COMSAE PHASE 1 FORM 114 — HIGH-YIELD EXAM QUESTIONS
COMPLETE WITH 100% VERIFIED ANSWERS (200 QUESTIONS)
Table of Contents
Section Domain Approx. Page
Questions Reference
1 Osteopathic Principles & 40 Page 2
Practice (OPP/OMT)
2 Anatomy & Embryology 20 Page 6
3 Physiology & Pathophysiology 20 Page 8
4 Biochemistry & Molecular 20 Page 10
Biology
5 Microbiology & Immunology 20 Page 12
6 Pathology 20 Page 14
7 Pharmacology 20 Page 16
8 Clinical Medicine (Cardio, Pulm, 20 Page 18
GI, Renal, Endo, Neuro)
9 Behavioral Science, Biostatistics 20 Page 20
& Ethics
,Section 1: Osteopathic Principles & Practice (OPP/OMT) — Questions
1–40
Question 1
A 32-year-old female presents with chronic headaches and neck pain.
On osteopathic structural exam, you note that the occipitoatlantal (OA)
joint is restricted in flexion and sidebending to the left. According to
Fryette's principles, how is this dysfunction classified?
A) Neutral Type I dysfunction with rotation and sidebending opposite
B) Non-neutral Type II dysfunction with rotation and sidebending to the
same side
C) Neutral Type II dysfunction with rotation and sidebending opposite
D) Non-neutral Type I dysfunction with rotation and sidebending to the
same side
Correct Answer: B
Rationale: Fryette's second principle (Type II mechanics) applies when a
single vertebral segment is in a non-neutral position (flexed or
extended). In Type II dysfunction, rotation and sidebending occur to the
same side. The OA joint is a classic Type II segment.
Question 2
A 45-year-old male presents with low back pain after lifting a heavy box.
On examination, the standing flexion test shows superior movement of
the right posterior superior iliac spine (PSIS). Which somatic dysfunction
is most likely?
A) Left posterior innominate
B) Right anterior innominate
,C) Right sacral torsion on a left oblique axis
D) Bilateral innominate rotation
Correct Answer: B
Rationale: A positive standing flexion test on the right suggests iliosacral
dysfunction. Superior movement of the PSIS on the right most
commonly correlates with a right anterior innominate, where the ASIS is
positioned anteriorly and inferiorly, creating a functional short leg.
Question 3
A 28-year-old male presents with acute low back pain. On examination,
you note a right sacral torsion on a left oblique axis. Which of the
following best describes this dysfunction?
A) The sacrum rotates right around an oblique axis from left inferior to
right superior
B) The sacrum rotates left around an oblique axis from left inferior to
right superior
C) The sacrum rotates right around an oblique axis from left superior to
right inferior
D) The sacrum is neutral with no rotation
Correct Answer: A
Rationale: In a right sacral torsion on a left oblique axis, the sacrum
rotates to the right around an oblique axis that runs from the left
inferior angle to the right superior angle. This is a common somatic
dysfunction pattern tested on COMSAE.
Question 4
According to Fryette's first principle (Type I mechanics), when the spine
is in a neutral position, sidebending and rotation occur:
, A) To the same side
B) To opposite sides
C) Without rotation
D) Only in the lumbar spine
Correct Answer: B
Rationale: Fryette's first principle states that in a neutral spine (neither
flexed nor extended), sidebending and rotation occur to opposite sides.
For example, sidebending right is accompanied by rotation left.
Question 5
A patient presents with a somatic dysfunction described as "left fibular
head, posterior." What motion is restricted?
A) Anterior glide
B) Posterior glide
C) Lateral glide
D) Medial glide
Correct Answer: A
Rationale: When the fibular head is positioned posteriorly, anterior
glide of the fibular head is restricted. Treatment would aim to restore
anterior glide mobility.
Question 6
The diagnostic criteria for somatic dysfunction are summarized by the
mnemonic TART. What does TART stand for?
