COMSAE Phase 1 Form 112 Practice Exam
Questions And Correct Answers (Verified
Answers) Plus Rationales 2025|2026 Q&A |
Instant Download Pdf,,
1. A 24-year-old male is brought to the emergency department after being
struck in the temporal region of the skull with a baseball bat. He initially lost
consciousness but recovered and was lucid for approximately 30 minutes
before rapidly deteriorating. A non-contrast head CT demonstrates a lens-
shaped hyperdensity. Which of the following vessels is most likely lacerated in
this patient?
• A) Bridging cortical veins
• B) Anterior communicating artery
• C) Middle meningeal artery
• D) Ophthalmic artery
Correct ,,,answer,,,: C
Rationale: The patient is presenting with a classic epidural hematoma following
trauma to the pterion. The middle meningeal artery, a branch of the maxillary
artery, runs directly beneath the pterion and is highly susceptible to laceration from
temporal skull fractures. The resulting arterial bleed creates a biconvex, lens-
shaped hematoma that cannot cross cranial suture lines.
2. A 74-year-old female with a history of chronic atrial fibrillation presents
with progressive confusion, gait instability, and frequent falls over the past
three weeks. Her family notes she bumped her head on a kitchen cabinet a
month ago but seemed fine at the time. A head CT reveals a crescent-shaped
collection of fluid crossing suture lines. What is the primary pathophysiology
underlying this condition?
, • A) Rupture of bridging cortical veins
• B) Rupture of the posterior communicating artery
• C) Laceration of the middle cerebral artery branches
• D) Shear injury to the corpus callosum axons
Correct ,,,answer,,,: A
Rationale: This patient is suffering from a chronic subdural hematoma, which is
common in elderly individuals due to age-related brain atrophy. Atrophy stretches
the bridging cortical veins as they traverse from the cortex to the dural sinuses,
making them prone to shearing from minor trauma. The venous nature of the bleed
results in a slow, gradual accumulation of blood that forms a crescent shape on CT.
3. A 43-year-old female presents to the clinic complaining of a "pins and
needles" sensation in her right thumb, index, and middle fingers that has been
worsening for several months. She works as a data entry clerk and notes the
symptoms are worse at night, often waking her from sleep. Phalen's maneuver
reproduces her symptoms within 20 seconds. Which of the following
structures is most likely compressed in this patient's condition?
• A) Median nerve at the carpal tunnel
• B) Ulnar nerve in Guyon's canal
• C) Radial nerve at the spiral groove
• D) Posterior interosseous nerve in the supinator muscle
Correct ,,,answer,,,: A
Rationale: The patient's symptoms (paresthesias in the thumb, index, and middle
fingers) are classic for carpal tunnel syndrome. The median nerve traverses the
carpal tunnel, which is bounded by the carpal bones and the transverse carpal
ligament. Symptoms are often exacerbated by sustained wrist flexion (Phalen’s
maneuver) and at night due to fluid shifts.
4. A 45-year-old patient presents with acute low back pain after lifting a heavy
box. On exam, you note tissue texture changes, asymmetry, restriction of
,motion, and tenderness at the L5 segment. Which mnemonic summarizes
these findings?
• A) SOAP
• B) TART
• C) PQRST
• D) OLD CARTS
Correct ,,,answer,,,: B
Rationale: TART stands for Tissue texture abnormality, Asymmetry, Restriction
of motion, and Tenderness — the four diagnostic criteria for somatic dysfunction.
5. Which of the following is an indirect osteopathic manipulative technique?
• A) High-velocity low-amplitude (HVLA) thrust
• B) Muscle energy (MET)
• C) Counterstrain
• D) Articulatory technique
Correct ,,,answer,,,: C
Rationale: Counterstrain is an indirect technique that positions the patient into a
position of ease to relieve a tender point. It is distinct from direct methods like
HVLA, MET, and articulatory techniques, which engage the restrictive barrier.
6. According to Fryette’s Type I mechanics, when the lumbar spine is in a
neutral position, sidebending and rotation occur in which directions?
• A) Same direction
• B) Opposite directions
• C) Rotation occurs without sidebending
• D) No relationship exists
, Correct ,,,answer,,,: B
Rationale: Fryette’s Type I (neutral mechanics) states that when the spine is in a
neutral position, sidebending and rotation occur in opposite directions.
7. A 28-year-old female presents with right-sided neck pain after a motor
vehicle collision. On exam, you find a tender point in the right trapezius
muscle. Which OMM technique is most appropriate as an initial treatment?
• A) HVLA thrust to C5
• B) Counterstrain targeted to the trapezius tender point
• C) High-velocity rotation of the skull
• D) Prolonged static stretching only
Correct ,,,answer,,,: B
Rationale: Acute tender points following trauma often respond well to
counterstrain, an indirect technique that relieves pain by positioning the patient
into a position of ease.
8. A 65-year-old man with a history of hypertension presents with sudden
onset of severe, tearing chest pain radiating to the back. His blood pressure is
190/100 mmHg in the right arm and 110/70 mmHg in the left arm. ECG shows
no ST-segment elevation. What is the most appropriate next diagnostic test?
• A) Transthoracic echocardiogram
• B) CT angiography of the chest
• C) Coronary angiography
• D) Chest X-ray
Correct ,,,answer,,,: B
Rationale: The presentation is classic for an acute aortic dissection. CT
angiography is the study of choice due to its high sensitivity and specificity, rapid
acquisition, and ability to define the extent of the dissection, which is critical for
surgical planning.
