COMSAE 114 {Comprehensive Osteopathic Medical Self-Assessment Examination}
Verified Multiple Choice and Conceptual Actual
Emended Exam Questions With Reviewed 100%
Correct Detailed Answers
Guaranteed Pass!!Current Update
1. A patient sustains a mandibular fracture and reports severe pain along the
lower jaw. Which nerve is most responsible for transmitting this pain?
A) Facial nerve (CN VII)
B) Lingual nerve
C) Buccal nerve
D) Inferior alveolar nerve
Answer: D inferior alveolar N. Lingual N. branches off earlier and provides
sensation to anterior 2/3 of tongue and floor of mouth.
2. A 22-year-old male has painless testicular swelling. What is the next best
step? A) CT abdomen
B) Transillumination
C) Scrotal ultrasound
D) Testicular biopsy
Answer: C
3. A 54-year-old man with a history of alcohol use disorder presents after
vomiting small amounts of blood. Endoscopy reveals a mucosal tear at the
gastroesophageal junction. Which structure is most likely affected?
A) Left gastric artery
B) Vagal trunk
, C) Thoracic duct
D) Azygos vein
Answer: B
4. A child with shortened metacarpals and hypocalcemia has a poor response
to exogenous PTH. Lab tests show elevated PTH and abnormal cAMP
signaling. What is the most likely molecular defect?
A) PTH receptor mutation
B) Gs alpha subunit dysfunction
C) Calcium-sensing receptor overexpression
D) Pseudohypoparathyroidism type 2
Answer: B
5. A patient with COPD presents with fever, cough, GI symptoms, and patchy
infiltrates. Gram-negative rods are seen. What is the most likely route of
infection?
A) Hematogenous spread
B) Fecal-oral contamination
C) Inhalation of environmental aerosols
D) Direct contact
Answer: C
6. A 67-year-old man loses consciousness briefly with no incontinence or
postictal confusion. ECG shows idioventricular rhythm. What is the cause of
his syncope?
A) Orthostatic hypotension
B) Vasovagal response
C) Pacemaker failure
D) Seizure disorder
Answer: C
7. A 50-year-old man with a family history of colon cancer presents for an
annual exam. What is the appropriate screening test?
A) Chest X-ray
B) Colonoscopy
, C) Fecal occult blood test
D) Abdominal ultrasound
Answer: B
8. An adolescent complains of chronic low back pain. Imaging reveals a narrow
radiolucent defect in the L5 spinous process with preserved sacroiliac joints.
Diagnosis?
A) Ankylosing spondylitis
B) Lumbar herniation
C) Spina bifida occulta
D) Spondylolysis
Answer: C
9. Which of the following is the most common cause of iron deficiency anemia
in elderly patients? A) Dietary deficiency
B) Chronic blood loss
C) Hemolysis
D) Malabsorption
Answer: B
10.A patient has a systolic ejection murmur that increases with Valsalva. What
is the likely diagnosis?
A) Aortic stenosis
B) Hypertrophic cardiomyopathy
C) Mitral regurgitation
D) Pulmonary valve stenosis
Answer: B
11.Which structure is derived from the third pharyngeal pouch?
A) Palatine tonsils
B) Thymus
C) Thyroid gland
D) Parotid gland
Answer: B
, 12.A newborn presents with cyanosis and a machine-like heart murmur. What
congenital heart defect is most likely?
A) Atrial septal defect
B) Patent ductus arteriosus
C) Tetralogy of Fallot
D) Coarctation of the aorta
Answer: B
13.A patient with multiple café-au-lait spots and neurofibromas is likely to have
a mutation in which gene?
A) RB1
B) NF1
C) BRCA1
D) TP53
Answer: B
14.An adult with chronic GERD is found to have columnar epithelium replacing
squamous epithelium in the lower esophagus. What is the diagnosis?
A) Adenocarcinoma
B) Barrett esophagus
C) Esophageal varices
D) Squamous cell carcinoma
Answer: B
15.What enzyme is deficient in a patient with fasting hypoglycemia,
hepatomegaly, and elevated lactic acid?
A) Glucose-6-phosphatase
B) Glycogen phosphorylase
C) Debranching enzyme
D) Fructokinase
Answer: A
16.A young female with a positive ANA, fatigue, and joint pain likely has:
A) Rheumatoid arthritis
B) Systemic lupus erythematosus
Verified Multiple Choice and Conceptual Actual
Emended Exam Questions With Reviewed 100%
Correct Detailed Answers
Guaranteed Pass!!Current Update
1. A patient sustains a mandibular fracture and reports severe pain along the
lower jaw. Which nerve is most responsible for transmitting this pain?
A) Facial nerve (CN VII)
B) Lingual nerve
C) Buccal nerve
D) Inferior alveolar nerve
Answer: D inferior alveolar N. Lingual N. branches off earlier and provides
sensation to anterior 2/3 of tongue and floor of mouth.
2. A 22-year-old male has painless testicular swelling. What is the next best
step? A) CT abdomen
B) Transillumination
C) Scrotal ultrasound
D) Testicular biopsy
Answer: C
3. A 54-year-old man with a history of alcohol use disorder presents after
vomiting small amounts of blood. Endoscopy reveals a mucosal tear at the
gastroesophageal junction. Which structure is most likely affected?
A) Left gastric artery
B) Vagal trunk
, C) Thoracic duct
D) Azygos vein
Answer: B
4. A child with shortened metacarpals and hypocalcemia has a poor response
to exogenous PTH. Lab tests show elevated PTH and abnormal cAMP
signaling. What is the most likely molecular defect?
A) PTH receptor mutation
B) Gs alpha subunit dysfunction
C) Calcium-sensing receptor overexpression
D) Pseudohypoparathyroidism type 2
Answer: B
5. A patient with COPD presents with fever, cough, GI symptoms, and patchy
infiltrates. Gram-negative rods are seen. What is the most likely route of
infection?
A) Hematogenous spread
B) Fecal-oral contamination
C) Inhalation of environmental aerosols
D) Direct contact
Answer: C
6. A 67-year-old man loses consciousness briefly with no incontinence or
postictal confusion. ECG shows idioventricular rhythm. What is the cause of
his syncope?
A) Orthostatic hypotension
B) Vasovagal response
C) Pacemaker failure
D) Seizure disorder
Answer: C
7. A 50-year-old man with a family history of colon cancer presents for an
annual exam. What is the appropriate screening test?
A) Chest X-ray
B) Colonoscopy
, C) Fecal occult blood test
D) Abdominal ultrasound
Answer: B
8. An adolescent complains of chronic low back pain. Imaging reveals a narrow
radiolucent defect in the L5 spinous process with preserved sacroiliac joints.
Diagnosis?
A) Ankylosing spondylitis
B) Lumbar herniation
C) Spina bifida occulta
D) Spondylolysis
Answer: C
9. Which of the following is the most common cause of iron deficiency anemia
in elderly patients? A) Dietary deficiency
B) Chronic blood loss
C) Hemolysis
D) Malabsorption
Answer: B
10.A patient has a systolic ejection murmur that increases with Valsalva. What
is the likely diagnosis?
A) Aortic stenosis
B) Hypertrophic cardiomyopathy
C) Mitral regurgitation
D) Pulmonary valve stenosis
Answer: B
11.Which structure is derived from the third pharyngeal pouch?
A) Palatine tonsils
B) Thymus
C) Thyroid gland
D) Parotid gland
Answer: B
, 12.A newborn presents with cyanosis and a machine-like heart murmur. What
congenital heart defect is most likely?
A) Atrial septal defect
B) Patent ductus arteriosus
C) Tetralogy of Fallot
D) Coarctation of the aorta
Answer: B
13.A patient with multiple café-au-lait spots and neurofibromas is likely to have
a mutation in which gene?
A) RB1
B) NF1
C) BRCA1
D) TP53
Answer: B
14.An adult with chronic GERD is found to have columnar epithelium replacing
squamous epithelium in the lower esophagus. What is the diagnosis?
A) Adenocarcinoma
B) Barrett esophagus
C) Esophageal varices
D) Squamous cell carcinoma
Answer: B
15.What enzyme is deficient in a patient with fasting hypoglycemia,
hepatomegaly, and elevated lactic acid?
A) Glucose-6-phosphatase
B) Glycogen phosphorylase
C) Debranching enzyme
D) Fructokinase
Answer: A
16.A young female with a positive ANA, fatigue, and joint pain likely has:
A) Rheumatoid arthritis
B) Systemic lupus erythematosus
