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COMLEX Level 1 Exam with complete solutions 2024_2025
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COMLEX Level 1 Exam with complete solutions 2024_2025
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COMLEX Level 1 Exam with completesolutions 2024/2025
cysteine stone - ANSWER- - *Hexagonal* stones
- *Ground, glass appearance*
- *(+) urinary cyanide nitroprusside test
- Defect in renal transport of COLA: Cysteine, Ornithine, Lysine, Arginine
- Does NOT respond to shock wave therapy
angiodysplasia - ANSWER- most common cause of lower GI bleeding in pt's >60
superior mesenteric artery - ANSWER- supplies the lower portion of the
duodenum, jejunum, ileum, cecum, ascending colon, and transverse colon to the
splenic flexure
pancreatic cancer - ANSWER- -usually arises in the *head* of the pancreas
-is associated with *jaundice and pain* due to obstruction of the common bile
duct
- it is the *4th* most common cause of cancer
-has a very poor prognosis
1. Calcium channel blockers--> specifically smooth muscle antagonists--> SM
dilation
2. Alpha adrenergic receptor blockers --> cause dilation of vessels instead of
constriction
3. Beta 2 agonists: causes dilation of smooth muscle vessels - ANSWER- Patients
with GERD normally have a dysfunction with LES sphincter tone that allows acid
to reflux into the esophagus, thus drugs that affect sphincter tone would make
GERD worse. What are the name of three drug categories that do this?
celiac disease - ANSWER- malabsorption syndrome caused by an immune
reaction to gliadian protein in gluten
,-Tissue transglutaminase
-results in villous atrophy of small intestine mucosa and causes steatorrhea,
diarrhea, bloating and abdominal pain
-*also associated with other autoimmune disorders like hashimotos thyroiditis*
make NPO, Place on an NG tube and suction obstruction out--> this will usually
resolve obstruction - ANSWER- after a patient comes to the ER with sudden onset
of pain and abdominal distention W/O peritoneal signs and after x-ray you
diagnose her with a small bowel obstruction. What do you do next?
Low total calcium due to low albumin levels from cirrhosis (95% of Ca2+ is bound
to albumin) and normal ionized Ca2+ because PTH regulates free ionized Ca2+
independently--> that is why there are no signs go hypocalcemia - ANSWER- In a
patient with liver cirrhosis what calcium levels would you expect to see?
Would there be signs of hypocalcemia--> tetany, paresthesias, abdominal
cramps?
T5-T11 - ANSWER- where would you find a viserosomatic reflex resulting in
placatory changes of the pancreas?
Deferoxamine (Desferal) - ANSWER- iron chelating agent used in the treatment of
iron intoxication
short leg syndrome - ANSWER- when a patient presents with a flexible scoliotic
curve it is important to evaluate for...
inferior trunk--> encompasses broadmann areas 22,39,40 which are in the
temporal region - ANSWER- Infarct to what trunk of the Left MCA results in
Wernicke's aphasia?
Superior division--> encompasses brooks area, frontal eye field, primary motor
cortex and primary somatosensory cortex - ANSWER- Infarct to what trunk of the
Left MCA results in Broca's aphasia?
Osteosarcoma - ANSWER- bone tumor that is present in young adult males that
involves the metaphysis of the long bones
Ewing's sarcoma t(11;22) - ANSWER- bone tumor that is present in young adult
males that involves the *diaphysis(mid-shaft)* of the long bones.
,fibrosarcoma - ANSWER- malignant fibroblasts within a collagenous matrix
chondrosarcoma - ANSWER- osseous sarcomas that affect older patients and
has a predilection for flat bones in the *shoulders and pelvis*
tyrosine, due to a defect in phenylalanine hydroxylase - ANSWER- PKU presents
as failure to thrive, mental retardation, gapped teeth, etc. What is the amino acid
that needs to be supplemented due to a defect in what enzyme?
Rib 2 - ANSWER- where does the posterior scalene attach to?
Paclitaxel - ANSWER- used in the treatment of breast and ovarian cancer
MOA: hyper stabilization of polymerized microtubules--> prevents the breakdown
of the mitotic spindle
restrictive barrier - ANSWER- maximum distance a patient can actually move a
joint, can be pathologic
narcissistic personality disorder - ANSWER- patterns of grandiosity, need for
admiration, lack of empathy for others
A carotid massage causes an increase in stretch of the carotid baroreceptors
which causes a reflexive PARASYM response which slows down the conduction
velocity through the AV node this slowing down Heart Rate--> used in paroxysmal
supra ventricular tachycardia - ANSWER- what does a carotid massage do and
how does it affect the AV node?
Chronic myelogenous leukemia t(9;22)--> Philly chx - ANSWER- a form of
leukemia characterized by the accumulation of abnormal, mature granulocytes
(granulocytes are a type of white blood cell), mild anemia, thrombocytosis and
basophilia. What is the associated chromosomal translocation?
Burkitt's lymphoma t(8;14) - ANSWER- germinal B celll lymphoma that is
associated with a translocation between c-MYC and the Ig heavy chain on which
two chromosomes? It is endemic in the continent of Africa which produces this
follicular lymphoma t(14;18) - ANSWER- second most common lymphoma in the
US, arises from germinal center B-cells. Presents with painless peripheral
lymphadenopathy w/ a history of lymph node enlargement . Positive for CD 10,
CD 19 and CD 20 expression. Results in what chromosomal translocation
evolving the BCL-2 gene?
, Acute promyelocytic leukemia t(15;17) - ANSWER- PML/RARA fusion gene
associated with DIC, characteristic folded, bilobed nuclei are found in these
certain type of cells. Coarse azurorophilic granules and multiple Auer rods are
also present on histo
Clopidogrel - ANSWER- inhibits platelet aggregation by irreversibly blocking the
P2Y12 component of ADP receptors
Bacillus anthracis, tendonopathy - ANSWER- textile industry worker that
develops a low-grade fever, non-productive cough and substernal chest pain
have what bug? Treatment is with a fluroquinolone and why are frequently
associated with what ADR?
G-6-PD deficiency - ANSWER- X-linked recessive disorder present in AAs and
Mediterraneans that cause an inability to generate reduced glutathione and lead
to acute hemolysis when stress occurs. You will see bite cells and Heinz bodies
on peripheral blood smear.
Itranuclear opthalmoplegia - ANSWER- seen in those with MS, causes impaired
horizontal eye movement w/ weak adduction of the affected eye and abduction
nystagmus of the contralateral eye. Due to a lesion in the MLF in the dorsomedial
brainstem tegmentum of wither the pons or the midbrain
lead poisoning - ANSWER- causes lethargy, seizures, or coma--> can also
develop distal motor neuropathies.
-leads to denaturation of the enzyme ribonuclease which causes ribosomes to
persist in the the RBCs and lead to basophilic stippling
myofasical release, BLT, FPR, counterstain - ANSWER- what are indirect OMM
techniques?
Articulatory technique - ANSWER- OMM technique classified as low velocity,
moderate to high amplitude
pericarditis - ANSWER- EKG presents with PR depression, ST segment elevation
and PR elevation in lead II. They also have sharp, midsternal, non-radiating chest
pain and mild lethargy. What do they have?
Bottom rib in ISD/ Top rib in ESD - ANSWER- BITE mnemonic is used for rib
dysfunction treatments, what is it?
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