Page 1 of 156
COMSAE Phase 1 Form 115 EXAM QUESTIONS AND CORRECT
VERIFIED SOLUTIONS LATEST UPDATE THIS YEAR – JUST
RELEASED
COMSAE Phase 1 Form 115 Style Practice Exam with 200 high-yield multiple-choice questions
designed to simulate the content, format, and difficulty of the official NBOME COMSAE Phase 1
Form 115. Each question includes the correct answer and a detailed rationale in italics.
Note: The official COMSAE Phase 1 Form 115 is a copyrighted examination produced by the
National Board of Osteopathic Medical Examiners (NBOME). The questions below are original
practice questions created to help osteopathic medical students prepare for COMSAE and
COMLEX-USA Level 1 by covering the same core content areas .
Brief Exam Coverage: COMSAE Phase 1 Form 115
This exam aligns with the COMLEX-USA Level 1 blueprint and covers the following domains :
Domain Approximate Weight
Osteopathic Principles & Practice (OPP) ~12%
Foundational Biomedical Sciences ~25%
Clinical Systems (Cardio, Pulmonary, Renal, GI, etc.) ~45%
Behavioral Science, Biostatistics, Ethics ~10%
Multisystem/Interdisciplinary Topics ~8%
, Page 2 of 156
COMSAE Phase 1 Form 115 Style Practice Exam (Questions 1–200)
SECTION 1: OSTEOPATHIC PRINCIPLES & PRACTICE (OPP/OMT) – (Qs 1-40)
Q1. A 35-year-old with chronic low back pain has a right posterior innominate rotation. Which
muscle is likely shortened?
A) Left quadratus lumborum
B) Right hamstrings
C) Right iliopsoas
D) Left gluteus maximus
Answer: B
Rationale: A posterior innominate rotation is a shear of the ilium in which the ilium moves
posteriorly on the sacrum. In this dysfunction, the ipsilateral hamstrings are shortened, whereas
the iliopsoas is typically shortened in an anterior innominate. This pattern is essential for
diagnosing sacroiliac dysfunctions and selecting the appropriate muscle-energy treatment .
Q2. During an osteopathic structural exam, you find a T4 spinous process deviated left, with
right rotation restriction. Fryette's Type II mechanics apply. Which of the following is true?
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A) Sidebending and rotation occur to opposite sides
B) Neutral mechanics apply
C) Rotation and sidebending occur to the same side
D) Only rotation is restricted
Answer: C
Rationale: Fryette's Type II (non-neutral) mechanics: rotation and sidebending occur to the same
side. Type I (neutral) mechanics: rotation and sidebending occur to opposite sides. This
distinction is critical for diagnosing and treating spinal dysfunctions using osteopathic
manipulative medicine (OMM) techniques .
Q3. A patient with asthma has tenderness at the 2nd intercostal space, right parasternal region.
This is a Chapman's reflex point for which organ?
A) Kidney
B) Lung
C) Liver
D) Stomach
Answer: B
Rationale: Anterior Chapman's reflex points for the lungs are located in the 2nd intercostal
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space, right and left parasternal. Posterior lung reflex points are found at T2–T4. Chapman's
points are small, tender nodules in the deep fascia that correspond to visceral dysfunction .
Q4. A patient with right lateral bending of the lumbar spine with rotation to the left. According
to Fryette, this is a:
A) Type I dysfunction
B) Type II dysfunction
C) Type III dysfunction
D) Neutral dysfunction
Answer: A
Rationale: In Fryette's Type I (neutral) mechanics, sidebending and rotation occur to opposite
sides. Right lateral bending with left rotation is the classic Type I pattern. This typically occurs in
group curves and involves multiple vertebral segments .
Q5. A 50-year-old with chronic constipation has a tender point at the tip of the 12th rib on the
right. Which viscerosomatic reflex is most likely?
