COMLEX Level 1 – 2025–2026 Comprehensive
Osteopathic Medicine Study Guide & Practice
Topics Focus: OMM principles, physiology,
pathology, pharmacology, microbiology,
systems-based concepts, and clinical decision-
making.
Osteopathic Manipulative Medicine (OMM) & Principles
1. What is the primary philosophical tenet of Osteopathic Medicine?
A) The body is a machine and disease is a mechanical breakdown.
B) The body is a unit; the person is a unit of body, mind, and spirit. ✓
C) Treatment should focus solely on eliminating symptoms.
D) Pharmacology is the first and most effective line of treatment.
2. The concept of structure and function being reciprocally interrelated is best demonstrated
by:
A) A patient with pneumonia being treated with antibiotics.
B) A patient with somatic dysfunction at T1-T4 experiencing tachycardia. ✓
C) A patient with diabetes monitoring their blood sugar.
D) A patient with a fractured femur getting a cast.
3. A patient presents with back pain and a visibly elevated right iliac crest. The most likely
postural diagnosis is:
A) Left sacral shear
B) Right innominate rotation
C) Right innominate shear
D) Left lumbar scoliosis ✓
4. The diagnostic criteria for somatic dysfunction are summarized by the mnemonic TART.
What does TART stand for?
A) Trauma, Atrophy, Redness, Temperature
B) Tenderness, Asymmetry, Range of motion restriction, Tissue texture change ✓
,C) Tremor, Ataxia, Rigidity, Tics
D) Tenderness, Alignment, Reflexes, Tone
5. During a structural exam, you note that the patient's right PSIS is posterior and inferior. This
describes:
A) A right anterior innominate rotation
B) A right posterior innominate rotation ✓
C) A left sacral torsion
D) A right sacral shear
6. A patient has difficulty taking a deep breath. When you place your hands over the lower
ribs, you notice significantly less lateral expansion on the right side during inhalation. This is a
restriction in what type of rib motion?
A) Pump handle motion
B) Bucket handle motion ✓
C) Caliper motion
D) Inhalation restriction
7. The Chapman's point for the appendix is located:
A) On the right side, on the tip of the 12th rib
B) On the right side, between the iliac crest and the greater trochanter ✓
C) On the left side, on the intertransverse ligament of T11
D) On the umbilicus
8. A facilitated segment at T5-T6 is most likely to affect which organ?
A) Heart ✓
B) Lungs
C) Stomach
D) Liver
9. Which of the following techniques is considered a direct technique?
A) Balanced Ligamentous Tension
B) Muscle Energy ✓
C) Still Technique
D) Facilitated Positional Release
10. High Velocity Low Amplitude (HVLA) is contraindicated in all of the following EXCEPT:
A) Osteoporosis
B) Joint instability
, C) Metastatic cancer
D) A stable, chronic T6 somatic dysfunction in an otherwise healthy patient ✓
11. The primary respiratory mechanism (PRM) involves all of the following EXCEPT:
A) The inherent motility of the brain and spinal cord
B) The fluctuation of the cerebrospinal fluid
C) The motility of the cranial bones
D) The voluntary contraction of the diaphragm ✓
12. The Sutherland Compression Test is used to assess:
A) Sacroiliac joint mobility
B) Sphenobasilar synchondrosis (SBS) strain patterns ✓
C) Thoracic outlet syndrome
D) Lumbar facet integrity
13. A patient's cranial mechanism presents with the sphenoid and sacrum both rotated to the
right. This describes which SBS strain pattern?
A) Torsion
B) Sidebending Rotation
C) Vertical Strain
D) Lateral Strain ✓
14. The major motion of the sacrum between the ilia is called:
A) Nutation and Counternutation ✓
B) Flexion and Extension
C) Rotation and Sidebending
D) Anterior and Posterior Tilt
15. Treatment of the cranial base (OA joint) is often used to influence the function of the:
A) Lumbar plexus
B) Vagus Nerve (CN X) ✓
C) Brachial plexus
D) Sciatic nerve
Physiology
16. What is the primary factor that determines the movement of fluid between the vascular
and interstitial compartments?
