Page 1 of 229
COMSAE Phase 1 Form 107 EXAM QUESTIONS AND CORRECT
VERIFIED SOLUTIONS LATEST UPDATE THIS YEAR – JUST
RELEASED
Brief Exam Coverage: COMSAE Phase 1 Form 107 (Practice Version)
This exam is designed to mimic the content and difficulty of the official COMSAE Phase 1 Form
107, which contains 176 total items divided into 4 sections of 44 questions each, all in single-
best-answer multiple-choice format . Key content areas include:
1. Cardiovascular System – Coronary artery anatomy, murmurs, heart failure, arrhythmias,
vascular pathology
2. Pulmonology – Obstructive vs. restrictive disease, pneumonia, pulmonary embolism,
tuberculosis
3. Gastrointestinal System – Hepatitis, pancreatitis, inflammatory bowel disease, liver
failure
4. Renal & Genitourinary – Acute kidney injury, chronic kidney disease, nephrolithiasis, UTI
5. Endocrine & Metabolism – Diabetes mellitus, thyroid disorders, adrenal pathology,
calcium metabolism
6. Neurology – Stroke localization, neurodegenerative diseases, meningitis, seizures
7. Infectious Disease & Immunology – Common pathogens, immunodeficiency,
autoimmune diseases, hypersensitivity
8. Genetics & Biochemistry – Inheritance patterns, storage diseases, vitamin deficiencies,
metabolic disorders
9. Hematology & Oncology – Anemia, leukemia, coagulation disorders, tumor markers,
chemotherapy toxicity
10. Osteopathic Principles (OPP) – Somatic dysfunction diagnosis, Chapman points,
viscerosomatic reflexes
11. Behavioral Science & Ethics – Informed consent, professionalism, physician-patient
relationship
, Page 2 of 229
COMSAE Phase 1 Form 107 Style Practice Exam (Questions 1–100)
Section 1: Cardiovascular System
Q1. A 65-year-old man presents with crushing substernal chest pain radiating to his left arm.
ECG shows ST-segment elevation in leads II, III, and aVF. Which coronary artery is most likely
occluded?
A) Left anterior descending (LAD)
B) Left circumflex (LCx)
C) Right coronary artery (RCA)
D) Left main coronary artery
E) Posterior descending artery (PDA)
Answer: C
Rationale: An inferior wall myocardial infarction (ST elevation in leads II, III, aVF) is most
commonly caused by occlusion of the right coronary artery (RCA), which supplies the inferior
wall of the left ventricle via the posterior descending artery (PDA). The LAD supplies the anterior
wall (V1–V4), the LCx supplies the lateral wall (I, aVL, V5–V6), and left main occlusion causes
widespread ischemia .
, Page 3 of 229
Q2. A patient with a history of hypertension presents with shortness of breath and bilateral
lower extremity edema. On auscultation, an S3 gallop is present. Which of the following is the
most likely diagnosis?
A) Aortic stenosis
B) Pericarditis
C) Hypertrophic cardiomyopathy
D) Heart failure with reduced ejection fraction (HFrEF)
E) Mitral valve prolapse
Answer: D
Rationale: The presence of an S3 gallop, shortness of breath, and peripheral edema is classic for
heart failure with reduced ejection fraction (HFrEF). An S3 occurs when blood enters a
non-compliant ventricle during rapid filling, often indicating elevated filling pressures and
systolic dysfunction.
Q3. A 22-year-old student develops increased heart rate and sweating before an exam. Which
neurotransmitter is primarily responsible for the sympathetic postganglionic response?
A) Acetylcholine
B) Dopamine
, Page 4 of 229
C) Norepinephrine
D) Serotonin
E) Epinephrine
Answer: C
Rationale: Most sympathetic postganglionic neurons release norepinephrine onto target organs
(sweat glands are an exception, as they release acetylcholine). This response is part of the
sympathetic nervous system's "fight or flight" activation .
Q4. A 65-year-old woman with atrial fibrillation presents with sudden onset of severe pain in
her right leg. On examination, the right leg is pale, cold to the touch, and pulseless. She reports
paresthesias and is unable to move her toes. What is the most likely diagnosis?