A) Colon
B) Stomach
COMSAE Phase 1 Form 115 EXAM QUESTIONS AND CORRECT
VERIFIED SOLUTIONS LATEST UPDATE THIS YEAR – JUST
RELEASED
COMSAE Phase 1 Form 115 Style Practice Exam with 200 high-yield multiple-choice questions
designed to simulate the content, format, and difficulty of the official NBOME COMSAE Phase 1
Form 115. Each question includes the correct answer and a detailed rationale in italics.
Note: The official COMSAE Phase 1 Form 115 is a copyrighted examination produced by the
National Board of Osteopathic Medical Examiners (NBOME). The questions below are original
practice questions created to help osteopathic medical students prepare for COMSAE and
COMLEX-USA Level 1 by covering the same core content areas .
Brief Exam Coverage: COMSAE Phase 1 Form 115
This exam aligns with the COMLEX-USA Level 1 blueprint and covers the following domains :
Domain Approximate Weight
Osteopathic Principles & Practice (OPP) ~12%
Foundational Biomedical Sciences ~25%
Clinical Systems (Cardio, Pulmonary, Renal, GI, etc.) ~45%
Behavioral Science, Biostatistics, Ethics ~10%
Multisystem/Interdisciplinary Topics ~8%
, Page 2 of 156
COMSAE Phase 1 Form 115 Style Practice Exam (Questions 1–200)
SECTION 1: OSTEOPATHIC PRINCIPLES & PRACTICE (OPP/OMT) – (Qs 1-40)
Q1. A 35-year-old with chronic low back pain has a right posterior innominate rotation. Which
muscle is likely shortened?
A) Left quadratus lumborum
B) Right hamstrings
C) Right iliopsoas
D) Left gluteus maximus
Answer: B
Rationale: A posterior innominate rotation is a shear of the ilium in which the ilium moves
posteriorly on the sacrum. In this dysfunction, the ipsilateral hamstrings are shortened, whereas
the iliopsoas is typically shortened in an anterior innominate. This pattern is essential for
diagnosing sacroiliac dysfunctions and selecting the appropriate muscle-energy treatment .
Q2. During an osteopathic structural exam, you find a T4 spinous process deviated left, with
right rotation restriction. Fryette's Type II mechanics apply. Which of the following is true?
, Page 3 of 156
A) Sidebending and rotation occur to opposite sides
B) Neutral mechanics apply
C) Rotation and sidebending occur to the same side
D) Only rotation is restricted
Answer: C
Rationale: Fryette's Type II (non-neutral) mechanics: rotation and sidebending occur to the same
side. Type I (neutral) mechanics: rotation and sidebending occur to opposite sides. This
distinction is critical for diagnosing and treating spinal dysfunctions using osteopathic
manipulative medicine (OMM) techniques .
Q3. A patient with asthma has tenderness at the 2nd intercostal space, right parasternal region.
This is a Chapman's reflex point for which organ?
A) Kidney
B) Lung
C) Liver
D) Stomach
Answer: B
Rationale: Anterior Chapman's reflex points for the lungs are located in the 2nd intercostal
, Page 4 of 156
space, right and left parasternal. Posterior lung reflex points are found at T2–T4. Chapman's
points are small, tender nodules in the deep fascia that correspond to visceral dysfunction .
Q4. A patient with right lateral bending of the lumbar spine with rotation to the left. According
to Fryette, this is a:
A) Type I dysfunction
B) Type II dysfunction
C) Type III dysfunction
D) Neutral dysfunction
Answer: A
Rationale: In Fryette's Type I (neutral) mechanics, sidebending and rotation occur to opposite
sides. Right lateral bending with left rotation is the classic Type I pattern. This typically occurs in
group curves and involves multiple vertebral segments .
Q5. A 50-year-old with chronic constipation has a tender point at the tip of the 12th rib on the
right. Which viscerosomatic reflex is most likely?
A) Colon
B) Stomach
