COMAT
SURGERY
Examination Practice Questions
2026/2027 Edition
Verified Answers Plus Rationales
Q&A; | Instant Download PDF
EXAM SPECIFICATIONS
Time Allocation: 2.5 Hours
Total Questions: 125 Questions
Question Format: Multiple Choice with Rationales
Minimum Competency: Passing per NBOME Standards
Core Focus: General Surgery, Trauma, Surgical Subspecialties, OMT
COMAT Surgery Exam Prep 2026/2027 Page 1
, Exam Overview & Content Outline
EXAM PURPOSE
This COMAT Surgery Examination Prep validates knowledge required for osteopathic medical
students on surgery rotations. Content covers general surgery principles, trauma, surgical
subspecialties, and perioperative care per NBOME COMAT Subject Examination standards with
osteopathic integration.
CONTENT DISTRIBUTION
• General Surgery & Surgical Principles (25%) — Preop/postop care, wound healing, surgical
infection, fluid/electrolytes, shock, nutrition
• Trauma & Acute Care Surgery (20%) — ATLS, head/chest/abdomen trauma, burns, shock,
damage control surgery
• GI Surgery (20%) — Acute abdomen, appendicitis, cholecystitis, bowel obstruction, hernias, GI
bleeding, colorectal
• Vascular, Thoracic & Cardiac (15%) — Aortic aneurysm, peripheral vascular disease, DVT/PE,
thoracic surgery basics
• Surgical Subspecialties (20%) — Urology, orthopedics, neurosurgery, ENT, plastics, pediatric
surgery, oncology, OMT applications
QUESTION FORMAT & SCORING
Each item presents four options. Correct answers are highlighted in green with checkmark (✓).
Every question includes detailed rationale with surgical principles and osteopathic considerations.
COMAT uses scaled scoring.
STUDY STRATEGY
Master surgical anatomy and pathophysiology. Know trauma algorithms (ATLS), common surgical
emergencies, and indications for surgery. Understand OMT applications pre/post-op. Use rationales
for clinical reasoning.
CURRICULUM ALIGNMENT
Questions reflect 2026/2027 standards: NBOME COMAT Surgery blueprint, Sabiston Textbook of
Surgery, ATLS guidelines, ACS principles, and osteopathic manipulative medicine integration.
COMAT Surgery Exam Prep 2026/2027 Page 2
, SECTION I: General Surgery & Surgical Principles
1. The most common cause of postoperative fever in the first 24 hours is:
A. Wound infection
✓ B. Atelectasis
C. Urinary tract infection
D. Deep vein thrombosis
Rationale: Post-op fever timing: Wind (atelectasis/pneumonia 24-48h), Water (UTI 3-5d), Wound (5-7d),
Walking (DVT 7-10d), Wonder drugs. Atelectasis most common first 24-48h due to shallow breathing.
2. A patient 3 days post-op with fever, abdominal pain, and elevated WBC. Most likely cause:
A. Atelectasis
✓ B. Anastomotic leak or abscess
C. Pulmonary embolism
D. Medication reaction
Rationale: Day 3-5 post-op fever with abdominal pain suggests intra-abdominal infection: anastomotic leak,
abscess. Atelectasis is day 1-2. PE presents with hypoxia/tachycardia. Get CT scan.
3. Primary survey in trauma (ATLS) follows:
A. CABDE
✓ B. ABCDE: Airway, Breathing, Circulation, Disability, Exposure
C. SAMPLE history
D. GCS assessment first
Rationale: ATLS primary survey: A-airway with C-spine, B-breathing, C-circulation with hemorrhage control,
D-disability (neuro), E-exposure/environment. Treat life threats as found. SAMPLE is history.
4. Hypovolemic shock Class III blood loss is:
A. <15% (<750mL)
✓ B. 30-40% (1500-2000mL)
C. 15-30% (750-1500mL)
D. >40% (>2000mL)
Rationale: Class I: <15% minimal vitals change. Class II: 15-30% tachycardia. Class III: 30-40% tachycardia,
tachypnea, hypotension, confusion. Class IV: >40% severe shock.
5. Indications for damage control surgery in trauma include:
A. Stable vitals
✓ B. Hypothermia, acidosis, coagulopathy (lethal triad)
C. Isolated extremity injury
D. Minor laceration
Rationale: Damage control for lethal triad: temp <35°C, pH <7.2, coagulopathy. Abbreviated laparotomy,
pack, close, ICU resuscitation, return to OR. Not for stable or isolated injuries.
