COMSAE 114 PRACTICE EXAM – QUESTIONS AND ANSWERS | VERIFIED AND WELL
DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
CORE DOMAINS*
- Osteopathic Principles and Practice
- Internal Medicine
- Surgery
- Pediatrics
- Obstetrics and Gynecology
- Psychiatry and Behavioral Science
- Pharmacology
- Pathology and Microbiology
- Ethics and Professionalism
- Preventive Medicine and Public Health
INTRODUCTION*
This assessment is designed to evaluate comprehensive clinical knowledge and decision-
making skills commonly tested on COMSAE-style examinations. The exam emphasizes
integration of foundational sciences with practical clinical application across multiple
medical disciplines. Questions include traditional multiple-choice formats as well as
,scenario-based cases requiring diagnostic reasoning, interpretation of findings, ethical
judgment, and treatment planning. Candidates are expected to demonstrate proficiency in
patient care, osteopathic concepts, pharmacology, pathology, and evidence-based medicine.
The assessment also measures the ability to prioritize interventions, recognize emergencies,
and apply professional standards in real-world healthcare settings while maintaining safe
and effective patient-centered care.
SECTION ONE (QUESTIONS 1–50)
1. A 65-year-old man presents with crushing substernal chest pain radiating to the left
arm for 45 minutes. ECG shows ST-segment elevation in leads II, III, and aVF. Which
coronary artery is most likely occluded?
A. Left anterior descending artery
B. Right coronary artery
C. Circumflex artery
D. Left main coronary artery
🟢 Correct Answer: B. Right coronary artery
🔴 Explanation: Inferior wall myocardial infarctions involving leads II, III, and aVF are most
commonly caused by occlusion of the right coronary artery.
2. A patient with chronic alcohol use develops confusion, ophthalmoplegia, and ataxia.
Which vitamin deficiency is responsible?
,A. Vitamin B1
B. Vitamin B12
C. Vitamin B6
D. Vitamin D
🟢 Correct Answer: A. Vitamin B1
🔴 Explanation: Wernicke encephalopathy results from thiamine deficiency and classically
presents with confusion, ophthalmoplegia, and ataxia.
3. A 7-year-old child presents with a barking cough and inspiratory stridor that worsens
at night. What is the most likely diagnosis?
A. Epiglottitis
B. Bronchiolitis
C. Croup
D. Asthma
🟢 Correct Answer: C. Croup
🔴 Explanation: Croup commonly presents with a barking cough, inspiratory stridor, and
nighttime worsening due to parainfluenza infection.
4. Which electrolyte abnormality is most associated with peaked T waves on ECG?
, A. Hypocalcemia
B. Hypernatremia
C. Hypokalemia
D. Hyperkalemia
🟢 Correct Answer: D. Hyperkalemia
🔴 Explanation: Hyperkalemia characteristically causes peaked T waves and may progress
to widened QRS complexes and arrhythmias.
5. A patient develops fever, rigidity, and autonomic instability after initiation of
haloperidol. What is the most likely diagnosis?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Malignant hyperthermia
D. Acute dystonia
🟢 Correct Answer: B. Neuroleptic malignant syndrome
🔴 Explanation: Neuroleptic malignant syndrome is associated with dopamine antagonist
use and presents with rigidity, fever, and autonomic dysfunction.
6. Which organism is the most common cause of community-acquired pneumonia in
adults?
DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
CORE DOMAINS*
- Osteopathic Principles and Practice
- Internal Medicine
- Surgery
- Pediatrics
- Obstetrics and Gynecology
- Psychiatry and Behavioral Science
- Pharmacology
- Pathology and Microbiology
- Ethics and Professionalism
- Preventive Medicine and Public Health
INTRODUCTION*
This assessment is designed to evaluate comprehensive clinical knowledge and decision-
making skills commonly tested on COMSAE-style examinations. The exam emphasizes
integration of foundational sciences with practical clinical application across multiple
medical disciplines. Questions include traditional multiple-choice formats as well as
,scenario-based cases requiring diagnostic reasoning, interpretation of findings, ethical
judgment, and treatment planning. Candidates are expected to demonstrate proficiency in
patient care, osteopathic concepts, pharmacology, pathology, and evidence-based medicine.
The assessment also measures the ability to prioritize interventions, recognize emergencies,
and apply professional standards in real-world healthcare settings while maintaining safe
and effective patient-centered care.
SECTION ONE (QUESTIONS 1–50)
1. A 65-year-old man presents with crushing substernal chest pain radiating to the left
arm for 45 minutes. ECG shows ST-segment elevation in leads II, III, and aVF. Which
coronary artery is most likely occluded?
A. Left anterior descending artery
B. Right coronary artery
C. Circumflex artery
D. Left main coronary artery
🟢 Correct Answer: B. Right coronary artery
🔴 Explanation: Inferior wall myocardial infarctions involving leads II, III, and aVF are most
commonly caused by occlusion of the right coronary artery.
2. A patient with chronic alcohol use develops confusion, ophthalmoplegia, and ataxia.
Which vitamin deficiency is responsible?
,A. Vitamin B1
B. Vitamin B12
C. Vitamin B6
D. Vitamin D
🟢 Correct Answer: A. Vitamin B1
🔴 Explanation: Wernicke encephalopathy results from thiamine deficiency and classically
presents with confusion, ophthalmoplegia, and ataxia.
3. A 7-year-old child presents with a barking cough and inspiratory stridor that worsens
at night. What is the most likely diagnosis?
A. Epiglottitis
B. Bronchiolitis
C. Croup
D. Asthma
🟢 Correct Answer: C. Croup
🔴 Explanation: Croup commonly presents with a barking cough, inspiratory stridor, and
nighttime worsening due to parainfluenza infection.
4. Which electrolyte abnormality is most associated with peaked T waves on ECG?
, A. Hypocalcemia
B. Hypernatremia
C. Hypokalemia
D. Hyperkalemia
🟢 Correct Answer: D. Hyperkalemia
🔴 Explanation: Hyperkalemia characteristically causes peaked T waves and may progress
to widened QRS complexes and arrhythmias.
5. A patient develops fever, rigidity, and autonomic instability after initiation of
haloperidol. What is the most likely diagnosis?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Malignant hyperthermia
D. Acute dystonia
🟢 Correct Answer: B. Neuroleptic malignant syndrome
🔴 Explanation: Neuroleptic malignant syndrome is associated with dopamine antagonist
use and presents with rigidity, fever, and autonomic dysfunction.
6. Which organism is the most common cause of community-acquired pneumonia in
adults?
