COMSAE Phase 1 Form 114 Test Bank | 200+ Practice
Questions with Bold Italic Answers & Rationales – NBOME
Osteopathic Medical Knowledge Self-Assessment Prep
*I passed my COMSAE Phase 1 Form 114 on the first attempt! The
bold italic answers made it easy to review, and the rationales helped me understand
the concepts, not just memorize answers. This was essential for my COMLEX-
USA Level 1 prep.* – Sarah M., OMS-II
EXAM OVERVIEW
The COMSAE (Comprehensive Osteopathic Medical Self-Assessment
Examination) Phase 1 Form 114 is a practice examination designed to assess
readiness for the COMLEX-USA Level 1. This guide provides comprehensive
practice questions aligned with the NBOME blueprint.
Component Details
Exam Name COMSAE Phase 1 Form 114
Format Computer-Based, Multiple Choice
Questions 200 Items
Content Osteopathic Principles & Practice, Anatomy, Biochemistry, Microbiology, Pathology,
Areas Pharmacology, Physiology, Behavioral Science, Clinical Presentation
TABLE OF CONTENTS
Section Topic Questions
1 Osteopathic Principles & Practice (OPP) 1-25
,2 Anatomy & Embryology 26-45
3 Biochemistry & Genetics 46-60
4 Microbiology & Immunology 61-80
5 Pathology 81-105
6 Pharmacology 106-125
7 Physiology 126-145
8 Behavioral Science & Ethics 146-160
9 Clinical Presentation & Diagnosis 161-180
10 Clinical Decision-Making & Management 181-200
SECTION 1: OSTEOPATHIC PRINCIPLES & PRACTICE (OPP)
Question 1 of 25
A 45-year-old male presents with chronic low back pain. On examination, you find
restricted motion of the L5 vertebral segment on flexion and extension. The patient
reports that the pain worsens with prolonged sitting. Which of the following
somatic dysfunctions is most consistent with these findings?
• A) Type I somatic dysfunction
• B) Type II somatic dysfunction
• C) Fryette's Type I mechanics
• D) Neutral mechanics
,Rationale: Fryette's Type II mechanics occur when the spine is in a non-neutral
position (flexion or extension), with dysfunction in a single vertebral segment.
Type II dysfunctions are characterized by a single vertebral segment that is
restricted in the opposite direction of side bending and rotation. The description of
L5 restricted on flexion and extension suggests a non-neutral dysfunction.
Question 2 of 25
A patient presents with a diagnosis of acute bronchitis. The physician performs
lymphatic pump techniques to enhance immune function. Which of the following
best describes the physiological mechanism of the lymphatic pump?
• A) Increases lymphatic flow and enhances immune surveillance
• B) Decreases lymphatic flow to reduce inflammation
• C) Directly stimulates antibody production
• D) Increases sympathetic tone to fight infection
Rationale: The lymphatic pump (thoracic or pedal) increases lymphatic flow
through mechanical compression and release, enhancing lymphatic circulation and
immune surveillance. This technique is used in osteopathic manipulative medicine
(OMM) to support the immune system, particularly in patients with respiratory
infections.
Question 3 of 25
A patient presents with a diagnosis of tension headache. On examination, you find
restricted motion of the occipitoatlantal (OA) joint. The patient reports pain with
rotation and side bending. Which of the following is the correct diagnosis for this
somatic dysfunction?
• A) OA flexion dysfunction
• B) OA extension dysfunction
• C) OA rotation dysfunction
• D) OA side bending dysfunction
, Rationale: The occipitoatlantal joint is a modified condyloid joint that allows for
flexion, extension, and side bending. Rotation at the OA joint is minimal; most
rotation occurs at C1-C2. However, OA dysfunction can present with rotation
restriction. The diagnosis is based on restriction patterns identified during motion
testing.
Question 4 of 25
A 30-year-old female presents with right-sided rib pain after a motor vehicle
accident. On examination, you find tenderness over the right 5th rib with restricted
motion on inspiration. The rib is positioned superiorly compared to the left. Which
of the following rib dysfunctions is most likely?
• A) Inhalation rib dysfunction
• B) Exhalation rib dysfunction
• C) Bucket handle dysfunction
• D) Pump handle dysfunction
Rationale: Inhalation rib dysfunction occurs when the rib is stuck in an elevated
position (superior) and has restricted motion on exhalation. This is commonly seen
after trauma. Exhalation rib dysfunction presents with the rib depressed (inferior)
and restricted on inhalation.
Question 5 of 25
A patient presents with a diagnosis of chronic obstructive pulmonary disease
(COPD). The physician performs thoracic inlet myofascial release to improve
respiratory function. Which of the following anatomical structures is the primary
target of this technique?
