COMSAE Phase 1 Form 110: High-Yield
Practice Questions with Answers &
Rationales
Section 1: Osteopathic Principles & Practice (Questions 1-15)
,Question 1
A 45-year-old patient presents with low back pain. On examination, you find that the L5 vertebra
translates more easily to the right and is more restricted in flexion. What is the correct somatic
dysfunction diagnosis?
A) L5 F RrSr
B) L5 F RlSl
C) L5 E RrSr
D) L5 E RlSl
Answer: B) L5 F RlSl
Rationale: The nomenclature for somatic dysfunction describes position in relation to rotation and
sidebending. "F" indicates flexion dysfunction, "R" indicates rotation to the right, and "l" indicates
sidebending to the left. A vertebra that translates more easily to one side with restricted motion in
a specific direction indicates the dysfunction type. Type I (neutral) mechanics follow Fryette's first
principle, while Type II (non-neutral) mechanics follow the second principle .
,Question 2
A patient presents with an exhalation dysfunction of ribs 6-10. Which muscles are primarily used to
correct this somatic dysfunction?
A) Serratus anterior
B) External intercostals
C) Internal intercostals
D) Diaphragm
Answer: A) Serratus anterior
Rationale: Ribs 6-10 are classified as "bucket handle" ribs. In exhalation dysfunction, the ribs are
restricted in the exhalation position. The serratus anterior is the primary muscle used in the
, treatment of exhalation dysfunction of these ribs. The external intercostals are more associated
with inhalation dysfunctions .
Question 3
A patient with a history of chronic alcohol use presents with confusion, ataxia, and
ophthalmoplegia. Which vitamin deficiency is the most likely cause?
A) Vitamin B6 (pyridoxine)
B) Vitamin B12 (cobalamin)
C) Vitamin C
D) Vitamin B1 (thiamine)
Answer: D) Vitamin B1 (thiamine)
Practice Questions with Answers &
Rationales
Section 1: Osteopathic Principles & Practice (Questions 1-15)
,Question 1
A 45-year-old patient presents with low back pain. On examination, you find that the L5 vertebra
translates more easily to the right and is more restricted in flexion. What is the correct somatic
dysfunction diagnosis?
A) L5 F RrSr
B) L5 F RlSl
C) L5 E RrSr
D) L5 E RlSl
Answer: B) L5 F RlSl
Rationale: The nomenclature for somatic dysfunction describes position in relation to rotation and
sidebending. "F" indicates flexion dysfunction, "R" indicates rotation to the right, and "l" indicates
sidebending to the left. A vertebra that translates more easily to one side with restricted motion in
a specific direction indicates the dysfunction type. Type I (neutral) mechanics follow Fryette's first
principle, while Type II (non-neutral) mechanics follow the second principle .
,Question 2
A patient presents with an exhalation dysfunction of ribs 6-10. Which muscles are primarily used to
correct this somatic dysfunction?
A) Serratus anterior
B) External intercostals
C) Internal intercostals
D) Diaphragm
Answer: A) Serratus anterior
Rationale: Ribs 6-10 are classified as "bucket handle" ribs. In exhalation dysfunction, the ribs are
restricted in the exhalation position. The serratus anterior is the primary muscle used in the
, treatment of exhalation dysfunction of these ribs. The external intercostals are more associated
with inhalation dysfunctions .
Question 3
A patient with a history of chronic alcohol use presents with confusion, ataxia, and
ophthalmoplegia. Which vitamin deficiency is the most likely cause?
A) Vitamin B6 (pyridoxine)
B) Vitamin B12 (cobalamin)
C) Vitamin C
D) Vitamin B1 (thiamine)
Answer: D) Vitamin B1 (thiamine)
