1
COMSAE Phase 1 Form 107 COMPLETE 176 REAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+ (MOST RECENT!!)
COMSAE Phase 1 – Practice Examination (Form 107-Style)
SECTION 1: ANATOMY & NEUROANATOMY (Questions 1–25)
1. A 55-year-old man presents with weakness in his right upper extremity.
Examination reveals loss of sensation over the lateral forearm and thenar
eminence, and weakened elbow flexion. Which nerve root is most likely
affected?
A. C5
B. C6
C. C7
D. C8
: Correct Answer : B
*Explanation: The C6 nerve root corresponds to the biceps reflex, sensation over
the lateral forearm and thumb (thenar eminence), and contributes to elbow
flexion and wrist extension. The classic C6 motor test is wrist extension and elbow
flexion, and sensory involves the thumb. C5 would show shoulder abduction
weakness, C7 triceps/wrist flexion, C8 finger flexion.*
2. A 34-year-old woman has a benign tumor compressing the facial nerve in the
internal acoustic meatus. Besides the muscles of facial expression, which other
function would likely be affected?
A. Hearing only
B. Taste from the anterior two-thirds of the tongue
C. Taste from the posterior one-third of the tongue
D. Palatal elevation
pg. 1
,2
: Correct Answer : B
Explanation: The facial nerve (CN VII) carries taste fibers from the anterior
two-thirds of the tongue via the chorda tympani. A lesion at the internal acoustic
meatus would also affect hearing and balance (CN VIII) but the question asks
specifically about CN VII functions besides facial muscles. Taste from the posterior
one-third is CN IX.
3. A 67-year-old male with a history of heavy alcohol use presents with a
staggering gait, nystagmus, and memory loss. Which part of the brain is most
likely affected?
A. Frontal lobe
B. Cerebellar vermis and mammillary bodies
C. Basal ganglia
D. Occipital cortex
: Correct Answer : B
Explanation: Wernicke-Korsakoff syndrome from thiamine deficiency causes
degeneration of the mammillary bodies, thalamus, and cerebellar vermis, leading
to ataxia, nystagmus, and confabulation.
4. A 45-year-old woman with a pituitary adenoma presents with bitemporal
hemianopia. Which structure is being compressed?
A. Optic chiasm
B. Optic nerve
C. Optic tract
D. Lateral geniculate nucleus
: Correct Answer : A
Explanation: The optic chiasm contains crossing fibers from the nasal retinas of
both eyes. Compression from a pituitary tumor causes loss of the temporal visual
fields in each eye, producing bitemporal hemianopia.
pg. 2
,3
5. A patient cannot abduct the arm at the shoulder beyond 15 degrees and has
loss of sensation over the deltoid region. Which nerve is injured?
A. Axillary nerve
B. Radial nerve
C. Musculocutaneous nerve
D. Long thoracic nerve
: Correct Answer : A
Explanation: The axillary nerve innervates the deltoid and teres minor, providing
shoulder abduction from 15-90 degrees. It also supplies sensation to the
“regimental badge” area over the deltoid. The radial nerve innervates the triceps
and forearm extensors.
6. A child is born with a “port-wine stain” over the forehead and upper eyelid.
Seizures develop in infancy. Which syndrome is most likely?
A. Neurofibromatosis type 1
B. Tuberous sclerosis
C. Sturge-Weber syndrome
D. von Hippel-Lindau disease
: Correct Answer : C
*Explanation: Sturge-Weber syndrome is a neurocutaneous disorder with a facial
port-wine stain in the V1/V2 trigeminal distribution, ipsilateral leptomeningeal
angiomas, and seizures.*
7. A 32-year-old woman sustains a fracture of the surgical neck of the humerus.
Which nerve is most at risk?
A. Radial nerve
B. Axillary nerve
C. Median nerve
D. Ulnar nerve
: Correct Answer : B
Explanation: The axillary nerve wraps around the surgical neck of the humerus and
pg. 3
, 4
is vulnerable to injury with fractures at that location. Injury leads to deltoid
paralysis and sensory loss over the shoulder.
8. A 28-year-old man is stabbed in the lower back. He has weakness of hip
extension and knee flexion, and loss of the ankle jerk reflex. Which nerve root is
damaged?
A. L3
B. L4
C. L5
D. S1
: Correct Answer : D
*Explanation: S1 nerve root innervates the gluteus maximus (hip extension),
hamstrings (knee flexion), and the gastrocnemius/soleus (ankle plantarflexion).
The ankle jerk is S1. L5 would affect foot dorsiflexion and the extensor hallucis
longus.*
9. A patient has a “claw hand” deformity with hyperextension at the MCP joints
and flexion at the IP joints of the ring and little fingers, and loss of sensation on
the medial hand. Which nerve is injured?
A. Median nerve
B. Radial nerve
C. Ulnar nerve
D. Musculocutaneous nerve
: Correct Answer : C
*Explanation: Ulnar nerve injury at the wrist or elbow causes paralysis of the
intrinsic hand muscles (interossei, lumbricals 3/4) resulting in clawing of the ring
and little fingers. Sensation is lost over the ulnar 1½ fingers.*
10. A 50-year-old male has difficulty climbing stairs and rising from a seated
position. Physical exam reveals a waddling gait and positive Gowers sign. Which
muscles are primarily affected?
pg. 4
COMSAE Phase 1 Form 107 COMPLETE 176 REAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+ (MOST RECENT!!)
