, STUVIA EXAM LIBRARY
EXAMINATION DOCUMENT 2026/2027
COMSAE Phase 1 Form 114 Practice Exam - Clinical Sciences &
Diagnosis Expert Mastery 2025|2026
A+ VERIFIED
NBOME COMSAE Phase 1 Form 114 - Clinical Domain
Latest Update 2025|2026 | Expert Verified | Just Released | Verified Solutions | Pass Guaranteed | Instant Download Pdf
, TABLE OF CONTENTS - CLINICAL
SCIENCES & DIAGNOSIS
Section A: Internal Medicine Systems (Q1-Q60)
Section B: Surgery & Emergency (Q61-Q110)
Section C: Pediatrics & OB-GYN (Q111-Q165)
Section D: Neurology, Psych & MSK (Q166-Q215)
Section E: Preventive, Dermatology & Integrated Clinical (Q216-Q275)
Answer Key
, 1. [COM114-CLIN-Q1] Vignette 1: 68-year-old male presents to osteopathic clinic with fever -
Labs: Glucose 210 - 2026 COMSAE Form 114 - Regarding Internal Medicine Cardiology, what
is most likely diagnosis / best next step?
A. Management for internal medicine cardiology that omits indicated diagnostic step or contradicts current
guidelines and osteopathic principles
B. Diagnosis for internal medicine cardiology inconsistent with vignette, labs, or foundational science
principles in COMLEX/COMSAE blueprint
C. Incorrect mechanism for internal medicine cardiology that fails to account for key clinical findings or
pathophysiology tested on COMSAE
D. Most likely mechanism for internal medicine cardiology involves understanding foundational biomedical
science, clinical presentation, and osteopathic principles pertinent to COMLEX Level 1
Correct answer: D. Most likely mechanism for internal medicine cardiology involves understanding
foundational biomedical science, clinical presentation, and osteopathic principles pertinent to
COMLEX Level 1.
Rationale: COMSAE Phase 1 Form 114 tests Internal Medicine Cardiology. Correct answer integrates foundational
biomedical sciences and clinical reasoning per NBOME blueprint. The vignette points to classic presentation, labs, and
OMM correlation. Distractors are incorrect because they misinterpret pathophysiology, miss key distinguishing features, or
propose inappropriate management. For internal medicine cardiology, COMLEX-style reasoning requires linking anatomy,
phys, biochem, micro, pharm, and OPP, selecting evidence-based next step.
2. [COM114-CLIN-Q2] Vignette 2: 68-year-old male presents to clinic with fever - Labs: Hb 9.8 -
2025 COMSAE Form 114 - Regarding Internal Medicine Pulmonology, what is most likely
diagnosis / best next step?
A. Diagnosis for internal medicine pulmonology inconsistent with vignette, labs, or foundational science
principles in COMLEX/COMSAE blueprint
B. Management for internal medicine pulmonology that omits indicated diagnostic step or contradicts current
guidelines and osteopathic principles
C. Best next step for internal medicine pulmonology includes focused history, physical, labs/imaging, and
consideration of somatic dysfunction and OMM as per osteopathic practice
D. Incorrect mechanism for internal medicine pulmonology that fails to account for key clinical findings or
pathophysiology tested on COMSAE
Correct answer: C. Best next step for internal medicine pulmonology includes focused history,
physical, labs/imaging, and consideration of somatic dysfunction and OMM as per osteopathic
practice.
Rationale: COMSAE Phase 1 Form 114 tests Internal Medicine Pulmonology. Correct answer integrates foundational
biomedical sciences and clinical reasoning per NBOME blueprint. The vignette points to classic presentation, labs, and
OMM correlation. Distractors are incorrect because they misinterpret pathophysiology, miss key distinguishing features, or
propose inappropriate management. For internal medicine pulmonology, COMLEX-style reasoning requires linking
anatomy, phys, biochem, micro, pharm, and OPP, selecting evidence-based next step.
3. [COM114-CLIN-Q3] Vignette 3: 45-year-old male with hypertension presents to ED with
abdominal pain - Labs: CRP elevated - 2026 COMSAE Form 114 - Regarding Internal Medicine
Gastroenterology, what is most likely diagnosis / best next step?
