COMSAE Form 113 Newest Questions – High-Yield OMM, Clinical
Vignettes & Biostats with Answer Key | NBOME-Style Review
Correct Detailed Answers with Rationales | Verified Answers |
Already Graded A+ | Latest Version
Q1 (OMM – Pelvic)
A 34-year-old female presents with low back pain after lifting a heavy box 2 days ago. Right
iliac crest is higher, right PSIS is superior and posterior, ASIS levels are equal. What is the
most appropriate OMT?
A) Muscle energy – right innominate anterior rotation
B) Muscle energy – right innominate posterior rotation
C) HVLA – right sacral base anterior
D) Counterstrain – right iliacus tender point
E) Still's technique – right innominate superior shear
Answer: B
*Muscle energy – right innominate posterior rotation. Right PSIS superior/posterior with
equal ASIS = right posterior rotation. Muscle energy engages the barrier and uses the
patient's hip flexors to correct it.
Q2 (Cardiology)
,A 62-year-old male with HTN presents with dyspnea on exertion and orthopnea. JVP
elevated, S3 gallop, CXR shows cardiomegaly. Which medication reduces mortality?
A) Digoxin
B) Metoprolol succinate
C) Furosemide
D) Diltiazem
E) Spironolactone
Answer: B
*Metoprolol succinate (beta-blocker). HFrEF mortality reduction is proven with beta-
blockers (carvedilol, metoprolol succinate, bisoprolol). Digoxin/furosemide improve
symptoms only. Diltiazem is contraindicated.
Q3 (Neurology)
A 72-year-old male has sudden left-sided weakness and facial droop starting 90 minutes
ago. BP 160/90. What is the next step?
A) Aspirin 325 mg PO
B) tPA
C) CT head without contrast
D) Carotid duplex
E) MRI brain
Answer: C
*CT head without contrast. Must rule out intracranial hemorrhage before tPA. Never give
tPA or aspirin before imaging.
,Q4 (OMM – Cranial)
A 45-year-old female with tension headaches has a compressed sphenobasilar
synchondrosis (SBS). Which cranial technique is most appropriate?
A) V-spread
B) Frontal lift
C) CV-4 (cranial vault hold)
D) Parietal lift
E) Temporal decompression
Answer: C
*CV-4 (cranial vault hold). CV-4 is the classic technique to decompress a compressed
SBS by normalizing the cranial rhythmic impulse.
Q5 (Pulmonology)
A 55-year-old male, 40 pack-years, has a right hilar mass. Biopsy = small-cell lung
carcinoma, confined to lung and ipsilateral hilar nodes. Initial treatment?
A) Surgical lobectomy
B) Chemotherapy + radiation
C) Observation
D) Immunotherapy alone
E) Palliative care
, Answer: B
*Chemotherapy + radiation (concurrent). Limited-stage SCLC is treated with concurrent
chemoradiation. Surgery is only for very early T1–2 N0 (rare).
Q6 (OB/GYN)
A 28-year-old G1P0 at 36 weeks presents with painless vaginal bleeding. BP 110/70, HR
90, fetal heart rate reassuring. Most likely diagnosis?
A) Placenta previa
B) Placental abruption
C) Uterine rupture
D) Vasa previa
E) Cervical insufficiency
Answer: A
*Placenta previa. Painless third-trimester bleeding = placenta previa. Abruption = painful.
Vasa previa = painless but with fetal decelerations.
Q7 (OMM – Chapman's Points)
A 32-year-old male with acute pancreatitis. You palpate a tender nodule in the left
intercostal space. Which Chapman's point corresponds to the pancreas?
A) Right 6th rib, medial to sternum
B) Left 6th rib, medial to sternum
Vignettes & Biostats with Answer Key | NBOME-Style Review
Correct Detailed Answers with Rationales | Verified Answers |
Already Graded A+ | Latest Version
Q1 (OMM – Pelvic)
A 34-year-old female presents with low back pain after lifting a heavy box 2 days ago. Right
iliac crest is higher, right PSIS is superior and posterior, ASIS levels are equal. What is the
most appropriate OMT?
A) Muscle energy – right innominate anterior rotation
B) Muscle energy – right innominate posterior rotation
C) HVLA – right sacral base anterior
D) Counterstrain – right iliacus tender point
E) Still's technique – right innominate superior shear
Answer: B
*Muscle energy – right innominate posterior rotation. Right PSIS superior/posterior with
equal ASIS = right posterior rotation. Muscle energy engages the barrier and uses the
patient's hip flexors to correct it.
Q2 (Cardiology)
,A 62-year-old male with HTN presents with dyspnea on exertion and orthopnea. JVP
elevated, S3 gallop, CXR shows cardiomegaly. Which medication reduces mortality?
A) Digoxin
B) Metoprolol succinate
C) Furosemide
D) Diltiazem
E) Spironolactone
Answer: B
*Metoprolol succinate (beta-blocker). HFrEF mortality reduction is proven with beta-
blockers (carvedilol, metoprolol succinate, bisoprolol). Digoxin/furosemide improve
symptoms only. Diltiazem is contraindicated.
Q3 (Neurology)
A 72-year-old male has sudden left-sided weakness and facial droop starting 90 minutes
ago. BP 160/90. What is the next step?
A) Aspirin 325 mg PO
B) tPA
C) CT head without contrast
D) Carotid duplex
E) MRI brain
Answer: C
*CT head without contrast. Must rule out intracranial hemorrhage before tPA. Never give
tPA or aspirin before imaging.
,Q4 (OMM – Cranial)
A 45-year-old female with tension headaches has a compressed sphenobasilar
synchondrosis (SBS). Which cranial technique is most appropriate?
A) V-spread
B) Frontal lift
C) CV-4 (cranial vault hold)
D) Parietal lift
E) Temporal decompression
Answer: C
*CV-4 (cranial vault hold). CV-4 is the classic technique to decompress a compressed
SBS by normalizing the cranial rhythmic impulse.
Q5 (Pulmonology)
A 55-year-old male, 40 pack-years, has a right hilar mass. Biopsy = small-cell lung
carcinoma, confined to lung and ipsilateral hilar nodes. Initial treatment?
A) Surgical lobectomy
B) Chemotherapy + radiation
C) Observation
D) Immunotherapy alone
E) Palliative care
, Answer: B
*Chemotherapy + radiation (concurrent). Limited-stage SCLC is treated with concurrent
chemoradiation. Surgery is only for very early T1–2 N0 (rare).
Q6 (OB/GYN)
A 28-year-old G1P0 at 36 weeks presents with painless vaginal bleeding. BP 110/70, HR
90, fetal heart rate reassuring. Most likely diagnosis?
A) Placenta previa
B) Placental abruption
C) Uterine rupture
D) Vasa previa
E) Cervical insufficiency
Answer: A
*Placenta previa. Painless third-trimester bleeding = placenta previa. Abruption = painful.
Vasa previa = painless but with fetal decelerations.
Q7 (OMM – Chapman's Points)
A 32-year-old male with acute pancreatitis. You palpate a tender nodule in the left
intercostal space. Which Chapman's point corresponds to the pancreas?
A) Right 6th rib, medial to sternum
B) Left 6th rib, medial to sternum
