10 exam-style questions with answers and explanations, straight from our 1,030-question bank. Tap an answer to check yourself. When you're ready, take the scored version in the free practice test.
The FM/OMT exam has 275 questions and runs 4 hours 54 minutes.
These 10 free FM/OMT questions are organized by exam domain, so you can see how each part of the Certification in Family Practice (and OMT) blueprint is tested. Reveal the answer and explanation under each question.
Domain 2: Cardiology & Pulmonology 10% of exam
Question 1
Six months after diagnosis of nonischemic cardiomyopathy, a 58-year-old still becomes dyspneic when climbing two flights of stairs. His ejection fraction is 32%. He is euvolemic and takes maximally tolerated sacubitril/valsartan, carvedilol, and spironolactone. Blood pressure is 112/70 mm Hg, and his pulse is 64/min in sinus rhythm. The eGFR is 68 mL/min/1.73 m², potassium is 4.3 mmol/L, and A1c is 5.4%; he does not have diabetes. Which addition would reduce heart-failure hospitalization and cardiovascular mortality?
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Correct answer: A - Dapagliflozin
Domain 3: Dermatology 6% of exam
Question 2
A 52-year-old reports an itchy rash and increasing difficulty rising from a low chair. There are violaceous, scaly papules over the dorsal metacarpophalangeal and proximal interphalangeal joints and dusky discoloration of the upper eyelids. Shoulder abduction and hip flexion are weak, but handgrip is preserved and the joints are not swollen. Creatine kinase is 2,180 U/L (reference 40-200), and TSH is normal. What diagnosis best unifies the cutaneous and muscle findings?
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Correct answer: B - Dermatomyositis
Domain 4: EENT 4% of exam
Question 3
An 18-month-old has had ear pain for three days and a temperature of 39.4°C. Examination shows a bulging, opaque left tympanic membrane with middle-ear effusion and thick purulent discharge from both eyes. The child is drinking adequately and has no medication allergies or antibiotic exposure during the past month. Treatment is indicated. Which antibiotic regimen is preferred for this presentation?
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Correct answer: D - Amoxicillin-clavulanate alone
Domain 5: Emergency Medicine 2% of exam
Question 4
Four hours into treatment of diabetic ketoacidosis, a 27-year-old with type 1 diabetes is alert and hemodynamically stable. Glucose has fallen from 568 to 176 mg/dL. Venous pH is 7.24, bicarbonate is 13 mmol/L, beta-hydroxybutyrate is 3.8 mmol/L, and potassium is 4.2 mmol/L. IV insulin and crystalloid without dextrose are running. What change to treatment is indicated at this point?
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Correct answer: B - Add IV dextrose and continue titrated insulin treatment.
Domain 6: Endocrinology 4% of exam
Question 5
A 68-year-old woman sustains a T12 compression fracture while lifting a small grocery bag. Imaging shows no destructive bone lesion. DXA T-scores are −1.8 at the femoral neck and −1.5 at the total hip. Calcium, 25-hydroxyvitamin D, and renal function are normal, and evaluation has not identified another metabolic bone disorder. She asks whether the DXA result means she should wait before taking osteoporosis medication. The most appropriate recommendation is to:
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Correct answer: A - Offer fracture-prevention medication on the basis of the low-trauma vertebral fracture.
Domain 7: Gastroenterology 8% of exam
Question 6
Six weeks after completing a 14-day bismuth quadruple regimen for Helicobacter pylori, a 45-year-old's dyspepsia has resolved. A stool antigen test is negative. Medication reconciliation reveals that he continued pantoprazole every day, including on the day the specimen was collected. He has taken no further antibiotics or bismuth. What is needed before eradication can be accepted?
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Correct answer: A - Withhold pantoprazole for two weeks, then repeat stool antigen testing.
Domain 10: Infectious Disease Medicine 6% of exam
Question 7
A urine culture obtained during preoperative screening for a 71-year-old man's elective knee arthroplasty grows more than 100,000 CFU/mL of Escherichia coli. Urinalysis shows nitrites and pyuria. He has no dysuria, new urinary frequency, suprapubic pain, flank pain, or fever; vital signs are normal. No urologic procedure is planned. How should this result affect his perioperative plan?
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Correct answer: D - Proceed with usual surgical prophylaxis; do not add urine-directed antibiotics.
Domain 11: Nephrology & Urology 6% of exam
Question 8
At visits spanning five months, a 54-year-old with type 2 diabetes has eGFR values of 82, 80, and 83 mL/min/1.73 m². First-morning urine albumin-to-creatinine ratios are 470, 510, and 490 mg/g, respectively. The samples were collected without fever, urinary infection, or recent strenuous exercise. Renal ultrasonography is normal. Which interpretation correctly accounts for both filtration and persistent albuminuria?
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Correct answer: C - G2 A3 chronic kidney disease, despite the relatively preserved eGFR
Domain 13: Orthopedic, Musculoskeletal & Sports Medicine 6% of exam
Question 9
A 16-year-old soccer player is reviewed 72 hours after a concussion. She has been staying in a darkened room and missing school. Symptoms are improving, although reading for 20 minutes brings on a mild headache. She has no vomiting, worsening headache, or focal neurologic findings. Which recovery plan should replace her current restrictions?
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Correct answer: D - Resume school with symptom-based accommodations and light walking, avoiding contact sport.
Domain 14: Osteopathic Principles & Practice 10% of exam
Question 10
A 39-year-old develops localized low-back pain after lifting a suitcase. Neurologic examination is normal. At L3, the right transverse process is posterior to the left; this asymmetry increases with flexion and nearly disappears with extension. L3 also sidebends more freely to the right. The physician selects direct muscle-energy treatment. Which initial position engages the restrictive barriers at this segment?
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Correct answer: C - Flexion, rotation left, and sidebending left