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2026 High-Yield Clinical Flashcards for
COMSAE 115
DESCRIPTION
COMSAE Phase 1 (Form 115) is a 176-question diagnostic exam used by osteopathic medical students to predict readiness for the COMLEX-USA Level 1 boards. Quick Stats
- Format: 4 sections of 44 questions (176 total).
- Time: 4 hours (~72 seconds per question).
- Passing Score: Typically 400 , though many schools require 450+ to sit for boards.
- Key Feature: The "b" version (e.g., 115b) now includes an answer key for student-purchased forms [1]. High-Yield Content
- OMM (Heavy): Focuses on Sacral Torsions , Cranial Strains , and Chapman Points.
- Systems: Strong emphasis on Neuro (stroke/cranial nerves) and Cardio (murmurs/ECG).
- Ethics: High frequency of questions regarding autonomy and informed consent. Strategic Use It is best used as a "mid-point" or "final" check during dedicated study to simulate board- style pacing and identify weak body systems.
QUESTION :G6PD deficiency - CORRECT ANSWER Identified by bite cells and Heinz bodies on blood smear, hemolytic anemia after fava bean ingestion. QUESTION :Thyroid storm - CORRECT ANSWER Occurs in a patient with hyperthyroidism who develops fever, tachycardia, confusion, and vomiting after surgery. QUESTION :Neural tube defect - CORRECT ANSWER Main concern with elevated AFP in a pregnant woman's amniotic fluid (e.g., spina bifida). QUESTION :Hereditary spherocytosis - CORRECT ANSWER Diagnosed with spherocytes, increased osmotic fragility, and negative Coombs test. QUESTION :Ankylosing spondylitis - CORRECT ANSWER Associated with HLA-B positivity, low back pain, and uveitis. QUESTION :Ulnar nerve - CORRECT ANSWER Affected in a patient with 'claw hand' deformity and loss of sensation in the medial hand. QUESTION :Left middle cerebral artery stroke - CORRECT ANSWER Causes sudden onset unilateral weakness, face droop, and expressive aphasia affecting Broca's area. QUESTION :Pyruvate kinase deficiency - CORRECT ANSWER Leads to impaired glycolysis and nonspherocytic hemolytic anemia. QUESTION :Granulosa cell tumor - CORRECT ANSWER Identified by 'soap bubble' appearance on ovarian tumor histology.
QUESTION :Duchenne muscular dystrophy - CORRECT ANSWER Characterized by difficulty climbing stairs, Gower's sign, and calf pseudohypertrophy. QUESTION :Adrenal insufficiency - CORRECT ANSWER Characterized by hyperpigmentation, hypotension, hyponatremia, and hyperkalemia. QUESTION :Hyperpigmentation, hypotension, hyponatremia, and hyperkalemia — diagnosis?
- CORRECT ANSWER Addison's disease (primary adrenal insufficiency). QUESTION :"Apple core" lesion seen on barium enema — diagnosis? - CORRECT ANSWER Colorectal adenocarcinoma. QUESTION :"String of pearls" sign on abdominal X-ray in a female with abdominal pain and infertility — diagnosis? - CORRECT ANSWER Polycystic ovary syndrome (PCOS). QUESTION :Erythema migrans rash (bull's eye) after tick bite — diagnosis? - CORRECT ANSWER Lyme disease (Borrelia burgdorferi). QUESTION :Sudden chest pain, tearing back pain, and mediastinal widening on CXR — diagnosis? - CORRECT ANSWER Aortic dissection. QUESTION :Hematuria following an upper respiratory infection — diagnosis? - CORRECT ANSWER Post-streptococcal glomerulonephritis. QUESTION :"Onion skin" periosteal reaction on X-ray in a child with bone pain — diagnosis? - CORRECT ANSWER Ewing sarcoma.
QUESTION :Patient with macrocytic anemia, glossitis, and neurologic symptoms — diagnosis?
- CORRECT ANSWER Vitamin B12 deficiency. QUESTION :Patient with sudden right-sided weakness, left gaze preference, and aphasia — where is the stroke? - CORRECT ANSWER Left middle cerebral artery infarct. QUESTION :Painful genital ulcer with a gray/yellow base and ragged edges — diagnosis? - CORRECT ANSWER Chancroid (Haemophilus ducreyi). QUESTION :Hematuria, flank pain, and palpable abdominal mass in a child — diagnosis? - CORRECT ANSWER Wilms tumor. QUESTION :Patient with fever, headache, neck stiffness, and altered mental status — diagnosis? - CORRECT ANSWER Bacterial meningitis. QUESTION :Young woman with butterfly rash, joint pain, and positive ANA — diagnosis? - CORRECT ANSWER Systemic lupus erythematosus (SLE). QUESTION :Postmenopausal woman with vaginal bleeding and thickened endometrial stripe on ultrasound — diagnosis? - CORRECT ANSWER Endometrial carcinoma. QUESTION :Newborn with projectile non-bilious vomiting and palpable olive-shaped mass — diagnosis? - CORRECT ANSWER Pyloric stenosis. QUESTION :Child with dry cough, "steeple sign" on neck X-ray — diagnosis? - CORRECT ANSWER Croup (laryngotracheobronchitis). QUESTION :Patient with pruritic, purple, polygonal papules on the wrist — diagnosis? - CORRECT ANSWER Lichen planus.
QUESTION :Diarrhea after camping, caused by a protozoan transmitted via contaminated water — diagnosis? - CORRECT ANSWER Giardia lamblia infection. QUESTION :Chronic cough, hemoptysis, and cavitary lung lesion on chest X-ray in an immunocompromised patient — diagnosis? - CORRECT ANSWER Aspergillosis. QUESTION :
