OMM
A patient has a left-on-left sacral torsion. Which axis is involved?
A. Right oblique axis
B. Left oblique axis
C. Superior transverse axis
D. Inferior transverse axis
Answer: B. Left Oblique Axis
Forward sacral torsions are named for the direction of rotation and the axis.
A patient with a documented DNR becomes pulseless during hospitalization. What is the next step?
A. Begin CPR
B. Intubate only
C. Honor the DNR order
D. Call family first
C. Honor the DNR order
A DNR (Do Not Resuscitate) order means that if the patient suffers cardiac arrest, CPR and advanced cardiac life support measures should not be initiated.
A valid DNR is the patient's expressed medical decision and should be respected.
An infant of a diabetic mother develops seizures on day 3 of life. Most likely cause?
A. Hypoglycemia
B. Hypocalcemia
C. Hypernatremia
D. Hyperbilirubinemia
B. Hypocalcemia
Infants of diabetic mothers are at risk for: Hypoglycemia, Hypocalcemia, Hypomagnesemia
Hypocalcemia classically presents around 24-72 hours after birth with: Jitteriness, Tremors, Seizures, Irritability
A patient with mucosal bleeding has abnormal ristocetin testing.
A. Hemophilia A
B. ITP
C. von Willebrand disease
D. DIC
C. von Willebrand disease
A trauma patient develops absent breath sounds, hypotension, and tracheal deviation.
A. Chest CT
B. Needle decompression
C. Bronchoscopy
D. Thoracotomy
B. Needle decompression
When an OMM question states a motion is "restricted in flexion," it means:
A. Flexion is the position of ease
B. Flexion is the restricted motion
C. Extension is restricted
D. Neutral mechanics are present
Answer: B Flexion is the restricted motion
The phrase "restricted in flexion" means the patient cannot move normally into flexion.
A resident sees a patient independently and bills Medicare. Which requirement must be met?
A. Nurse cosignature
B. Attending physician involvement
C. Case manager review
D. Hospital administrator approval
B. Attending physician involvement
Under CMS teaching physician rules, the attending physician must participate in the patient's care and document their involvement.
Residents cannot independently generate billable Medicare services
A child swallows a coin. Imaging shows it at the level of the carina. Where is the coin most likely located?
A. Trachea
B. Right mainstem bronchus
C. Esophagus
D. Stomach
C. Esophagus
Hairy cell leukemia is classically associated with:
A. Auer rods
B. TRAP positivity
C. Philadelphia chromosome
D. Reed-Sternberg cells
B. TRAP positivity
A patient with a pneumothorax has no air leak and remains stable on water seal. Next step?
A. Increase suction
B. Leave tube indefinitely
C. Remove chest tube
D. Repeat needle decompression
C. Remove chest tube
Sympathetic innervation to the midgut originates from:
A. T1-T4
B. T5-T9
C.ç
D. L1-L2
Answer: C. T10-T11
The midgut extends from the distal duodenum to the proximal two-thirds of the transverse colon.
Sympathetic levels:
"The thing speaks for itself" is the legal doctrine known as:
A. Proximate cause
B. Res ipsa loquitur
C. Comparative negligence
D. Vicarious liability
B. Res ipsa loquitur
Res ipsa loquitur means "the thing speaks for itself."
Certain events should not occur without negligence. Leaving a sponge inside a patient is one of the classic examples.
A pregnant woman with cocaine use develops abdominal pain, vaginal bleeding, and fetal distress.
A. Placenta previa
B. Placental abruption
C. Vasa previa
D. Uterine rupture
B. Placental abruption
Broad-based budding yeast is most consistent with:
A. Histoplasmosis
B. Cryptococcus
C. Blastomycosis
D. Coccidioidomycosis
C. Blastomycosis
The definitive test required during brain death evaluation is:
A. EEG
B. MRI brain
C. Apnea testing
D. Cerebral angiography
C. Apnea testing
An innominate inflare is commonly treated using which muscle group?
A. Quadriceps
B. Hamstrings
C. Abductors
D. Adductors
Answer: D. Adductors
An inflare occurs when the ASIS moves medially.
Muscle energy uses the adductors to correct this dysfunction.
An employer is liable for the actions of an employee under:
A. Res ipsa loquitur
B. Assault
C. Vicarious liability
D. Strict liability
C. Vicarious liability
Employers may be responsible for negligent actions performed by employees acting within the scope of employment.
Hospitals are frequently held liable for employee mistakes under this principle.
A. Proximate cause describes causation, not employer liability.
D. Assault is intentional threatening behavior.
A pregnant woman develops intensely pruritic abdominal plaques that spare the umbilicus.
A. Intrahepatic cholestasis of pregnancy
B. Pemphigoid gestationis
C. PUPPP
D. Atopic eruption
C. PUPPP
First-line treatment for cryptosporidiosis in an immunocompetent patient:
A. Amphotericin B
B. Nitazoxanide
C. Ivermectin
D. Fluconazole
B. Nitazoxanide
A fracture is associated with diminished distal pulses. Next best step?
A. Splint and discharge
B. Pain control only
C. Immediate vascular evaluation/reduction
D. Repeat x-ray in 1 week
C. Immediate vascular evaluation/reduction
A 67-year-old man presents with a 3-month history of alternating constipation and diarrhea, unintentional weight loss, and iron-deficiency anemia. Colonoscopy is pending. Osteopathic structural examination demonstrates:
Which of the following osteopathic findings is most specifically associated with the suspected visceral pathology?
A. Tenderness at the left fifth intercostal space near the sternum
B. Tenderness at the right sixth intercostal space near the sternum
C. Tenderness along the proximal iliotibial band
D. Tenderness within the second intercostal space bilaterally
E. Tenderness 1 inch superior and lateral to the umbilicus
C. Tenderness along the proximal iliotibial band
A. Left 5th intercostal space: Stomach (gastric acidity)
B. Right 6th intercostal space: Liver/Gallbladder
C. Proximal iliotibial band: Anterior Chapman point for the colon
D. 2nd intercostal space bilaterally: Eyes/thyroid/upper respiratory structures
E. 1 inch superior and lateral to the umbilicus: Kidney
A healthcare model centered around coordinated primary care is:
A. PPO
B. HMO
C. ACO
D. Patient-Centered Medical Home
D. Patient-Centered Medical Home
PCMH: Primary care hub- coordinated, preventive, longitudinal care with a continuous physician-patient relationship
ACO: Population health + cost savings; providers share responsibility for quality metrics and reducing spending
HMO: Insurance model with a primary care gatekeeper and restricted network
PPO: Insurance model with greater flexibility and out-of-network options
A postmenopausal woman has vaginal bleeding and an endometrial stripe measuring 20 mm.
A. Reassure and repeat ultrasound
B. Oral progesterone trial
C. Endometrial biopsy
D. Hysterectomy
C. Endometrial biopsy
A patient with a T-score of -4.0 is at very high fracture risk. Appropriate treatment includes:
A. Calcium alone
B. Vitamin D alone
C. Bisphosphonate therapy
D. Observation
C. Bisphosphonate therapy
A patient with recurrent symptomatic pleural effusions would most likely require:
A. Thoracostomy tube placement
B. Needle decompression
C. Tracheostomy
D. Pericardiocentesis
A. Thoracostomy tube placement