Obstetrics & Gynecology Actual Exam 2026/2027 –
Complete Exam-Style Questions | Detailed Rationales –
Pass Guaranteed – A+ Graded
Osteopathic Principles and Practice in Obstetrics &
Gynecology – Practice Exam
1. A 32-year-old G2P1 at 28 weeks gestation presents with low back pain worse on
the right. Examination reveals a right posterior innominate rotation. Which
osteopathic manipulative treatment (OMT) position is safest and most
appropriate?
• A) Prone with a pelvic cushion
• B) Side-lying with the left side down
• C) Supine flat without wedge
• D) Standing with HVLA
Correct Answer: B
Rationale: After 20 weeks, prone positioning risks aortocaval compression and
reduced placental perfusion. Side-lying avoids compression and allows safe
treatment of the innominate. Supine flat (C) also risks compression; standing HVLA
(D) is unsafe and impractical.
2. A 28-year-old G0 with primary dysmenorrhea has a tender Chapman’s reflex at
the right pubic tubercle. This finding suggests viscerosomatic involvement of
which structure?
• A) Right kidney
, • B) Right ovary
• C) Appendix
• D) Right ureter
Correct Answer: B
Rationale: Anterior Chapman’s reflexes for the ovaries are located at the pubic
tubercles, ipsilateral. Right pubic tubercle tenderness suggests right ovarian reflex
activity, which may contribute to dysmenorrhea.
3. A 34-year-old G3P3 at 36 weeks gestation presents with pubic symphysis pain
and a waddling gait. Palpation reveals mild widening of the symphysis. What is the
most likely diagnosis?
• A) Osteitis pubis
• B) Symphysis pubis dysfunction (diastasis)
• C) Stress fracture
• D) Hip osteoarthritis
Correct Answer: B
Rationale: Symphysis pubis dysfunction is common in late pregnancy due to
relaxin-mediated ligamentous laxity. Presentation includes anterior pelvic pain,
waddling gait, and tenderness over the symphysis. Osteitis pubis (A) is typically
postpartum and inflammatory.
4. A 30-year-old G1P0 at 32 weeks gestation presents with left-sided sciatica. MRI
shows no disc herniation. Examination reveals left piriformis spasm. Which OMT is
most appropriate?
• A) Prone HVLA to L5–S1
• B) Side-lying left piriformis release (muscle energy or positional release)
, • C) Cranial sacral flexion
• D) Lumbar thrust in prone
Correct Answer: B
Rationale: Piriformis syndrome in pregnancy is common. Side-lying MET or
positional release is safe and effective. Prone positioning (A, D) is contraindicated
after the first trimester. Cranial technique (C) is not specific to piriformis.
5. Which of the following osteopathic techniques is most effective for reducing
uterine congestion and pelvic pain in a patient with dysmenorrhea?
• A) Thoracic lymphatic pump
• B) Pelvic diaphragm release and sacral rocking
• C) Cervical myofascial release
• D) High-velocity lumbar thrust
Correct Answer: B
Rationale: Pelvic diaphragm release and sacral rocking improve venous and
lymphatic drainage from pelvic viscera, reducing congestion. Thoracic pump (A)
affects upper body; cervical (C) and thrust (D) are not specific to pelvic congestion.
6. A 26-year-old G0 with chronic pelvic pain and endometriosis has a diagnosis of
sacral torsion (right on left). Which autonomic nerves are most likely affected?
• A) Thoracic sympathetic (T1–T4)
• B) Pelvic splanchnic nerves (S2–S4) and hypogastric plexus
• C) Phrenic nerve (C3–C5)
• D) Vagus nerve
Correct Answer: B
Rationale: Sacral dysfunction affects parasympathetic outflow via S2–S4 (pelvic
, splanchnic nerves) and sympathetic fibers from the hypogastric plexus (T10–L2).
These innervate the uterus, adnexa, and pelvic vessels. Endometriosis pain often
has an autonomic component.
7. A 35-year-old G2P2, 8 weeks postpartum, presents with stress urinary
incontinence. On examination, she has weak pelvic floor muscles (Oxford grade
2/5). Which OMT is most appropriate initially?
• A) Lumbar HVLA
• B) Pelvic floor myofascial release followed by graded strengthening
• C) Cranial sacral flexion
• D) Thoracic pump
Correct Answer: B
Rationale: Stress incontinence with pelvic floor weakness requires myofascial
release to address any hypertonic restrictions, followed by strengthening. HVLA (A)
is not specific; cranial (C) and thoracic (D) do not target the pelvic floor.
8. A 29-year-old G1P0 at 34 weeks gestation presents with right round ligament
pain. Which anatomical course guides OMT for this condition?
• A) From sacrum to ischial spine
• B) From right uterine cornu through inguinal canal to labium majus
• C) From xiphoid to pubis
• D) From iliac crest to greater trochanter
Correct Answer: B
Rationale: The round ligament originates at the uterine cornu, passes through the
inguinal canal, and inserts on the labium majus. Myofascial release should follow
this course. Option A describes uterosacral ligaments.
