Family Medicine COMAT Exam Questions And
Answers A+ Graded
Treatment of infant with Hep B+ mom - ANSWER Hep B Ig within 12 hours of birth +
vaccination (prevents 90% of infection)
Adults at risk for Hep B - ANSWER Sexually-active persons w/ >1 partner in the last 6
months, persons seeking evaluation/treatment for a STD, current/recent IVDU, MSM,
health care and public safety workers exposed to blood or body fluids, ESRD, HIV,
chronic liver disease
Patients born between which years should be screened for HCV infection? - ANSWER
1945-1965
Varicella
Schedule
Contraindications - ANSWER 2 doses of vaccine are required, 4-8 weeks apart,
regardless of age; should not be given before 12 months
Non-immune pregnant women or immunocompromized should not receive the
vaccination until after delivery; household contacts of immunocompetent pregnant
women need not delay vaccination
Tdap schedule - ANSWER Recommended for adults 19-64 to replace the next booster
dose of tetanus; should be given to patients 65 years or older, regardless of interval
since most recent Td-containing vaccine
Td booster every 10 years
,Clean, minor wound + tetanus vaccination within 10 years - ANSWER Do nothing
Potentially contaminated wound + >5 years since vaccination - ANSWER Give booster
High risk wound + unimmunized - ANSWER Give tetanus Ig + vaccination
MMR contraindications - ANSWER Neomycin allergy
Live-attenuated vaccine = not for pregnant or immunocompromized patients
Wait 3 months if blood or Ig products given
Rubella vaccination contraindications - ANSWER Vaccination should not occur if
pregnant or planning pregnancy in next 4 weeks
If patient is currently pregnant and non-immune, she should be vaccinated early in
postpartum period
Meningitis vaccine schedule - ANSWER 2 doses of MCV4 recommended for adolescents
11 through 18 years of age; first dose at 11 or 12 years of age, with booster dose at age
16
Pneumococcal vaccine schedule - ANSWER PPSV23: adult vaccination indications =
chronic diseases, functional asplenia, residents of long-term care facilities
PCV13: infants and toddlers at 2, 4, 6 and 12-15 months
PPSV23 - ANSWER Adult vaccination = chronic diseases, functional asplenia, residents
of long-term care facilities
PCV13 - ANSWER For infants and toddlers at 2, 4, 6 and 12-15 months
,Pneumococcal polysaccharide vaccine - ANSWER >65 years old or <65 with chronic
medical conditions
2nd 5-year revaccination in patients with CKD, liver disease, immunodeficiency,
asplenia
Influenza vaccine effectiveness - ANSWER 30-90%
Influenza vaccination schedule - ANSWER Recommended for kids 6 months and older;
minimum age for live, attenuated vaccine is 2 years (do not give to immunocompromised
or those around them)
Administer 2 doses (separated by 4 weeks) to children 6 months - 8 years who are
receiving seasonal vaccine for the first time, or who were vaccinated for the 1st time
during the previous influenza season but only received 1 dose
Intranasal influenza vaccine contraindications - ANSWER Pregnant or
immunocompromised patients
Influenza vaccine contraindications - ANSWER Egg allergies
HPV vaccination - ANSWER Recommended for all women and men 9-26 years
Most effective if given before female becomes sexually active; can be administered
when patient has abnormal Pap or when breast-feeding
Not recommended for use during pregnancy
Herpes Zoster vaccination - ANSWER Recommended for those 60 or older regardless of
having prior episode of herpes zoster
, Colorectal cancer screening - ANSWER Screen with FOBT, sigmoidoscopy or
colonoscopy in adults beginning at age 50 and continuing until age 75
If family history, screen 10 years before cancer was found in the family member, or at 50
- whichever is sooner
Recommend against screening when >85 years
Breast imaging in women <30 - ANSWER Do not do a mammogram; do ultrasound
instead
Standard of care for all palpable breast masses in women >40 - ANSWER Biopsy
Mammogram schedule - ANSWER Every 2 years for women between ages 50-74
Cervical cancer screening indications - ANSWER Screen women age 21-65 via Pap
smear cytology every 3 years OR every 5 years via cytology + HPV testing starting at 30
Recommend against screening in women under 21
ACS recommends discontinuing at 70 but notes that a woman who has had 3 or more
normal Pap tests and non abnormal Pap tests in the last 10 years can safely stop
No screening in women who have had hysterectomy with cervix removal if no history of
high grade lesion
AAA screening - ANSWER One-time screening for AAA by ultrasonography in men aged
65-75 who have ever smoked
Not recommended for or against screening for AAA in men aged 65-75 who have never