• A) Scalene muscles
• B) Pectoralis major
• C) Thoracic inlet fascia and surrounding structures
• D) Sternocleidomastoid muscle
Questions with Bold Italic Answers & Rationales – NBOME
Osteopathic Medical Knowledge Self-Assessment Prep
*I passed my COMSAE Phase 1 Form 114 on the first attempt! The
bold italic answers made it easy to review, and the rationales helped me understand
the concepts, not just memorize answers. This was essential for my COMLEX-
USA Level 1 prep.* – Sarah M., OMS-II
EXAM OVERVIEW
The COMSAE (Comprehensive Osteopathic Medical Self-Assessment
Examination) Phase 1 Form 114 is a practice examination designed to assess
readiness for the COMLEX-USA Level 1. This guide provides comprehensive
practice questions aligned with the NBOME blueprint.
Component Details
Exam Name COMSAE Phase 1 Form 114
Format Computer-Based, Multiple Choice
Questions 200 Items
Content Osteopathic Principles & Practice, Anatomy, Biochemistry, Microbiology, Pathology,
Areas Pharmacology, Physiology, Behavioral Science, Clinical Presentation
TABLE OF CONTENTS
Section Topic Questions
1 Osteopathic Principles & Practice (OPP) 1-25
,2 Anatomy & Embryology 26-45
3 Biochemistry & Genetics 46-60
4 Microbiology & Immunology 61-80
5 Pathology 81-105
6 Pharmacology 106-125
7 Physiology 126-145
8 Behavioral Science & Ethics 146-160
9 Clinical Presentation & Diagnosis 161-180
10 Clinical Decision-Making & Management 181-200
SECTION 1: OSTEOPATHIC PRINCIPLES & PRACTICE (OPP)
Question 1 of 25
A 45-year-old male presents with chronic low back pain. On examination, you find
restricted motion of the L5 vertebral segment on flexion and extension. The patient
reports that the pain worsens with prolonged sitting. Which of the following
somatic dysfunctions is most consistent with these findings?
• A) Type I somatic dysfunction
• B) Type II somatic dysfunction
• C) Fryette's Type I mechanics
• D) Neutral mechanics
,Rationale: Fryette's Type II mechanics occur when the spine is in a non-neutral
position (flexion or extension), with dysfunction in a single vertebral segment.
Type II dysfunctions are characterized by a single vertebral segment that is
restricted in the opposite direction of side bending and rotation. The description of
L5 restricted on flexion and extension suggests a non-neutral dysfunction.
Question 2 of 25
A patient presents with a diagnosis of acute bronchitis. The physician performs
lymphatic pump techniques to enhance immune function. Which of the following
best describes the physiological mechanism of the lymphatic pump?
• A) Increases lymphatic flow and enhances immune surveillance
• B) Decreases lymphatic flow to reduce inflammation
• C) Directly stimulates antibody production
• D) Increases sympathetic tone to fight infection
Rationale: The lymphatic pump (thoracic or pedal) increases lymphatic flow
through mechanical compression and release, enhancing lymphatic circulation and
immune surveillance. This technique is used in osteopathic manipulative medicine
(OMM) to support the immune system, particularly in patients with respiratory
infections.
Question 3 of 25
A patient presents with a diagnosis of tension headache. On examination, you find
restricted motion of the occipitoatlantal (OA) joint. The patient reports pain with
rotation and side bending. Which of the following is the correct diagnosis for this
somatic dysfunction?
• A) OA flexion dysfunction
• B) OA extension dysfunction
• C) OA rotation dysfunction
• D) OA side bending dysfunction
, Rationale: The occipitoatlantal joint is a modified condyloid joint that allows for
flexion, extension, and side bending. Rotation at the OA joint is minimal; most
rotation occurs at C1-C2. However, OA dysfunction can present with rotation
restriction. The diagnosis is based on restriction patterns identified during motion
testing.
Question 4 of 25
A 30-year-old female presents with right-sided rib pain after a motor vehicle
accident. On examination, you find tenderness over the right 5th rib with restricted
motion on inspiration. The rib is positioned superiorly compared to the left. Which
of the following rib dysfunctions is most likely?
• A) Inhalation rib dysfunction
• B) Exhalation rib dysfunction
• C) Bucket handle dysfunction
• D) Pump handle dysfunction
Rationale: Inhalation rib dysfunction occurs when the rib is stuck in an elevated
position (superior) and has restricted motion on exhalation. This is commonly seen
after trauma. Exhalation rib dysfunction presents with the rib depressed (inferior)
and restricted on inhalation.
Question 5 of 25
A patient presents with a diagnosis of chronic obstructive pulmonary disease
(COPD). The physician performs thoracic inlet myofascial release to improve
respiratory function. Which of the following anatomical structures is the primary
target of this technique?
• A) Scalene muscles
• B) Pectoralis major
• C) Thoracic inlet fascia and surrounding structures
• D) Sternocleidomastoid muscle