COMSAE Phase 1 – Practice Examination (Form 107-Style)
SECTION 1: ANATOMY & NEUROANATOMY (Questions 1–25)
1. A 55-year-old man presents with weakness in his right upper extremity.
Examination reveals loss of sensation over the lateral forearm and thenar
eminence, and weakened elbow flexion. Which nerve root is most likely
affected?
A. C5
B. C6
C. C7
D. C8
: Correct Answer : B
*Explanation: The C6 nerve root corresponds to the biceps reflex, sensation over
the lateral forearm and thumb (thenar eminence), and contributes to elbow
flexion and wrist extension. The classic C6 motor test is wrist extension and elbow
flexion, and sensory involves the thumb. C5 would show shoulder abduction
weakness, C7 triceps/wrist flexion, C8 finger flexion.*
2. A 34-year-old woman has a benign tumor compressing the facial nerve in the
internal acoustic meatus. Besides the muscles of facial expression, which other
function would likely be affected?
A. Hearing only
B. Taste from the anterior two-thirds of the tongue
C. Taste from the posterior one-third of the tongue
D. Palatal elevation
pg. 1
,2
: Correct Answer : B
Explanation: The facial nerve (CN VII) carries taste fibers from the anterior
two-thirds of the tongue via the chorda tympani. A lesion at the internal acoustic
meatus would also affect hearing and balance (CN VIII) but the question asks
specifically about CN VII functions besides facial muscles. Taste from the posterior
one-third is CN IX.
3. A 67-year-old male with a history of heavy alcohol use presents with a
staggering gait, nystagmus, and memory loss. Which part of the brain is most
likely affected?
A. Frontal lobe
B. Cerebellar vermis and mammillary bodies
C. Basal ganglia
D. Occipital cortex
: Correct Answer : B
Explanation: Wernicke-Korsakoff syndrome from thiamine deficiency causes
degeneration of the mammillary bodies, thalamus, and cerebellar vermis, leading
to ataxia, nystagmus, and confabulation.
4. A 45-year-old woman with a pituitary adenoma presents with bitemporal
hemianopia. Which structure is being compressed?
A. Optic chiasm
B. Optic nerve
C. Optic tract
D. Lateral geniculate nucleus
: Correct Answer : A
Explanation: The optic chiasm contains crossing fibers from the nasal retinas of
both eyes. Compression from a pituitary tumor causes loss of the temporal visual
fields in each eye, producing bitemporal hemianopia.
pg. 2
,3
5. A patient cannot abduct the arm at the shoulder beyond 15 degrees and has
loss of sensation over the deltoid region. Which nerve is injured?
A. Axillary nerve
B. Radial nerve
C. Musculocutaneous nerve
D. Long thoracic nerve
: Correct Answer : A
Explanation: The axillary nerve innervates the deltoid and teres minor, providing
shoulder abduction from 15-90 degrees. It also supplies sensation to the
“regimental badge” area over the deltoid. The radial nerve innervates the triceps
and forearm extensors.
6. A child is born with a “port-wine stain” over the forehead and upper eyelid.
Seizures develop in infancy. Which syndrome is most likely?
A. Neurofibromatosis type 1
B. Tuberous sclerosis
C. Sturge-Weber syndrome
D. von Hippel-Lindau disease
: Correct Answer : C
*Explanation: Sturge-Weber syndrome is a neurocutaneous disorder with a facial
port-wine stain in the V1/V2 trigeminal distribution, ipsilateral leptomeningeal
angiomas, and seizures.*
7. A 32-year-old woman sustains a fracture of the surgical neck of the humerus.
Which nerve is most at risk?
A. Radial nerve
B. Axillary nerve
C. Median nerve
D. Ulnar nerve
: Correct Answer : B
Explanation: The axillary nerve wraps around the surgical neck of the humerus and
pg. 3
, 4
is vulnerable to injury with fractures at that location. Injury leads to deltoid
paralysis and sensory loss over the shoulder.
8. A 28-year-old man is stabbed in the lower back. He has weakness of hip
extension and knee flexion, and loss of the ankle jerk reflex. Which nerve root is
damaged?
A. L3
B. L4
C. L5
D. S1
: Correct Answer : D
*Explanation: S1 nerve root innervates the gluteus maximus (hip extension),
hamstrings (knee flexion), and the gastrocnemius/soleus (ankle plantarflexion).
The ankle jerk is S1. L5 would affect foot dorsiflexion and the extensor hallucis
longus.*
9. A patient has a “claw hand” deformity with hyperextension at the MCP joints
and flexion at the IP joints of the ring and little fingers, and loss of sensation on
the medial hand. Which nerve is injured?
A. Median nerve
B. Radial nerve
C. Ulnar nerve
D. Musculocutaneous nerve
: Correct Answer : C
*Explanation: Ulnar nerve injury at the wrist or elbow causes paralysis of the
intrinsic hand muscles (interossei, lumbricals 3/4) resulting in clawing of the ring
and little fingers. Sensation is lost over the ulnar 1½ fingers.*
10. A 50-year-old male has difficulty climbing stairs and rising from a seated
position. Physical exam reveals a waddling gait and positive Gowers sign. Which
muscles are primarily affected?
pg. 4
