COMLEX Level 1 QUESTIONS AND COMPLETE SOLUTIONS
cysteine stone - Correct 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 - Correct Answer most common cause of lower GI bleeding in pt's >60
superior mesenteric artery - Correct Answer supplies the lower portion of the duodenum, jejunum,
ileum, cecum, ascending colon, and transverse colon to the splenic flexure
pancreatic cancer - Correct 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 - Correct 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 - Correct 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 -
Correct 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 - Correct 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 - Correct Answer where would you find a viserosomatic reflex resulting in placatory changes of
the pancreas?
Deferoxamine (Desferal) - Correct Answer iron chelating agent used in the treatment of iron intoxication
short leg syndrome - Correct 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 - Correct
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 - Correct Answer Infarct to what trunk of the Left MCA results in Broca's aphasia?
Osteosarcoma - Correct Answer bone tumor that is present in young adult males that involves the
metaphysis of the long bones
Ewing's sarcoma t(11;22) - Correct Answer bone tumor that is present in young adult males that
involves the *diaphysis(mid-shaft)* of the long bones.
,fibrosarcoma - Correct Answer malignant fibroblasts within a collagenous matrix
chondrosarcoma - Correct 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 - Correct 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 - Correct Answer where does the posterior scalene attach to?
Paclitaxel - Correct 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 - Correct Answer maximum distance a patient can actually move a joint, can be
pathologic
narcissistic personality disorder - Correct 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 - Correct Answer what does a carotid
massage do and how does it affect the AV node?
Chronic myelogenous leukemia t(9;22)--> Philly chx - Correct 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) - Correct 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) - Correct 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) - Correct 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 - Correct Answer inhibits platelet aggregation by irreversibly blocking the P2Y12 component
of ADP receptors
Bacillus anthracis, tendonopathy - Correct 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 - Correct 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 - Correct 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 - Correct 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 - Correct Answer what are indirect OMM techniques?
Articulatory technique - Correct Answer OMM technique classified as low velocity, moderate to high
amplitude
