American College of Osteopathic Family Physicians (ACOFP) Practice Test

These questions are part of the practice quiz. Start practicing

• Palpation and motion testing for somatic dysfunction are integrated into which examinations?
• Which OMT technique is used to relieve constipation quickly after knee replacement?
• In the calculation of the pelvic index, which line serves as the denominator?
• The prevalence figure of nearly 90% pertains to which headache type?
• What term describes impaired or altered function of related components of the neuromuscular system that is treatable by OMT?
• Which of the following is not a quadrant in the Hering Cross Method?
• Which technique would be least helpful to increase thoracic cage compliance in a bedridden patient?
• The onset of Parkinson's disease symptoms is typically not evident until what percentage of substantia nigra has degenerated?
• Anterior knee pain from chondromalacia of the patella typically starts as the result of:
• Which lymphatic procedure is particularly appropriate for the acutely ill hospitalized patient with pneumonia?
• Sympathetic viscerosomatic reflexes from the ovaries may be found at which spinal levels?
• Congestive heart failure can be exacerbated by which of the following?
• A functional short leg can be the result of an ipsilateral which structure?
• A viscerosomatic reflex pattern indicates the influence of visceral pathology on which of the following?
• To help a patient develop personal commitment to their treatment plan you must
• Which dysfunctional pattern is most likely to cause an individual to shift from nasal to mouth breathing?
• Which history-taking technique will allow the addicted patient to feel comfortable sharing information with the physician?
• The autonomic nervous system balance is a goal of OMT in Parkinson's disease. Which statement aligns with this approach?
• The parasympathetic viscerosomatic reflex for most female genitourinary tract is located at which levels?
• Which principle is foundational to the philosophy of osteopathic medicine?
• Structural factors contributing to otitis media include dysfunction of which bone?
• Primary somatic dysfunction of the pubic symphysis typically occurs as which mechanical stress?
• Compared with controls, PD patients have a higher frequency of which condition?
• The emotional stages of grief may occur in any order but eventually must lead to what final stage?
• Understanding cultural differences in clinical practice is important because:
• Understanding the overall health status and age of the patient affects the manipulative prescription by
• Which statement best captures the osteopathic approach to somatic dysfunction?
• The application of osteopathic medicine in oncology should be considered as?
• Which feature is characteristic of acupuncture needles?
• The two lines used to calculate the pelvic index are which of the following?
• A patient presents with bilateral viscerosomatic reflexes along the T11–L2 region. The structures implicated are?
• When the dysfunctional barrier of a given somatic dysfunction is the result of articular dysfunction, the most appropriate OMT to employ would be
• Holistic clinical logic tends to be which type of process?
• Which statement best describes pediatric patients in relation to musculoskeletal complaints?
• The body of which vertebra is rotated away from the rib head in the described technique?
• Cross-over points between A-P curvatures are often the location of which dysfunction?
• During palpation of dysfunctional paravertebral soft tissues, focal pressure commonly what?
• In aging, reduced muscle mass leads to what functional outcome?
• In the Larson's Syndrome case, sensory disturbance and dysesthesia were predominantly on which side?
• Following a good history, the musculoskeletal examination of the athlete should begin with an analysis of which of the following?
• Pathologic studies suggest PD patients may remain symptom free until what percent of the substantia nigra has degenerated?
• AT Still saw the problem of pneumonia as a vascular stasis to be solved primarily by which technique?
• A postcholecystectomy syndrome illustrates the clinical impact of which type of reflex?
• In the presence of an upper respiratory infection, the upper cervical viscerosomatic reflex is mediated through which nerve?
• Which procedures may be employed to normalize sympathetic tone?
• Postcholecystectomy syndrome is an example of which phenomenon?
• Viscerosomatic reflexes are a form of somatic dysfunction that originates from what kind of process?
• A renal disorder can cause dysfunction in the pelvic region through fascias; the renal fascia communicates with which fascia?
• Piriformis muscle spasm is commonly linked with which dysfunction?
