COMSAE Phase 1 Form 114 Exam And Practice Exam Newest 2026/2027 Test Bank | VERSION 1 - EXAM |
Comprehensive Osteopathic Medical Self Assessment Examination Phase 1 Exam Prep With Complete 150 Real
Exam Questions And Correct Verified Answers | Already Graded A+ (Most Recent!)
150 QUESTIONS - COMSAE PHASE 1 FORM 114 VERSION 1 - EXAM - CORRECTED - DISTINCT
ANSWERS - MOST RECENT 2026/2027
DOMAIN 1: ANATOMY
Question 1
What is brachial plexus lesion Erb's palsy?
A. Only deliver classroom lectures with no medical knowledge
B. C5 C6 roots upper trunk lesion waiter's tip posture arm adducted internally rotated elbow extended forearm
pronated due to nursemaid birth injury
C. Only inspect buildings and not manage medicine
D. Only drive fire trucks and not teach medicine
Answer: B
Rationale: Erb's palsy: C5-C6 upper trunk brachial plexus lesion, waiter's tip posture arm adducted internally rotated
elbow extended forearm pronated wrist flexed, loss deltoid biceps brachialis brachioradialis supraspinatus
infraspinatus, due to excessive lateral traction birth shoulder dystocia.
DOMAIN 1: ANATOMY
Question 2
What is carpal tunnel contents?
A. Only inspect buildings and not manage medicine
B. Only deliver classroom lectures with no medical knowledge
C. Only drive fire trucks and not teach medicine
D. 9 flexor tendons 4 FDS 4 FDP 1 FPL and median nerve, compression causes thenar atrophy sensory loss
thumb index middle half ring finger
Answer: D
Rationale: Carpal tunnel: 9 flexor tendons 4 flexor digitorum superficialis FDS 4 profundus FDP 1 flexor pollicis longus
FPL and median nerve under transverse carpal ligament flexor retinaculum, compression median nerve causes thenar
atrophy abductor pollicis brevis sensory loss palmar thumb index middle half ring, Phalen Tinel positive.
DOMAIN 2: PHYSIOLOGY
Question 3
What is cardiac action potential phases?
A. Only inspect buildings and not manage medicine
B. Phase 0 fast Na+ influx, 1 transient K+ efflux, 2 Ca2+ influx plateau, 3 K+ efflux repolarization, 4 resting
membrane potential
C. Only deliver classroom lectures with no medical knowledge
, D. Only drive fire trucks and not teach medicine
Answer: B
Rationale: Cardiac action potential ventricular: Phase 0 fast Na+ influx depolarization, Phase 1 transient K+ efflux Ito,
Phase 2 Ca2+ influx L-type plateau K+ efflux balance, Phase 3 K+ efflux rapid repolarization, Phase 4 resting -90 mV
K+ equilibrium. Pacemaker SA node Phase 4 funny current If slow diastolic depolarization Ca2+ T-type.
DOMAIN 2: PHYSIOLOGY
Question 4
What is Starling curve?
A. Only deliver classroom lectures with no medical knowledge
B. Only drive fire trucks and not teach medicine
C. Increased preload EDV increases stroke volume up to point via increased sarcomere stretch actin myosin
overlap
D. Only inspect buildings and not manage medicine
Answer: C
Rationale: Frank-Starling law: increased preload end-diastolic volume EDV increases stroke volume up to point due
increased sarcomere stretch optimal actin myosin overlap. Heart failure curve flattened decreased contractility.
Increased afterload decreases stroke volume. Increased contractility shifts curve up left.
DOMAIN 3: BIOCHEMISTRY
Question 5
What is rate limiting enzyme glycolysis?
A. Only drive fire trucks and not teach medicine
B. Phosphofructokinase-1 PFK-1 inhibited ATP citrate H+ activated AMP fructose 2,6-bisphosphate
C. Only deliver classroom lectures with no medical knowledge
D. Only inspect buildings and not manage medicine
Answer: B
Rationale: Glycolysis rate limiting: hexokinase glucokinase glucose to G6P, PFK-1 fructose 6P to fructose 1,6
bisphosphate rate limiting inhibited ATP citrate H+ activated AMP fructose 2,6-bisphosphate insulin, pyruvate kinase
PEP to pyruvate inhibited ATP alanine activated fructose 1,6 bisphosphate.
DOMAIN 3: BIOCHEMISTRY
Question 6
What is urea cycle?
