Page 1 of 188
COMSAE Phase 1 Form 112 EXAM QUESTIONS AND CORRECT
VERIFIED SOLUTIONS LATEST UPDATE THIS YEAR – JUST
RELEASED
COMSAE Phase 1 Form 112 Exam Practice Questions
Exam Overview
The Comprehensive Osteopathic Medical Self-Assessment Examination (COMSAE) Phase 1 is
designed to assess foundational knowledge in preparation for COMLEX-USA Level 1 . Developed
by the NBOME, each form is presented in a format that aligns with the COMLEX-USA blueprint.
Form 112 covers essential topics including Osteopathic Principles & OMM,
cardiovascular/pulmonary/renal systems, neurology, microbiology, pharmacology, and
biostatistics .
SECTION 1: OSTEOPATHIC PRINCIPLES & OMM
1. A 45-year-old woman presents with epigastric burning and bloating after meals for several
months. On osteopathic structural exam, you find tenderness and increased tissue texture at
the right T6–T8 paraspinal region. Which viscerosomatic reflex best explains this finding?
A) Gallbladder
B) Pancreas
C) Liver
D) Stomach
Answer: D) Stomach
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Rationale: Viscerosomatic reflexes map spinal cord levels to organs. The stomach corresponds
to T6–T9, with a predilection for the right side. The gallbladder (T7–T9) often presents on the
right, but epigastric symptoms and bilateral T6–T8 tenderness more specifically point to the
stomach .
2. A 28-year-old runner presents with chronic low back pain. On seated flexion test, the right
PSIS moves superiorly earlier and more than the left. In the prone position, the right ILA is more
posterior than the left, and both ILAs move equally with spring test. What is the most likely
sacral diagnosis?
A) Left on left sacral torsion
B) Right on right sacral torsion
C) Left unilateral sacral flexion
D) Bilateral sacral extension
Answer: B) Right on right sacral torsion
Rationale: The seated flexion test indicates somatic dysfunction on the right. In a sacral torsion,
the side named first is the axis (side of deep sulcus and posterior ILA). Here, the right ILA is
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posterior, meaning the axis is on the right. Equal spring test indicates torsion rather than
unilateral flexion .
3. A patient with chronic low back pain has a seated flexion test positive on the left. In the
prone position, the left ILA is more posterior than the right. What is the most likely diagnosis?
A) Left on left sacral torsion
B) Right on right sacral torsion
C) Left unilateral sacral flexion
D) Bilateral sacral extension
Answer: A) Left on left sacral torsion
Rationale: The seated flexion test points to the side of dysfunction (left). A posterior ILA
indicates the axis. In a left on left torsion, the axis is on the left and the left ILA is posterior .
4. During a screening exam, you palpate a small, tender nodule in the second intercostal space,
right parasternal region. This Chapman's point is most likely associated with which condition?
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A) Mitral valve dysfunction
B) Gastric ulcer
C) Appendicitis
D) Pulmonary congestion
Answer: A) Mitral valve dysfunction
Rationale: Anterior Chapman's points for the heart are in the 2nd–5th intercostal spaces
parasternally. The mitral valve corresponds to the right 2nd intercostal space. Gastric points are
lower (6th–7th ribs) .
5. A patient has restriction of sidebending to the right and rotation to the left in the thoracic
spine with neutral mechanics. This is best described as:
A) Type I dysfunction
B) Type II dysfunction
C) Type III dysfunction
D) Normal mechanics
Answer: A) Type I dysfunction
COMSAE Phase 1 Form 112 EXAM QUESTIONS AND CORRECT
VERIFIED SOLUTIONS LATEST UPDATE THIS YEAR – JUST
RELEASED
COMSAE Phase 1 Form 112 Exam Practice Questions
Exam Overview
The Comprehensive Osteopathic Medical Self-Assessment Examination (COMSAE) Phase 1 is
designed to assess foundational knowledge in preparation for COMLEX-USA Level 1 . Developed
by the NBOME, each form is presented in a format that aligns with the COMLEX-USA blueprint.
Form 112 covers essential topics including Osteopathic Principles & OMM,
cardiovascular/pulmonary/renal systems, neurology, microbiology, pharmacology, and
biostatistics .
SECTION 1: OSTEOPATHIC PRINCIPLES & OMM
1. A 45-year-old woman presents with epigastric burning and bloating after meals for several
months. On osteopathic structural exam, you find tenderness and increased tissue texture at
the right T6–T8 paraspinal region. Which viscerosomatic reflex best explains this finding?
A) Gallbladder
B) Pancreas
C) Liver
D) Stomach
Answer: D) Stomach
, Page 2 of 188
Rationale: Viscerosomatic reflexes map spinal cord levels to organs. The stomach corresponds
to T6–T9, with a predilection for the right side. The gallbladder (T7–T9) often presents on the
right, but epigastric symptoms and bilateral T6–T8 tenderness more specifically point to the
stomach .
2. A 28-year-old runner presents with chronic low back pain. On seated flexion test, the right
PSIS moves superiorly earlier and more than the left. In the prone position, the right ILA is more
posterior than the left, and both ILAs move equally with spring test. What is the most likely
sacral diagnosis?
A) Left on left sacral torsion
B) Right on right sacral torsion
C) Left unilateral sacral flexion
D) Bilateral sacral extension
Answer: B) Right on right sacral torsion
Rationale: The seated flexion test indicates somatic dysfunction on the right. In a sacral torsion,
the side named first is the axis (side of deep sulcus and posterior ILA). Here, the right ILA is
, Page 3 of 188
posterior, meaning the axis is on the right. Equal spring test indicates torsion rather than
unilateral flexion .
3. A patient with chronic low back pain has a seated flexion test positive on the left. In the
prone position, the left ILA is more posterior than the right. What is the most likely diagnosis?
A) Left on left sacral torsion
B) Right on right sacral torsion
C) Left unilateral sacral flexion
D) Bilateral sacral extension
Answer: A) Left on left sacral torsion
Rationale: The seated flexion test points to the side of dysfunction (left). A posterior ILA
indicates the axis. In a left on left torsion, the axis is on the left and the left ILA is posterior .
4. During a screening exam, you palpate a small, tender nodule in the second intercostal space,
right parasternal region. This Chapman's point is most likely associated with which condition?
, Page 4 of 188
A) Mitral valve dysfunction
B) Gastric ulcer
C) Appendicitis
D) Pulmonary congestion
Answer: A) Mitral valve dysfunction
Rationale: Anterior Chapman's points for the heart are in the 2nd–5th intercostal spaces
parasternally. The mitral valve corresponds to the right 2nd intercostal space. Gastric points are
lower (6th–7th ribs) .
5. A patient has restriction of sidebending to the right and rotation to the left in the thoracic
spine with neutral mechanics. This is best described as:
A) Type I dysfunction
B) Type II dysfunction
C) Type III dysfunction
D) Normal mechanics
Answer: A) Type I dysfunction
