1
COMSAE Phase 1 Form 113 Practice Exam Questions And
Correct Answers (Verified Answers) Plus Rationales
2025|2026 Q&A | Instant Download Pdf
COMSAE Phase 1, Form 113: Practice Questions
These questions cover core topics found in Form 113, such as neuroanatomy, endocrinology,
pharmacology, and more.
1. A 23-year-old man presents with right arm pain after a fall. He cannot extend his wrist. What nerve
is most likely injured?
• A) Median
• B) Ulnar
• C) Radial
• D) Axillary
✔✔Answer ✔✔C) Radial
Rationale: The radial nerve innervates the extensor muscles of the forearm, which control wrist
extension. Injury to this nerve typically results in "wrist drop," an inability to extend the wrist.
2. Which of the following agents inhibits bacterial dihydrofolate reductase (DHFR)?
• A) Sulfamethoxazole
• B) Trimethoprim
• C) Ciprofloxacin
• D) Rifampin
✔✔Answer ✔✔B) Trimethoprim
Rationale: Trimethoprim acts as an antimetabolite by competitively inhibiting bacterial dihydrofolate
reductase. This disrupts the synthesis of tetrahydrofolate, a critical cofactor for bacterial DNA and
protein production.
3. A patient with an elevated mean corpuscular volume (MCV) and neurologic symptoms likely has a
deficiency in which of the following?
,2
• A) Folate
• B) Vitamin B12
• C) Iron
• D) Vitamin C
✔✔Answer ✔✔B) Vitamin B12
Rationale: Vitamin B12 deficiency leads to a megaloblastic anemia, which is characterized by a high MCV
(macrocytic anemia). B12 is essential for myelin synthesis; its deficiency can cause neurological
symptoms such as peripheral neuropathy and subacute combined degeneration of the spinal cord.
4. A positive Trendelenburg sign indicates weakness in which muscle?
• A) Vastus lateralis
• B) Gluteus medius
• C) Gluteus maximus
• D) Piriformis
✔✔Answer ✔✔B) Gluteus medius
Rationale: The gluteus medius and minimus are the primary hip abductors that stabilize the pelvis when
the contralateral leg is lifted. Weakness in these muscles causes the pelvis to drop on the opposite side,
a finding known as a positive Trendelenburg sign.
5. A 68-year-old woman presents with pain over the lateral elbow. Resisted wrist extension
exacerbates the pain. What is the most likely diagnosis?
• A) Medial epicondylitis
• B) Lateral epicondylitis
• C) Olecranon bursitis
• D) Radial head subluxation
✔✔Answer ✔✔B) Lateral epicondylitis
Rationale: Lateral epicondylitis, or "tennis elbow," is a tendinopathy of the common extensor origin,
particularly the extensor carpi radialis brevis. Pain over the lateral elbow that worsens with resisted
wrist extension is a classic finding.
6. A positive Lachman test suggests injury to which structure?
• A) Posterior cruciate ligament (PCL)
• B) Anterior cruciate ligament (ACL)
• C) Medial collateral ligament (MCL)
• D) Lateral collateral ligament (LCL)
,3
✔✔Answer ✔✔B) Anterior cruciate ligament (ACL)
Rationale: The Lachman test is a highly sensitive and specific physical exam maneuver for assessing the
integrity of the ACL. With the knee flexed at 20-30 degrees, anterior translation of the tibia relative to
the femur indicates an ACL injury.
7. Which hormone is characteristically elevated in 21-hydroxylase deficiency?
• A) Aldosterone
• B) Cortisol
• C) 17-hydroxyprogesterone (17-OHP)
• D) Dopamine
✔✔Answer ✔✔C) 17-hydroxyprogesterone (17-OHP)
Rationale: 21-hydroxylase deficiency is the most common cause of congenital adrenal hyperplasia. The
enzyme defect prevents the conversion of 17-OHP to 11-deoxycortisol, leading to a buildup of 17-OHP
and its shunting into the androgen synthesis pathway, causing virilization.
8. A 30-year-old woman presents with exophthalmos and heat intolerance. What is the most likely
diagnosis?
• A) Hashimoto thyroiditis
• B) Subacute thyroiditis
• C) Graves disease
• D) Toxic nodular goiter
✔✔Answer ✔✔C) Graves disease
Rationale: Exophthalmos (proptosis) is a pathognomonic finding of Graves disease, an autoimmune
hyperthyroid condition. Heat intolerance, along with other signs of hypermetabolism, is a classic
symptom of thyrotoxicosis.
9. A 25-year-old female presents with headaches, diplopia, peripheral vision loss, galactorrhea, and
amenorrhea. MRI of the brain is ordered. The secretory cells most likely causing this patient's
conditions are which of the following?
• A) Corticotrophs
• B) Gonadotrophs
• C) Lactotrophs
• D) Somatotrophs
✔✔Answer ✔✔C) Lactotrophs
Rationale: This clinical picture is classic for a prolactin-secreting pituitary adenoma. The mass effect
from the tumor compresses the optic chiasm, causing visual field deficits (often bitemporal hemianopia)
, 4
and headaches. The elevated prolactin inhibits gonadotropin release, leading to hypogonadism
(amenorrhea) and stimulates milk production (galactorrhea).