A. Only inspect buildings and not manage medicine
B. Only drive fire trucks and not teach medicine
C. Only deliver classroom lectures with no medical knowledge
, D. Converts ammonia to urea in liver mitochondria cytosol 2 NH3 + CO2 + 3 ATP -> urea, rate limiting CPS1
carbamoyl phosphate synthetase I
Answer: D
Rationale: Urea cycle: converts toxic ammonia to urea in liver periportal cells mitochondria cytosol, 2 NH3 + CO2 + 3
ATP -> urea + 2 ADP + AMP + 4 Pi, rate limiting carbamoyl phosphate synthetase I CPS1 activated N-acetylglutamate,
ornithine cycle intermediates ornithine citrulline argininosuccinate arginine.
DOMAIN 4: MICROBIOLOGY
Question 7
What is Gram positive cocci?
A. Only deliver classroom lectures with no medical knowledge
B. Only inspect buildings and not manage medicine
C. Staphylococcus aureus clusters catalase positive coagulase positive, Streptococcus pyogenes chains catalase
negative beta hemolytic
D. Only drive fire trucks and not teach medicine
Answer: C
Rationale: Gram positive cocci: Staphylococcus clusters catalase positive S. aureus coagulase positive protein A, S.
epidermidis coagulase negative novobiocin sensitive, S. saprophyticus novobiocin resistant UTI. Streptococcus chains
catalase negative S. pyogenes Group A beta hemolytic bacitracin sensitive, S. agalactiae Group B, S. pneumoniae
alpha hemolytic optochin sensitive bile soluble diplococcus.
DOMAIN 4: MICROBIOLOGY
Question 8
What is tuberculosis?
A. Only inspect buildings and not manage medicine
B. Mycobacterium tuberculosis acid fast bacilli caseating granulomas Ghon complex Ranke complex
C. Only deliver classroom lectures with no medical knowledge
D. Only drive fire trucks and not teach medicine
Answer: B
Rationale: TB: Mycobacterium tuberculosis aerobic acid fast bacilli Ziehl-Neelsen stain, caseating granulomas
Langhans giant cells, transmission airborne droplet nuclei, primary Ghon focus lung plus hilar lymph node Ghon
complex Ranke complex calcified, secondary reactivation apical cavitary, PPD skin test interferon gamma release
assay IGRA, treatment RIPE rifampin isoniazid pyrazinamide ethambutol.
DOMAIN 5: PHARMACOLOGY
Question 9
What is ACE inhibitor mechanism?
A. Only inspect buildings and not manage medicine
, B. Only deliver classroom lectures with no medical knowledge
C. Only drive fire trucks and not teach medicine
D. Inhibits angiotensin converting enzyme blocks Angiotensin I to Angiotensin II decreases aldosterone increases
bradykinin dry cough angioedema
Answer: D
Rationale: ACE inhibitors: inhibits angiotensin converting enzyme kininase II blocks Angiotensin I to Angiotensin II
decreases vasoconstriction aldosterone decreases Na water retention increases bradykinin vasodilation, side dry
cough due bradykinin accumulation angioedema hyperkalemia teratogenic, names -pril lisinopril enalapril. ARB -sartan
blocks AT1 receptor no cough.
DOMAIN 5: PHARMACOLOGY
Question 10
What is warfarin mechanism?
A. Only deliver classroom lectures with no medical knowledge
B. Only drive fire trucks and not teach medicine
C. Inhibits vitamin K epoxide reductase decreases clotting factors II VII IX X proteins C S, monitored INR, reversal
vitamin K FFP PCC
D. Only inspect buildings and not manage medicine
Answer: C
Rationale: Warfarin: vitamin K antagonist inhibits vitamin K epoxide reductase VKORC1 decreases synthesis clotting
factors II VII IX X proteins C S vitamin K dependent, monitored INR international normalized ratio target 2-3, reversal
vitamin K phytonadione FFP fresh frozen plasma 4 factor PCC prothrombin complex concentrate, teratogenic,
interactions CYP450.
DOMAIN 6: PATHOLOGY
Question 11
What is apoptosis vs necrosis?
A. Only drive fire trucks and not teach medicine
B. Only deliver classroom lectures with no medical knowledge
C. Only inspect buildings and not manage medicine
D. Apoptosis programmed cell death cell shrinkage chromatin condensation intact membrane no inflammation
caspase dependent, necrosis cell swelling membrane rupture inflammation
Answer: D
Rationale: Apoptosis vs necrosis: apoptosis programmed cell death physiologic pathologic cell shrinkage chromatin
condensation pyknosis karyorrhexis membrane intact blebs apoptotic bodies phagocytosed no inflammation caspase
dependent intrinsic extrinsic pathway. Necrosis pathologic cell swelling membrane rupture organelles spill
inflammation types coagulative MI liquefactive brain caseous TB fat enzymatic pancreatitis fibrinoid vasculitis.
