High-Yield Clinical Flashcards for
COMSAE 115
DESCRIPTION
COMSAE Phase 1 (Form 115) is a 176-question diagnostic exam used by osteopathic
medical students to predict readiness for the COMLEX-USA Level 1 boards.
Quick Stats
• Format: 4 sections of 44 questions (176 total).
• Time: 4 hours (~72 seconds per question).
• Passing Score: Typically 400, though many schools require 450+ to sit for
boards.
• Key Feature: The "b" version (e.g., 115b) now includes an answer key for
student-purchased forms [1].
High-Yield Content
• OMM (Heavy): Focuses on Sacral Torsions, Cranial Strains, and Chapman
Points.
• Systems: Strong emphasis on Neuro (stroke/cranial nerves)
and Cardio (murmurs/ECG).
• Ethics: High frequency of questions regarding autonomy and informed
consent.
Strategic Use
It is best used as a "mid-point" or "final" check during dedicated study to simulate board-
style pacing and identify weak body systems.
2026 Question And ANSWER Latest Update
, Section 1: Osteopathic Manipulative Medicine (OMM)
1. A 24-year-old male presents with a T4 segment that is restricted in right
rotation and right sidebending. The dysfunction worsens when the patient
is asked to slump forward. What is the correct diagnosis?
A) T4 Neutral, Sidebent Left, Rotated Right
B) T4 Extended, Rotated Left, Sidebent Left
C) T4 Flexed, Rotated Left, Sidebent Left
D) T4 Extended, Rotated Right, Sidebent Right
Answer: B
Rationale: If the dysfunction worsens in flexion (slumping), it is an Extension (E)
dysfunction. In Type II mechanics (single segment), rotation and sidebending
occur to the same side. Since it is restricted in right rotation/sidebending, its
preference (diagnosis) is the opposite: Left.
2. During a cranial exam, the physician notes that the sphenoid base moves
superiorly while the paired bones of the cranium undergo internal rotation.
Which of the following is true?
A) This represents the flexion phase of the Primary Respiratory Mechanism
(PRM).
B) The midline bones are increasing their anterior-posterior diameter.
C) The sacral base is moving posteriorly (counternutation).
D) The transverse diameter of the head is increasing.
Answer: C
Rationale: This describes Cranial Extension. In extension, the SBS moves
superiorly, paired bones internally rotate, the head narrows/lengthens (decreased
transverse diameter), and the sacral base moves posteriorly (counternutation).
3. A patient presents with an inhalation dysfunction of Ribs 3, 4, and 5 on the
right. Which rib is the "key rib" for treatment, and which muscle is used for
Muscle Energy?
A) Rib 3; Pectoralis minor
B) Rib 5; Pectoralis minor
C) Rib 3; Serratus anterior
D) Rib 5; Serratus anterior
Answer: B
2026 Question And ANSWER Latest Update
COMSAE 115
DESCRIPTION
COMSAE Phase 1 (Form 115) is a 176-question diagnostic exam used by osteopathic
medical students to predict readiness for the COMLEX-USA Level 1 boards.
Quick Stats
• Format: 4 sections of 44 questions (176 total).
• Time: 4 hours (~72 seconds per question).
• Passing Score: Typically 400, though many schools require 450+ to sit for
boards.
• Key Feature: The "b" version (e.g., 115b) now includes an answer key for
student-purchased forms [1].
High-Yield Content
• OMM (Heavy): Focuses on Sacral Torsions, Cranial Strains, and Chapman
Points.
• Systems: Strong emphasis on Neuro (stroke/cranial nerves)
and Cardio (murmurs/ECG).
• Ethics: High frequency of questions regarding autonomy and informed
consent.
Strategic Use
It is best used as a "mid-point" or "final" check during dedicated study to simulate board-
style pacing and identify weak body systems.
2026 Question And ANSWER Latest Update
, Section 1: Osteopathic Manipulative Medicine (OMM)
1. A 24-year-old male presents with a T4 segment that is restricted in right
rotation and right sidebending. The dysfunction worsens when the patient
is asked to slump forward. What is the correct diagnosis?
A) T4 Neutral, Sidebent Left, Rotated Right
B) T4 Extended, Rotated Left, Sidebent Left
C) T4 Flexed, Rotated Left, Sidebent Left
D) T4 Extended, Rotated Right, Sidebent Right
Answer: B
Rationale: If the dysfunction worsens in flexion (slumping), it is an Extension (E)
dysfunction. In Type II mechanics (single segment), rotation and sidebending
occur to the same side. Since it is restricted in right rotation/sidebending, its
preference (diagnosis) is the opposite: Left.
2. During a cranial exam, the physician notes that the sphenoid base moves
superiorly while the paired bones of the cranium undergo internal rotation.
Which of the following is true?
A) This represents the flexion phase of the Primary Respiratory Mechanism
(PRM).
B) The midline bones are increasing their anterior-posterior diameter.
C) The sacral base is moving posteriorly (counternutation).
D) The transverse diameter of the head is increasing.
Answer: C
Rationale: This describes Cranial Extension. In extension, the SBS moves
superiorly, paired bones internally rotate, the head narrows/lengthens (decreased
transverse diameter), and the sacral base moves posteriorly (counternutation).
3. A patient presents with an inhalation dysfunction of Ribs 3, 4, and 5 on the
right. Which rib is the "key rib" for treatment, and which muscle is used for
Muscle Energy?
A) Rib 3; Pectoralis minor
B) Rib 5; Pectoralis minor
C) Rib 3; Serratus anterior
D) Rib 5; Serratus anterior
Answer: B
2026 Question And ANSWER Latest Update
