OMSITE EXAM QUESTIONS 2026’27 WITH
GUARANTEED ACCURATE ANSWERS |COMPLETE!!
1. Alignment of which of the following is the most reliable for proper reduction of
the zygomaticomaxillary complex fracture?
A. Frontozygomatic suture
B. Sphenozygomatic suture
C. Infraorbital rim
D. Medial orbital rim -Accurate Answer: B Rationale:
The sphenozygomatic suture area has been previously analyzed and shown to be an
area for confirmation of alignment of the zygomatic arch and the zygomatic
complex (ZMC). This has also been shown to key point for fixation thru
biomechanical studies.
The sphenozygomatic suture is a broad area along the greater wing of the sphenoid
and can be approached along the internal aspect of the lateral orbit. Even in severe
midface fractures the greater wing of the sphenoid is intact thus acting as a key
landmark for proper reduction of the ZMC fracture.
Reduction of the frontozygomatic suture or the infraorbital rim alone can result in
errors due to the small surface area. The medial orbit is generally not involved in a
ZMC fracture.
Reference:
Rohner D, Tay A, Meny CS, Hutmacker DW, Hammer B.: The sphenozygomatic
suture as a key site for osteosynthesis of the orbitozygomatic complex in panfacial
fractures: A biomechanical study in human cadavers based on clinical practice.
Plast Reconstr Surg 110: 1463, 2002.
Manson PN, Clark N, Robertson B, et al. Subunit principles in midface fractures:
the importance of sagittal buttresses, soft tissue reductions and sequencing
treatments of segmental fractures. Plast Reconstr Surg 103: 1287, 1999.
,1. When the medial canthal ligament is attached to a bony segment in naso-orbito-
ethmoidal(NOE) fracture repair the transcanthal wire is best placed:
A. after all soft tissue injuries have been addressed.
B. anterior to the original insertion of the canthal ligament.
C. posterior and inferior to the original insertion.
D. posterior and superior to the original insertion. -Accurate Answer: D Rationale:
The purpose of the trans-canthal wire is to secure the canthal ligament and boney
segment in the pretraumatic position. Pull of the soft tissues displaces the bone and
canthal ligament in an anterior and inferior direction. Therefore a wire placed
posterior and superior to the original insertion provides a vector whose resistance
to displacement is most ideal and provides the best alignment.
Reference:
OMS Knowledge Update, Volume three, Section 6. Abubaker AO and Strauss RA,
eds. p TRA 75-76. Classification D - Trauma - Soft tissue Oral and Maxillofacial
Surgery In- Training Examination (OMSITE) questions for the Trauma Section.
1. A 21-year-old female is an unrestrained driver involved in a MVA. She suffers a
scalp laceration and is noted to have lost 1000mL of blood at the scene. You would
expect her vital signs to be consistent with:
A. Pulse rate >100, normal systolic blood pressure, decreased pulse pressure,
respiratory rate of 20-30, urinary output of 20-30mL/hr.
B. Pulse rate <100, normal systolic blood pressure, normal or increased pulse
pressure, respiratory rate of 14-20, urinary output of >30mL/hr.
C. Pulse rate >120, decreased systolic blood pressure, decreased pulse pressure,
respiratory rate of 30-40, urinary output of 5-15mL/hr.
D. Pulse rate >140, decreased systolic blood pressure, decreased pulse pressure,
respiratory rate of >35, urinary output that's negligible. -Accurate Answer: A
Rationale:
,These findings are consistent with a Class II hemorrhage, 750-1500ml, The vitals
signs or such a blood loss are consistent with those in response A. Response D
reflects the vital signs of a Type IV blood loss, Response C a Type III and
Response B a Type I.
Reference:
1997 ATLS for Doctors, Sixth Edition.
1. A 65-year-old man fell down the stairs. Upon examination of him, you notice
that he opens his eyes to speech, localizes pain, and mutters inappropriate words.
You assess his Glasgow coma scale (GCS) to be:
A. 13
B. 11
C. 9
D. 7 -Accurate Answer: B Rationale:
According to the Glascow Coma Scale, the patient can open his eyes in response to
commands speech, (3 out of 4); localizes pain, (5 out of 5); yet produces
inappropriate words, (3 out of 6); for a Glascow coma score of 11.
