COMSAE Phase 1 Form 114 Test Bank |
176+ Practice Questions with Bold Italic
Answers & Rationales – NBOME
Osteopathic Medical Knowledge Self
Assessment Prep
1. A patient presents with a structural exam revealing a restricted
T5 segment. The segment prefers rotation to the right and side-
bending to the right. It improves when the patient slumps forward
into spinal flexion. What is the correct diagnosis?
A) T5 Neutral SR RL
B) T5 Extended RR SR
C) T5 Flexed RR SR
D) T5 Flexed RL SL
,,,,answer,,,,: C
Rationale: Because the dysfunction improves in flexion, the segment is
diagnosed as Flexed. According to Fryette’s Second Law (Type II
mechanics), when a single segment is in a non-neutral position (flexion
or extension), rotation and side-bending occur in the same direction.
Hence, rotation right and side-bending right yields a diagnosis of
"Flexed RR SR" .
2. According to Fryette’s first principle (Type I mechanics), when
the spine is in a neutral position (neither flexed nor extended), which
of the following occurs?
,A) Side-bending and rotation occur to the same side
B) Side-bending occurs without rotation
C) Side-bending and rotation occur to opposite sides
D) Rotation occurs without side-bending
,,,,answer,,,,: C
Rationale: Fryette’s first principle (Type I mechanics) describes that
when multiple vertebral segments are in neutral position, side-bending
and rotation occur in opposite directions .
3. In muscle energy technique (MET), the patient’s contraction force
should be:
A) Maximal contraction against a fixed barrier
B) Submaximal (approximately 20% of maximal) isometric
contraction
C) Eccentric contraction only
D) Isotonic contraction through full range
,,,,answer,,,,: B
Rationale: MET uses a gentle (submaximal, ~20% effort), isometric
contraction by the patient, followed by relaxation and repositioning to
the new barrier. This avoids muscle fatigue and injury .
4. What is the most specific early marker of myocardial infarction?
A) AST
B) CK-MB
C) Troponin I
D) LDH
,,,,answer,,,,: C
Rationale: Troponin I is the most specific and sensitive marker for
myocardial injury and rises early after infarction .
,5. Which part of the nephron is primarily responsible for glucose
reabsorption?
A) Distal convoluted tubule
B) Loop of Henle
C) Proximal convoluted tubule
D) Collecting duct
,,,,answer,,,,: C
Rationale: The proximal convoluted tubule reabsorbs nearly all filtered
glucose via SGLT transporters .
6. Which organism is classically associated with "rice-water stools"?
A) Shigella dysenteriae
B) Vibrio cholerae
C) Escherichia coli O157:H7
D) Salmonella typhi
,,,,answer,,,,: B
Rationale: Vibrio cholerae produces profuse watery diarrhea described
as rice-water stools .
7. What is the primary function of surfactant in the lungs?
A) Increase airway resistance
B) Decrease surface tension
C) Increase mucus production
D) Promote alveolar collapse
,,,,answer,,,,: B
Rationale: Surfactant reduces surface tension, preventing alveolar
collapse during expiration .
8. A 45-year-old male presents with low back pain after lifting. The
standing flexion test shows superior movement of the right PSIS.
, Which somatic dysfunction is most likely?
A) Right anterior innominate
B) Left posterior innominate
C) Right sacral torsion on a left oblique axis
D) Bilateral innominate rotation
,,,,answer,,,,: A
Rationale: A positive standing flexion test on the right suggests
iliosacral dysfunction. The superior movement of the PSIS often
correlates with a right anterior innominate, where the ASIS is positioned
anteriorly and inferiorly, creating a functional short leg .
9. A 23-year-old man presents with fever, cough, and rusty sputum.
Chest X-ray shows lobar consolidation. Which organism is most
likely?
A) Haemophilus influenzae
B) Mycoplasma pneumoniae
C) Streptococcus pneumoniae
D) Chlamydophila pneumoniae
,,,,answer,,,,: C
Rationale: Streptococcus pneumoniae is the most common cause of
lobar pneumonia. Rusty sputum results from extravasated blood mixed
with inflammatory exudate .
