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COMSAE Phase 2 Form 114 Exam QUESTIONS AND
VERIFIED ANSWERS LATEST UPDATE
COMSAE Phase 2 Form 114 Exam – Coverage Summary & 200 Exam-Relevant Questions
The COMSAE (Comprehensive Osteopathic Medical Self-Assessment Examination) Phase 2 is designed
to assess concepts and principles necessary for making appropriate medical diagnoses, serving as
preparation for the COMLEX-USA Level 2-CE examination .
Exam Overview
Feature Details
Total Questions 160 items
Format 4 sections of 40 questions each
Time Limit 4 hours (timed version)
Question Type Single-best-answer, multiple-choice
Features Some forms include videos/images; headphones required for video forms
Form 114 BSA 114i (student form with answer key, includes videos)
Content Domains
• Emergency Medicine
• Family Medicine
• Internal Medicine
• Obstetrics and Gynecology
• Pediatrics
• Psychiatry
• Surgery
• Osteopathic Principles
Internal Medicine (Questions 1-50)
Question 1
A 24-year-old woman presents with acute lower abdominal pain and fever. Pelvic exam shows cervical
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motion tenderness. What is the most likely diagnosis?
A) Ovarian cyst rupture
B) Appendicitis
C) Pelvic inflammatory disease (PID)
D) Ectopic pregnancy
Answer: C
Lower abdominal pain, fever, and cervical motion tenderness (chandelier sign) are classic for PID,
typically caused by Neisseria gonorrhoeae or Chlamydia trachomatis ascending from the cervix .
Question 2
A 65-year-old man with a 50 pack-year smoking history presents with painless hematuria. What is the
most likely diagnosis?
A) Nephrolithiasis
B) Bladder cancer (urothelial carcinoma)
C) Urinary tract infection
D) Benign prostatic hyperplasia
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Answer: B
Smoking is the strongest risk factor for bladder cancer, and painless hematuria is the classic
presentation .
Question 3
A 55-year-old man develops substernal chest pain during exertion, relieved by rest. ECG is normal. What
is the most likely diagnosis?
A) Unstable angina
B) Acute myocardial infarction
C) Stable angina
D) Pericarditis
Answer: C
Predictable exertional chest pain relieved by rest defines stable angina. A normal resting ECG does not
exclude this diagnosis .
Question 4
A 45-year-old woman has tremor, heat intolerance, weight loss, and palpitations. Labs: TSH low, T4 high.
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What is the most likely cause?
A) Hashimoto's thyroiditis
B) Subacute thyroiditis
C) Graves' disease
D) Toxic multinodular goiter
Answer: C
Graves' disease is the most common cause of hyperthyroidism, with autoantibodies (TSI) stimulating the
TSH receptor. Findings may include diffuse goiter, ophthalmopathy, and pretibial myxedema .
Question 5
A 4-year-old boy presents with hemarthrosis after minor trauma. Labs show increased PTT, normal PT.
Which factor is deficient?
A) Factor VII
B) Factor VIII
C) Factor IX
D) von Willebrand factor
COMSAE Phase 2 Form 114 Exam QUESTIONS AND
VERIFIED ANSWERS LATEST UPDATE
COMSAE Phase 2 Form 114 Exam – Coverage Summary & 200 Exam-Relevant Questions
The COMSAE (Comprehensive Osteopathic Medical Self-Assessment Examination) Phase 2 is designed
to assess concepts and principles necessary for making appropriate medical diagnoses, serving as
preparation for the COMLEX-USA Level 2-CE examination .
Exam Overview
Feature Details
Total Questions 160 items
Format 4 sections of 40 questions each
Time Limit 4 hours (timed version)
Question Type Single-best-answer, multiple-choice
Features Some forms include videos/images; headphones required for video forms
Form 114 BSA 114i (student form with answer key, includes videos)
Content Domains
• Emergency Medicine
• Family Medicine
• Internal Medicine
• Obstetrics and Gynecology
• Pediatrics
• Psychiatry
• Surgery
• Osteopathic Principles
Internal Medicine (Questions 1-50)
Question 1
A 24-year-old woman presents with acute lower abdominal pain and fever. Pelvic exam shows cervical
, Page 2 of 143
motion tenderness. What is the most likely diagnosis?
A) Ovarian cyst rupture
B) Appendicitis
C) Pelvic inflammatory disease (PID)
D) Ectopic pregnancy
Answer: C
Lower abdominal pain, fever, and cervical motion tenderness (chandelier sign) are classic for PID,
typically caused by Neisseria gonorrhoeae or Chlamydia trachomatis ascending from the cervix .
Question 2
A 65-year-old man with a 50 pack-year smoking history presents with painless hematuria. What is the
most likely diagnosis?
A) Nephrolithiasis
B) Bladder cancer (urothelial carcinoma)
C) Urinary tract infection
D) Benign prostatic hyperplasia
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Answer: B
Smoking is the strongest risk factor for bladder cancer, and painless hematuria is the classic
presentation .
Question 3
A 55-year-old man develops substernal chest pain during exertion, relieved by rest. ECG is normal. What
is the most likely diagnosis?
A) Unstable angina
B) Acute myocardial infarction
C) Stable angina
D) Pericarditis
Answer: C
Predictable exertional chest pain relieved by rest defines stable angina. A normal resting ECG does not
exclude this diagnosis .
Question 4
A 45-year-old woman has tremor, heat intolerance, weight loss, and palpitations. Labs: TSH low, T4 high.
, Page 4 of 143
What is the most likely cause?
A) Hashimoto's thyroiditis
B) Subacute thyroiditis
C) Graves' disease
D) Toxic multinodular goiter
Answer: C
Graves' disease is the most common cause of hyperthyroidism, with autoantibodies (TSI) stimulating the
TSH receptor. Findings may include diffuse goiter, ophthalmopathy, and pretibial myxedema .
Question 5
A 4-year-old boy presents with hemarthrosis after minor trauma. Labs show increased PTT, normal PT.
Which factor is deficient?
A) Factor VII
B) Factor VIII
C) Factor IX
D) von Willebrand factor