COMAT Surgery Exam Prep 2026/2027 Page 3
SURGERY
Examination Practice Questions
2026/2027 Edition
Verified Answers Plus Rationales
Q&A; | Instant Download PDF
EXAM SPECIFICATIONS
Time Allocation: 2.5 Hours
Total Questions: 125 Questions
Question Format: Multiple Choice with Rationales
Minimum Competency: Passing per NBOME Standards
Core Focus: General Surgery, Trauma, Surgical Subspecialties, OMT
COMAT Surgery Exam Prep 2026/2027 Page 1
, Exam Overview & Content Outline
EXAM PURPOSE
This COMAT Surgery Examination Prep validates knowledge required for osteopathic medical
students on surgery rotations. Content covers general surgery principles, trauma, surgical
subspecialties, and perioperative care per NBOME COMAT Subject Examination standards with
osteopathic integration.
CONTENT DISTRIBUTION
• General Surgery & Surgical Principles (25%) — Preop/postop care, wound healing, surgical
infection, fluid/electrolytes, shock, nutrition
• Trauma & Acute Care Surgery (20%) — ATLS, head/chest/abdomen trauma, burns, shock,
damage control surgery
• GI Surgery (20%) — Acute abdomen, appendicitis, cholecystitis, bowel obstruction, hernias, GI
bleeding, colorectal
• Vascular, Thoracic & Cardiac (15%) — Aortic aneurysm, peripheral vascular disease, DVT/PE,
thoracic surgery basics
• Surgical Subspecialties (20%) — Urology, orthopedics, neurosurgery, ENT, plastics, pediatric
surgery, oncology, OMT applications
QUESTION FORMAT & SCORING
Each item presents four options. Correct answers are highlighted in green with checkmark (✓).
Every question includes detailed rationale with surgical principles and osteopathic considerations.
COMAT uses scaled scoring.
STUDY STRATEGY
Master surgical anatomy and pathophysiology. Know trauma algorithms (ATLS), common surgical
emergencies, and indications for surgery. Understand OMT applications pre/post-op. Use rationales
for clinical reasoning.
CURRICULUM ALIGNMENT
Questions reflect 2026/2027 standards: NBOME COMAT Surgery blueprint, Sabiston Textbook of
Surgery, ATLS guidelines, ACS principles, and osteopathic manipulative medicine integration.
COMAT Surgery Exam Prep 2026/2027 Page 2
, SECTION I: General Surgery & Surgical Principles
1. The most common cause of postoperative fever in the first 24 hours is:
A. Wound infection
✓ B. Atelectasis
C. Urinary tract infection
D. Deep vein thrombosis
Rationale: Post-op fever timing: Wind (atelectasis/pneumonia 24-48h), Water (UTI 3-5d), Wound (5-7d),
Walking (DVT 7-10d), Wonder drugs. Atelectasis most common first 24-48h due to shallow breathing.
2. A patient 3 days post-op with fever, abdominal pain, and elevated WBC. Most likely cause:
A. Atelectasis
✓ B. Anastomotic leak or abscess
C. Pulmonary embolism
D. Medication reaction
Rationale: Day 3-5 post-op fever with abdominal pain suggests intra-abdominal infection: anastomotic leak,
abscess. Atelectasis is day 1-2. PE presents with hypoxia/tachycardia. Get CT scan.
3. Primary survey in trauma (ATLS) follows:
A. CABDE
✓ B. ABCDE: Airway, Breathing, Circulation, Disability, Exposure
C. SAMPLE history
D. GCS assessment first
Rationale: ATLS primary survey: A-airway with C-spine, B-breathing, C-circulation with hemorrhage control,
D-disability (neuro), E-exposure/environment. Treat life threats as found. SAMPLE is history.
4. Hypovolemic shock Class III blood loss is:
A. <15% (<750mL)
✓ B. 30-40% (1500-2000mL)
C. 15-30% (750-1500mL)
D. >40% (>2000mL)
Rationale: Class I: <15% minimal vitals change. Class II: 15-30% tachycardia. Class III: 30-40% tachycardia,
tachypnea, hypotension, confusion. Class IV: >40% severe shock.
5. Indications for damage control surgery in trauma include:
A. Stable vitals
✓ B. Hypothermia, acidosis, coagulopathy (lethal triad)
C. Isolated extremity injury
D. Minor laceration
Rationale: Damage control for lethal triad: temp <35°C, pH <7.2, coagulopathy. Abbreviated laparotomy,
pack, close, ICU resuscitation, return to OR. Not for stable or isolated injuries.
COMAT Surgery Exam Prep 2026/2027 Page 3
