COMSAE 114 EXAM 2026/2027
COMPLETE ACCURATE TEST EXAM ACTUAL QUESTIONS
AND CORRECT DETAILE
2026-2027
150 Questions
100% VERIFIED
Introduction
The COMSAE 114 Exam 2026/2027 is a comprehensive assessment designed to evaluate
osteopathic medical students' knowledge across foundational biomedical sciences,
osteopathic principles and operations, clinical medicine and patient care, pharmacology and
therapeutics, public health and preventive medicine, diagnostic imaging and laboratory
interpretation, and professional ethics and legal standards. This examination assesses
readiness for clinical execution and professional competence in osteopathic medical
education. The following 150 questions represent the breadth and depth of knowledge
required for successful completion of this examination.
1. Which cellular organelle is primarily responsible for the synthesis of proteins
destined for secretion or membrane insertion?
• A. Smooth endoplasmic reticulum
• B. Rough endoplasmic reticulum
• C. Golgi apparatus
• D. Lysosome
Rationale: The rough endoplasmic reticulum (RER) contains ribosomes on its cytoplasmic surface,
which synthesize proteins destined for secretion, membrane insertion, or lysosomal targeting.
Smooth ER is involved in lipid synthesis and detoxification. The Golgi apparatus modifies and
packages proteins but does not synthesize them. Lysosomes are involved in degradation, not protein
synthesis.
2. During which phase of the cell cycle does DNA replication occur?
• A. G1 phase
• B. S phase
• C. G2 phase
,• D. M phase
Rationale: DNA replication occurs during the S (synthesis) phase of the cell cycle. G1 is the first gap
phase where cells grow and prepare for DNA synthesis. G2 is the second gap phase where cells
prepare for mitosis. M phase is when mitosis and cell division occur.
3. Which enzyme is responsible for unwinding the DNA double helix during
replication?
• A. DNA polymerase
• B. Helicase
• C. Ligase
• D. Primase
Rationale: Helicase unwinds the DNA double helix by breaking hydrogen bonds between base pairs,
creating the replication fork. DNA polymerase synthesizes new DNA strands. Ligase joins Okazaki
fragments on the lagging strand. Primase synthesizes RNA primers.
4. Which of the following best describes the function of the sodium-potassium pump?
• A. Moves sodium into the cell and potassium out of the cell
• B. Moves sodium out of the cell and potassium into the cell
• C. Moves both sodium and potassium into the cell
• D. Moves both sodium and potassium out of the cell
Rationale: The Na+/K+ ATPase pump moves 3 sodium ions out of the cell and 2 potassium ions into
the cell against their concentration gradients, using ATP. This maintains the resting membrane
potential and cellular volume.
5. Which type of RNA carries amino acids to the ribosome during protein synthesis?
• A. mRNA
• B. tRNA
• C. rRNA
• D. snRNA
Rationale: Transfer RNA (tRNA) carries specific amino acids to the ribosome during translation,
matching its anticodon to the mRNA codon. mRNA carries the genetic code from DNA. rRNA is a
structural component of ribosomes. snRNA is involved in splicing.
6. Which of the following is a characteristic of malignant tumors?
,• A. Well-differentiated cells
• B. Slow growth rate
• C. Invasion of surrounding tissues
• D. Encapsulated borders
Rationale: Malignant tumors are characterized by invasion of surrounding tissues, potential for
metastasis, poor differentiation, and rapid growth. Benign tumors are well-differentiated, slow-
growing, and encapsulated.
7. Which neurotransmitter is primarily involved in the parasympathetic nervous
system?
• A. Norepinephrine
• B. Acetylcholine
• C. Dopamine
• D. Serotonin
Rationale: Acetylcholine is the primary neurotransmitter of the parasympathetic nervous system,
acting at both preganglionic and postganglionic synapses. Norepinephrine is the primary
postganglionic neurotransmitter in the sympathetic nervous system.
8. Which hormone is produced by the posterior pituitary gland?
• A. Growth hormone
• B. Thyroid-stimulating hormone
• C. Antidiuretic hormone
• D. Adrenocorticotropic hormone
Rationale: The posterior pituitary stores and releases antidiuretic hormone (ADH) and oxytocin,
which are synthesized in the hypothalamus. Growth hormone, TSH, and ACTH are produced by the
anterior pituitary.
9. Which of the following is the primary function of the loop of Henle?
• A. Glomerular filtration
• B. Concentration of urine
• C. Secretion of hydrogen ions
• D. Reabsorption of glucose
Rationale: The loop of Henle creates a concentration gradient in the renal medulla through the
countercurrent multiplier system, allowing for urine concentration. Filtration occurs in the
, glomerulus. H+ secretion occurs in the collecting duct. Glucose reabsorption occurs in the proximal
tubule.
10. Which type of immunity is provided by maternal antibodies transferred to a
newborn?
• A. Active natural immunity
• B. Active artificial immunity
• C. Passive natural immunity
• D. Passive artificial immunity
Rationale: Maternal antibodies transferred via placenta or breast milk provide passive natural
immunity. Active immunity involves the individual's own immune response (natural from infection,
artificial from vaccination). Passive artificial immunity involves administration of preformed
antibodies.
11. Which of the following best describes the Frank-Starling law of the heart?
• A. Heart rate increases with sympathetic stimulation
• B. Stroke volume increases with increased venous return
• C. Cardiac output is constant regardless of preload
• D. Contractility is independent of fiber length
Rationale: The Frank-Starling law states that stroke volume increases as ventricular filling (preload)
increases, up to a physiological limit. This is due to optimal overlap of actin and myosin filaments at
increased sarcomere lengths.
12. Which enzyme initiates the digestion of carbohydrates in the mouth?
• A. Pepsin
• B. Trypsin
• C. Salivary amylase
• D. Lipase
Rationale: Salivary amylase (ptyalin) begins starch digestion in the mouth by breaking alpha-1,4-
glycosidic bonds. Pepsin digests proteins in the stomach. Trypsin digests proteins in the small
intestine. Lipase digests fats.
13. Which of the following is a function of the spleen?
• A. Production of bile
COMPLETE ACCURATE TEST EXAM ACTUAL QUESTIONS
AND CORRECT DETAILE
2026-2027
150 Questions
100% VERIFIED
Introduction
The COMSAE 114 Exam 2026/2027 is a comprehensive assessment designed to evaluate
osteopathic medical students' knowledge across foundational biomedical sciences,
osteopathic principles and operations, clinical medicine and patient care, pharmacology and
therapeutics, public health and preventive medicine, diagnostic imaging and laboratory
interpretation, and professional ethics and legal standards. This examination assesses
readiness for clinical execution and professional competence in osteopathic medical
education. The following 150 questions represent the breadth and depth of knowledge
required for successful completion of this examination.
1. Which cellular organelle is primarily responsible for the synthesis of proteins
destined for secretion or membrane insertion?
• A. Smooth endoplasmic reticulum
• B. Rough endoplasmic reticulum
• C. Golgi apparatus
• D. Lysosome
Rationale: The rough endoplasmic reticulum (RER) contains ribosomes on its cytoplasmic surface,
which synthesize proteins destined for secretion, membrane insertion, or lysosomal targeting.
Smooth ER is involved in lipid synthesis and detoxification. The Golgi apparatus modifies and
packages proteins but does not synthesize them. Lysosomes are involved in degradation, not protein
synthesis.
2. During which phase of the cell cycle does DNA replication occur?
• A. G1 phase
• B. S phase
• C. G2 phase
,• D. M phase
Rationale: DNA replication occurs during the S (synthesis) phase of the cell cycle. G1 is the first gap
phase where cells grow and prepare for DNA synthesis. G2 is the second gap phase where cells
prepare for mitosis. M phase is when mitosis and cell division occur.
3. Which enzyme is responsible for unwinding the DNA double helix during
replication?
• A. DNA polymerase
• B. Helicase
• C. Ligase
• D. Primase
Rationale: Helicase unwinds the DNA double helix by breaking hydrogen bonds between base pairs,
creating the replication fork. DNA polymerase synthesizes new DNA strands. Ligase joins Okazaki
fragments on the lagging strand. Primase synthesizes RNA primers.