Questions And Correct Answers (Verified
Answers) Plus Rationales 2025|2026 Q&A |
Instant Download Pdf,,
1. A 24-year-old male is brought to the emergency department after being
struck in the temporal region of the skull with a baseball bat. He initially lost
consciousness but recovered and was lucid for approximately 30 minutes
before rapidly deteriorating. A non-contrast head CT demonstrates a lens-
shaped hyperdensity. Which of the following vessels is most likely lacerated in
this patient?
• A) Bridging cortical veins
• B) Anterior communicating artery
• C) Middle meningeal artery
• D) Ophthalmic artery
Correct ,,,answer,,,: C
Rationale: The patient is presenting with a classic epidural hematoma following
trauma to the pterion. The middle meningeal artery, a branch of the maxillary
artery, runs directly beneath the pterion and is highly susceptible to laceration from
temporal skull fractures. The resulting arterial bleed creates a biconvex, lens-
shaped hematoma that cannot cross cranial suture lines.
2. A 74-year-old female with a history of chronic atrial fibrillation presents
with progressive confusion, gait instability, and frequent falls over the past
three weeks. Her family notes she bumped her head on a kitchen cabinet a
month ago but seemed fine at the time. A head CT reveals a crescent-shaped
collection of fluid crossing suture lines. What is the primary pathophysiology
underlying this condition?
, • A) Rupture of bridging cortical veins
• B) Rupture of the posterior communicating artery
• C) Laceration of the middle cerebral artery branches
• D) Shear injury to the corpus callosum axons
Correct ,,,answer,,,: A
Rationale: This patient is suffering from a chronic subdural hematoma, which is
common in elderly individuals due to age-related brain atrophy. Atrophy stretches
the bridging cortical veins as they traverse from the cortex to the dural sinuses,
making them prone to shearing from minor trauma. The venous nature of the bleed
results in a slow, gradual accumulation of blood that forms a crescent shape on CT.
3. A 43-year-old female presents to the clinic complaining of a "pins and
needles" sensation in her right thumb, index, and middle fingers that has been
worsening for several months. She works as a data entry clerk and notes the
symptoms are worse at night, often waking her from sleep. Phalen's maneuver
reproduces her symptoms within 20 seconds. Which of the following
structures is most likely compressed in this patient's condition?
• A) Median nerve at the carpal tunnel
• B) Ulnar nerve in Guyon's canal
• C) Radial nerve at the spiral groove
• D) Posterior interosseous nerve in the supinator muscle
Correct ,,,answer,,,: A
Rationale: The patient's symptoms (paresthesias in the thumb, index, and middle
fingers) are classic for carpal tunnel syndrome. The median nerve traverses the
carpal tunnel, which is bounded by the carpal bones and the transverse carpal
ligament. Symptoms are often exacerbated by sustained wrist flexion (Phalen’s
maneuver) and at night due to fluid shifts.
4. A 45-year-old patient presents with acute low back pain after lifting a heavy
box. On exam, you note tissue texture changes, asymmetry, restriction of
,motion, and tenderness at the L5 segment. Which mnemonic summarizes
these findings?
• A) SOAP
• B) TART
• C) PQRST
• D) OLD CARTS
Correct ,,,answer,,,: B
Rationale: TART stands for Tissue texture abnormality, Asymmetry, Restriction
of motion, and Tenderness — the four diagnostic criteria for somatic dysfunction.
5. Which of the following is an indirect osteopathic manipulative technique?
• A) High-velocity low-amplitude (HVLA) thrust
• B) Muscle energy (MET)
• C) Counterstrain
• D) Articulatory technique
Correct ,,,answer,,,: C
Rationale: Counterstrain is an indirect technique that positions the patient into a
position of ease to relieve a tender point. It is distinct from direct methods like
HVLA, MET, and articulatory techniques, which engage the restrictive barrier.
6. According to Fryette’s Type I mechanics, when the lumbar spine is in a
neutral position, sidebending and rotation occur in which directions?
• A) Same direction
• B) Opposite directions
• C) Rotation occurs without sidebending
• D) No relationship exists
, Correct ,,,answer,,,: B
Rationale: Fryette’s Type I (neutral mechanics) states that when the spine is in a
neutral position, sidebending and rotation occur in opposite directions.
7. A 28-year-old female presents with right-sided neck pain after a motor
vehicle collision. On exam, you find a tender point in the right trapezius
muscle. Which OMM technique is most appropriate as an initial treatment?
• A) HVLA thrust to C5
• B) Counterstrain targeted to the trapezius tender point
• C) High-velocity rotation of the skull
• D) Prolonged static stretching only
Correct ,,,answer,,,: B
Rationale: Acute tender points following trauma often respond well to
counterstrain, an indirect technique that relieves pain by positioning the patient
into a position of ease.
8. A 65-year-old man with a history of hypertension presents with sudden
onset of severe, tearing chest pain radiating to the back. His blood pressure is
190/100 mmHg in the right arm and 110/70 mmHg in the left arm. ECG shows
no ST-segment elevation. What is the most appropriate next diagnostic test?
• A) Transthoracic echocardiogram
• B) CT angiography of the chest
• C) Coronary angiography
• D) Chest X-ray
Correct ,,,answer,,,: B
Rationale: The presentation is classic for an acute aortic dissection. CT
angiography is the study of choice due to its high sensitivity and specificity, rapid
acquisition, and ability to define the extent of the dissection, which is critical for
surgical planning.
