Family Medicine COMAT Questions And
100% Verified Answers Latest 2026
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B (the stem describes an abdominal aortic aneurysm with rupture - this
is most likely in patients with history of smoking, vasculitis,
hypertension, trauma, and family history - they are usually found in
patients between 65 and 70)
(according to the USPSTF, men who are 65-75 and who have ever
smoked should be screened at least once for abdominal aortic
aneurysm by abdominal ultrasonography) - correct answer -An elderly
patient presents to the office for a routine wellness examination.
Although a history is unremarkable, physical examination reveals a
pulsatile abdominal mass with ecchymoses around the umbilicus.
Which of the following has the highest risk for this patient's most likely
condition?
A. 62-year-old male with medically managed hypertension
B. 66-year-old male with a 5-pack-year smoking history
C. 67-year-old alcoholic female
D. 77-year-old male with uncontrolled diabetes mellitus type II
E. 78-year-old female with hypertriglyceridemia
,B (Goodpasture syndrome typically presents in a male patient in his mid
20s with hemoptysis and hematuria - renal biopsy will reveal linear anti-
glomerular basement membrane deposits) (A; Alport syndrome is a
hereditary form of glomerulonephritis classically associated with
deafness and basement membrane splitting on renal biopsy) (C; IgA
nephropathy may present as episodiec gross hematuria or persistent
microscopic hematuria - patients will not have pulmonary involvement)
(D; membranoproliferative nephropathy may be nephritic and/or
nephrotic - it may be associated with other conditions such as hepatitis
C, cryoglobulinemia, and autoimmune disorders, which are not present
in this patient - it also does not explain this patient's hemoptysis) (E;
although Wegener's granulomatosis would explain this patient's
hemoptysis and hematuria, it typically affects older patients - further,
although cANCA is present in Wegener's - correct answer -A 26-ear-old
Caucasian man presents to the emergency department after
experiencing one episode of blood-tinged sputum that day while
coughing. this episode was associated with chest pain that has not
resolved. He has been feeling fatigued for the past two weeks. During
this interval, his urine has become dark brown. He denies any recent
illnesses. He denies alcohol, tobacco, and recreational drug use. Vitals
reveal his temperature is 100F, pulse is 104, respiratory rate is 24, and
blood pressure is 144/88. Physical examination reveals his conjunctiva
are pale. He has 2+ pitting edema of the upper and lower extremities,
as well as periorbital edema. Respiratory examination reveals bilateral
inspiratory crackles over the lower lung fields. You note paravertebral
hypertonicity from T2-6 and T10-12 bilaterally that is ropy and tender to
,palpation. Chest radiograph reveals patchy bilateral pulmonary
opacities. Serum laboratory results are shown.
Sodium 139
Potassium 3.7
Chloride 109
Bicarbonate 25
BUN 38
Creatinine 2.5
Glucose 101
Calcium 9.9
Phosphate 2.9
Magnesium 1.5
A complete blood count is obtained as follows.
WBC 11,800
Hemoglobin 12.9
Hematocrit 37%
Platelets 179,000
MCV 78
, Follow up laboratory studies are positive for cytoplasmic
antineutrophilic cytoplasmic antibodies and perinuclear
antineutrophilic cytoplasmic antibodies. A urinalysis reveals a pH of 5.9,
specific gravity of 1.015, RBCs at 31/hpf, and numerous red blood cell
casts. The most likely diagnosis is
A. Alport syndrome
B. Goodpasture syndrome
C. IgA nephropathy
D. membranoproliferative nephropathy
E. Wegener's granulomatosis
D (aggressive fluid hydration is the most important step in acute
management of influenza) (A; amantadine is an antiviral that used to be
used for influenza A - however, due to increasing resistance, it is no
longer recommended) (B; the influenza vaccine should be avoided in
those with acute influenza) (C, E; since this patient presented after 72
hours with no high risk factors, neuraminidase inhibitors like oseltamivir
and zanamivir are not indicated in this patient) - correct answer -A 36-
year-old female presents in November with fever and chills with
associated nausea of four days duration. History reveals diffuse myalgias
and an intermittent headache moderately relieved with ibuprofen.
