COMSAE Phase 1 Form 114 Study Guide |
Complete Practice Exam with Questions,
Answers in Bold Italic, and Detailed
Explanations for Osteopathic Medical
Students
Are you preparing for the COMSAE (Comprehensive Osteopathic Medical Self Assessment
Examination) Phase 1 Form 114? Do you need a comprehensive practice exam that mirrors the
actual NBOME assessment? This complete study guide provides 200+ practice questions with
correct answers in bold italic and detailed rationales to help you assess your readiness for
COMLEX-USA Level 1
COCAINE intoxication - CORRECT ANSWERS-impaired judgement, pupil dilate, hallucination
(coke bugs) sudden cardiac death; paranoid ideations, angina
Tx: alpha blockers/ benzos
caution B block bc can cause unopposed alpha
Osteoporosis histo - CORRECT ANSWERS-trabecular and cortical bone lose mass and
interconnection despite normal bone mineralization
assoc w/ Colles fracture- distal radial fracture; fracture of femoral neck
Gilbert Syndrome - CORRECT ANSWERS-mild dec UDP glucuronosyltransferase conjugation and
impaired bilirubin uptake; asymptomatic or mild jaundice>> inc unconjugated bilirubin w/o
hemolysis; w/ fasting and stress
,Crigler Najjar - CORRECT ANSWERS-ABSENT UDP glucuronsyltransferase; early in life; die few
years
find: jaundice, kernicterus (in brain) inc unconjugated bilirubin;
tx: plasmapheresis and phototherapy; type II respond phenobarbital
Dubin Johnson - CORRECT ANSWERS-Conjugated hyperbilirubinemia b/c defective liver
excretion;
grossly black liver
Benign
Rotor syndrome - CORRECT ANSWERS-milder in presentation w/o black liver
impaired hepatic uptake and excretion
wilson Disease - CORRECT ANSWERS-copper transporting ATPase; ATP7B on Chromosome 13
s/s: before 40 yo, liver dz, neurodisease, psych dz, Kayser Fleischer ring, hemolytic anemia, renal
dz;
find: dec serum ceruloplasmin, inc urine copper
tx: chelation w/ penicillamine or Tridentine, oral zinc
Hemochromatosis - CORRECT ANSWERS-recessive, HFE, chromosome 6; abnormal iron sensing,
increase intestinal absorb
find: inc ferritin, inc iron, dec TIBC, inc transferrin saturation
,identify w/ Prussian blue stain/ liver MRI
Hemochromatosis finds - CORRECT ANSWERS-after age 40
>20 iron;
triad: cirrhosis, DM, skin pigmentation; dilated cardiomyopathy, hypogonadism, arhtropathy;
HCC is common cause death
Treatment Hemochromatosis - CORRECT ANSWERS-repeat phlebotomy, chelation deferasirox,
deferoxamine, oral deferiprone
Wolff Parkinson White Syndrome - CORRECT ANSWERS-MC ventricular pre excitation syndrome
abnmlJfastJatriaJtoJventricleJ(bundleJofJKent);JbypassesJAVJnode>>JventriclesJbeginJpartiallyJdepol
arizationJearlierJ(NOTEDJBYJDELTAJWAVEJONJEKG)JwidenedJQRSJandJshortenedJPR
ConductionJpathwayJheartJ-JJCORRECTJANSWERS-
SAJnode>Jatira>JAVJnode>JbundleJHIS,JRJandJLJbundleJbranches>JpurkinjeJfibers>Jventricles
LJbranchJanterior/posteriorJfascicles
EdemaJ-JJCORRECTJANSWERS-incJcapillaryJpressure
decJplasmaJproteinsJ(decJoncoticJcapillaryJpressure)
incJcapillaryJpermeability
increaseJinterstitialJfluidJcolloidJoncoticJpressure
CeliacJDiseaseJ-JJCORRECTJANSWERS-setting:J14JmoJkidJlosingJweightJeatingJlotsJofJfoods;
, histology:JcryptJabnormalitiesJ(hyperplasia);JvillousJatrophy,JlymphocyticJinfiltration
presentsJasJmalabsorbtionJ(diarrheaJetcJinJkids)
inJadults=JshortJstature,JanemiaJdelayedJpuberty
MusculocutaneousJnerveJC5-C7J-JJCORRECTJANSWERS-
upperJtrunkJcompressionJcauseJinjury;JlossJforearmJflexion/supination;JlossJsensationJoverJlateral
Jforearm
AxillaryJnerveJC5-C6J-JJCORRECTJANSWERS-
flatJdeltoid;JlossJarmJabduction,JlossJsensationJoverJdeltoidJandJlateralJarm
RadialJC5-T1J-JJCORRECTJANSWERS-midJshaftJfractureJhumerus,JcompressionJaxilla
find:JdecJgrip,JlossJextensionJ(wristJdrop);JlossJsensationJposteriorJarm,JdorsalJhand
MedianJC5-T1J-JJCORRECTJANSWERS-
supracondylarJfractureJhumerusJ(proximal)JCTS,JwristJlacerationJ(distal)
apeJhandJpope'sJblessing
lossJwristJflexion,JflexJofJlateralJfingers,JthumbJopposition,JlumbricalsJ2ndJandJ3rdJdigit;JlossJsensa
tionJoverJthenarJeminenceJandJdorsalJandJpalmarJaspectsJofJlateralJ3J1/2JfingersJw/Jproximal
UlnarJC8-T1J-JJCORRECTJANSWERS-
FractureJmedialJepicondyleJhumerus;JfracturedJhookJhamateJ(distalJlesion)
ulnarJclawJonJextension;JradialJdeceptionJwristJuponJflexionJ(proximalJlesion)
