Page 1 of 190
Family Medicine COMAT ACTUAL EXAM 2026-2027
COMPLETE 350 QUESTIONS AND VERIFIED
SOLUTIONS LATEST UPDATE THIS YEAR
Family Medicine COMAT Exam
FINAL EXAMINATION
Academic Year: 2026–2027
Exam Title: Family Medicine COMAT Examination
Content: Multiple-Choice Questions with Verified Solutions
Edition: Latest Update This Year
EXAMINATION INSTRUCTIONS
This examination evaluates knowledge of common adult and pediatric presentations,
preventive care, obstetrics, urology, endocrinology, and infectious disease management.
Each question has four or five answer choices. Select the single best answer.
Rationales are provided to reinforce clinical reasoning and evidence-based management
strategies.
Answer all questions based on current guidelines and standard clinical practice.
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EXAM COVERAGE
• Endocrinology: hyperthyroidism
• Dermatology: onychomycosis
• Infectious disease: catheter-associated urinary tract infections
• Obstetrics: first and second trimester complications
• Gynecology: miscarriage risk factors
• Preventive care: preconception assessment and asymptomatic bacteriuria
EXAM QUESTIONS
Question 1
A 56-year-old female complains of palpitations and an unintentional 20 lb weight loss in the
past six months. History reveals menopause 7 years ago. Vital signs: BP 135/85, HR 110.
Physical exam: non-tender enlarged thyroid without nodules. Labs: TSH 0.05, free T3 380, free
T4 22. Thyroid stimulating immunoglobulin positive. The most appropriate initial management
is:
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A) Levothyroxine
B) Methimazole
C) Propylthiouracil
D) Radioactive iodine ablation
E) Thyroidectomy
Correct Answer:
B) Methimazole
Rationale:
Although several therapies are available for Graves’ disease (methimazole, propylthiouracil,
radioactive iodine, surgery), methimazole is first-line due to its safety profile and lower
hepatotoxicity risk compared to propylthiouracil.
Question 2
A 66-year-old female presents with a discolored, brittle right great toenail noticed 4 months
ago. Exam: yellowed, thickened nail with white subungual debris. The most appropriate
modality to confirm diagnosis is:
A) Bacterial culture of nail clippings
B) Culture of toenail scrapings on Sabouraud's medium
C) Histopathologic examination of nail clippings under periodic acid-Schiff stain
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D) Microscopic evaluation of toenail scrapings using KOH prep
E) One month terbinafine trial
Correct Answer:
D) Microscopic evaluation of toenail scrapings using KOH prep
Rationale:
The most likely diagnosis is onychomycosis. KOH prep is fast, cost-effective, and first-line for
confirming fungal elements. Culture or PAS staining can be used if KOH is inconclusive.
Question 3
A 70-year-old female, 3 days post-urologic surgery with a Foley catheter, develops fever
102.2°F. Exam: mild suprapubic tenderness, tender nodule lateral to umbilicus. Urinalysis: WBC
60/hpf, leukocyte esterase +, nitrites +, no casts. Reflex culture: motile gram-negative rods with
dark green appearance and fruity odor. Most appropriate pharmacologic therapy:
A) Amoxicillin
B) Cefotaxime
C) Ceftriaxone
D) Ciprofloxacin
E) Trimethoprim-sulfamethoxazole
Family Medicine COMAT ACTUAL EXAM 2026-2027
COMPLETE 350 QUESTIONS AND VERIFIED
SOLUTIONS LATEST UPDATE THIS YEAR
Family Medicine COMAT Exam
FINAL EXAMINATION
Academic Year: 2026–2027
Exam Title: Family Medicine COMAT Examination
Content: Multiple-Choice Questions with Verified Solutions
Edition: Latest Update This Year
EXAMINATION INSTRUCTIONS
This examination evaluates knowledge of common adult and pediatric presentations,
preventive care, obstetrics, urology, endocrinology, and infectious disease management.
Each question has four or five answer choices. Select the single best answer.
Rationales are provided to reinforce clinical reasoning and evidence-based management
strategies.
Answer all questions based on current guidelines and standard clinical practice.
,Page 2 of 190
EXAM COVERAGE
• Endocrinology: hyperthyroidism
• Dermatology: onychomycosis
• Infectious disease: catheter-associated urinary tract infections
• Obstetrics: first and second trimester complications
• Gynecology: miscarriage risk factors
• Preventive care: preconception assessment and asymptomatic bacteriuria
EXAM QUESTIONS
Question 1
A 56-year-old female complains of palpitations and an unintentional 20 lb weight loss in the
past six months. History reveals menopause 7 years ago. Vital signs: BP 135/85, HR 110.
Physical exam: non-tender enlarged thyroid without nodules. Labs: TSH 0.05, free T3 380, free
T4 22. Thyroid stimulating immunoglobulin positive. The most appropriate initial management
is:
,Page 3 of 190
A) Levothyroxine
B) Methimazole
C) Propylthiouracil
D) Radioactive iodine ablation
E) Thyroidectomy
Correct Answer:
B) Methimazole
Rationale:
Although several therapies are available for Graves’ disease (methimazole, propylthiouracil,
radioactive iodine, surgery), methimazole is first-line due to its safety profile and lower
hepatotoxicity risk compared to propylthiouracil.
Question 2
A 66-year-old female presents with a discolored, brittle right great toenail noticed 4 months
ago. Exam: yellowed, thickened nail with white subungual debris. The most appropriate
modality to confirm diagnosis is:
A) Bacterial culture of nail clippings
B) Culture of toenail scrapings on Sabouraud's medium
C) Histopathologic examination of nail clippings under periodic acid-Schiff stain
, Page 4 of 190
D) Microscopic evaluation of toenail scrapings using KOH prep
E) One month terbinafine trial
Correct Answer:
D) Microscopic evaluation of toenail scrapings using KOH prep
Rationale:
The most likely diagnosis is onychomycosis. KOH prep is fast, cost-effective, and first-line for
confirming fungal elements. Culture or PAS staining can be used if KOH is inconclusive.
Question 3
A 70-year-old female, 3 days post-urologic surgery with a Foley catheter, develops fever
102.2°F. Exam: mild suprapubic tenderness, tender nodule lateral to umbilicus. Urinalysis: WBC
60/hpf, leukocyte esterase +, nitrites +, no casts. Reflex culture: motile gram-negative rods with
dark green appearance and fruity odor. Most appropriate pharmacologic therapy:
A) Amoxicillin
B) Cefotaxime
C) Ceftriaxone
D) Ciprofloxacin
E) Trimethoprim-sulfamethoxazole