Reference:
1997 ATLS for Doctors, Sixth Edition
1. A 79-year-old white male presents to your office for removal of carious teeth.
Medical history review reveals chronic obstructive pulmonary disease (COPD),
hypertension, peptic ulcer disease, athlerosclerosis with occasional angina, and
osteoarthritis. Daily medications include isosorbide dinitrate, furosemide, and
acetaminophen. After conscious sedation with midazolam and local anesthesia with
prilocaine, you note that in recovery he has slowly become ashen looking and the
pulse oximetry reading has fallen to 85%. Which of the following measures is most
appropriate?
A. Intubation and hyperventilation with 100% oxygen
, B. Titrated administration of 0.4 mg flumazenil IV
C. Methylene blue administration 1 mg/kg IV
D. Assisted ventilation by face mask with room air. -Accurate Answer: C
Rationale:
This situation may appear to be pulmonary in origin, but in fact represents acquired
methemoglobinemia. This condition can be precipitated by nitrates, (such as
isosorbide dinitrate) acetaminophen, prilocaine, articaine, and a number of other
medications, especially in genetically susceptible individuals. The oxidized (ferric)
state of the methemoglobin molecule cannot be reversed by increasing the FIO2,
which also may decrease the respiratory drive in COPD. Sedation reversal by
flumazenil will have no effect on the condition.
Cautious administration of methylene blue will reduce methemoglobin back to a
ferrous state, normalizing the oxygen binding/delivering capacity of hemoglobin.
Reference:
Benumof JL Anesthesia & Uncommon Diseases, 4th ed. WB Saunders, 1998
pp288-9
1. When performing a z-plasty to remove a prominent labial frenum the secondary
incisions are made at an angle approximately 60 degrees to allow the main limb to
be rotated:
A. 33 degrees
B. 45 degrees
C. 60 degrees
D. 90 degrees -Accurate Answer: D Rationale:
A z-plasty is designed to rotate the frenum or scar 90 degrees. Secondary incisions
made at other angles may not allow as great a rotation of the main limb (in this
case, the main frenum incision) as those made at 60 degrees tothe main limb.
Reference:
GUARANTEED ACCURATE ANSWERS |COMPLETE!!
1. Alignment of which of the following is the most reliable for proper reduction of
the zygomaticomaxillary complex fracture?
A. Frontozygomatic suture
B. Sphenozygomatic suture
C. Infraorbital rim
D. Medial orbital rim -Accurate Answer: B Rationale:
The sphenozygomatic suture area has been previously analyzed and shown to be an
area for confirmation of alignment of the zygomatic arch and the zygomatic
complex (ZMC). This has also been shown to key point for fixation thru
biomechanical studies.
The sphenozygomatic suture is a broad area along the greater wing of the sphenoid
and can be approached along the internal aspect of the lateral orbit. Even in severe
midface fractures the greater wing of the sphenoid is intact thus acting as a key
landmark for proper reduction of the ZMC fracture.
Reduction of the frontozygomatic suture or the infraorbital rim alone can result in
errors due to the small surface area. The medial orbit is generally not involved in a
ZMC fracture.
Reference:
Rohner D, Tay A, Meny CS, Hutmacker DW, Hammer B.: The sphenozygomatic
suture as a key site for osteosynthesis of the orbitozygomatic complex in panfacial
fractures: A biomechanical study in human cadavers based on clinical practice.
Plast Reconstr Surg 110: 1463, 2002.
Manson PN, Clark N, Robertson B, et al. Subunit principles in midface fractures:
the importance of sagittal buttresses, soft tissue reductions and sequencing
treatments of segmental fractures. Plast Reconstr Surg 103: 1287, 1999.
,1. When the medial canthal ligament is attached to a bony segment in naso-orbito-
ethmoidal(NOE) fracture repair the transcanthal wire is best placed:
A. after all soft tissue injuries have been addressed.
B. anterior to the original insertion of the canthal ligament.
C. posterior and inferior to the original insertion.
D. posterior and superior to the original insertion. -Accurate Answer: D Rationale:
The purpose of the trans-canthal wire is to secure the canthal ligament and boney
segment in the pretraumatic position. Pull of the soft tissues displaces the bone and
canthal ligament in an anterior and inferior direction. Therefore a wire placed
posterior and superior to the original insertion provides a vector whose resistance
to displacement is most ideal and provides the best alignment.