A) Trauma, Atrophy, Redness, Temperature
B) Tenderness, Asymmetry, Restricted motion, Tissue texture change
C) Tremor, Areflexia, Rigidity, Tachycardia
D) Tension, Atrophy, Restriction, Tenderness
COMPLETE WITH 100% VERIFIED ANSWERS (200 QUESTIONS)
Table of Contents
Section Domain Approx. Page
Questions Reference
1 Osteopathic Principles & 40 Page 2
Practice (OPP/OMT)
2 Anatomy & Embryology 20 Page 6
3 Physiology & Pathophysiology 20 Page 8
4 Biochemistry & Molecular 20 Page 10
Biology
5 Microbiology & Immunology 20 Page 12
6 Pathology 20 Page 14
7 Pharmacology 20 Page 16
8 Clinical Medicine (Cardio, Pulm, 20 Page 18
GI, Renal, Endo, Neuro)
9 Behavioral Science, Biostatistics 20 Page 20
& Ethics
,Section 1: Osteopathic Principles & Practice (OPP/OMT) — Questions
1–40
Question 1
A 32-year-old female presents with chronic headaches and neck pain.
On osteopathic structural exam, you note that the occipitoatlantal (OA)
joint is restricted in flexion and sidebending to the left. According to
Fryette's principles, how is this dysfunction classified?
A) Neutral Type I dysfunction with rotation and sidebending opposite
B) Non-neutral Type II dysfunction with rotation and sidebending to the
same side
C) Neutral Type II dysfunction with rotation and sidebending opposite
D) Non-neutral Type I dysfunction with rotation and sidebending to the
same side
Correct Answer: B
Rationale: Fryette's second principle (Type II mechanics) applies when a
single vertebral segment is in a non-neutral position (flexed or
extended). In Type II dysfunction, rotation and sidebending occur to the
same side. The OA joint is a classic Type II segment.
Question 2
A 45-year-old male presents with low back pain after lifting a heavy box.
On examination, the standing flexion test shows superior movement of
the right posterior superior iliac spine (PSIS). Which somatic dysfunction
is most likely?
A) Left posterior innominate
B) Right anterior innominate
,C) Right sacral torsion on a left oblique axis
D) Bilateral innominate rotation
Correct Answer: B
Rationale: A positive standing flexion test on the right suggests iliosacral
dysfunction. Superior movement of the PSIS on the right most
commonly correlates with a right anterior innominate, where the ASIS is
positioned anteriorly and inferiorly, creating a functional short leg.
Question 3
A 28-year-old male presents with acute low back pain. On examination,
you note a right sacral torsion on a left oblique axis. Which of the
following best describes this dysfunction?
A) The sacrum rotates right around an oblique axis from left inferior to
right superior
B) The sacrum rotates left around an oblique axis from left inferior to
right superior
C) The sacrum rotates right around an oblique axis from left superior to
right inferior
D) The sacrum is neutral with no rotation
Correct Answer: A
Rationale: In a right sacral torsion on a left oblique axis, the sacrum
rotates to the right around an oblique axis that runs from the left
inferior angle to the right superior angle. This is a common somatic
dysfunction pattern tested on COMSAE.
Question 4
According to Fryette's first principle (Type I mechanics), when the spine
is in a neutral position, sidebending and rotation occur:
, A) To the same side
B) To opposite sides
C) Without rotation
D) Only in the lumbar spine
Correct Answer: B
Rationale: Fryette's first principle states that in a neutral spine (neither
flexed nor extended), sidebending and rotation occur to opposite sides.
For example, sidebending right is accompanied by rotation left.
Question 5
A patient presents with a somatic dysfunction described as "left fibular
head, posterior." What motion is restricted?
A) Anterior glide
B) Posterior glide
C) Lateral glide
D) Medial glide
Correct Answer: A
Rationale: When the fibular head is positioned posteriorly, anterior
glide of the fibular head is restricted. Treatment would aim to restore
anterior glide mobility.
Question 6
The diagnostic criteria for somatic dysfunction are summarized by the
mnemonic TART. What does TART stand for?
A) Trauma, Atrophy, Redness, Temperature
B) Tenderness, Asymmetry, Restricted motion, Tissue texture change
C) Tremor, Areflexia, Rigidity, Tachycardia
D) Tension, Atrophy, Restriction, Tenderness