• The upper respiratory tract viscerosomatic reflex sites include occiput to C2 and which bilateral levels?
• The ear receives its sympathetic innervation from which spinal levels?
• Current diagnostic criteria divide TMJ dysfunction into three categories: internal derangement injury, degenerative joint disease, and which syndrome?
• Which is an appropriate consideration when developing a treatment protocol for patients with Chronic Fatigue Syndrome and Fibromyalgia?
• The ventricles\u2019 sympathetic innervation originates from which spinal levels?
• A thorough osteopathic treatment for Bell's palsy would not be complete without proper evaluation of cranial structures along the course of which nerve and which accompanying treatment?
• Which ribs are targeted by the Reverse Rib technique described?
• You determine that the fibular head glides easily anteriorly but resists posteriorly. What is the name of this dysfunction?
• The use of osteopathic manipulative treatment (OMT) is recorded using which type of code?
• In evaluating shoulder abduction in a seated patient, which muscle sequence is described as the correct firing order?
• A patient presents to the ED complaining of a headache. After ruling out life-threatening etiologies, you screen for somatic dysfunction. Which region should you pay particular attention to?
• In patients suffering from addiction who receive residential care, what is the most common cofactor?
• When diagnosing pain from sagittal plane decompensation, a pelvic index of what value or greater is significant?
• It is stated that cultural factors in healthcare are a federal standard of care because they influence attitudes toward illness and pain, health outcomes, and health literacy.
• Referral to a scoliosis specialist should be considered when spinal lateral curves exceed how many degrees?
• A prolonged red reflex is a sign of which of the following?
• In osteopathic considerations for cluster headaches, which region is emphasized for treatment?
• Structural factors that affect otitis media are temporal bone dysfunction often in association with hypertonicity of the which muscle?
• In patients with Parkinson's Disease, which therapy was associated with faster improvement, longer retention of movement quality, and reduced side effects?
• Which of the following psychiatric diagnoses are more likely to involve somatization focused on the musculoskeletal system?
• Louisa Burns studied viscerosomatic relationships between the thyroid and somatic dysfunction at which vertebral levels?
• The structures that manifest the "breath of life" are
• AT Still believed that we all possess what we need to heal, and OMT stimulates
• In a patient with bilateral lower extremity edema that worsens in summer, which OMT technique is appropriate to relieve edema?
• The empowered patient is best described as a:
• The Reverse Rib technique is used to treat which ribs?
• Which osteopathic technique is described as most appropriate to stimulate gastrointestinal tract function in terminal illness?
• Which cranial nerve is most likely affected when a patient has medial deviation of the left eye in the setting of increased intracranial pressure?
• Which statement best describes the typical TMJ pain pattern?
• In which body region do chronic pain patients have the most significant somatic dysfunction?
• OMT is the definitive treatment for which ICD-9-CM code?
• Which pattern best describes the pancreatic viscerosomatic reflex?
• Which factors affect the interpretation of touch in a clinical encounter?
• Which characterization best captures the grief process as described in the material?
• When billing for OMT, the evaluation and management (E&M) code must be followed by which modifier?
• The osteopathic approach to treating the thyroid is focused on which physiologic mechanism?
• Which side is specified as involved in the example's rib and vertebral rotation?
• Single segment dysfunctions that are non-neutral are
• A significant differentiation between osteopathic and allopathic medicine is which of the following?
• Which category of OMT is generally most appropriate when treating articular motion restriction associated with somatic dysfunction?
• OMT may be used to treat dysfunctional hypertonicity restrictions of which muscles that appear to contribute to patient's traditional parkinsonian posturing?
• When treating a headache secondary to a viscerosomatic reflex, first treat which component?
• A patient post total knee replacement on pain meds presents with constipation. Which OMT technique might be used to help relatively quickly?
• Pathology affecting which structure would be expected to produce a sacral parasympathetic viscerosomatic reflex?
• Who is described as the 'Father of American Homeopathy'?
• Scoliosis is associated with a persistent lateral curvature of the spine measuring greater than how many degrees?
• Which statement best describes the mechanical stress associated with pubic symphysis dysfunction?
