Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) Foundational Biomedical Sciences Syllabus

Foundational Biomedical Sciences syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Foundational Biomedical Sciences in Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA), not a summary of it.

1. 1

   Anatomy and Embryology

   4 topics

   • Gross and Regional Anatomy
     • Musculoskeletal and neurovascular relationships
     • Thoracic, abdominal, and pelvic viscera
   • Neuroanatomy
     • Central pathways and tracts
     • Peripheral and autonomic nervous system
     • Cranial nerves and brainstem
   • Histology
     • Epithelial, connective, muscle, and nervous tissue
     • Organ-specific microanatomy
   • Developmental Biology and Embryology
     • Germ layer derivatives
     • Congenital malformations and teratogenesis
2. 2

   Physiology

   4 topics

   • Cellular and Membrane Physiology
     • Transport, signaling, and action potentials
   • Cardiovascular and Respiratory Physiology
     • Hemodynamics and cardiac cycle
     • Gas exchange and ventilation-perfusion
   • Renal, Endocrine, and GI Physiology
     • Fluid, electrolyte, and acid-base balance
     • Hormonal regulation and feedback loops
   • Neuromuscular and Integrative Physiology
     • Reflex arcs and motor control
     • Thermoregulation and exercise response
3. 3

   Biochemistry, Genetics, and Molecular Biology

   4 topics

   • Metabolic Pathways
     • Carbohydrate, lipid, and amino acid metabolism
     • Energy production and bioenergetics
   • Molecular Biology
     • DNA replication, transcription, translation
     • Gene regulation and epigenetics
   • Medical Genetics
     • Mendelian and non-Mendelian inheritance
     • Chromosomal and single-gene disorders
   • Nutrition and Vitamins
     • Deficiency and toxicity syndromes
4. 4

   Microbiology and Immunology

   4 topics

   • Bacteriology
     • Gram-positive and gram-negative pathogens
     • Mechanisms of pathogenicity and resistance
   • Virology, Mycology, and Parasitology
     • Major viral families and replication
     • Fungal and parasitic infections
   • Immunology
     • Innate and adaptive immunity
     • Hypersensitivity and immunodeficiency
   • Vaccines and Antimicrobial Principles
     • Active and passive immunization
     • Mechanisms of antimicrobial action
5. 5

   Pathology and Pharmacology

   4 topics

   • General Pathology
     • Cell injury, inflammation, and repair
     • Neoplasia and tumor biology
   • Systemic Pathology
     • Organ-specific disease mechanisms
   • Pharmacokinetics and Pharmacodynamics
     • Absorption, distribution, metabolism, excretion
     • Receptor theory and dose-response
   • Pharmacology by Drug Class
     • Autonomic, cardiovascular, and CNS agents
     • Adverse effects and drug interactions

Foundational Biomedical Sciences flashcards for Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA)

19 of 51 cards from the Foundational Biomedical Sciences deck — real questions with worked answers.

1. What are the borders of the femoral triangle, and what structures pass through it from lateral to medial?

   Borders: inguinal ligament (superior), sartorius (lateral), adductor longus (medial). Contents lateral-to-medial (NAVEL): femoral Nerve, Artery, Vein, Empty space (femoral canal), Lymphatics. The femoral nerve lies outside the femoral sheath.

2. Which nerve roots form the brachial plexus, and what is the correct order of its components?

   Roots C5-T1. Order: Roots, Trunks, Divisions, Cords, Branches (mnemonic: Read That Damn Cadaver Book). Three trunks (upper, middle, lower), each split into anterior/posterior divisions, forming lateral, posterior, and medial cords.

3. What are the four rotator cuff muscles and their primary actions?

   SITS: Supraspinatus (abduction, initiates 0-15 degrees), Infraspinatus (external rotation), Teres minor (external rotation), Subscapularis (internal rotation). They stabilize the glenohumeral joint.

4. What are the major ascending and descending tracts of the spinal cord and what do they carry?

   Ascending: dorsal columns (fine touch, vibration, proprioception; decussate in medulla), spinothalamic (pain/temperature; decussate at the cord). Descending: lateral corticospinal tract (voluntary motor; decussates at the medullary pyramids).

5. What is the function of cranial nerve VII (facial) and how is a central lesion distinguished from a peripheral (Bell's palsy) lesion?

   CN VII supplies muscles of facial expression, stapedius, anterior 2/3 tongue taste, lacrimal/salivary glands. Central (UMN) lesion spares the forehead (bilateral cortical input to upper face); peripheral (LMN) lesion affects the entire ipsilateral face including forehead.