Complete Practice Exam with Questions,
Answers in Bold Italic, and Detailed
Explanations for Osteopathic Medical
Students
Are you preparing for the COMSAE (Comprehensive Osteopathic Medical Self Assessment
Examination) Phase 1 Form 114? Do you need a comprehensive practice exam that mirrors the
actual NBOME assessment? This complete study guide provides 200+ practice questions with
correct answers in bold italic and detailed rationales to help you assess your readiness for
COMLEX-USA Level 1
COCAINE intoxication - CORRECT ANSWERS-impaired judgement, pupil dilate, hallucination
(coke bugs) sudden cardiac death; paranoid ideations, angina
Tx: alpha blockers/ benzos
caution B block bc can cause unopposed alpha
Osteoporosis histo - CORRECT ANSWERS-trabecular and cortical bone lose mass and
interconnection despite normal bone mineralization
assoc w/ Colles fracture- distal radial fracture; fracture of femoral neck
Gilbert Syndrome - CORRECT ANSWERS-mild dec UDP glucuronosyltransferase conjugation and
impaired bilirubin uptake; asymptomatic or mild jaundice>> inc unconjugated bilirubin w/o
hemolysis; w/ fasting and stress
,Crigler Najjar - CORRECT ANSWERS-ABSENT UDP glucuronsyltransferase; early in life; die few
years
find: jaundice, kernicterus (in brain) inc unconjugated bilirubin;
tx: plasmapheresis and phototherapy; type II respond phenobarbital
Dubin Johnson - CORRECT ANSWERS-Conjugated hyperbilirubinemia b/c defective liver
excretion;
grossly black liver
Benign
Rotor syndrome - CORRECT ANSWERS-milder in presentation w/o black liver
impaired hepatic uptake and excretion
wilson Disease - CORRECT ANSWERS-copper transporting ATPase; ATP7B on Chromosome 13
s/s: before 40 yo, liver dz, neurodisease, psych dz, Kayser Fleischer ring, hemolytic anemia, renal
dz;
find: dec serum ceruloplasmin, inc urine copper
tx: chelation w/ penicillamine or Tridentine, oral zinc
Hemochromatosis - CORRECT ANSWERS-recessive, HFE, chromosome 6; abnormal iron sensing,
increase intestinal absorb
find: inc ferritin, inc iron, dec TIBC, inc transferrin saturation
,identify w/ Prussian blue stain/ liver MRI
Hemochromatosis finds - CORRECT ANSWERS-after age 40
>20 iron;
triad: cirrhosis, DM, skin pigmentation; dilated cardiomyopathy, hypogonadism, arhtropathy;
HCC is common cause death
Treatment Hemochromatosis - CORRECT ANSWERS-repeat phlebotomy, chelation deferasirox,
deferoxamine, oral deferiprone
Wolff Parkinson White Syndrome - CORRECT ANSWERS-MC ventricular pre excitation syndrome
abnmlJfastJatriaJtoJventricleJ(bundleJofJKent);JbypassesJAVJnode>>JventriclesJbeginJpartiallyJdepol
arizationJearlierJ(NOTEDJBYJDELTAJWAVEJONJEKG)JwidenedJQRSJandJshortenedJPR
ConductionJpathwayJheartJ-JJCORRECTJANSWERS-
SAJnode>Jatira>JAVJnode>JbundleJHIS,JRJandJLJbundleJbranches>JpurkinjeJfibers>Jventricles
LJbranchJanterior/posteriorJfascicles
EdemaJ-JJCORRECTJANSWERS-incJcapillaryJpressure
decJplasmaJproteinsJ(decJoncoticJcapillaryJpressure)
incJcapillaryJpermeability
increaseJinterstitialJfluidJcolloidJoncoticJpressure
CeliacJDiseaseJ-JJCORRECTJANSWERS-setting:J14JmoJkidJlosingJweightJeatingJlotsJofJfoods;
, histology:JcryptJabnormalitiesJ(hyperplasia);JvillousJatrophy,JlymphocyticJinfiltration
presentsJasJmalabsorbtionJ(diarrheaJetcJinJkids)
inJadults=JshortJstature,JanemiaJdelayedJpuberty
MusculocutaneousJnerveJC5-C7J-JJCORRECTJANSWERS-
upperJtrunkJcompressionJcauseJinjury;JlossJforearmJflexion/supination;JlossJsensationJoverJlateral
Jforearm
AxillaryJnerveJC5-C6J-JJCORRECTJANSWERS-
flatJdeltoid;JlossJarmJabduction,JlossJsensationJoverJdeltoidJandJlateralJarm
RadialJC5-T1J-JJCORRECTJANSWERS-midJshaftJfractureJhumerus,JcompressionJaxilla
find:JdecJgrip,JlossJextensionJ(wristJdrop);JlossJsensationJposteriorJarm,JdorsalJhand
MedianJC5-T1J-JJCORRECTJANSWERS-
supracondylarJfractureJhumerusJ(proximal)JCTS,JwristJlacerationJ(distal)
apeJhandJpope'sJblessing
lossJwristJflexion,JflexJofJlateralJfingers,JthumbJopposition,JlumbricalsJ2ndJandJ3rdJdigit;JlossJsensa
tionJoverJthenarJeminenceJandJdorsalJandJpalmarJaspectsJofJlateralJ3J1/2JfingersJw/Jproximal
UlnarJC8-T1J-JJCORRECTJANSWERS-
FractureJmedialJepicondyleJhumerus;JfracturedJhookJhamateJ(distalJlesion)
ulnarJclawJonJextension;JradialJdeceptionJwristJuponJflexionJ(proximalJlesion)