DOMAIN 6: PATHOLOGY
Comprehensive Osteopathic Medical Self Assessment Examination Phase 1 Exam Prep With Complete 150 Real
Exam Questions And Correct Verified Answers | Already Graded A+ (Most Recent!)
150 QUESTIONS - COMSAE PHASE 1 FORM 114 VERSION 1 - EXAM - CORRECTED - DISTINCT
ANSWERS - MOST RECENT 2026/2027
DOMAIN 1: ANATOMY
Question 1
What is brachial plexus lesion Erb's palsy?
A. Only deliver classroom lectures with no medical knowledge
B. C5 C6 roots upper trunk lesion waiter's tip posture arm adducted internally rotated elbow extended forearm
pronated due to nursemaid birth injury
C. Only inspect buildings and not manage medicine
D. Only drive fire trucks and not teach medicine
Answer: B
Rationale: Erb's palsy: C5-C6 upper trunk brachial plexus lesion, waiter's tip posture arm adducted internally rotated
elbow extended forearm pronated wrist flexed, loss deltoid biceps brachialis brachioradialis supraspinatus
infraspinatus, due to excessive lateral traction birth shoulder dystocia.
DOMAIN 1: ANATOMY
Question 2
What is carpal tunnel contents?
A. Only inspect buildings and not manage medicine
B. Only deliver classroom lectures with no medical knowledge
C. Only drive fire trucks and not teach medicine
D. 9 flexor tendons 4 FDS 4 FDP 1 FPL and median nerve, compression causes thenar atrophy sensory loss
thumb index middle half ring finger
Answer: D
Rationale: Carpal tunnel: 9 flexor tendons 4 flexor digitorum superficialis FDS 4 profundus FDP 1 flexor pollicis longus
FPL and median nerve under transverse carpal ligament flexor retinaculum, compression median nerve causes thenar
atrophy abductor pollicis brevis sensory loss palmar thumb index middle half ring, Phalen Tinel positive.
DOMAIN 2: PHYSIOLOGY
Question 3
What is cardiac action potential phases?
A. Only inspect buildings and not manage medicine
B. Phase 0 fast Na+ influx, 1 transient K+ efflux, 2 Ca2+ influx plateau, 3 K+ efflux repolarization, 4 resting
membrane potential
C. Only deliver classroom lectures with no medical knowledge
, D. Only drive fire trucks and not teach medicine
Answer: B
Rationale: Cardiac action potential ventricular: Phase 0 fast Na+ influx depolarization, Phase 1 transient K+ efflux Ito,
Phase 2 Ca2+ influx L-type plateau K+ efflux balance, Phase 3 K+ efflux rapid repolarization, Phase 4 resting -90 mV
K+ equilibrium. Pacemaker SA node Phase 4 funny current If slow diastolic depolarization Ca2+ T-type.
DOMAIN 2: PHYSIOLOGY
Question 4
What is Starling curve?
A. Only deliver classroom lectures with no medical knowledge
B. Only drive fire trucks and not teach medicine
C. Increased preload EDV increases stroke volume up to point via increased sarcomere stretch actin myosin
overlap
D. Only inspect buildings and not manage medicine
Answer: C
Rationale: Frank-Starling law: increased preload end-diastolic volume EDV increases stroke volume up to point due
increased sarcomere stretch optimal actin myosin overlap. Heart failure curve flattened decreased contractility.
Increased afterload decreases stroke volume. Increased contractility shifts curve up left.
DOMAIN 3: BIOCHEMISTRY
Question 5
What is rate limiting enzyme glycolysis?
A. Only drive fire trucks and not teach medicine
B. Phosphofructokinase-1 PFK-1 inhibited ATP citrate H+ activated AMP fructose 2,6-bisphosphate
C. Only deliver classroom lectures with no medical knowledge
D. Only inspect buildings and not manage medicine
Answer: B
Rationale: Glycolysis rate limiting: hexokinase glucokinase glucose to G6P, PFK-1 fructose 6P to fructose 1,6
bisphosphate rate limiting inhibited ATP citrate H+ activated AMP fructose 2,6-bisphosphate insulin, pyruvate kinase
PEP to pyruvate inhibited ATP alanine activated fructose 1,6 bisphosphate.
DOMAIN 3: BIOCHEMISTRY
Question 6
What is urea cycle?