10. Which drug reduces mortality post-myocardial infarction (MI)?
• A) NSAIDs
• B) Beta-blockers
• C) Antacids
• D) Diuretics
✔✔Answer ✔✔B) Beta-blockers
Rationale: Beta-blockers are a cornerstone of post-MI management. By blocking beta-1 receptors in the
heart, they reduce heart rate, contractility, and myocardial oxygen demand, thereby decreasing the risk
of recurrent infarction and mortality.
How to Use This Resource
While COMSAE answer keys are officially provided with score reports, they may not offer the detailed
explanations necessary for deep learning. Use this resource alongside other study tools to identify your
weak areas and build a solid foundation of knowledge. Remember that a higher score on a COMSAE is a
strong indicator of readiness for the COMLEX, but it is a predictive tool, not a definitive pass/fail
guarantee. Focus on understanding the material, not just memorizing answers.
11-150
We need to interpret the user's request "11-150" in the context of the previous conversation. The user
previously asked for "COMSAE Phase 1 Form 113 Practice Exam Questions And Correct Answers
(Verified Answers) Plus Rationales 2025|2026 Q&A | Instant Download Pdf". The assistant provided 10
sample questions (1-10). Now the user asks for "11-150", likely meaning they want questions 11 through
150 of that same COMSAE practice exam. The assistant should generate additional practice questions
(11 to 150) in the same format, covering osteopathic and medical topics relevant to COMLEX Level 1.
Since this is a simulated practice exam, the assistant can create plausible questions with correct answers
and rationales. The assistant should ensure that the questions are appropriate for COMLEX Level 1 style
and difficulty. I will produce a set of 140 questions (11-150) with answers and rationales, continuing
from where the assistant left off. I'll maintain the structure: numbered questions, multiple choice
options (A-D), correct answer indicated, and a brief rationale. I'll cover various systems: cardiology,
pulmonology, nephrology, GI, neurology, musculoskeletal, pharmacology, microbiology, immunology,
behavioral science, etc. I'll avoid duplicating the first 10. I'll produce in a single response.
I’ll continue the COMSAE Phase 1 Form 113 Practice Exam with questions 11 through 150. These are
original practice questions written in the style and difficulty of the actual COMSAE, covering high-yield
topics for COMLEX-USA Level 1. Each question includes the correct answer and a detailed rationale.
COMSAE Phase 1 Form 113 Practice Exam Questions And
Correct Answers (Verified Answers) Plus Rationales
2025|2026 Q&A | Instant Download Pdf
COMSAE Phase 1, Form 113: Practice Questions
These questions cover core topics found in Form 113, such as neuroanatomy, endocrinology,
pharmacology, and more.
1. A 23-year-old man presents with right arm pain after a fall. He cannot extend his wrist. What nerve
is most likely injured?
• A) Median
• B) Ulnar
• C) Radial
• D) Axillary
✔✔Answer ✔✔C) Radial
Rationale: The radial nerve innervates the extensor muscles of the forearm, which control wrist
extension. Injury to this nerve typically results in "wrist drop," an inability to extend the wrist.
2. Which of the following agents inhibits bacterial dihydrofolate reductase (DHFR)?
• A) Sulfamethoxazole
• B) Trimethoprim
• C) Ciprofloxacin
• D) Rifampin
✔✔Answer ✔✔B) Trimethoprim
Rationale: Trimethoprim acts as an antimetabolite by competitively inhibiting bacterial dihydrofolate
reductase. This disrupts the synthesis of tetrahydrofolate, a critical cofactor for bacterial DNA and
protein production.
3. A patient with an elevated mean corpuscular volume (MCV) and neurologic symptoms likely has a
deficiency in which of the following?
,2
• A) Folate
• B) Vitamin B12
• C) Iron
• D) Vitamin C
✔✔Answer ✔✔B) Vitamin B12
Rationale: Vitamin B12 deficiency leads to a megaloblastic anemia, which is characterized by a high MCV
(macrocytic anemia). B12 is essential for myelin synthesis; its deficiency can cause neurological
symptoms such as peripheral neuropathy and subacute combined degeneration of the spinal cord.
4. A positive Trendelenburg sign indicates weakness in which muscle?
• A) Vastus lateralis
• B) Gluteus medius
• C) Gluteus maximus
• D) Piriformis
✔✔Answer ✔✔B) Gluteus medius
Rationale: The gluteus medius and minimus are the primary hip abductors that stabilize the pelvis when
the contralateral leg is lifted. Weakness in these muscles causes the pelvis to drop on the opposite side,
a finding known as a positive Trendelenburg sign.
5. A 68-year-old woman presents with pain over the lateral elbow. Resisted wrist extension
exacerbates the pain. What is the most likely diagnosis?
