OPP MED 509A OPP II Practice Test Block 3 Spring Final 2023/24

OPP MED 509A OPP II Practice Test Block 3 Spring Final 2023/24 Chapman’s, VSR, Top 10 Technique, Standardized Patient/Clinical OMM, and GI/Visceral Related Questions A 74-year-old male presents to the office with heart burn that he has been having for the past 3 years. He has tried many medications that have only helped his symptoms minimally. Which of the following is the correct location for the Chapman Point that corresponds to the stomach? A. 2nd Costochondral Joint B. 5th Costochondral Joint on Right C. 5th Costochondral Joint on Left D. 6th Costochondral joint on Left Correct Answer: C A 14-year-old male presents to the emergency department with right lower quadrant pain that initially started in the peri-umbilical region but has since moved to the RLQ. The patient has had multiple episodes of emesis associated with the pain that was non-bilious and non-bloody. Upon physical exam the patient has tenderness at McBurney’s point. Appendicitis is expected. As an osteopathic physician you decide to look for a Chapman Point that you can treat while this patient is waiting to undergo surgery. Which of the following is the Chapman Point most likely associated with this presentation? A. Lesser trochanter of the femur B. Tip of the 12th rib on the left C. Tip of the 12th rib on the right D. 9th and 10th costochondral joints Correct Answer: C A 60-year-old man presents to your office with increased frequency of urination and nocturia. Which of the following regions would most likely have a corresponding sympathetic viscerosomatic reflex? A. T10-T11 B. S2-S4 C. L3-L5 D. T8-T10 E. T12-L2 Correct Answer: E A 31-year-old female complains of dyspnea, fatigue, weakness, weight loss & increased appetite. On physical exam you note a goiter, warm sweaty skin, & a hand tremor. Where would you find the chapman point for the suspected disease? A. Ribs 1 & 2 B. Ribs 2 & 3 C. Ribs 3 & 4 D. Ribs 4 & 5 E. Ribs 5 & 6 Correct Answer: B (same location for bronchus, esophagus, and myocardium, note: the thyroid will be covered more in 2nd year) A 40-year-old female presents to the emergency department with jaundice, fever and RUQ pain. What Chapman’s reflex would be palpable on physical exam? A. 5th intercostal space on the left B. 5th intercostal space on the right C. 6th intercostal space on the left D. 6th intercostal space on the right E. 7th intercostal space on the right Correct Answer: D (liver between ribs 6-7 and lateralized to the right) The osteopathic attending physician is demonstrating an osteopathic technique during hospital rounds. She describes the technique as a firm, rotary motion applied focally using the pads of her fingers. Treatment is directed at the anterior right 6th intercostal space at the mid-clavicular line. The patient’s most likely diagnosis is which of the following: A. Acute cholecystitis. B. Acute pancreatitis. C. Nephrolithiasis. D. Gastroparesis. E. Acute appendicitis. Correct Answer: A (again gall bladder and liver) A 30-year-old male presents to your office with postprandial epigastric discomfort shortly after eating and achieves minimal relief with antacids. What Chapman’s reflex would be palpable on physical exam? A. 5th intercostal space on the left B. 5th intercostal space on the right C. 6th intercostal space on the left D. 7th intercostal space on the right E. 7th intercostal space on the left Correct Answer: A A 44-year-old obese female presents to the office with right upper quadrant pain that radiates toward the back. She says the pain has been worse when she eats fatty meals. Assuming the most probable diagnosis which of the following the presynaptic nerve fiber that causes this dysfunction? A. least splanchnic nerve B. lesser splanchnic nerve C. greater splanchnic nerve D. greatest splanchnic nerve Correct Answer: C A 14-year-old male is brought to the family physician by his father for wheezing and acute-onset shortness of breath. The child has a history of asthma, which is controlled with albuterol as- needed. His father states that the patient had a cough and runny nose for the past 48 hours and began breathing more rapidly that morning. At what vertebral levels would this patient most likely have tissue texture changes from a viscerosomatic reflex? A. T1-T2 B. T2-T7 C. T5-T9 D. T12-L2 E. T10-T11 Correct Answer: B Which of the following correctly pairs the organ/system with its sympathetic innervation? A. Head and Neck: T3-T7 B. Heart: T4-T7 C. Kidneys: T5-T9 D. Esophagus: T2-T8 E. Respiratory system: T12-L2 Correct Answer: D What is the sympathetic levels of innervation for the liver? A. T1-T4 B. T5-T9 C. T10-T11 D. T12-L2 E. L3-L5 Correct Answer: B What is the sympathetic levels of innervation for the sigmoid colon? A. T1-T4 B. T5-T9 C. T10-T11 D. T12-L2 E. L3-L5 Correct Answer: D What is the sympathetic levels of innervation for the heart? A. T1-T4 B. T5-T9 C. T10-T11 D. T12-L2 E. L3-L5 Correct Answer: A What is the sympathetic levels of innervation for the gonads? A. T1-T4 B. T5-T9 C. T10-T11 D. T12-L2 E. L3-L5 Correct Answer: C What is the sympathetic levels of innervation for the lower ureter? A. T1-T4 B. T5-T9 C. T10-T11 D. L1-L2 E. L3-L5 Correct Answer: C What is the sympathetic levels of innervation for the descending colon? A. T1-T4 B. T5-T9 C. T10-T11 D. L1-L2 E. L3-L5 Correct Answer: D What is the sympathetic levels of innervation for the head and neck? A. T1-T4 B. T5-T9 C. T10-T11 D. T12-L2 E. L3-L5 Correct Answer: A What is the sympathetic levels of innervation for the spleen? A. T1-T4 B. T5-T9 C. T10-T11 D. T12-L2 E. L3-L5 Correct Answer: B What is the sympathetic levels of innervation for the stomach? A. T1-T4 B. T5-T9 C. T10-T11 D. T12-L2 E. L3-L5 Correct Answer: B A 15-year-old female presents to the ED with RLQ abdominal pain. On initial physical the patient has tenderness at McBurney’s point. An ultrasound shows a probable appendicitis. Which of the following is the correct location for the Chapman Point associated with this? A. 2nd intercostal space B. 5th intercostal space C. 6th intercostal space D. Tip of the 12th rib on the right Correct Answer: D . . . . . . . . .