A) Deep vein thrombosis
B) Acute arterial embolism
C) Cellulitis
D) Neuropathy
E) Venous insufficiency
Answer: B
Rationale: The 5 P's of acute limb ischemia (Pain, Pallor, Pulselessness, Paresthesia, Paralysis)
COMSAE Phase 1 Form 107 EXAM QUESTIONS AND CORRECT
VERIFIED SOLUTIONS LATEST UPDATE THIS YEAR – JUST
RELEASED
Brief Exam Coverage: COMSAE Phase 1 Form 107 (Practice Version)
This exam is designed to mimic the content and difficulty of the official COMSAE Phase 1 Form
107, which contains 176 total items divided into 4 sections of 44 questions each, all in single-
best-answer multiple-choice format . Key content areas include:
1. Cardiovascular System – Coronary artery anatomy, murmurs, heart failure, arrhythmias,
vascular pathology
2. Pulmonology – Obstructive vs. restrictive disease, pneumonia, pulmonary embolism,
tuberculosis
3. Gastrointestinal System – Hepatitis, pancreatitis, inflammatory bowel disease, liver
failure
4. Renal & Genitourinary – Acute kidney injury, chronic kidney disease, nephrolithiasis, UTI
5. Endocrine & Metabolism – Diabetes mellitus, thyroid disorders, adrenal pathology,
calcium metabolism
6. Neurology – Stroke localization, neurodegenerative diseases, meningitis, seizures
7. Infectious Disease & Immunology – Common pathogens, immunodeficiency,
autoimmune diseases, hypersensitivity
8. Genetics & Biochemistry – Inheritance patterns, storage diseases, vitamin deficiencies,
metabolic disorders
9. Hematology & Oncology – Anemia, leukemia, coagulation disorders, tumor markers,
chemotherapy toxicity
10. Osteopathic Principles (OPP) – Somatic dysfunction diagnosis, Chapman points,
viscerosomatic reflexes
11. Behavioral Science & Ethics – Informed consent, professionalism, physician-patient
relationship
, Page 2 of 229
COMSAE Phase 1 Form 107 Style Practice Exam (Questions 1–100)
Section 1: Cardiovascular System
Q1. A 65-year-old man presents with crushing substernal chest pain radiating to his left arm.
ECG shows ST-segment elevation in leads II, III, and aVF. Which coronary artery is most likely
occluded?
A) Left anterior descending (LAD)
B) Left circumflex (LCx)
C) Right coronary artery (RCA)
D) Left main coronary artery
E) Posterior descending artery (PDA)
Answer: C
Rationale: An inferior wall myocardial infarction (ST elevation in leads II, III, aVF) is most
commonly caused by occlusion of the right coronary artery (RCA), which supplies the inferior
wall of the left ventricle via the posterior descending artery (PDA). The LAD supplies the anterior
wall (V1–V4), the LCx supplies the lateral wall (I, aVL, V5–V6), and left main occlusion causes
widespread ischemia .
, Page 3 of 229
Q2. A patient with a history of hypertension presents with shortness of breath and bilateral
lower extremity edema. On auscultation, an S3 gallop is present. Which of the following is the
most likely diagnosis?
A) Aortic stenosis
B) Pericarditis
C) Hypertrophic cardiomyopathy
D) Heart failure with reduced ejection fraction (HFrEF)
E) Mitral valve prolapse
Answer: D
Rationale: The presence of an S3 gallop, shortness of breath, and peripheral edema is classic for
heart failure with reduced ejection fraction (HFrEF). An S3 occurs when blood enters a
non-compliant ventricle during rapid filling, often indicating elevated filling pressures and
systolic dysfunction.
Q3. A 22-year-old student develops increased heart rate and sweating before an exam. Which
neurotransmitter is primarily responsible for the sympathetic postganglionic response?
A) Acetylcholine
B) Dopamine
, Page 4 of 229
C) Norepinephrine
D) Serotonin
E) Epinephrine
Answer: C
Rationale: Most sympathetic postganglionic neurons release norepinephrine onto target organs
(sweat glands are an exception, as they release acetylcholine). This response is part of the
sympathetic nervous system's "fight or flight" activation .
Q4. A 65-year-old woman with atrial fibrillation presents with sudden onset of severe pain in
her right leg. On examination, the right leg is pale, cold to the touch, and pulseless. She reports
paresthesias and is unable to move her toes. What is the most likely diagnosis?
A) Deep vein thrombosis
B) Acute arterial embolism
C) Cellulitis
D) Neuropathy
E) Venous insufficiency
Answer: B
Rationale: The 5 P's of acute limb ischemia (Pain, Pallor, Pulselessness, Paresthesia, Paralysis)
