10 exam-style questions with answers and explanations, straight from our 1,030-question bank. Tap an answer to check yourself. When you're ready, take the scored version in the free practice test.
These 10 free COP questions are organized by exam domain, so you can see how each part of the Certification in Orofacial Pain (COP) blueprint is tested. Reveal the answer and explanation under each question.
Domain 1: Neurovascular Disorders
Question 1
A 14-year-old has had eight headaches over five months. Each untreated episode lasts about three hours and causes bilateral frontotemporal throbbing, nausea, and avoidance of stairs because movement worsens the pain. She has no preceding visual, sensory, or language symptoms. Neurological and funduscopic examinations are normal. Mild temporalis tenderness does not reproduce her headache, and chewing does not modify it. Which diagnosis fits her age and attack pattern?
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Correct answer: A - Migraine without aura
Question 2
During an active cluster period, a 61-year-old with established cluster headache develops his usual severe orbital pain, ipsilateral tearing, and agitation. The attack began ten minutes ago and typically lasts about an hour. He has ischemic coronary artery disease and a previous myocardial infarction. Which treatment is appropriate to abort this attack?
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Correct answer: C - Give 100% oxygen by nonrebreather mask at 15 L/min for 15 minutes.
Question 3
At an orofacial pain consultation, a 73-year-old describes a new temporal headache, scalp tenderness, and jaw aching that appears after several minutes of chewing and resolves with rest. Earlier today, vision in one eye briefly became gray. There is a longstanding painless TMJ click. ESR and CRP are within the laboratory's reference ranges. Which action is time-critical?
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Correct answer: A - Arrange emergency assessment and glucocorticoid treatment without awaiting temporal artery biopsy.
Domain 2: Neuropathic Disorders
Question 4
An appropriately performed cranial MRI in a patient with recurrent, touch-triggered, severe electric shocks lasting 15 seconds in the left maxillary division of the trigeminal nerve shows an artery touching the trigeminal root. There is no root displacement or atrophy, demyelinating plaque, mass, or other causative lesion. The neurological examination is normal. What can be concluded about the vascular finding?
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Correct answer: D - Contact without morphological root change does not establish classical trigeminal neuralgia.
Question 5
Four months after removal of a right mandibular third molar, a patient reports persistent burning of the right lower lip and chin, with occasional shocks when the skin is brushed. Symptoms began within days of the procedure, during which an inferior alveolar nerve injury was documented. Examination shows reduced pinprick sensation and brush-evoked pain in the same territory, without edema, color or temperature asymmetry, sweating changes, or trophic abnormalities. Which diagnosis integrates these findings?
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Correct answer: D - Painful post-traumatic trigeminal neuropathy
Domain 3: Musculoskeletal Disorders (Masticatory and cervical)
Question 6
For six weeks, a patient has felt an ache over the right masseter and mandibular molars after prolonged chewing. Comparative pulp sensibility tests, percussion, bite testing, periodontal probing, and periapical radiographs reveal no explanatory dental finding. Five seconds of right masseter palpation reproduces the familiar muscle pain and molar ache, beyond the muscle's anatomical boundary. TMJ palpation is painless. How is this provoked pain classified under DC/TMD?
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Correct answer: C - Myofascial pain with referral
Question 7
An adult previously experienced closed locking severe enough to interfere with eating. Opening has improved, but current MRI still demonstrates a disc that does not reduce. The maximum unassisted interincisal gap is 34 mm, the maximum assisted gap is 38 mm, and positive vertical incisal overlap is 5 mm. Which entry correctly applies the adult DC/TMD opening criterion to this disc displacement without reduction?
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Correct answer: A - 43 mm total assisted opening; without limited opening
Question 8
A reproducible TMJ click is noticed during a routine examination. The patient reports that it has been present for years, without pain, locking, or difficulty eating. Opening is unrestricted, there is no crepitus or familiar pain on provocation, and the occlusion is stable. The patient asks whether treatment is needed to prevent future joint damage. What should be recommended?
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Correct answer: C - Explain the finding and observe without treatment directed at the click.
Domain 4: Behavioral Sciences
Question 9
An adult's Graded Chronic Pain Scale version 2 assessment (30-day recall) gives a characteristic pain intensity of 40/100, an interference score of 60/100, and four disability days. Which overall grade follows from these results?
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Correct answer: B - Grade III, because the combined disability point total is 4.
Domain 5: Pathoses, Sleep Disorders and Pain
Question 10
The respiratory summary from an adult's diagnostic polysomnogram lists 48 apneas and 96 hypopneas, all obstructive. Time in bed was 8.0 hours, but EEG-confirmed total sleep time was 4.0 hours. All listed events satisfy the laboratory's scoring criteria. Which apnea-hypopnea index and adult severity classification belong in the report?
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Correct answer: B - 36 events/hour; severe obstructive sleep apnea
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