COMSAE Phase 1 Form 114 Test Bank | Practice Questions with Bold Italic Answers & Rationales – NBOME Osteopathic Medical Knowledge Self-Assessment Prep

COMSAE Phase 1 Form 114 Test Bank | Practice Questions with Bold Italic Answers & Rationales – NBOME Osteopathic Medical Knowledge Self-Assessment Prep 1. A 45-year-old male presents with chronic low back pain. On examination, you find restricted motion of the L5 vertebral segment on flexion and extension. The patient reports that the pain worsens with prolonged sitting. Which of the following somatic dysfunctions is most consistent with these findings? ○ A. Type I somatic dysfunction ○ B. Type II somatic dysfunction ○ C. Fryette's Type I mechanics ○ D. Neutral mechanics Answer: B. Type II somatic dysfunction Rationale: Fryette's Type II mechanics occur when the spine is in a non-neutral position (flexion or extension), with dysfunction in a single vertebral segment. 2. A patient presents with a diagnosis of acute bronchitis. The physician performs lymphatic pump techniques to enhance immune function. Which of the following best describes the physiological mechanism of the lymphatic pump? ○ A. Increases lymphatic flow and enhances immune surveillance ○ B. Decreases lymphatic flow to reduce inflammation ○ C. Directly stimulates antibody production ○ D. Increases sympathetic tone to fight infection Answer: A. Increases lymphatic flow and enhances immune surveillance Rationale: The lymphatic pump increases lymphatic flow through mechanical compression and release, enhancing lymphatic circulation and immune surveillance. 3. A patient presents with a diagnosis of tension headache. On examination, you find restricted motion of the occipitoatlantal (OA) joint. The patient reports pain with rotation and side bending. Which of the following is the correct diagnosis for this somatic dysfunction? ○ A. Type I somatic dysfunction ○ B. Type II somatic dysfunction ○ C. Fryette's Type I mechanics ○ D. Neutral mechanics Answer: B. Type II somatic dysfunction Rationale: The occipitoatlantal joint allows for flexion, extension, and side bending, and dysfunction here presents with rotation restriction, consistent with a Type II somatic dysfunction. 4. A 30-year-old female presents with right-sided rib pain after a motor vehicle accident. On examination, you find tenderness over the right 5th rib with restricted motion on inspiration. The rib is positioned superiorly compared to the left. Which of the following rib dysfunctions is most likely? ○ A. Inhalation rib dysfunction ○ B. Exhalation rib dysfunction ○ C. Bucket handle dysfunction ○ D. Pump handle dysfunction Answer: A. Inhalation rib dysfunction Rationale: Inhalation rib dysfunction occurs when the rib is stuck in an elevated (superior) position and has restricted motion on exhalation. 5. A patient presents with a diagnosis of chronic obstructive pulmonary disease (COPD). The physician performs thoracic inlet myofascial release to improve respiratory function. Which of the following anatomical structures is the primary target of this technique? ○ A. Scalene muscles ○ B. Pectoralis major ○ C. Thoracic inlet fascia and surrounding structures ○ D. Diaphragm Answer: C. Thoracic inlet fascia and surrounding structures Rationale: Thoracic inlet myofascial release targets the fascia and structures of the thoracic inlet to relieve restrictions and improve respiratory mechanics. 6. A 28-year-old male presents with acute onset of severe flank pain radiating to the groin. He has a history of recurrent calcium oxalate kidney stones. Which of the following is the most likely anatomical location of the stone causing this pain? ○ A. Renal pelvis ○ B. Proximal ureter ○ C. Distal ureter ○ D. Bladder Answer: C. Distal ureter Rationale: Distal ureteral stones typically cause severe flank pain radiating to the groin due to irritation of the ureteral wall.j 7. A 65-year-old female presents with sudden onset of painless vision loss in her right eye. Fundoscopic examination reveals a pale retina with a cherry-red spot at the macula. Which of the following is the most likely diagnosis? ○ A. Central retinal vein occlusion ○ B. Central retinal artery occlusion ○ C. Vitreous hemorrhage ○ D. Retinal detachment Answer: B. Central retinal artery occlusion Rationale: Central retinal artery occlusion presents with sudden painless vision loss and a cherry-red spot on fundoscopy. 8. A 4-year-old boy is brought to the clinic with a barky cough and inspiratory stridor. His symptoms worsen at night. Which of the following is the most likely causative agent? ○ A. Respiratory syncytial virus ○ B. Parainfluenza virus ○ C. Influenza A virus ○ D. Adenovirus Answer: B. Parainfluenza virus Rationale: Parainfluenza virus is the most common cause of croup, which presents with a barky cough and inspiratory stridor. 9. A 55-year-old male with a history of alcohol abuse presents with severe epigastric pain radiating to his back. Labs show elevated lipase and amylase. Which of the following is the most likely diagnosis? ○ A. Acute pancreatitis ○ B. Peptic ulcer disease ○ C. Cholecystitis ○ D. Myocardial infarction Answer: A. Acute pancreatitis Rationale: Acute pancreatitis classically presents with severe epigastric pain radiating to the back, often triggered by alcohol use, with elevated lipase and amylase. 10. A 22-year-old female presents with a 2-day history of dysuria, urinary frequency, and urgency. Urinalysis shows positive leukocyte esterase and nitrites. Which of the following is the most likely causative organism? ○ A. Escherichia coli ○ B. Staphylococcus saprophyticus ○ C. Klebsiella pneumoniae ○ D. Proteus mirabilis Answer: A. Escherichia coli Rationale: Escherichia coli is the most common cause of uncomplicated urinary tract infections in young women. 11. A 70-year-old male presents with progressive dyspnea on exertion and paroxysmal nocturnal dyspnea. Physical exam reveals bibasilar crackles and an S3 gallop. Which of the following is the most likely diagnosis? ○ A. Congestive heart failure ○ B. Chronic obstructive pulmonary disease ○ C. Pneumonia ○ D. Pulmonary embolism Answer: A. Congestive heart failure Rationale: Congestive heart failure presents with dyspnea, orthopnea, paroxysmal nocturnal dyspnea, bibasilar crackles, and an S3 gallop.