Page 1 of 184
Family Medicine COMAT EXAM ALL 300
QUESTIONS AND CORRECT ANSWERS
LATEST UPDATE THIS YEAR
QUESTION: A 32-year-old G1P0 female at 16 weeks' gestation presents with vaginal bleeding.
History reveals she had pelvic inflammatory disease of unknown etiology prior to conception.
Pelvic examination reveals the cervical os to be closed. The most likely diagnosis is
A. complete abortion
B. incomplete abortion
C. inevitable abortion
D. partial abortion
E. threatened abortion - ANSWER-E (threatened abortion is used to describe any vaginal
bleeding that occurs within the first 20 weeks of pregnancy) (A; a complete abortion is when
the products of conception have completely evacuated the uterus and the cervical os is closed)
(B; an incomplete abortion is when the products of conception can be seen or palpated in the
cervical canal, and the cervical os is open) (C; an inevitable abortion is when the products of
conception can be seen or palpated within the uterus through the dilated cervical os) (D; partial
abortion is not an appropriate or defined medical term)
1
, Page 2 of 184
QUESTION: A 32-year-old G1P0 female at 16 weeks' gestation presents with vaginal bleeding.
History reveals she had pelvic inflammatory disease of unknown etiology prior to conception.
Pelvic examination reveals the cervical os to be closed. The patient ultimately has a miscarriage
and undergoes a successful dilation and curettage. You explain that she is likely to experience
another miscarriage because she has a history of
A. advanced maternal age
B. nulliparity
C. pelvic inflammatory disease
D. spontaneous abortion
E. uterine instrumentation - ANSWER-D (the most documented causes of miscarriages are
maternal age, history of previous miscarriage, and maternal smoking) (A; risk of miscarriage
according to maternal age is 20% for 35 years, 40% for 40 years, and 80% for 45 years) (B;
miscarriages can be related to increased gravidity but not nulliparity) (C; PID increases a
patient's risk for infertility, but not miscarriage unless there is an active infection) (E; there are
no studies to indicate that this is a significant contributor)
2
, Page 3 of 184
QUESTION: A 30-year-old female presents to the office for a health maintenance examination.
She states she feels healthy and wants a routine check as she is planning to become pregnant in
the near future. Physical exam is normal and osteopathic structural exam reveals only mild
anterior innominate rotation on the left without significant TART changes throughout the spine.
A urinalysis is obtained and dipstick reveals the following
Color: yellow
Specific gravity: 1.012
pH: 5.5
Blood: none
Protein: none
Glucose: none
Leukocyte esterase: none
Nitrite: none
Bacteria: occult
RBC: 2/hpf
WBC: 5/hpf
3
, Page 4 of 184
A follow-up urine culture is obtained revealing two different types of bacteria with 10^3
CFU/mL. The most likely diagnosis is
A. contaminated specimen
B. cystitis
C. pyelonephritis
D. pyuria
E. urinary tract infection - ANSWER-A (contamination of the specimen must be ruled out in a
patient with asymptomatic bacteriuria) (B, C, E; these diagnoses would likely have symptoms,
including dysuria, fever, suprapubic or costovertebral tenderness, as well as positive findings on
dipstick such as leukocyte esterase or nitrites) (D; pyuria is defined as 6-10 WBC/hpf)
QUESTION: A new mother presents with fever, chills and unilateral right breast pain. She has
been breastfeeding without complications since delivery two weeks ago. Physical examination
reveals right breast tenderness, erythema, swelling, and purulent nipple discharge. The most
appropriate recommendation and treatment is to
4
Family Medicine COMAT EXAM ALL 300
QUESTIONS AND CORRECT ANSWERS
LATEST UPDATE THIS YEAR
QUESTION: A 32-year-old G1P0 female at 16 weeks' gestation presents with vaginal bleeding.
History reveals she had pelvic inflammatory disease of unknown etiology prior to conception.
Pelvic examination reveals the cervical os to be closed. The most likely diagnosis is
A. complete abortion
B. incomplete abortion
C. inevitable abortion
D. partial abortion
E. threatened abortion - ANSWER-E (threatened abortion is used to describe any vaginal
bleeding that occurs within the first 20 weeks of pregnancy) (A; a complete abortion is when
the products of conception have completely evacuated the uterus and the cervical os is closed)
(B; an incomplete abortion is when the products of conception can be seen or palpated in the
cervical canal, and the cervical os is open) (C; an inevitable abortion is when the products of
conception can be seen or palpated within the uterus through the dilated cervical os) (D; partial
abortion is not an appropriate or defined medical term)
1
, Page 2 of 184
QUESTION: A 32-year-old G1P0 female at 16 weeks' gestation presents with vaginal bleeding.
History reveals she had pelvic inflammatory disease of unknown etiology prior to conception.
Pelvic examination reveals the cervical os to be closed. The patient ultimately has a miscarriage
and undergoes a successful dilation and curettage. You explain that she is likely to experience
another miscarriage because she has a history of
A. advanced maternal age
B. nulliparity
C. pelvic inflammatory disease
D. spontaneous abortion
E. uterine instrumentation - ANSWER-D (the most documented causes of miscarriages are
maternal age, history of previous miscarriage, and maternal smoking) (A; risk of miscarriage
according to maternal age is 20% for 35 years, 40% for 40 years, and 80% for 45 years) (B;
miscarriages can be related to increased gravidity but not nulliparity) (C; PID increases a
patient's risk for infertility, but not miscarriage unless there is an active infection) (E; there are
no studies to indicate that this is a significant contributor)
2
, Page 3 of 184
QUESTION: A 30-year-old female presents to the office for a health maintenance examination.
She states she feels healthy and wants a routine check as she is planning to become pregnant in
the near future. Physical exam is normal and osteopathic structural exam reveals only mild
anterior innominate rotation on the left without significant TART changes throughout the spine.
A urinalysis is obtained and dipstick reveals the following
Color: yellow
Specific gravity: 1.012
pH: 5.5
Blood: none
Protein: none
Glucose: none
Leukocyte esterase: none
Nitrite: none
Bacteria: occult
RBC: 2/hpf
WBC: 5/hpf
3
, Page 4 of 184
A follow-up urine culture is obtained revealing two different types of bacteria with 10^3
CFU/mL. The most likely diagnosis is
A. contaminated specimen
B. cystitis
C. pyelonephritis
D. pyuria
E. urinary tract infection - ANSWER-A (contamination of the specimen must be ruled out in a
patient with asymptomatic bacteriuria) (B, C, E; these diagnoses would likely have symptoms,
including dysuria, fever, suprapubic or costovertebral tenderness, as well as positive findings on
dipstick such as leukocyte esterase or nitrites) (D; pyuria is defined as 6-10 WBC/hpf)
QUESTION: A new mother presents with fever, chills and unilateral right breast pain. She has
been breastfeeding without complications since delivery two weeks ago. Physical examination
reveals right breast tenderness, erythema, swelling, and purulent nipple discharge. The most
appropriate recommendation and treatment is to
4