10. A patient with COPD develops increased CO₂ retention. The
primary driver of respiration in this state becomes:
A) Increased oxygen levels
B) Hypoxia (low oxygen levels)
C) Hypercapnia (high CO₂ levels)
D) Increased pH
176+ Practice Questions with Bold Italic
Answers & Rationales – NBOME
Osteopathic Medical Knowledge Self
Assessment Prep
1. A patient presents with a structural exam revealing a restricted
T5 segment. The segment prefers rotation to the right and side-
bending to the right. It improves when the patient slumps forward
into spinal flexion. What is the correct diagnosis?
A) T5 Neutral SR RL
B) T5 Extended RR SR
C) T5 Flexed RR SR
D) T5 Flexed RL SL
,,,,answer,,,,: C
Rationale: Because the dysfunction improves in flexion, the segment is
diagnosed as Flexed. According to Fryette’s Second Law (Type II
mechanics), when a single segment is in a non-neutral position (flexion
or extension), rotation and side-bending occur in the same direction.
Hence, rotation right and side-bending right yields a diagnosis of
"Flexed RR SR" .
2. According to Fryette’s first principle (Type I mechanics), when
the spine is in a neutral position (neither flexed nor extended), which
of the following occurs?
,A) Side-bending and rotation occur to the same side
B) Side-bending occurs without rotation
C) Side-bending and rotation occur to opposite sides
D) Rotation occurs without side-bending
,,,,answer,,,,: C
Rationale: Fryette’s first principle (Type I mechanics) describes that
when multiple vertebral segments are in neutral position, side-bending
and rotation occur in opposite directions .
3. In muscle energy technique (MET), the patient’s contraction force
should be:
A) Maximal contraction against a fixed barrier
B) Submaximal (approximately 20% of maximal) isometric
contraction
C) Eccentric contraction only
D) Isotonic contraction through full range
,,,,answer,,,,: B
Rationale: MET uses a gentle (submaximal, ~20% effort), isometric
contraction by the patient, followed by relaxation and repositioning to
the new barrier. This avoids muscle fatigue and injury .
4. What is the most specific early marker of myocardial infarction?
A) AST
B) CK-MB
C) Troponin I
D) LDH
,,,,answer,,,,: C
Rationale: Troponin I is the most specific and sensitive marker for
myocardial injury and rises early after infarction .
,5. Which part of the nephron is primarily responsible for glucose
reabsorption?
A) Distal convoluted tubule
B) Loop of Henle
C) Proximal convoluted tubule
D) Collecting duct
,,,,answer,,,,: C
Rationale: The proximal convoluted tubule reabsorbs nearly all filtered
glucose via SGLT transporters .
6. Which organism is classically associated with "rice-water stools"?
A) Shigella dysenteriae
B) Vibrio cholerae
C) Escherichia coli O157:H7
D) Salmonella typhi
,,,,answer,,,,: B
Rationale: Vibrio cholerae produces profuse watery diarrhea described
as rice-water stools .
7. What is the primary function of surfactant in the lungs?
A) Increase airway resistance
B) Decrease surface tension
C) Increase mucus production
D) Promote alveolar collapse
,,,,answer,,,,: B
Rationale: Surfactant reduces surface tension, preventing alveolar
collapse during expiration .
8. A 45-year-old male presents with low back pain after lifting. The
standing flexion test shows superior movement of the right PSIS.
, Which somatic dysfunction is most likely?
A) Right anterior innominate
B) Left posterior innominate
C) Right sacral torsion on a left oblique axis
D) Bilateral innominate rotation
,,,,answer,,,,: A
Rationale: A positive standing flexion test on the right suggests
iliosacral dysfunction. The superior movement of the PSIS often
correlates with a right anterior innominate, where the ASIS is positioned
anteriorly and inferiorly, creating a functional short leg .
9. A 23-year-old man presents with fever, cough, and rusty sputum.
Chest X-ray shows lobar consolidation. Which organism is most
likely?
A) Haemophilus influenzae
B) Mycoplasma pneumoniae
C) Streptococcus pneumoniae
D) Chlamydophila pneumoniae
,,,,answer,,,,: C
Rationale: Streptococcus pneumoniae is the most common cause of
lobar pneumonia. Rusty sputum results from extravasated blood mixed
with inflammatory exudate .
10. A patient with COPD develops increased CO₂ retention. The
primary driver of respiration in this state becomes:
A) Increased oxygen levels
B) Hypoxia (low oxygen levels)
C) Hypercapnia (high CO₂ levels)
D) Increased pH