Associated symptoms include rhinorrhea with clear mucus discharge
100% Verified Answers Latest 2026
Update | Graded A+ | 100% Success
B (the stem describes an abdominal aortic aneurysm with rupture - this
is most likely in patients with history of smoking, vasculitis,
hypertension, trauma, and family history - they are usually found in
patients between 65 and 70)
(according to the USPSTF, men who are 65-75 and who have ever
smoked should be screened at least once for abdominal aortic
aneurysm by abdominal ultrasonography) - correct answer -An elderly
patient presents to the office for a routine wellness examination.
Although a history is unremarkable, physical examination reveals a
pulsatile abdominal mass with ecchymoses around the umbilicus.
Which of the following has the highest risk for this patient's most likely
condition?
A. 62-year-old male with medically managed hypertension
B. 66-year-old male with a 5-pack-year smoking history
C. 67-year-old alcoholic female
D. 77-year-old male with uncontrolled diabetes mellitus type II
E. 78-year-old female with hypertriglyceridemia
,B (Goodpasture syndrome typically presents in a male patient in his mid
20s with hemoptysis and hematuria - renal biopsy will reveal linear anti-
glomerular basement membrane deposits) (A; Alport syndrome is a
hereditary form of glomerulonephritis classically associated with
deafness and basement membrane splitting on renal biopsy) (C; IgA
nephropathy may present as episodiec gross hematuria or persistent
microscopic hematuria - patients will not have pulmonary involvement)
(D; membranoproliferative nephropathy may be nephritic and/or
nephrotic - it may be associated with other conditions such as hepatitis
C, cryoglobulinemia, and autoimmune disorders, which are not present
in this patient - it also does not explain this patient's hemoptysis) (E;
although Wegener's granulomatosis would explain this patient's
hemoptysis and hematuria, it typically affects older patients - further,
although cANCA is present in Wegener's - correct answer -A 26-ear-old
Caucasian man presents to the emergency department after
experiencing one episode of blood-tinged sputum that day while
coughing. this episode was associated with chest pain that has not
resolved. He has been feeling fatigued for the past two weeks. During
this interval, his urine has become dark brown. He denies any recent
illnesses. He denies alcohol, tobacco, and recreational drug use. Vitals
reveal his temperature is 100F, pulse is 104, respiratory rate is 24, and
blood pressure is 144/88. Physical examination reveals his conjunctiva
are pale. He has 2+ pitting edema of the upper and lower extremities,
as well as periorbital edema. Respiratory examination reveals bilateral
inspiratory crackles over the lower lung fields. You note paravertebral
hypertonicity from T2-6 and T10-12 bilaterally that is ropy and tender to
,palpation. Chest radiograph reveals patchy bilateral pulmonary
opacities. Serum laboratory results are shown.
Sodium 139
Potassium 3.7
Chloride 109
Bicarbonate 25
BUN 38
Creatinine 2.5
Glucose 101
Calcium 9.9
Phosphate 2.9
Magnesium 1.5
A complete blood count is obtained as follows.
WBC 11,800
Hemoglobin 12.9
Hematocrit 37%
Platelets 179,000
MCV 78
, Follow up laboratory studies are positive for cytoplasmic
antineutrophilic cytoplasmic antibodies and perinuclear
antineutrophilic cytoplasmic antibodies. A urinalysis reveals a pH of 5.9,
specific gravity of 1.015, RBCs at 31/hpf, and numerous red blood cell
casts. The most likely diagnosis is
A. Alport syndrome
B. Goodpasture syndrome
C. IgA nephropathy
D. membranoproliferative nephropathy
E. Wegener's granulomatosis
D (aggressive fluid hydration is the most important step in acute
management of influenza) (A; amantadine is an antiviral that used to be
used for influenza A - however, due to increasing resistance, it is no
longer recommended) (B; the influenza vaccine should be avoided in
those with acute influenza) (C, E; since this patient presented after 72
hours with no high risk factors, neuraminidase inhibitors like oseltamivir
and zanamivir are not indicated in this patient) - correct answer -A 36-
year-old female presents in November with fever and chills with
associated nausea of four days duration. History reveals diffuse myalgias
and an intermittent headache moderately relieved with ibuprofen.
Associated symptoms include rhinorrhea with clear mucus discharge