Complete Exam-Style Questions | Detailed Rationales –
Pass Guaranteed – A+ Graded
Osteopathic Principles and Practice in Obstetrics &
Gynecology – Practice Exam
1. A 32-year-old G2P1 at 28 weeks gestation presents with low back pain worse on
the right. Examination reveals a right posterior innominate rotation. Which
osteopathic manipulative treatment (OMT) position is safest and most
appropriate?
• A) Prone with a pelvic cushion
• B) Side-lying with the left side down
• C) Supine flat without wedge
• D) Standing with HVLA
Correct Answer: B
Rationale: After 20 weeks, prone positioning risks aortocaval compression and
reduced placental perfusion. Side-lying avoids compression and allows safe
treatment of the innominate. Supine flat (C) also risks compression; standing HVLA
(D) is unsafe and impractical.
2. A 28-year-old G0 with primary dysmenorrhea has a tender Chapman’s reflex at
the right pubic tubercle. This finding suggests viscerosomatic involvement of
which structure?
• A) Right kidney
, • B) Right ovary
• C) Appendix
• D) Right ureter
Correct Answer: B
Rationale: Anterior Chapman’s reflexes for the ovaries are located at the pubic
tubercles, ipsilateral. Right pubic tubercle tenderness suggests right ovarian reflex
activity, which may contribute to dysmenorrhea.
3. A 34-year-old G3P3 at 36 weeks gestation presents with pubic symphysis pain
and a waddling gait. Palpation reveals mild widening of the symphysis. What is the
most likely diagnosis?
• A) Osteitis pubis
• B) Symphysis pubis dysfunction (diastasis)
• C) Stress fracture
• D) Hip osteoarthritis
Correct Answer: B
Rationale: Symphysis pubis dysfunction is common in late pregnancy due to
relaxin-mediated ligamentous laxity. Presentation includes anterior pelvic pain,
waddling gait, and tenderness over the symphysis. Osteitis pubis (A) is typically
postpartum and inflammatory.
4. A 30-year-old G1P0 at 32 weeks gestation presents with left-sided sciatica. MRI
shows no disc herniation. Examination reveals left piriformis spasm. Which OMT is
most appropriate?
• A) Prone HVLA to L5–S1
• B) Side-lying left piriformis release (muscle energy or positional release)
, • C) Cranial sacral flexion
• D) Lumbar thrust in prone
Correct Answer: B
Rationale: Piriformis syndrome in pregnancy is common. Side-lying MET or
positional release is safe and effective. Prone positioning (A, D) is contraindicated
after the first trimester. Cranial technique (C) is not specific to piriformis.
5. Which of the following osteopathic techniques is most effective for reducing
uterine congestion and pelvic pain in a patient with dysmenorrhea?
• A) Thoracic lymphatic pump
• B) Pelvic diaphragm release and sacral rocking
• C) Cervical myofascial release
• D) High-velocity lumbar thrust
Correct Answer: B
Rationale: Pelvic diaphragm release and sacral rocking improve venous and
lymphatic drainage from pelvic viscera, reducing congestion. Thoracic pump (A)
affects upper body; cervical (C) and thrust (D) are not specific to pelvic congestion.
6. A 26-year-old G0 with chronic pelvic pain and endometriosis has a diagnosis of
sacral torsion (right on left). Which autonomic nerves are most likely affected?
• A) Thoracic sympathetic (T1–T4)
• B) Pelvic splanchnic nerves (S2–S4) and hypogastric plexus
• C) Phrenic nerve (C3–C5)
• D) Vagus nerve
Correct Answer: B
Rationale: Sacral dysfunction affects parasympathetic outflow via S2–S4 (pelvic
, splanchnic nerves) and sympathetic fibers from the hypogastric plexus (T10–L2).
These innervate the uterus, adnexa, and pelvic vessels. Endometriosis pain often
has an autonomic component.
7. A 35-year-old G2P2, 8 weeks postpartum, presents with stress urinary
incontinence. On examination, she has weak pelvic floor muscles (Oxford grade
2/5). Which OMT is most appropriate initially?
• A) Lumbar HVLA
• B) Pelvic floor myofascial release followed by graded strengthening
• C) Cranial sacral flexion
• D) Thoracic pump
Correct Answer: B
Rationale: Stress incontinence with pelvic floor weakness requires myofascial
release to address any hypertonic restrictions, followed by strengthening. HVLA (A)
is not specific; cranial (C) and thoracic (D) do not target the pelvic floor.
8. A 29-year-old G1P0 at 34 weeks gestation presents with right round ligament
pain. Which anatomical course guides OMT for this condition?
• A) From sacrum to ischial spine
• B) From right uterine cornu through inguinal canal to labium majus
• C) From xiphoid to pubis
• D) From iliac crest to greater trochanter
Correct Answer: B
Rationale: The round ligament originates at the uterine cornu, passes through the
inguinal canal, and inserts on the labium majus. Myofascial release should follow
this course. Option A describes uterosacral ligaments.