Answers A+ Graded
Treatment of infant with Hep B+ mom - ANSWER Hep B Ig within 12 hours of birth +
vaccination (prevents 90% of infection)
Adults at risk for Hep B - ANSWER Sexually-active persons w/ >1 partner in the last 6
months, persons seeking evaluation/treatment for a STD, current/recent IVDU, MSM,
health care and public safety workers exposed to blood or body fluids, ESRD, HIV,
chronic liver disease
Patients born between which years should be screened for HCV infection? - ANSWER
1945-1965
Varicella
Schedule
Contraindications - ANSWER 2 doses of vaccine are required, 4-8 weeks apart,
regardless of age; should not be given before 12 months
Non-immune pregnant women or immunocompromized should not receive the
vaccination until after delivery; household contacts of immunocompetent pregnant
women need not delay vaccination
Tdap schedule - ANSWER Recommended for adults 19-64 to replace the next booster
dose of tetanus; should be given to patients 65 years or older, regardless of interval
since most recent Td-containing vaccine
Td booster every 10 years
,Clean, minor wound + tetanus vaccination within 10 years - ANSWER Do nothing
Potentially contaminated wound + >5 years since vaccination - ANSWER Give booster
High risk wound + unimmunized - ANSWER Give tetanus Ig + vaccination
MMR contraindications - ANSWER Neomycin allergy
Live-attenuated vaccine = not for pregnant or immunocompromized patients
Wait 3 months if blood or Ig products given
Rubella vaccination contraindications - ANSWER Vaccination should not occur if
pregnant or planning pregnancy in next 4 weeks
If patient is currently pregnant and non-immune, she should be vaccinated early in
postpartum period
Meningitis vaccine schedule - ANSWER 2 doses of MCV4 recommended for adolescents
11 through 18 years of age; first dose at 11 or 12 years of age, with booster dose at age
16
Pneumococcal vaccine schedule - ANSWER PPSV23: adult vaccination indications =
chronic diseases, functional asplenia, residents of long-term care facilities
PCV13: infants and toddlers at 2, 4, 6 and 12-15 months
PPSV23 - ANSWER Adult vaccination = chronic diseases, functional asplenia, residents
of long-term care facilities
PCV13 - ANSWER For infants and toddlers at 2, 4, 6 and 12-15 months
,Pneumococcal polysaccharide vaccine - ANSWER >65 years old or <65 with chronic
medical conditions
2nd 5-year revaccination in patients with CKD, liver disease, immunodeficiency,
asplenia
Influenza vaccine effectiveness - ANSWER 30-90%
Influenza vaccination schedule - ANSWER Recommended for kids 6 months and older;
minimum age for live, attenuated vaccine is 2 years (do not give to immunocompromised
or those around them)
Administer 2 doses (separated by 4 weeks) to children 6 months - 8 years who are
receiving seasonal vaccine for the first time, or who were vaccinated for the 1st time
during the previous influenza season but only received 1 dose
Intranasal influenza vaccine contraindications - ANSWER Pregnant or
immunocompromised patients
Influenza vaccine contraindications - ANSWER Egg allergies
HPV vaccination - ANSWER Recommended for all women and men 9-26 years
Most effective if given before female becomes sexually active; can be administered
when patient has abnormal Pap or when breast-feeding
Not recommended for use during pregnancy
Herpes Zoster vaccination - ANSWER Recommended for those 60 or older regardless of
having prior episode of herpes zoster
, Colorectal cancer screening - ANSWER Screen with FOBT, sigmoidoscopy or
colonoscopy in adults beginning at age 50 and continuing until age 75
If family history, screen 10 years before cancer was found in the family member, or at 50
- whichever is sooner
Recommend against screening when >85 years
Breast imaging in women <30 - ANSWER Do not do a mammogram; do ultrasound
instead
Standard of care for all palpable breast masses in women >40 - ANSWER Biopsy
Mammogram schedule - ANSWER Every 2 years for women between ages 50-74
Cervical cancer screening indications - ANSWER Screen women age 21-65 via Pap
smear cytology every 3 years OR every 5 years via cytology + HPV testing starting at 30
Recommend against screening in women under 21
ACS recommends discontinuing at 70 but notes that a woman who has had 3 or more
normal Pap tests and non abnormal Pap tests in the last 10 years can safely stop
No screening in women who have had hysterectomy with cervix removal if no history of
high grade lesion
AAA screening - ANSWER One-time screening for AAA by ultrasonography in men aged
65-75 who have ever smoked
Not recommended for or against screening for AAA in men aged 65-75 who have never
