COMLEX LEVEL 3 EXAM 2025 UPDATE/PRACTICE
QUESTIONS AND CORRECT VERIFIED ANSWERS
(complete solutions) ASSURED SUCCESS/GRADED A+!!!
Thyroid changes during pregnancy - CORRECT ANSWER-increased estrogen ->
increased thyroid binding globulin ->
- increased total and bound T4 and T3 (due to increased TBG-binding)
hCG similar to TSH- may act as thyroid simulator which may slightly decrease TSH
Free thyroxine remains unchanged
Most sensitive test for C.diff - CORRECT ANSWER-stool culture
First line treatment of C. diff - CORRECT ANSWER-oral vancomycin (or
fidaxomicin)
can use metronidazole if vanco or fidaxomicin not available
Kid with fever, odynophagia, dysphagia, trismus, neck pain, torticollis, muffled
voice, midline swelling of posterior pharynx, respiratory distress with recent
,infection of middle ear/nasopharynx/paranasal sinuses. Dx? - CORRECT
ANSWER-retropharyngeal abscess
Sudden onset of drooling, dysphagia, distress.
(Tripoding, non-immunized; fever, stridor, muffled voice). Dx? - CORRECT
ANSWER-epiglottitis
Imaging test of choice for suspected retropharyngeal abscess - CORRECT
ANSWER-contrast-enhanced CT of neck = area of low attenuation surrounded by
enhanced ring
(helps differentiate from retropharyngeal cellulitis)
Tx retropharyngeal abscess - CORRECT ANSWER-IV clindamycin and ampicillin-
sulbactam
Surgical drainage if: failure to respond to antibiotics, airway compromise, very
large abscess
L5 mechanics in backwards sacral torsions - CORRECT ANSWER-Type II
mechanics
STRT - always towards the side of the deeper sulcus
Ex:
,Sidebending component of L5 is ALWAYS towards the side of ___ of the sacrum -
CORRECT ANSWER-side of the axis (in both forward and backward torsions)
Rotation is SAME in backwards torsions and OPPOSITE in neutral torsions
Site MCly affected by Crohn's disease - CORRECT ANSWER-distal ileum
Findings on colonoscopy in Crohn's disease - CORRECT ANSWER-granulomatous
lesions, transmural involvement, multiple non-connecting areas of inflammation
(skip lesions)
AMS, tinnitus, hyperventilation, tachycardia, nausea/vomiting, metabolic acidosis
(respiratory alkalosis). Dx? - CORRECT ANSWER-Salicylate overdose
Mixed primary metabolic acidosis and primary respiratory alkalosis
Tx of salicylate overdose - CORRECT ANSWER-sodium bicarbonate
--> alkalize the urine and promote excretion
Tachycardia, hypertension, agitation, psychosis, diaphoresis. Dx? - CORRECT
ANSWER-stimulant OD (eg, cocaine, amphetamine)
Tx: benzo
, Fomepizole is used to treat - CORRECT ANSWER-ethylene glycol or methanol
intoxication
Labs in polycythemia vera - CORRECT ANSWER-Elevated:
Hgb
Hct
Plt
leukocyte
Decreased:
EPO
Dx: headaches, vertigo, pruritus after shower, signs of thrombosis - CORRECT
ANSWER-polycythemia vera
Caused by mutation of JAK2 gene
Post exposure prophylaxis for roommate with Neisseria meningitidis - CORRECT
ANSWER-rifampin
Odds ratio - CORRECT ANSWER-(a/b)/(c/d)= (ad)/(bd)
QUESTIONS AND CORRECT VERIFIED ANSWERS
(complete solutions) ASSURED SUCCESS/GRADED A+!!!
Thyroid changes during pregnancy - CORRECT ANSWER-increased estrogen ->
increased thyroid binding globulin ->
- increased total and bound T4 and T3 (due to increased TBG-binding)
hCG similar to TSH- may act as thyroid simulator which may slightly decrease TSH
Free thyroxine remains unchanged
Most sensitive test for C.diff - CORRECT ANSWER-stool culture
First line treatment of C. diff - CORRECT ANSWER-oral vancomycin (or
fidaxomicin)
can use metronidazole if vanco or fidaxomicin not available
Kid with fever, odynophagia, dysphagia, trismus, neck pain, torticollis, muffled
voice, midline swelling of posterior pharynx, respiratory distress with recent
,infection of middle ear/nasopharynx/paranasal sinuses. Dx? - CORRECT
ANSWER-retropharyngeal abscess
Sudden onset of drooling, dysphagia, distress.
(Tripoding, non-immunized; fever, stridor, muffled voice). Dx? - CORRECT
ANSWER-epiglottitis
Imaging test of choice for suspected retropharyngeal abscess - CORRECT
ANSWER-contrast-enhanced CT of neck = area of low attenuation surrounded by
enhanced ring
(helps differentiate from retropharyngeal cellulitis)
Tx retropharyngeal abscess - CORRECT ANSWER-IV clindamycin and ampicillin-
sulbactam
Surgical drainage if: failure to respond to antibiotics, airway compromise, very
large abscess
L5 mechanics in backwards sacral torsions - CORRECT ANSWER-Type II
mechanics
STRT - always towards the side of the deeper sulcus
Ex:
,Sidebending component of L5 is ALWAYS towards the side of ___ of the sacrum -
CORRECT ANSWER-side of the axis (in both forward and backward torsions)
Rotation is SAME in backwards torsions and OPPOSITE in neutral torsions
Site MCly affected by Crohn's disease - CORRECT ANSWER-distal ileum
Findings on colonoscopy in Crohn's disease - CORRECT ANSWER-granulomatous
lesions, transmural involvement, multiple non-connecting areas of inflammation
(skip lesions)
AMS, tinnitus, hyperventilation, tachycardia, nausea/vomiting, metabolic acidosis
(respiratory alkalosis). Dx? - CORRECT ANSWER-Salicylate overdose
Mixed primary metabolic acidosis and primary respiratory alkalosis
Tx of salicylate overdose - CORRECT ANSWER-sodium bicarbonate
--> alkalize the urine and promote excretion
Tachycardia, hypertension, agitation, psychosis, diaphoresis. Dx? - CORRECT
ANSWER-stimulant OD (eg, cocaine, amphetamine)
Tx: benzo
, Fomepizole is used to treat - CORRECT ANSWER-ethylene glycol or methanol
intoxication
Labs in polycythemia vera - CORRECT ANSWER-Elevated:
Hgb
Hct
Plt
leukocyte
Decreased:
EPO
Dx: headaches, vertigo, pruritus after shower, signs of thrombosis - CORRECT
ANSWER-polycythemia vera
Caused by mutation of JAK2 gene
Post exposure prophylaxis for roommate with Neisseria meningitidis - CORRECT
ANSWER-rifampin
Odds ratio - CORRECT ANSWER-(a/b)/(c/d)= (ad)/(bd)
