COMLEX LEVEL 2 EXAM WITH CORRECT
ACTUAL QUESTIONS AND CORRECTLY
WELL DEFINED ANSWERS LATEST 2025-
2026 ALREADY GRADED A+
Pt w/ CNS depression, respiratory/cardiac arrest and "almond-like odor in
breath" - likely toxicity; tx - ANSWERS-Cyanide; amyl nitrite
TCA overdose - antagonizes which receptors? - ANSWERS-α-1 adrenergic,
muscarinic ACh, histamine
,Quinidine toxicity - causes what; tx? - ANSWERS-Torsade de pointes &
cinchonism (tinnitus, flushed skin, CNS disturbance); IV magnesium
Seizure vs. syncope - good question to differentiate the two? - ANSWERS-Did
the pt lose bladder control? (yes for seizure, usu. tonic-clonic)
6 month old w/ CMV infection - characteristic findings? - ANSWERS-Hearing loss
& cerebral calcifications
23 y.o. @ 33 weeks gestation develops eclampsia, seized a few minutes ago - tx?
- ANSWERS-Airway management, IV magnesium sulfate, induce vaginal delivery,
betamethasone (for fetal lung development, fetus < 34 weeks)
16 y.o. female undergoes D&C for missed abortion, 2 days later vaginal bleeding
and abdominal pain, BP105/70, T 100.5, P105, R18, cervix dilated 2 cm w/
uterine tenderness - tx? - ANSWERS-Antibiotics and D&C (septic abortion, may
have retained products of conception)
Pt's dog bit him - tx? - ANSWERS-Irrigate w/ saline
ALS - dx test? - ANSWERS-EMG (confirms lower motor neuron lesions, r/o
myasthenia gravis, MS, carpal tunnel, Guillain-Barre)
Spinal stenosis - initial test; most accurate test; tx that provides long-term
relief? - ANSWERS-X-ray; MRI; weight loss
,Pseudomembranous colitis - fastest test to establish dx? - ANSWERS-
Proctoscopy (C difficile toxin ELISA usu. takes 24 hrs for results)
Pt w/ sickle cell anemia is getting 3 units PRBC, 30 min after initiation of
transfusion develops chills, mild SOB, T101 - dx; tx? - ANSWERS-Non-hemolytic
febrile reaction (most common reaction, 2/2 reaction of recipient to donor
WBCs); use leukocyte washed blood products
Blood transfusion results in acute hemolytic reaction due to ABO incompatibility
- physical findings? - ANSWERS-Fever, flank pain, red/brown urine (Hb in
urine...tx IV fluids to protect kidneys)
Pt is non-compliant with her medicine, has altered mental status for past 2
hours, T96.2, BP90/60, R6, sugar is normal - which med caused it: propranolol,
levothyroxine, spironolactone, insulin, hydrocortisone? - ANSWERS-
Levothyroxine (myxedema coma is a complication of hypothyroidism and is
often fatal...tx IV T3 and/or T4 plus IV hydrocortisone)
Trousseau's sign - cause; what is it? - ANSWERS-Hypocalcemia; blood pressure
cuff on the arm causes carpopedal spasms
Ovarian tumor causing virilization? - ANSWERS-Sertoli-Leydig cell tumor
(androgen-secreting)
, Sudden pruritic rash on palms and soles, no meds - causative organism; name of
rash? - ANSWERS-Herpes simplex virus; erythema multiforme minor
Erythema multiforme major - name of syndrome; usual cause; which bug
causes; difference between minor? - ANSWERS-Stevens-Johnson syndrome;
medications; mycoplasma pneumonia; mucous membrane ulceration w/ target
lesions
Non-pruritic macules on palms and soles - most likely dx? - ANSWERS-Secondary
syphilis
[OMM] T9 ESL - setup for Muscle Energy? - ANSWERS-Flex, sidebend R, rotate R
Labyrinthitis - tx? - ANSWERS-Corticosteroids
Meniere's dz - acute tx; chronic tx? - ANSWERS-Benzodiazepine or meclizine;
diuretic & low salt
Acute sinusitis - days after which bacterial concern > viral; supportive tx
options? - ANSWERS-10 days; antihistamine, saline spray, NSAIDS,
decongestants
Rhabdomyolysis - initial tx; likely metabolic disturbance and screening test; tx to
reduce renal failure after initial step? - ANSWERS-IV hydration; hyperkalemia
check EKG; IV NaHCO3 to alkalinize urine
ACTUAL QUESTIONS AND CORRECTLY
WELL DEFINED ANSWERS LATEST 2025-
2026 ALREADY GRADED A+
Pt w/ CNS depression, respiratory/cardiac arrest and "almond-like odor in
breath" - likely toxicity; tx - ANSWERS-Cyanide; amyl nitrite
TCA overdose - antagonizes which receptors? - ANSWERS-α-1 adrenergic,
muscarinic ACh, histamine
,Quinidine toxicity - causes what; tx? - ANSWERS-Torsade de pointes &
cinchonism (tinnitus, flushed skin, CNS disturbance); IV magnesium
Seizure vs. syncope - good question to differentiate the two? - ANSWERS-Did
the pt lose bladder control? (yes for seizure, usu. tonic-clonic)
6 month old w/ CMV infection - characteristic findings? - ANSWERS-Hearing loss
& cerebral calcifications
23 y.o. @ 33 weeks gestation develops eclampsia, seized a few minutes ago - tx?