4. Which of the following best describes the function of the sodium-potassium pump?
• A. Moves sodium into the cell and potassium out of the cell
• B. Moves sodium out of the cell and potassium into the cell
• C. Moves both sodium and potassium into the cell
• D. Moves both sodium and potassium out of the cell
Rationale: The Na+/K+ ATPase pump moves 3 sodium ions out of the cell and 2 potassium ions into
the cell against their concentration gradients, using ATP. This maintains the resting membrane
potential and cellular volume.
5. Which type of RNA carries amino acids to the ribosome during protein synthesis?
• A. mRNA
• B. tRNA
• C. rRNA
• D. snRNA
Rationale: Transfer RNA (tRNA) carries specific amino acids to the ribosome during translation,
matching its anticodon to the mRNA codon. mRNA carries the genetic code from DNA. rRNA is a
structural component of ribosomes. snRNA is involved in splicing.
6. Which of the following is a characteristic of malignant tumors?
,• A. Well-differentiated cells
• B. Slow growth rate
• C. Invasion of surrounding tissues
• D. Encapsulated borders
Rationale: Malignant tumors are characterized by invasion of surrounding tissues, potential for
metastasis, poor differentiation, and rapid growth. Benign tumors are well-differentiated, slow-
growing, and encapsulated.
7. Which neurotransmitter is primarily involved in the parasympathetic nervous
system?
• A. Norepinephrine
• B. Acetylcholine
• C. Dopamine
• D. Serotonin
Rationale: Acetylcholine is the primary neurotransmitter of the parasympathetic nervous system,
acting at both preganglionic and postganglionic synapses. Norepinephrine is the primary
postganglionic neurotransmitter in the sympathetic nervous system.
8. Which hormone is produced by the posterior pituitary gland?
• A. Growth hormone
• B. Thyroid-stimulating hormone
• C. Antidiuretic hormone
• D. Adrenocorticotropic hormone
Rationale: The posterior pituitary stores and releases antidiuretic hormone (ADH) and oxytocin,
which are synthesized in the hypothalamus. Growth hormone, TSH, and ACTH are produced by the
anterior pituitary.
9. Which of the following is the primary function of the loop of Henle?
• A. Glomerular filtration
• B. Concentration of urine
• C. Secretion of hydrogen ions
• D. Reabsorption of glucose
Rationale: The loop of Henle creates a concentration gradient in the renal medulla through the
countercurrent multiplier system, allowing for urine concentration. Filtration occurs in the
, glomerulus. H+ secretion occurs in the collecting duct. Glucose reabsorption occurs in the proximal
tubule.
10. Which type of immunity is provided by maternal antibodies transferred to a
newborn?
• A. Active natural immunity
• B. Active artificial immunity
• C. Passive natural immunity
• D. Passive artificial immunity
Rationale: Maternal antibodies transferred via placenta or breast milk provide passive natural
immunity. Active immunity involves the individual's own immune response (natural from infection,
artificial from vaccination). Passive artificial immunity involves administration of preformed
antibodies.
11. Which of the following best describes the Frank-Starling law of the heart?
• A. Heart rate increases with sympathetic stimulation
• B. Stroke volume increases with increased venous return
• C. Cardiac output is constant regardless of preload
• D. Contractility is independent of fiber length
Rationale: The Frank-Starling law states that stroke volume increases as ventricular filling (preload)
increases, up to a physiological limit. This is due to optimal overlap of actin and myosin filaments at
increased sarcomere lengths.
12. Which enzyme initiates the digestion of carbohydrates in the mouth?
• A. Pepsin
• B. Trypsin
• C. Salivary amylase
• D. Lipase
Rationale: Salivary amylase (ptyalin) begins starch digestion in the mouth by breaking alpha-1,4-
glycosidic bonds. Pepsin digests proteins in the stomach. Trypsin digests proteins in the small
intestine. Lipase digests fats.
13. Which of the following is a function of the spleen?
• A. Production of bile