• A) Medial epicondylitis
• B) Lateral epicondylitis
• C) Olecranon bursitis
• D) Radial head subluxation
✔✔Answer ✔✔B) Lateral epicondylitis
Rationale: Lateral epicondylitis, or "tennis elbow," is a tendinopathy of the common extensor origin,
particularly the extensor carpi radialis brevis. Pain over the lateral elbow that worsens with resisted
wrist extension is a classic finding.
6. A positive Lachman test suggests injury to which structure?
• A) Posterior cruciate ligament (PCL)
• B) Anterior cruciate ligament (ACL)
• C) Medial collateral ligament (MCL)
• D) Lateral collateral ligament (LCL)
,3
✔✔Answer ✔✔B) Anterior cruciate ligament (ACL)
Rationale: The Lachman test is a highly sensitive and specific physical exam maneuver for assessing the
integrity of the ACL. With the knee flexed at 20-30 degrees, anterior translation of the tibia relative to
the femur indicates an ACL injury.
7. Which hormone is characteristically elevated in 21-hydroxylase deficiency?
• A) Aldosterone
• B) Cortisol
• C) 17-hydroxyprogesterone (17-OHP)
• D) Dopamine
✔✔Answer ✔✔C) 17-hydroxyprogesterone (17-OHP)
Rationale: 21-hydroxylase deficiency is the most common cause of congenital adrenal hyperplasia. The
enzyme defect prevents the conversion of 17-OHP to 11-deoxycortisol, leading to a buildup of 17-OHP
and its shunting into the androgen synthesis pathway, causing virilization.
8. A 30-year-old woman presents with exophthalmos and heat intolerance. What is the most likely
diagnosis?
• A) Hashimoto thyroiditis
• B) Subacute thyroiditis
• C) Graves disease
• D) Toxic nodular goiter
✔✔Answer ✔✔C) Graves disease
Rationale: Exophthalmos (proptosis) is a pathognomonic finding of Graves disease, an autoimmune
hyperthyroid condition. Heat intolerance, along with other signs of hypermetabolism, is a classic
symptom of thyrotoxicosis.
9. A 25-year-old female presents with headaches, diplopia, peripheral vision loss, galactorrhea, and
amenorrhea. MRI of the brain is ordered. The secretory cells most likely causing this patient's
conditions are which of the following?
• A) Corticotrophs
• B) Gonadotrophs
• C) Lactotrophs
• D) Somatotrophs
✔✔Answer ✔✔C) Lactotrophs
Rationale: This clinical picture is classic for a prolactin-secreting pituitary adenoma. The mass effect
from the tumor compresses the optic chiasm, causing visual field deficits (often bitemporal hemianopia)
, 4
and headaches. The elevated prolactin inhibits gonadotropin release, leading to hypogonadism
(amenorrhea) and stimulates milk production (galactorrhea).
10. Which drug reduces mortality post-myocardial infarction (MI)?
• A) NSAIDs
• B) Beta-blockers
• C) Antacids
• D) Diuretics
✔✔Answer ✔✔B) Beta-blockers
Rationale: Beta-blockers are a cornerstone of post-MI management. By blocking beta-1 receptors in the
heart, they reduce heart rate, contractility, and myocardial oxygen demand, thereby decreasing the risk
of recurrent infarction and mortality.
How to Use This Resource
While COMSAE answer keys are officially provided with score reports, they may not offer the detailed
explanations necessary for deep learning. Use this resource alongside other study tools to identify your
weak areas and build a solid foundation of knowledge. Remember that a higher score on a COMSAE is a
strong indicator of readiness for the COMLEX, but it is a predictive tool, not a definitive pass/fail
guarantee. Focus on understanding the material, not just memorizing answers.
11-150
We need to interpret the user's request "11-150" in the context of the previous conversation. The user
previously asked for "COMSAE Phase 1 Form 113 Practice Exam Questions And Correct Answers
(Verified Answers) Plus Rationales 2025|2026 Q&A | Instant Download Pdf". The assistant provided 10
sample questions (1-10). Now the user asks for "11-150", likely meaning they want questions 11 through
150 of that same COMSAE practice exam. The assistant should generate additional practice questions
(11 to 150) in the same format, covering osteopathic and medical topics relevant to COMLEX Level 1.
Since this is a simulated practice exam, the assistant can create plausible questions with correct answers
and rationales. The assistant should ensure that the questions are appropriate for COMLEX Level 1 style
and difficulty. I will produce a set of 140 questions (11-150) with answers and rationales, continuing
from where the assistant left off. I'll maintain the structure: numbered questions, multiple choice
options (A-D), correct answer indicated, and a brief rationale. I'll cover various systems: cardiology,
pulmonology, nephrology, GI, neurology, musculoskeletal, pharmacology, microbiology, immunology,
behavioral science, etc. I'll avoid duplicating the first 10. I'll produce in a single response.
I’ll continue the COMSAE Phase 1 Form 113 Practice Exam with questions 11 through 150. These are
original practice questions written in the style and difficulty of the actual COMSAE, covering high-yield
topics for COMLEX-USA Level 1. Each question includes the correct answer and a detailed rationale.