- ANSWERS-Airway management, IV magnesium sulfate, induce vaginal delivery,
betamethasone (for fetal lung development, fetus < 34 weeks)
16 y.o. female undergoes D&C for missed abortion, 2 days later vaginal bleeding
and abdominal pain, BP105/70, T 100.5, P105, R18, cervix dilated 2 cm w/
uterine tenderness - tx? - ANSWERS-Antibiotics and D&C (septic abortion, may
have retained products of conception)
Pt's dog bit him - tx? - ANSWERS-Irrigate w/ saline
ALS - dx test? - ANSWERS-EMG (confirms lower motor neuron lesions, r/o
myasthenia gravis, MS, carpal tunnel, Guillain-Barre)
Spinal stenosis - initial test; most accurate test; tx that provides long-term
relief? - ANSWERS-X-ray; MRI; weight loss
,Pseudomembranous colitis - fastest test to establish dx? - ANSWERS-
Proctoscopy (C difficile toxin ELISA usu. takes 24 hrs for results)
Pt w/ sickle cell anemia is getting 3 units PRBC, 30 min after initiation of
transfusion develops chills, mild SOB, T101 - dx; tx? - ANSWERS-Non-hemolytic
febrile reaction (most common reaction, 2/2 reaction of recipient to donor
WBCs); use leukocyte washed blood products
Blood transfusion results in acute hemolytic reaction due to ABO incompatibility
- physical findings? - ANSWERS-Fever, flank pain, red/brown urine (Hb in
urine...tx IV fluids to protect kidneys)
Pt is non-compliant with her medicine, has altered mental status for past 2
hours, T96.2, BP90/60, R6, sugar is normal - which med caused it: propranolol,
levothyroxine, spironolactone, insulin, hydrocortisone? - ANSWERS-
Levothyroxine (myxedema coma is a complication of hypothyroidism and is
often fatal...tx IV T3 and/or T4 plus IV hydrocortisone)
Trousseau's sign - cause; what is it? - ANSWERS-Hypocalcemia; blood pressure
cuff on the arm causes carpopedal spasms
Ovarian tumor causing virilization? - ANSWERS-Sertoli-Leydig cell tumor
(androgen-secreting)
, Sudden pruritic rash on palms and soles, no meds - causative organism; name of
rash? - ANSWERS-Herpes simplex virus; erythema multiforme minor
Erythema multiforme major - name of syndrome; usual cause; which bug
causes; difference between minor? - ANSWERS-Stevens-Johnson syndrome;
medications; mycoplasma pneumonia; mucous membrane ulceration w/ target
lesions
Non-pruritic macules on palms and soles - most likely dx? - ANSWERS-Secondary
syphilis
[OMM] T9 ESL - setup for Muscle Energy? - ANSWERS-Flex, sidebend R, rotate R
Labyrinthitis - tx? - ANSWERS-Corticosteroids
Meniere's dz - acute tx; chronic tx? - ANSWERS-Benzodiazepine or meclizine;
diuretic & low salt
Acute sinusitis - days after which bacterial concern > viral; supportive tx
options? - ANSWERS-10 days; antihistamine, saline spray, NSAIDS,
decongestants
Rhabdomyolysis - initial tx; likely metabolic disturbance and screening test; tx to
reduce renal failure after initial step? - ANSWERS-IV hydration; hyperkalemia
check EKG; IV NaHCO3 to alkalinize urine