• The most common type of TMJ pain is which of the following?
• Which SBS dysfunctional pattern has been demonstrated to be associated with nonsynostotic plagiocephaly?
• Using counterstrain to treat the piriformis, which statement about the piriformis muscle is true?
• From the perspective of psychoneuroimmunology, the starting point in osteopathic patient care management should be the
• Viscerosomatic reflex dysfunction at the T1-T3 level arises from which areas?
• Post MVA, a patient is treated with OMT. Which modality would you likely utilize the most?
• A patient presents with lateral epicondylitis. Which OMT technique will be most helpful?
• In the absence of a musculoskeletal complaint, somatic dysfunction is
• Which concept describes the body's regulatory capabilities in osteopathic theory?
• AT Still's belief is that we all possess what we need to heal, and OMT stimulates
• The greatest therapeutic impact of cranial OMT upon intraosseous dysfunction can be expected when?
• Which therapy has been shown to yield better results for chronic spinal pain than pain medication?
• Which of the following is NOT an example of neuropathic pain?
• A viscerosomatic reflex is specifically addressed by treating
• Which statement is true regarding Chronic Fatigue Syndrome and Fibromyalgia?
• In evaluating somatic dysfunction, palpation is integrated into which type of examination?
• Which pattern has been associated with nonsynostotic plagiocephaly?
• Which spinal levels are commonly associated with viscerosomatic reflexes affecting bladder function?
• Osteopathic manipulative treatment often provides symptomatic relief from all of the following, EXCEPT which?
• What is one objective physical finding at the region of greatest complaint?
• The highest-yield manipulation when the barrier is articular dysfunction is
• How is the pelvic index calculated?
• OMT treatment of Parkinson's disease aims to establish balance in the somatic system associated with changes toward balance in which system?
• For established hypertension it is suggested that OMT should focus on somatic dysfunction involving the
• The chief complaint of a patient presenting with short leg syndrome is most commonly which of the following?
• Addressing distant, related anatomic areas first in acute musculoskeletal pain is recommended to avoid which outcome?
• Equally as important as oxygenation in function and dysfunction of the respiratory system is which of the following?
• Which medical practice model assumes the patient is unable to understand information or refuses to comply?
• Cultural personal space can lead to hostility if not respected.
• Paravertebral viscerosomatic reflexes in patients with essential hypertension are found at the spinal levels associated with the
• Which muscles are targeted by OMT to address hypertonicity that contributes to parkinsonian posturing?
• The vagus is involved with pain transmission by directly irritating afferent nociceptors in the
• Type II extension dysfunction is typically expected at a cross-over point in which part of the spine?
• The renal fascia communicates with which fascia to influence pelvic dysfunction?
• An acute somatic dysfunction should have characteristic findings of
• What is the name of the technique described that treats ribs 2-4 in the example?
• Which statement correctly characterizes neuropathic pain?
• For a patient with muscle tension headache and nausea, somatic dysfunction is often found at which region?
• Activation of the locus ceruleus-norepinephrine axis is associated with
• In viscerosomatic reflex headaches, the initial treatment focus should be on which component?
• A muscle whose hypertonicity is commonly associated with temporal bone dysfunction in otitis media is which?
• A short right leg would typically be expected to result in which sacral position?
• A viscerosomatic reflex palpable at the level of T9-T10 right is most consistent with pathology affecting which organ?
• Viscerosomatic reflexes tend to manifest with which type of barrier?
• Empathy in osteopathic patient care can be expressed in which domain?
• The spinal cord links seemingly unrelated systems and structures through which reflexes?
• It has been shown that OMT for chronic spinal pain yields better results than
• In Larson's Syndrome, the primary somatic dysfunction is located on the left side in which region?
• Most patients with Chronic Fatigue Syndrome and Fibromyalgia tend to improve within how many years?
• Uterine pathology will manifest a sympathetic viscerosomatic reflex in which area?
• Somatic dysfunctions following Fryette's Type 1 mechanics are always
• For TMJ dysfunction, which statement about prevalence is true?