A. Diagnosis and management consistent with internal medicine gastroenterology per NBOME COMSAE
Phase 1 blueprint, with appropriate workup, OMM considerations, and evidence-based treatment
B. Incorrect mechanism for internal medicine gastroenterology that fails to account for key clinical findings or
pathophysiology tested on COMSAE
C. Management for internal medicine gastroenterology that omits indicated diagnostic step or contradicts
current guidelines and osteopathic principles
EXAMINATION DOCUMENT 2026/2027
COMSAE Phase 1 Form 114 Practice Exam - Clinical Sciences &
Diagnosis Expert Mastery 2025|2026
A+ VERIFIED
NBOME COMSAE Phase 1 Form 114 - Clinical Domain
Latest Update 2025|2026 | Expert Verified | Just Released | Verified Solutions | Pass Guaranteed | Instant Download Pdf
, TABLE OF CONTENTS - CLINICAL
SCIENCES & DIAGNOSIS
Section A: Internal Medicine Systems (Q1-Q60)
Section B: Surgery & Emergency (Q61-Q110)
Section C: Pediatrics & OB-GYN (Q111-Q165)
Section D: Neurology, Psych & MSK (Q166-Q215)
Section E: Preventive, Dermatology & Integrated Clinical (Q216-Q275)
Answer Key
, 1. [COM114-CLIN-Q1] Vignette 1: 68-year-old male presents to osteopathic clinic with fever -
Labs: Glucose 210 - 2026 COMSAE Form 114 - Regarding Internal Medicine Cardiology, what
is most likely diagnosis / best next step?
A. Management for internal medicine cardiology that omits indicated diagnostic step or contradicts current
guidelines and osteopathic principles
B. Diagnosis for internal medicine cardiology inconsistent with vignette, labs, or foundational science
principles in COMLEX/COMSAE blueprint
C. Incorrect mechanism for internal medicine cardiology that fails to account for key clinical findings or
pathophysiology tested on COMSAE
D. Most likely mechanism for internal medicine cardiology involves understanding foundational biomedical
science, clinical presentation, and osteopathic principles pertinent to COMLEX Level 1
Correct answer: D. Most likely mechanism for internal medicine cardiology involves understanding
foundational biomedical science, clinical presentation, and osteopathic principles pertinent to
COMLEX Level 1.
Rationale: COMSAE Phase 1 Form 114 tests Internal Medicine Cardiology. Correct answer integrates foundational
biomedical sciences and clinical reasoning per NBOME blueprint. The vignette points to classic presentation, labs, and
OMM correlation. Distractors are incorrect because they misinterpret pathophysiology, miss key distinguishing features, or
propose inappropriate management. For internal medicine cardiology, COMLEX-style reasoning requires linking anatomy,
phys, biochem, micro, pharm, and OPP, selecting evidence-based next step.
2. [COM114-CLIN-Q2] Vignette 2: 68-year-old male presents to clinic with fever - Labs: Hb 9.8 -
2025 COMSAE Form 114 - Regarding Internal Medicine Pulmonology, what is most likely
diagnosis / best next step?
A. Diagnosis for internal medicine pulmonology inconsistent with vignette, labs, or foundational science
principles in COMLEX/COMSAE blueprint
B. Management for internal medicine pulmonology that omits indicated diagnostic step or contradicts current
guidelines and osteopathic principles
C. Best next step for internal medicine pulmonology includes focused history, physical, labs/imaging, and
consideration of somatic dysfunction and OMM as per osteopathic practice
D. Incorrect mechanism for internal medicine pulmonology that fails to account for key clinical findings or
pathophysiology tested on COMSAE
Correct answer: C. Best next step for internal medicine pulmonology includes focused history,
physical, labs/imaging, and consideration of somatic dysfunction and OMM as per osteopathic
practice.
Rationale: COMSAE Phase 1 Form 114 tests Internal Medicine Pulmonology. Correct answer integrates foundational
biomedical sciences and clinical reasoning per NBOME blueprint. The vignette points to classic presentation, labs, and
OMM correlation. Distractors are incorrect because they misinterpret pathophysiology, miss key distinguishing features, or
propose inappropriate management. For internal medicine pulmonology, COMLEX-style reasoning requires linking
anatomy, phys, biochem, micro, pharm, and OPP, selecting evidence-based next step.
3. [COM114-CLIN-Q3] Vignette 3: 45-year-old male with hypertension presents to ED with
abdominal pain - Labs: CRP elevated - 2026 COMSAE Form 114 - Regarding Internal Medicine
Gastroenterology, what is most likely diagnosis / best next step?
A. Diagnosis and management consistent with internal medicine gastroenterology per NBOME COMSAE
Phase 1 blueprint, with appropriate workup, OMM considerations, and evidence-based treatment
B. Incorrect mechanism for internal medicine gastroenterology that fails to account for key clinical findings or
pathophysiology tested on COMSAE
C. Management for internal medicine gastroenterology that omits indicated diagnostic step or contradicts
current guidelines and osteopathic principles
