COMLEX-USA LEVEL 3 EXAMINATION QUESTIONS
AND CORRECT ANSWER WITH DETAILED
EXPLANATION GRADED A+ STUDY GUIDE FOR
OSTEOPATHIC MEDICAL STUDENT
1. A 55-year-old with HTN presents for routine follow-up. Best first-line long-term
medication?
A. ACE inhibitor
B. NSAID
C. Steroid
D. Loop diuretic
Answer: A
ACE inhibitors are first-line for HTN, especially with renal/cardiac protection.
2. A postpartum woman has heavy bleeding and a boggy uterus. Next step?
A. Methylergonovine
B. Warfarin
C. Heparin
D. Observation
Answer: A
Uterine atony treated with uterotonics.
3. Elderly patient with confusion, constipation, urinary retention, dry skin. Likely drug?
A. SSRI
B. Anticholinergic
C. Beta blocker
D. ACE inhibitor
Answer: B
Anticholinergic toxicity causes classic symptoms.
4. Best screening test for colon cancer?
A. FOBT
B. Colonoscopy
C. CT scan
D. MRI
, Answer: B
Colonoscopy is gold standard screening.
5. A patient refuses blood transfusion due to religion. Physician should?
A. Override consent
B. Respect autonomy
C. Call police
D. Sedate patient
Answer: B
Respect patient autonomy in competent adults.
6. First-line for type 2 diabetes?
A. Insulin
B. Metformin
C. Sulfonylurea
D. GLP-1 agonist
Answer: B
Metformin improves insulin sensitivity.
7. A patient with chronic NSAID use develops epigastric pain. Cause?
A. GERD
B. Gastric ulcer
C. IBS
D. Pancreatitis
Answer: B
NSAIDs inhibit prostaglandins.
8. Best initial step in chest pain evaluation in ER?
A. Troponin
B. ECG
C. CT scan
D. MRI
Answer: B
ECG within 10 minutes.
9. Elderly with hip fracture prevention?
A. Calcium + vitamin D
B. Steroids
C. NSAIDs
D. Antibiotics
, Answer: A
Prevents osteoporosis.
10. A patient has painless hematuria. Next step?
A. Antibiotics
B. Cystoscopy
C. Observation
D. KUB X-ray
Answer: B
Rule out bladder cancer.
11. Most appropriate vaccine in elderly?
A. MMR
B. Pneumococcal
C. Varicella
D. HPV
Answer: B
Prevents pneumonia.
12. A diabetic foot ulcer with necrosis requires?
A. Oral antibiotics only
B. Surgical debridement
C. No treatment
D. Steroids
Answer: B
Remove necrotic tissue.
13. Patient with jaundice, RUQ pain, fever?
A. Cholecystitis
B. Ascending cholangitis
C. Hepatitis A
D. Pancreatitis
Answer: B
Charcot triad.
14. First-line HTN drug in pregnancy?
A. ACE inhibitors
B. Methyldopa
C. ARBs
D. Spironolactone
AND CORRECT ANSWER WITH DETAILED
EXPLANATION GRADED A+ STUDY GUIDE FOR
OSTEOPATHIC MEDICAL STUDENT
1. A 55-year-old with HTN presents for routine follow-up. Best first-line long-term
medication?
A. ACE inhibitor
B. NSAID
C. Steroid
D. Loop diuretic
Answer: A
ACE inhibitors are first-line for HTN, especially with renal/cardiac protection.
2. A postpartum woman has heavy bleeding and a boggy uterus. Next step?
A. Methylergonovine
B. Warfarin
C. Heparin
D. Observation
Answer: A
Uterine atony treated with uterotonics.
3. Elderly patient with confusion, constipation, urinary retention, dry skin. Likely drug?
A. SSRI
B. Anticholinergic
C. Beta blocker
D. ACE inhibitor
Answer: B
Anticholinergic toxicity causes classic symptoms.
4. Best screening test for colon cancer?
A. FOBT
B. Colonoscopy
C. CT scan
D. MRI
, Answer: B
Colonoscopy is gold standard screening.
5. A patient refuses blood transfusion due to religion. Physician should?
A. Override consent
B. Respect autonomy
C. Call police
D. Sedate patient
Answer: B
Respect patient autonomy in competent adults.
6. First-line for type 2 diabetes?
A. Insulin
B. Metformin
C. Sulfonylurea
D. GLP-1 agonist
Answer: B
Metformin improves insulin sensitivity.
7. A patient with chronic NSAID use develops epigastric pain. Cause?
A. GERD
B. Gastric ulcer
C. IBS
D. Pancreatitis
Answer: B
NSAIDs inhibit prostaglandins.
8. Best initial step in chest pain evaluation in ER?
A. Troponin
B. ECG
C. CT scan
D. MRI
Answer: B
ECG within 10 minutes.
9. Elderly with hip fracture prevention?
A. Calcium + vitamin D
B. Steroids
C. NSAIDs
D. Antibiotics
, Answer: A
Prevents osteoporosis.
10. A patient has painless hematuria. Next step?
A. Antibiotics
B. Cystoscopy
C. Observation
D. KUB X-ray
Answer: B
Rule out bladder cancer.
11. Most appropriate vaccine in elderly?
A. MMR
B. Pneumococcal
C. Varicella
D. HPV
Answer: B
Prevents pneumonia.
12. A diabetic foot ulcer with necrosis requires?
A. Oral antibiotics only
B. Surgical debridement
C. No treatment
D. Steroids
Answer: B
Remove necrotic tissue.
13. Patient with jaundice, RUQ pain, fever?
A. Cholecystitis
B. Ascending cholangitis
C. Hepatitis A
D. Pancreatitis
Answer: B
Charcot triad.
14. First-line HTN drug in pregnancy?
A. ACE inhibitors
B. Methyldopa
C. ARBs
D. Spironolactone