• The rib head is translated laterally as part of the described movement. Which structure is translated?
• Which two body compartments are engaged in the two-chambered pump concept?
• Bell's palsy management includes evaluating cranial structures along the course of which nerve?
• A prolonged red reflex is associated with what in somatic dysfunction?
• Louisa Burns used both animal and human models to demonstrate viscerosomatic relationships between the thyroid and somatic dysfunction at which levels?
• Fryette's Type 1 mechanics are characterized by being
• Which statement is true regarding autonomic viscerosomatic mapping?
• Which spinal levels are viscerosomatic reflex sites for the upper respiratory tract?
• Which of the following is a recognized TMJ dysfunction category?
• Approximately ___% of back pain is idiopathic according to the allopathic profession.
• The pelvic index is used to assess which type of deformity?
• Which medical practice model is an example of an Adult-Adult transaction?
• In the provided example, which rib is involved?
• Spinal facilitation from somatic dysfunction in which spinal segments results in increased sympathetic tone to the urinary system?
• Which line is drawn from the anterior tip of the sacrum inferiorly?
• Which physician is credited as the Father of American Homeopathy?
• No parasympathetic viscerosomatic reflex has been found for which structure?
• Areas of focus in the examination of a patient with ocular complaints should include all of the following except:
• In cases of acute onset of musculoskeletal pain, it is most appropriate to:
• A postpartum patient who recently delivered via NSVD complains of low back pain. Which areas should you focus your gentle OMT on?
• If the spinal center of gravity lies anterior to the sacral promontory, chronic tension develops in which muscles?
• Chapman's anterior points for the colon are located on what body region?
• In the Larson's Syndrome case, sensory disturbance and dysesthesia were noted on which side of the body?
• In PTSD unconscious mechanisms can produce what kind of findings?
• Pathology of most of the female genitourinary tract will manifest a parasympathetic viscerosomatic reflex in which area?
• A major determinant of preload is distribution of blood volume between which compartments?
• Which statement best describes viscerosomatic reflex as it relates to somatic dysfunction that persists despite OMT?
• TMJ dysfunction is second only to which condition as the most frequent source of facial pain?
• In the described Reverse Rib technique example, which two structures are primarily involved?
• OMM can complement cancer diagnosis and treatment, enhance survivorship, and strengthen total care. Which option best reflects this concept?
• Which statement is NOT true regarding acupuncture points?
• Reflex somatosomatic dysfunction in patients with post-op pulmonary complications may be found at which levels?
• A patient with persistent nausea and vomiting despite antiemetics: which areas would you treat with OMT?
• The sympathetic innervations of the ventricles of the heart arise in spinal levels
• In viscerosomatic reflexes, which group of neurons is thought to become facilitated?
• Approximately how many Americans per year seek medical care for athletic and recreational injuries?
• Which practice model emphasizes shared decision making and patient involvement in care planning?
• The proximity of the sympathetic chain ganglia to the rib heads allows which phenomenon?
• The highest incidence of TMJ dysfunction occurs in adults aged 20-40 with what female-male ratio?
• Scoliotic curvatures rotate toward which side?
• An area of somatic dysfunction that is responsible for and maintains a total pattern of dysfunction is the
• Which statement most accurately describes the TART criteria for somatic dysfunction?
• For patients with increased intracranial pressure from a malignant process, cranial OMM can be safely employed and should include addressing any sacral restriction. Which statement is true?
• Cranial OMT is most effective on intraosseous dysfunction prior to what event?
• A viscerosomatic reflex consisting of bilateral grouped somatic dysfunction from T5 to T9 is most consistent with pathology affecting which organ?
• Treatment plans in otitis media should always address which aspect?
• Inseparable interaction between the mind and the body is referred to as
• The parasympathetic innervation reaches the middle ear through which nerve via which ganglion?
• Which principle describes the osteopathic view that the body functions as a unit of body, mind, and spirit?
• The area of somatic dysfunction that maintains the total pattern is called
• Pectus excavatum is associated with which dysfunctional pattern?
• Primary somatic dysfunction of which joint tends to present with superior/inferior shear stress?
• Acute somatic dysfunction is commonly associated with which finding?
• Which statement best describes pediatric patients' presentation compared to adults?
• In osteopathic considerations for cluster headaches, treatment should include addressing which region?
• Primary lymphatic drainage from the lower body enters the general circulation via the
• Somatic dysfunction of the thoracic spine, ribs, and thoraco-abdominal diaphragm results in which of the following?
• Sensory input from the upper respiratory tract reaches the central nervous system through which cranial nerve?
• The treatment team that exploits ideas and participation from each member and seeks to reach a set of conclusions superior to what any team member could do alone is a
• For hyperthyroidism, which osteopathic technique should be avoided?
• Which mechanism is most commonly implicated in chondromalacia patellae leading to anterior knee pain?
• A 63-year-old rehabilitation patient has tenderness at the insertion of the levator scapulae on the superior medial border of the scapula. Which statement about this somatic dysfunction is true?
• Some of Larson's syndrome presentations share characteristics with which condition?
• As the paravertebral soft tissue dysfunction becomes chronic, which changes are commonly manifested?
• Which rib is held during the Reverse Rib technique in the example?
• Recurrent somatic dysfunction despite repeated OMT should lead you to believe that it is possibly the result of which reflex?
• TMJ dysfunction resulting from trauma (e.g., tooth extraction) is often self-limiting and responds well to which combination of interventions?
• Neonatal somatic dysfunction is often caused by birth trauma and/or childhood injuries, but is influenced by what?
• Pulmonary circulation holds approximately what percent of circulating blood as a left heart reservoir?
• A somatovisceral reflex at spinal levels T8-T10 would be expected to produce which condition?
• Through palpation, a practitioner may determine which of the following?
• Which muscle is identified as a tonic dysfunction when tender at the scapular insertion?
• The parasympathetic innervation to the middle ear travels with which cranial nerve?
• Chapman's anterior points for the colon can be found on which area?
• The '2-chambered pump' refers to the relationship between which cavities?
• When identifying the criteria for the diagnosis of somatic dysfunction, the mnemonic TART stands for
• Complementary and alternative medicine (CAM) is defined as what?
• Appendicitis produces tenderness to palpation in the area of McBurney's point, located at which dermatomal level?
• Which of the following is NOT a pathway for the neurotransmission of pain?
• The primary concern in a pediatric patient with strabismus is which condition?
• Which of the following is among the criteria for diagnosing fibromyalgia?
• Most of the potential viscerosomatic responses in the upper thoracics are located where?
• Which cranial nerve carries sensory information from the upper respiratory tract to the brainstem?
• The osteopathic concept goes beyond a holistic approach to the body to include
• Stimulation of visceral pericardium and heart results in contraction of which muscle groups?
• During seated shoulder abduction assessment, which sequence of muscle firing is described as correct?
• Which prognosis statement best describes Chronic Fatigue Syndrome and Fibromyalgia?
• Metastatic lesions to the right lung may present with somatic dysfunction at which region?
• Examination for scoliosis is the same as the structural exam with emphasis on identifying which dysfunction?
• With careful history and physical examinations, communication, and individualized care plans OMM can be used to?
• Rib raising is most directly related to modulation of which neural structure?
• What are the first parts of the initial assessment that must be completed for the addicted patient?
• How is the usefulness of OMT described in the material?
• Which two components should be completed in the initial assessment of an addicted patient?
• One OMT procedure specifically developed to treat Eustachian tube dysfunction is which technique?
• In a patient with spinal cord injury admitted to rehabilitation, which osteopathic manipulation technique should be avoided?
• In the lateral standing structural exam, the physician should look for increased or decreased what?
• The cranial concept is most closely associated with which physician?
• The structures that relay vital forces throughout the body are
• Which joint is strained by the described movement in the technique?
• Fibromyalgia diagnostic criteria require pain on pressure at least how many tenderpoints out of 18?