A. Only inspect buildings and not manage medicine
B. Only drive fire trucks and not teach medicine
C. Only deliver classroom lectures with no medical knowledge
, D. Converts ammonia to urea in liver mitochondria cytosol 2 NH3 + CO2 + 3 ATP -> urea, rate limiting CPS1
carbamoyl phosphate synthetase I
Answer: D
Rationale: Urea cycle: converts toxic ammonia to urea in liver periportal cells mitochondria cytosol, 2 NH3 + CO2 + 3
ATP -> urea + 2 ADP + AMP + 4 Pi, rate limiting carbamoyl phosphate synthetase I CPS1 activated N-acetylglutamate,
ornithine cycle intermediates ornithine citrulline argininosuccinate arginine.
DOMAIN 4: MICROBIOLOGY
Question 7
What is Gram positive cocci?
A. Only deliver classroom lectures with no medical knowledge
B. Only inspect buildings and not manage medicine
C. Staphylococcus aureus clusters catalase positive coagulase positive, Streptococcus pyogenes chains catalase
negative beta hemolytic
D. Only drive fire trucks and not teach medicine
Answer: C
Rationale: Gram positive cocci: Staphylococcus clusters catalase positive S. aureus coagulase positive protein A, S.
epidermidis coagulase negative novobiocin sensitive, S. saprophyticus novobiocin resistant UTI. Streptococcus chains
catalase negative S. pyogenes Group A beta hemolytic bacitracin sensitive, S. agalactiae Group B, S. pneumoniae
alpha hemolytic optochin sensitive bile soluble diplococcus.
DOMAIN 4: MICROBIOLOGY
Question 8
What is tuberculosis?
A. Only inspect buildings and not manage medicine
B. Mycobacterium tuberculosis acid fast bacilli caseating granulomas Ghon complex Ranke complex
C. Only deliver classroom lectures with no medical knowledge
D. Only drive fire trucks and not teach medicine
Answer: B
Rationale: TB: Mycobacterium tuberculosis aerobic acid fast bacilli Ziehl-Neelsen stain, caseating granulomas
Langhans giant cells, transmission airborne droplet nuclei, primary Ghon focus lung plus hilar lymph node Ghon
complex Ranke complex calcified, secondary reactivation apical cavitary, PPD skin test interferon gamma release
assay IGRA, treatment RIPE rifampin isoniazid pyrazinamide ethambutol.
DOMAIN 5: PHARMACOLOGY
Question 9
What is ACE inhibitor mechanism?
A. Only inspect buildings and not manage medicine
, B. Only deliver classroom lectures with no medical knowledge
C. Only drive fire trucks and not teach medicine
D. Inhibits angiotensin converting enzyme blocks Angiotensin I to Angiotensin II decreases aldosterone increases
bradykinin dry cough angioedema
Answer: D
Rationale: ACE inhibitors: inhibits angiotensin converting enzyme kininase II blocks Angiotensin I to Angiotensin II
decreases vasoconstriction aldosterone decreases Na water retention increases bradykinin vasodilation, side dry
cough due bradykinin accumulation angioedema hyperkalemia teratogenic, names -pril lisinopril enalapril. ARB -sartan
blocks AT1 receptor no cough.
DOMAIN 5: PHARMACOLOGY
Question 10
What is warfarin mechanism?
A. Only deliver classroom lectures with no medical knowledge
B. Only drive fire trucks and not teach medicine
C. Inhibits vitamin K epoxide reductase decreases clotting factors II VII IX X proteins C S, monitored INR, reversal
vitamin K FFP PCC
D. Only inspect buildings and not manage medicine
Answer: C
Rationale: Warfarin: vitamin K antagonist inhibits vitamin K epoxide reductase VKORC1 decreases synthesis clotting
factors II VII IX X proteins C S vitamin K dependent, monitored INR international normalized ratio target 2-3, reversal
vitamin K phytonadione FFP fresh frozen plasma 4 factor PCC prothrombin complex concentrate, teratogenic,
interactions CYP450.
DOMAIN 6: PATHOLOGY
Question 11
What is apoptosis vs necrosis?
A. Only drive fire trucks and not teach medicine
B. Only deliver classroom lectures with no medical knowledge
C. Only inspect buildings and not manage medicine
D. Apoptosis programmed cell death cell shrinkage chromatin condensation intact membrane no inflammation
caspase dependent, necrosis cell swelling membrane rupture inflammation
Answer: D
Rationale: Apoptosis vs necrosis: apoptosis programmed cell death physiologic pathologic cell shrinkage chromatin
condensation pyknosis karyorrhexis membrane intact blebs apoptotic bodies phagocytosed no inflammation caspase
dependent intrinsic extrinsic pathway. Necrosis pathologic cell swelling membrane rupture organelles spill
inflammation types coagulative MI liquefactive brain caseous TB fat enzymatic pancreatitis fibrinoid vasculitis.
DOMAIN 6: PATHOLOGY