6. What are the three main components of the basal ganglia circuitry, and what neurotransmitter is deficient in Parkinson disease?

   Direct pathway (facilitates movement) and indirect pathway (inhibits movement), modulated by dopamine from the substantia nigra pars compacta. Parkinson disease results from loss of nigrostriatal dopamine, reducing facilitation of movement.

7. What are the four types of epithelial tissue based on cell layers and shape, with an example of each?

   Simple squamous (alveoli/endothelium), simple cuboidal (kidney tubules), simple columnar (GI tract), stratified squamous (skin/esophagus). Also pseudostratified columnar (respiratory tract) and transitional/urothelium (bladder).

8. What are the three types of muscle tissue and the distinguishing histologic features of cardiac muscle?

   Skeletal (striated, multinucleated, voluntary), cardiac (striated, single central nucleus, involuntary, intercalated discs with gap junctions and desmosomes), smooth (non-striated, spindle-shaped, single nucleus, involuntary).

9. From which embryonic germ layers do the nervous system, gut epithelium, and muscle/bone derive?

   Ectoderm: epidermis and nervous system (neural tube/neural crest). Endoderm: gut epithelium, liver, pancreas, lung lining. Mesoderm: muscle, bone, connective tissue, blood, kidneys, gonads.

10. What are the pharyngeal (branchial) arch derivatives of arches 1 and 2, including their nerves?

    Arch 1 (CN V3): muscles of mastication, malleus and incus, Meckel cartilage. Arch 2 (CN VII): muscles of facial expression, stapes, styloid process, hyoid (lesser horn).

11. What is the Nernst equation and what does it calculate?

    E_ion = (61/z) x log([ion]_out/[ion]_in) mV at 37C. It calculates the equilibrium (reversal) potential for a single ion at which its electrochemical gradient is zero (no net flux).

12. Describe the phases of a cardiac ventricular myocyte action potential and the ions responsible.

    Phase 0: rapid Na+ influx (depolarization). Phase 1: transient K+ efflux. Phase 2: plateau, Ca2+ influx balances K+ efflux. Phase 3: K+ efflux repolarization. Phase 4: resting potential maintained by K+ (and Na/K ATPase).

13. What determines the resting membrane potential of a typical neuron and why is it near the K+ equilibrium potential?

    It is set primarily by the high resting permeability to K+ via leak channels, so it approaches E_K (about -90 mV); the Na/K ATPase maintains gradients and contributes a small electrogenic component. Actual RMP (~-70 mV) is slightly above E_K due to minor Na+ leak.

14. State the Fick principle for cardiac output and give the formula.

    Cardiac output = O2 consumption / (arterial O2 content - venous O2 content). CO = VO2 / (CaO2 - CvO2). It measures CO from oxygen uptake and the arteriovenous O2 difference.

15. What is the oxygen-hemoglobin dissociation curve, and what factors shift it to the right?

    Sigmoidal curve relating PO2 to Hb saturation. A right shift (decreased O2 affinity, easier unloading) is caused by increased CO2, increased H+ (lower pH), increased temperature, and increased 2,3-BPG (Bohr effect).

16. Define preload and afterload, and how does the Frank-Starling mechanism relate to preload?

    Preload = ventricular end-diastolic volume/wall stretch; afterload = resistance the ventricle pumps against (approx. aortic pressure/wall stress). Frank-Starling: increased preload (sarcomere stretch) increases stroke volume up to an optimal length.

17. Write the equation for glomerular filtration rate using clearance, and why is inulin/creatinine used?

    Clearance = (U x V)/P. GFR is estimated by inulin clearance because it is freely filtered and neither reabsorbed nor secreted; creatinine clearance is the clinical approximation (slightly overestimates GFR due to minor secretion).

18. What is the action of aldosterone on the kidney and what stimulates its release?

    Aldosterone acts on principal cells of the collecting duct to increase Na+ reabsorption and K+/H+ secretion (water follows Na+). It is stimulated by angiotensin II and by hyperkalemia.

19. How do insulin and glucagon oppositely regulate blood glucose?

    Insulin (beta cells) lowers glucose: promotes glycogenesis, glycolysis, lipogenesis, GLUT4-mediated uptake in muscle/fat. Glucagon (alpha cells) raises glucose: promotes glycogenolysis and gluconeogenesis in the liver.

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