• According to the reported findings, osteopathic manipulative treatment in patients with Parkinson's Disease was associated with reduced which of the following?
• Dr. A.T. Still believed that
• For a diagnosis of Chronic Fatigue Syndrome and Fibromyalgia, fatigue must have been present for longer than how many months?
• What percentage of primary care visits include chief complaints with strong psychological undercurrents?
• Which lymphatic procedure is particularly appropriate for the acutely ill hospitalized patient with pneumonia?
• Which statement best summarizes the Parkinson's disease management approach with OMT described in the material?
• The paravertebral viscerosomatic reflexes in hypertension are associated with the spinal levels of which organs?
• In the setting of acute injuries that may not tolerate palpation or motion testing, the clinician should:
• The most common cause of hypothyroidism is which?
• In that example, which vertebra is described as being right rotated?
• The lateral weight bearing line passes through all of the following structures except which?
• The term describing the inseparable interaction between mind and body is
• From which edge is the horizontal line X drawn on the lateral standing pelvis X-ray?
• To establish functional balance of the sacrum in short leg syndrome you should aim to eliminate chronic engagement of what?
• In the terminal stages of a disease process with progressive loss of physical mobility and diminished mechanical stimulation of the gastrointestinal tract which procedure would be most appropriate?
• Which inspiratory change would be expected with thoracic somatic dysfunction?
• Which cranial nerve innervates the lateral rectus muscle?
• According to psychoneuroimmunology, the starting point in patient care emphasizes the impact of what on health?
• Which craniovertebral compression is more frequent in PD patients than in controls?
• Reflex Sympathetic Dystrophy is another name for which condition?
• Diabetic neuropathy, postherpetic neuralgia, and phantom limb pain are examples of what type of pain?
• The most common type of primary headache affecting nearly 90% of adults is which of the following?
• Primary lymphatic drainage from the lower body enters the general circulation via which vein?
• The brain structure that processes both pain and emotion and can amplify nociceptive input or even misinterpret other sensory input as pain is the
• The cranial concept was developed by which physician?
• In a bedridden 76-year-old stroke patient, which technique would be least likely to help increase thoracic cage compliance?
• The effect of somatic dysfunction on the thyroid is primarily which autonomic state?
• Which viscerosomatic reflex pattern is associated with upper GI pathology?
• The body's ability to compensate for stress decreases with age while which of the following changes occurs?
• The aim of partnering with a patient in treatment planning is to achieve:
• Lowering of the visual field and shift in neutral position of the vestibular apparatus is most apt to result from which of the following?
• In evaluating a knee and leg pain with negative orthopedic tests, which diagnosis name corresponds to a fibular head that glides anteriorly and resists posteriorly?
• Posterior sacrum, sacroiliac somatic dysfunction results in spasms of which muscle?
• The most effective treatment of hypertension begins with
• The locus ceruleus-norepinephrine axis is activated in
• Visceral autonomic mapping for the ovaries is most consistent with which level and division?
• Which of the following best describes the role of palpation in evaluating patients?
• Neonatal or pediatric somatic dysfunction is often caused by birth trauma and/or childhood injuries. It is influenced by which mechanism?
• Increased muscular tension as a result of an upper respiratory tract viscerosomatic reflex is palpable over which muscles?
• When evaluating the patient with urologic symptoms, other aspects to consider include?
• Which vertebral level is associated with a gallbladder viscerosomatic reflex?
• Which vertebral levels are targeted for nausea management with OMT as described in the material?
• Which statement best describes the role of OMM in cancer care?
• Clinical presentation of metastatic lesions in the right lung may include somatic dysfunction involving which levels?
• The current leading causes of death in the United States are which type?
• Dr. Sutherland developed the
• Which elements of pneumonia treatment have been shown to be improved by OMT?
• Anterior cervical soft tissue procedures affect the patient\u2019s ability to respond to an upper respiratory tract infection through their effect on which system?
• Which statement best describes empathy's relation to the musculoskeletal system?
• Among the following, which region is most closely associated with upper thoracic viscerosomatic responses?