Reference:
OMS Knowledge Update, Volume three, Section 6. Abubaker AO and Strauss RA,
eds. p TRA 75-76. Classification D - Trauma - Soft tissue Oral and Maxillofacial
Surgery In- Training Examination (OMSITE) questions for the Trauma Section.
1. A 21-year-old female is an unrestrained driver involved in a MVA. She suffers a
scalp laceration and is noted to have lost 1000mL of blood at the scene. You would
expect her vital signs to be consistent with:
A. Pulse rate >100, normal systolic blood pressure, decreased pulse pressure,
respiratory rate of 20-30, urinary output of 20-30mL/hr.
B. Pulse rate <100, normal systolic blood pressure, normal or increased pulse
pressure, respiratory rate of 14-20, urinary output of >30mL/hr.
C. Pulse rate >120, decreased systolic blood pressure, decreased pulse pressure,
respiratory rate of 30-40, urinary output of 5-15mL/hr.
D. Pulse rate >140, decreased systolic blood pressure, decreased pulse pressure,
respiratory rate of >35, urinary output that's negligible. -Accurate Answer: A
Rationale:
,These findings are consistent with a Class II hemorrhage, 750-1500ml, The vitals
signs or such a blood loss are consistent with those in response A. Response D
reflects the vital signs of a Type IV blood loss, Response C a Type III and
Response B a Type I.
Reference:
1997 ATLS for Doctors, Sixth Edition.
1. A 65-year-old man fell down the stairs. Upon examination of him, you notice
that he opens his eyes to speech, localizes pain, and mutters inappropriate words.
You assess his Glasgow coma scale (GCS) to be:
A. 13
B. 11
C. 9
D. 7 -Accurate Answer: B Rationale:
According to the Glascow Coma Scale, the patient can open his eyes in response to
commands speech, (3 out of 4); localizes pain, (5 out of 5); yet produces
inappropriate words, (3 out of 6); for a Glascow coma score of 11.
Reference:
1997 ATLS for Doctors, Sixth Edition
1. A 79-year-old white male presents to your office for removal of carious teeth.
Medical history review reveals chronic obstructive pulmonary disease (COPD),
hypertension, peptic ulcer disease, athlerosclerosis with occasional angina, and
osteoarthritis. Daily medications include isosorbide dinitrate, furosemide, and
acetaminophen. After conscious sedation with midazolam and local anesthesia with
prilocaine, you note that in recovery he has slowly become ashen looking and the
pulse oximetry reading has fallen to 85%. Which of the following measures is most
appropriate?
A. Intubation and hyperventilation with 100% oxygen
, B. Titrated administration of 0.4 mg flumazenil IV
C. Methylene blue administration 1 mg/kg IV
D. Assisted ventilation by face mask with room air. -Accurate Answer: C
Rationale:
This situation may appear to be pulmonary in origin, but in fact represents acquired
methemoglobinemia. This condition can be precipitated by nitrates, (such as
isosorbide dinitrate) acetaminophen, prilocaine, articaine, and a number of other
medications, especially in genetically susceptible individuals. The oxidized (ferric)
state of the methemoglobin molecule cannot be reversed by increasing the FIO2,
which also may decrease the respiratory drive in COPD. Sedation reversal by
flumazenil will have no effect on the condition.
Cautious administration of methylene blue will reduce methemoglobin back to a
ferrous state, normalizing the oxygen binding/delivering capacity of hemoglobin.
Reference:
Benumof JL Anesthesia & Uncommon Diseases, 4th ed. WB Saunders, 1998
pp288-9
1. When performing a z-plasty to remove a prominent labial frenum the secondary
incisions are made at an angle approximately 60 degrees to allow the main limb to
be rotated:
A. 33 degrees
B. 45 degrees
C. 60 degrees
D. 90 degrees -Accurate Answer: D Rationale:
A z-plasty is designed to rotate the frenum or scar 90 degrees. Secondary incisions
made at other angles may not allow as great a rotation of the main limb (in this
case, the main frenum incision) as those made at 60 degrees tothe main limb.
Reference:
