Comlex 2, OMT questions. Please Reply DOs!

[confused_amused]

I did poorly on the OMT section of Comlex 2 apparently, is the old addage that "if you see OMT as an answer to a board question, pick it", still in effect?

If you come down to thinking what they'd really do in real life versus OMT, which is the right answer?

Example being

18 year old girl comes in with 3 days of cough with productive sputum, which is the first step in management.
A. CXR
B. oral ABX and d/c home
C. OMM to level blah blah
D. cough syrup, reassess in 1 week
E. CT chest

Should I put OMM because i'm taking COMLEX? I wouldn't have thought so, but now I wonder? What did you guys that did well on the exam do in situations like these? Thanks.

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[Hernandez]

18 year old girl comes in with 3 days of cough with productive sputum, which is the first step in management.
A. CXR
B. oral ABX and d/c home
C. OMM to level blah blah
D. cough syrup, reassess in 1 week
E. CT chest

What's sad, is this is very typical of many of the questions that are on there: way too short, not enough information, no physical findings, no labs, and they expect you to read their minds. With this type of question, without knowing if they're febrile or any physical findings or more history, I'd say CXR, screw the OMM until you have a diagnosis of pneumonia/sinusitis/brochiolitis/etc. IMHO, OMM isn't worth a damn without a diagnosis of what you're treating, and they can not convince me otherwise.

That rant being said, I took step 2 and passed it, but I honestly do not know what they want and what I questions I did well on and which ones I missed.

 

[Sugar72]

you are so right about the caliber of questions...i felt like i needed more info for almost all of the questions before i could pick an answer. I would have picked omt if was a lymphatic drainage technique, but probably cough syrup and recheck. it had only been 3 days so no abx and no cxr. of course if she has a fever and a leukocytosis i would get a cxr - if she sounds crappy on ascultation a cxr - but they don't give you that info and it was a frustrating test!

the only omm i studied was from a cheat sheet that i found a link to from this website and i did quite well on levels 2 and 3 just using that cheat sheet.

good luck.

 

[TUCOMSam]

How happy this makes me to be done with that test... and how angry it gets me to see a question like that (without ANY info!)...

I did pretty well on the OMT portion of the exam (I will say it was most likely LUCK)...

A question such as that is so vague, and gives you absolutely no idea what this kid looks like, so I simply asked myself:

As a DO, what do I want to know first if I know that OMM would take very little time (as to not put this kid into respiratory distress)... I would use OMM first to help in Diagnosis, not necessarily treatment. This is why in this examply I would choose the manipulation answer. The rest of the treatment can only be decided with more info. The OMT could be done quickly and result in improvement.

Then again, what do I know... these questions are ridiculous!

 

[Dr JPH]

Example being

18 year old girl comes in with 3 days of cough with productive sputum, which is the first step in management.
A. CXR
B. oral ABX and d/c home
C. OMM to level blah blah
D. cough syrup, reassess in 1 week
E. CT chest

Frustrating.

Can OMT be used as a first step in management? Sure, but not alone.

Thats what gets me on these OMM questions...you either chose OMM or standard therapy, but they are never combined!

What would I do assuming this is an 18 year old, otherwise healthy, not on birth control, no exposure history...

- OMT (T1-6, Ribs, Diaphragm, Lymphatics)
- Expectorant containing Rx
- Possibly oral ABX

More information would be needed and I wouldnt use OMT alone.

She is 18...does she live in a dorm at college? Does she volunteer with homeless people? Is she taking birth control, smokes, is overweight and diabetic?

Cough is productive...I think theyre trying to lead to bacterial infection...bronchitis or pneumonia.

Pneumonia I would get a CXR.

Lungs sound clear...maybe just URI...no CXR.

 

[Dr JPH]

Here...I rewrote the question!!


An 18 year old female comes into the Emergency Department with a 3 day history of cough with productive sputum. Her temp is 99.2 and she states she is coughing up "yellow stuff", but denies coughing up any blood. She denies any other symptoms and her history reveals no significant medical history. She is a nonsmoker and works as a teller in a local bank. What would be the most appropriate first step in managing this patient?

A. P/A and Lateral Chest X-ray followed by Albuterol Nebulizer
B. Oral ABX and discharge the patient home
C. P/A and Lateral Chest X-ray, OMT and prescription for oral antibiotics
D. Cough syrup and instructions to follow up with her family physician
E. CT of the chest

 

[Hernandez]

Here...I rewrote the question!!


An 18 year old female comes into the Emergency Department with a 3 day history of cough with productive sputum. Her temp is 99.2 and she states she is coughing up "yellow stuff", but denies coughing up any blood. She denies any other symptoms and her history reveals no significant medical history. She is a nonsmoker and works as a teller in a local bank. What would be the most appropriate first step in managing this patient?

A. P/A and Lateral Chest X-ray followed by Albuterol Nebulizer
B. Oral ABX and discharge the patient home
C. P/A and Lateral Chest X-ray, OMT and prescription for oral antibiotics
D. Cough syrup and instructions to follow up with her family physician
E. CT of the chest

I nominate you for COMLEX associate question author. I'll even throw in a buck fifty.

 

[smgilles]

Here...I rewrote the question!!


An 18 year old female comes into the Emergency Department with a 3 day history of cough with productive sputum. Her temp is 99.2 and she states she is coughing up "yellow stuff", but denies coughing up any blood. She denies any other symptoms and her history reveals no significant medical history. She is a nonsmoker and works as a teller in a local bank. What would be the most appropriate first step in managing this patient?

A. P/A and Lateral Chest X-ray followed by Albuterol Nebulizer
B. Oral ABX and discharge the patient home
C. P/A and Lateral Chest X-ray, OMT and prescription for oral antibiotics
D. Cough syrup and instructions to follow up with her family physician
E. CT of the chest

In reality COMLEX would give you this.

A. Pregnancy test
B. P/A and Lateral XRAY
C. OMT
D. Rx ABX
E. CT of the chest

Good luck.