Page 1 of 165
COMSAE Phase 1 Form 116 EXAM QUESTIONS AND CORRECT
VERIFIED SOLUTIONS LATEST UPDATE THIS YEAR – JUST
RELEASED
COMSAE Phase 1 Form 116 Exam Practice Questions
Below is a comprehensive practice question bank for the COMSAE Phase 1 Form
116 examination with a content distribution that follows the COMLEX-USA Level 1 blueprint .
Exam Overview
COMSAE Phase 1 is designed to help osteopathic medical students gauge their readiness for
COMLEX-USA Level 1. Form 116 is available on a non-secure browser and includes answer keys
with detailed rationales to help identify knowledge gaps .
Content Breakdown (COMLEX-USA Level 1 Blueprint) :
Approximate
Category Topics Included
%
Viscerosomatic reflexes, Chapman points, Fryette's laws,
Osteopathic Principles &
15% sacral/innominate diagnostics, HVLA, muscle energy,
OMM
counterstrain, cranial, lymphatic
Brachial plexus, cranial nerves, spinal cord syndromes, vasc
Human Anatomy 15%
supply, pelvic anatomy, hernias, nerve injuries
Cell injury, inflammation, neoplasia, autoimmune diseases,
Pathology 18%
organ-specific pathology, shock, hemostasis
Cardiac cycle, renal function, acid-base, pulmonary mechan
Physiology 15%
endocrine axes, GI physiology, neurophysiology
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Approximate
Category Topics Included
%
Autonomic drugs, antibiotics, cardiovascular agents, CNS dr
Pharmacology 12%
chemotherapy, endocrine agents, adverse effects
Bacterial/viral/fungal identification, toxins, STIs, CNS infecti
Microbiology/Immunology 10%
HIV, hypersensitivity, immunodeficiencies
Metabolic pathways, vitamin deficiencies, lysosomal storag
Biochemistry/Genetics 8%
diseases, inheritance patterns, inborn errors
Stroke localization, spinal cord syndromes, neurodegenerati
Neurology/Psychiatry 7%
diseases, aphasias, psychiatric disorders
SECTION 1: OSTeopathic Principles & OMM (Questions 1-30)
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
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C) Liver
D) Stomach
Answer: D) Stomach
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
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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
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.
COMSAE Phase 1 Form 116 EXAM QUESTIONS AND CORRECT
VERIFIED SOLUTIONS LATEST UPDATE THIS YEAR – JUST
RELEASED
COMSAE Phase 1 Form 116 Exam Practice Questions
Below is a comprehensive practice question bank for the COMSAE Phase 1 Form
116 examination with a content distribution that follows the COMLEX-USA Level 1 blueprint .
Exam Overview
COMSAE Phase 1 is designed to help osteopathic medical students gauge their readiness for
COMLEX-USA Level 1. Form 116 is available on a non-secure browser and includes answer keys
with detailed rationales to help identify knowledge gaps .
Content Breakdown (COMLEX-USA Level 1 Blueprint) :
Approximate
Category Topics Included
%
Viscerosomatic reflexes, Chapman points, Fryette's laws,
Osteopathic Principles &
15% sacral/innominate diagnostics, HVLA, muscle energy,
OMM
counterstrain, cranial, lymphatic
Brachial plexus, cranial nerves, spinal cord syndromes, vasc
Human Anatomy 15%
supply, pelvic anatomy, hernias, nerve injuries
Cell injury, inflammation, neoplasia, autoimmune diseases,
Pathology 18%
organ-specific pathology, shock, hemostasis
Cardiac cycle, renal function, acid-base, pulmonary mechan
Physiology 15%
endocrine axes, GI physiology, neurophysiology
, Page 2 of 165
Approximate
Category Topics Included
%
Autonomic drugs, antibiotics, cardiovascular agents, CNS dr
Pharmacology 12%
chemotherapy, endocrine agents, adverse effects
Bacterial/viral/fungal identification, toxins, STIs, CNS infecti
Microbiology/Immunology 10%
HIV, hypersensitivity, immunodeficiencies
Metabolic pathways, vitamin deficiencies, lysosomal storag
Biochemistry/Genetics 8%
diseases, inheritance patterns, inborn errors
Stroke localization, spinal cord syndromes, neurodegenerati
Neurology/Psychiatry 7%
diseases, aphasias, psychiatric disorders
SECTION 1: OSTeopathic Principles & OMM (Questions 1-30)
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
, Page 3 of 165
C) Liver
D) Stomach
Answer: D) Stomach
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
, Page 4 of 165
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
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.
