunction
B. Inhalation dysfunction
C. Neutral dysfunction
D. Bucket-handle restriction only
Answer: B. Inhalation dysfunction
Rationale: Inhalation dysfunction ribs remain elevated and resist exhalation.
3.
A clinical trial shows a medication reduces mortality from 10% to 5%. What is the absolute risk
reduction?
A. 2%
B. 5%
, Page 4 of 139
C. 10%
D. 50%
Answer: B. 5%
Rationale: Absolute risk reduction equals 10% − 5% = 5%.
4.
A physician discloses a medication error to a patient despite no apparent harm occurring. Which ethical
principle is primarily demonstrated?
A. Justice
B. Fidelity and honesty
C. Nonmaleficence
D. Paternalism
Answer: B. Fidelity and honesty
Rationale: Ethical practice requires truthful disclosure of medical errors.
COMSAE Phase 1 Form 111 — exam COMPLETE
QUESTIONS AND DETAILED SOLUTIONS LATEST
UPDATE THIS YEAR-JUST RELEASED
COMSAE Phase 1 Form 111 — covarage
1. Osteopathic Principles & OMM: TART, autonomics/viscerosomatic reflexes, Chapman points,
counterstrain, muscle energy, HVLA contraindications, MFR, ribs, Fryette laws,
sacral/innominate dysfunctions, lymphatics, cranial SBS strain patterns.
2. Biostatistics & Epidemiology: Sensitivity/specificity/PPV/NPV, RR vs OR, CI/p-values, Type I/II
errors and power, study designs, bias/confounding, screening vs diagnostic tests, ARR/NNT.
3. Ethics & Professionalism: Consent/autonomy, capacity vs competency,
confidentiality/reporting, DNR/advance directives, surrogate hierarchy, error disclosure,
boundaries/conflicts, impaired physician reporting.
4. Cardiovascular: Preload/afterload/contractility, murmurs, heart failure, arrhythmias/AV blocks,
shock, hypertension drugs, MI pathology/complications, atherosclerosis, endocarditis/rheumatic
fever.
5. Pulmonary & Critical Care: Obstructive vs restrictive, PFTs, V/Q mismatch/shunt/dead space,
ARDS, pneumonia organisms, PE diagnosis, pleural effusions, respiratory acid-base disorders.
6. Renal/Electrolytes/Acid-Base: GFR/clearance, AKI types, nephritic vs nephrotic, diuretics, acid-
base compensation, anion gap causes, potassium/ECG changes, SIADH vs DI.
7. Endocrine: Diabetes/DKA/HHS, thyroid disorders, adrenal disorders, aldosteronism, pituitary
axes, MEN syndromes, calcium/parathyroid disorders.
8. GI & Hepatobiliary: Hepatitis serology, cirrhosis complications, pancreatitis, gallstones/biliary
disease, PUD/H. pylori, malabsorption/IBD, GI bleeding causes.
9. Heme/Onc: Anemia types, hemolysis labs, coagulation/anticoagulants, DIC vs TTP vs HUS,
leukemia/lymphoma, multiple myeloma, tumor markers/paraneoplastic syndromes.
10. Neurology & Psychiatry: Stroke territories, brainstem/CN deficits, spinal cord syndromes,
seizures/drugs, MS/GBS, neurodegeneration, neurotransmitters, mood/psychotic disorders,
intoxication/withdrawal.
11. MSK/Derm/Rheum: OA vs RA, gout/pseudogout, SLE/Sjogren antibodies, vasculitis syndromes,
bone tumors, osteomyelitis, skin cancers, psoriasis.
12. Reproductive/Embryology/Genetics: Embryologic derivatives, pregnancy hormones, menstrual
cycle, STIs, gynecologic cancers/HPV, testicular tumors, inheritance/chromosomal disorders.
13. Microbiology: Gram ID and lab tests, meningitis organisms by age, respiratory pathogens, GI
pathogens/toxins, STIs, opportunistic infections, fungi/dimorphic fungi, viral
classification/hepatitis.
14. Immunology: Innate/adaptive immunity, immunoglobulins, MHC presentation, hypersensitivity
I–IV, complement deficiencies, immunodeficiencies, autoimmune mechanisms, vaccine
response.
15. Pharmacology: Autonomics, antibiotics/antivirals/antifungals, CV drugs, CNS drugs, endocrine
drugs, chemotherapy toxicity, CYP450 interactions, teratogens.
16. Biochemistry & Metabolism: Enzyme kinetics, glycolysis/gluconeogenesis/glycogen,
TCA/OXPHOS, fatty acids/ketogenesis, urea cycle defects, amino acid disorders, heme synthesis,
vitamin deficiencies.
, Page 2 of 139
17. General Pathology/Cell Biology: Adaptation/injury, free radicals/reperfusion, inflammation
mediators, wound healing/collagen, carcinogenesis, thrombosis/embolism/infarction,
amyloidosis.
18. Systems Integration/Reasoning: Mixed-topic vignettes, lab interpretation, next-step
diagnosis/management, mechanism-based drug questions, ABC stabilization, classic board
pattern recognition.
1.
A 32-year-old woman with asthma has increased sympathetic activity to the lungs identified during
osteopathic examination. Which spinal levels are most associated with sympathetic innervation to the
lungs?
A. T1–T4
B. T5–T9
C. T10–L2
D. S2–S4
Answer: A. T1–T4
Rationale: Pulmonary sympathetic innervation originates primarily from T1–T4 spinal segments.
2.
, Page 3 of 139
A patient with rib dysfunction demonstrates a rib that prefers inhalation and resists exhalation. What
type of rib dysfunction is present?
A. Exhalation dysfunction
B. Inhalation dysfunction
C. Neutral dysfunction
D. Bucket-handle restriction only
Answer: B. Inhalation dysfunction
Rationale: Inhalation dysfunction ribs remain elevated and resist exhalation.
3.
A clinical trial shows a medication reduces mortality from 10% to 5%. What is the absolute risk
reduction?
A. 2%
B. 5%
, Page 4 of 139
C. 10%
D. 50%
Answer: B. 5%
Rationale: Absolute risk reduction equals 10% − 5% = 5%.
4.
A physician discloses a medication error to a patient despite no apparent harm occurring. Which ethical
principle is primarily demonstrated?
A. Justice
B. Fidelity and honesty
C. Nonmaleficence
D. Paternalism
Answer: B. Fidelity and honesty
Rationale: Ethical practice requires truthful disclosure of medical errors.