A) Plasma oncotic pressure
Osteopathic Medicine Study Guide & Practice
Topics Focus: OMM principles, physiology,
pathology, pharmacology, microbiology,
systems-based concepts, and clinical decision-
making.
Osteopathic Manipulative Medicine (OMM) & Principles
1. What is the primary philosophical tenet of Osteopathic Medicine?
A) The body is a machine and disease is a mechanical breakdown.
B) The body is a unit; the person is a unit of body, mind, and spirit. ✓
C) Treatment should focus solely on eliminating symptoms.
D) Pharmacology is the first and most effective line of treatment.
2. The concept of structure and function being reciprocally interrelated is best demonstrated
by:
A) A patient with pneumonia being treated with antibiotics.
B) A patient with somatic dysfunction at T1-T4 experiencing tachycardia. ✓
C) A patient with diabetes monitoring their blood sugar.
D) A patient with a fractured femur getting a cast.
3. A patient presents with back pain and a visibly elevated right iliac crest. The most likely
postural diagnosis is:
A) Left sacral shear
B) Right innominate rotation
C) Right innominate shear
D) Left lumbar scoliosis ✓
4. The diagnostic criteria for somatic dysfunction are summarized by the mnemonic TART.
What does TART stand for?
A) Trauma, Atrophy, Redness, Temperature
B) Tenderness, Asymmetry, Range of motion restriction, Tissue texture change ✓
,C) Tremor, Ataxia, Rigidity, Tics
D) Tenderness, Alignment, Reflexes, Tone
5. During a structural exam, you note that the patient's right PSIS is posterior and inferior. This
describes:
A) A right anterior innominate rotation
B) A right posterior innominate rotation ✓
C) A left sacral torsion
D) A right sacral shear
6. A patient has difficulty taking a deep breath. When you place your hands over the lower
ribs, you notice significantly less lateral expansion on the right side during inhalation. This is a
restriction in what type of rib motion?
A) Pump handle motion
B) Bucket handle motion ✓
C) Caliper motion
D) Inhalation restriction
7. The Chapman's point for the appendix is located:
A) On the right side, on the tip of the 12th rib
B) On the right side, between the iliac crest and the greater trochanter ✓
C) On the left side, on the intertransverse ligament of T11
D) On the umbilicus
8. A facilitated segment at T5-T6 is most likely to affect which organ?
A) Heart ✓
B) Lungs
C) Stomach
D) Liver
9. Which of the following techniques is considered a direct technique?
A) Balanced Ligamentous Tension
B) Muscle Energy ✓
C) Still Technique
D) Facilitated Positional Release
10. High Velocity Low Amplitude (HVLA) is contraindicated in all of the following EXCEPT:
A) Osteoporosis
B) Joint instability
, C) Metastatic cancer
D) A stable, chronic T6 somatic dysfunction in an otherwise healthy patient ✓
11. The primary respiratory mechanism (PRM) involves all of the following EXCEPT:
A) The inherent motility of the brain and spinal cord
B) The fluctuation of the cerebrospinal fluid
C) The motility of the cranial bones
D) The voluntary contraction of the diaphragm ✓
12. The Sutherland Compression Test is used to assess:
A) Sacroiliac joint mobility
B) Sphenobasilar synchondrosis (SBS) strain patterns ✓
C) Thoracic outlet syndrome
D) Lumbar facet integrity
13. A patient's cranial mechanism presents with the sphenoid and sacrum both rotated to the
right. This describes which SBS strain pattern?
A) Torsion
B) Sidebending Rotation
C) Vertical Strain
D) Lateral Strain ✓
14. The major motion of the sacrum between the ilia is called:
A) Nutation and Counternutation ✓
B) Flexion and Extension
C) Rotation and Sidebending
D) Anterior and Posterior Tilt
15. Treatment of the cranial base (OA joint) is often used to influence the function of the:
A) Lumbar plexus
B) Vagus Nerve (CN X) ✓
C) Brachial plexus
D) Sciatic nerve
Physiology
16. What is the primary factor that determines the movement of fluid between the vascular
and interstitial compartments?
A) Plasma oncotic pressure
