COMSAE PHASE 1 FORM 115 EXAM – QUESTIONS AND ANSWERS | VERIFIED
AND WELL DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS |
LATEST EXAM UPDATE
Core Domains:
- Osteopathic Principles and Practice
- Cardiovascular System
- Respiratory System
- Gastrointestinal System
- Musculoskeletal System
- Neurological System
- Renal and Genitourinary System
- Endocrine and Metabolic Systems
- Hematology and Oncology
- Behavioral Science and Medical Ethics
Introduction
The purpose of this assessment is to evaluate foundational medical knowledge and
clinical decision-making skills required for osteopathic medical licensing. The exam
encompasses a comprehensive range of basic science disciplines integrated with clinical
scenarios, emphasizing real-world application, diagnostic reasoning, and patient
management strategies. Spanning key organ systems, regulatory compliance, and
ethical standards, this structural layout ensures rigorous testing through standardized
,multiple-choice and scenario-based questions. Candidates must synthesize
pathophysiological principles, physical exam findings, and structural examinations to
determine the most appropriate diagnostic and therapeutic steps, reflecting the
competencies expected in professional clinical practice.
Section One: Questions 1–100
Question 1
A 24-year-old female presents with a 3-day history of dysuria, urinary frequency, and
suprapubic pain. She denies fever, chills, or flank pain. A urine dipstick is positive for
leukocyte esterase and nitrites. Which of the following is the most likely causative
organism?
A. Staphylococcus saprophyticus
B. Escherichia coli
C. Proteus mirabilis
D. Klebsiella pneumoniae
🟢 B. Escherichia coli
🔴 Explanation: Escherichia coli is a Gram-negative rod that is the most common cause
of uncomplicated urinary tract infections (UTIs) in young women, accounting for over
,80% of cases. It is a lactose fermenter and is typically nitrite-positive due to its ability to
reduce nitrates to nitrites.
Question 2
A 45-year-old male presents for a routine wellness exam. Physical examination reveals
an asymmetric somatic dysfunction at the level of T5. Structural evaluation demonstrates
that T5 prefers rotation to the right and sidebending to the right. When the patient's spine
is extended, the asymmetry worsens, but it improves significantly during flexion. Which of
the following is the correct structural diagnosis?
A. T5 Flexed, Rotated Right, Sidebent Right
B. T5 Extended, Rotated Right, Sidebent Right
C. T5 Flexed, Rotated Left, Sidebent Left
D. T5 Extended, Rotated Left, Sidebent Left
🟢 A. T5 Flexed, Rotated Right, Sidebent Right
🔴 Explanation: Type II somatic dysfunctions involve a single vertebral segment where
rotation and sidebending occur to the same side. The dysfunction is named for its
position of comfort (where it improves). Because the asymmetry improves in flexion, it is
a flexed dysfunction, making the diagnosis T5 Flexed, Rotated Right, Sidebent Right (T5
F RxSx).
, Question 3
A 62-year-old male presents to the emergency department with severe, crushing
substernal chest pain that radiates to his left jaw and arm. An electrocardiogram reveals
ST-segment elevations in leads II, III, and aVF. Which coronary artery is most likely
occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Marginal artery
🟢 C. Right coronary artery
🔴 Explanation: ST-segment elevations in leads II, III, and aVF signify an acute inferior
wall myocardial infarction. The inferior wall of the heart is primarily supplied by the
posterior descending artery, which branches off the right coronary artery in approximately
85% of individuals (right-dominant circulation).
Question 4
A 35-year-old female presents with fatigue, weight gain, constipation, and cold
intolerance over the past six months. Physical examination shows dry skin and a
diffusely enlarged, non-tender thyroid gland. Laboratory studies reveal an elevated
thyroid-stimulating hormone (TSH) level and decreased free T4. Which of the following
antibodies is most specific for this patient's underlying condition?
AND WELL DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS |
LATEST EXAM UPDATE
Core Domains:
- Osteopathic Principles and Practice
- Cardiovascular System
- Respiratory System
- Gastrointestinal System
- Musculoskeletal System
- Neurological System
- Renal and Genitourinary System
- Endocrine and Metabolic Systems
- Hematology and Oncology
- Behavioral Science and Medical Ethics
Introduction
The purpose of this assessment is to evaluate foundational medical knowledge and
clinical decision-making skills required for osteopathic medical licensing. The exam
encompasses a comprehensive range of basic science disciplines integrated with clinical
scenarios, emphasizing real-world application, diagnostic reasoning, and patient
management strategies. Spanning key organ systems, regulatory compliance, and
ethical standards, this structural layout ensures rigorous testing through standardized
,multiple-choice and scenario-based questions. Candidates must synthesize
pathophysiological principles, physical exam findings, and structural examinations to
determine the most appropriate diagnostic and therapeutic steps, reflecting the
competencies expected in professional clinical practice.
Section One: Questions 1–100
Question 1
A 24-year-old female presents with a 3-day history of dysuria, urinary frequency, and
suprapubic pain. She denies fever, chills, or flank pain. A urine dipstick is positive for
leukocyte esterase and nitrites. Which of the following is the most likely causative
organism?
A. Staphylococcus saprophyticus
B. Escherichia coli
C. Proteus mirabilis
D. Klebsiella pneumoniae
🟢 B. Escherichia coli
🔴 Explanation: Escherichia coli is a Gram-negative rod that is the most common cause
of uncomplicated urinary tract infections (UTIs) in young women, accounting for over
,80% of cases. It is a lactose fermenter and is typically nitrite-positive due to its ability to
reduce nitrates to nitrites.
Question 2
A 45-year-old male presents for a routine wellness exam. Physical examination reveals
an asymmetric somatic dysfunction at the level of T5. Structural evaluation demonstrates
that T5 prefers rotation to the right and sidebending to the right. When the patient's spine
is extended, the asymmetry worsens, but it improves significantly during flexion. Which of
the following is the correct structural diagnosis?
A. T5 Flexed, Rotated Right, Sidebent Right
B. T5 Extended, Rotated Right, Sidebent Right
C. T5 Flexed, Rotated Left, Sidebent Left
D. T5 Extended, Rotated Left, Sidebent Left
🟢 A. T5 Flexed, Rotated Right, Sidebent Right
🔴 Explanation: Type II somatic dysfunctions involve a single vertebral segment where
rotation and sidebending occur to the same side. The dysfunction is named for its
position of comfort (where it improves). Because the asymmetry improves in flexion, it is
a flexed dysfunction, making the diagnosis T5 Flexed, Rotated Right, Sidebent Right (T5
F RxSx).
, Question 3
A 62-year-old male presents to the emergency department with severe, crushing
substernal chest pain that radiates to his left jaw and arm. An electrocardiogram reveals
ST-segment elevations in leads II, III, and aVF. Which coronary artery is most likely
occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Marginal artery
🟢 C. Right coronary artery
🔴 Explanation: ST-segment elevations in leads II, III, and aVF signify an acute inferior
wall myocardial infarction. The inferior wall of the heart is primarily supplied by the
posterior descending artery, which branches off the right coronary artery in approximately
85% of individuals (right-dominant circulation).
Question 4
A 35-year-old female presents with fatigue, weight gain, constipation, and cold
intolerance over the past six months. Physical examination shows dry skin and a
diffusely enlarged, non-tender thyroid gland. Laboratory studies reveal an elevated
thyroid-stimulating hormone (TSH) level and decreased free T4. Which of the following
antibodies is most specific for this patient's underlying condition?
