COMLEX LEVEL 2 ONE LINERS EXAM
QUESTIONS AND ANSWERS
Zenker's Diverticulum: Si/Sx? Dx? Tx? - Correct Answers -Si/Sx: Dysphagia, Halitosis,
Regurgitation of
Undigested Food, Throat Clearing, Neck Mass
Dx: Barium Swallow
Tx: Myotomy of Cricopharyngeus +/- Diverticulectomy
Cervical Cancer Screening - Correct Answers -- Pap smears start at age 21
- Age 21-30: Pap q3Y
- Age 30 - 69: Pap q3Y OR Pap + HPV test q5Y
- Age 70: DC if 3 consecutive (-) and no abnormal paps in last 10 years
Breast Cancer Screening - Correct Answers -Mammography q2Y starting at age 50
(USPSTF) or 40 (ACOG)
STD Screening - Correct Answers -- GC and CHL for all sexually active non-pregnant
women 24 y/o and younger
- HIV for all individuals 15-65 y/o
What is a Boxer's Fracture? - Correct Answers -Fracture of the shaft of the 5th
metacarpal
What is Galeazzi's Fracture? - Correct Answers -Diaphyseal fracture of the radius with
derangement of the radioulnar joint (tx: ORIF, cast in supination)
What is Colle's Fracture? - Correct Answers -Dorsally displaced fracture of the distal
radius
What is a Nightstick Fracture? - Correct Answers -Fracture of the shaft of the ulna
Colorectal Cancer Screening - Correct Answers -- Start at 50
- FOBTx3 q1Y OR Sigmoidoscopy q5Y OR Colonoscopy q10Y
- Previous polyp: q3Y until clear, then q5Y
- Previous colon ca: 1Y after resection, then 3Y, then 5Y
- FH in single family member: 10 years earlier than age of dx or age 40
- HNPCC: start at 25, q1-2Y
- FAP: start at 12, q1Y
,AAA Screening - Correct Answers -Men ages 65-75 who have ever smoked should
undergo a one-time abdominal U/S
Guidelines for Pneumovax - Correct Answers -All persons aged 65 y/o and older should
receive a one time pneumococcal vaccination
Booster is recommended if the pt received the vaccine >=5 years previously and was
age <65y/o at time of vaccination
*One time dose for Diabetic patients at time of diagnosis
Adult vaccines - Correct Answers -- Influenza annually for all people over 6 mos
- TDaP once after 11 y/o, Td booster q 10 yrs
- VZV at 60 y/o
Mgmt of pt with FAP - Correct Answers -Total Colectomy (100% risk of developing
colonic adenocarcinoma)
COMQUEST tool for Visceral Innervation - Correct Answers -S 5-9
L 6-9
P 5-11
S 9-11
K 10-11
B 11-2
L 11-2
Counterstrain Technique - Correct Answers -1. Locate and Palpate TP
2. Place pt in position of optimal comfort (SHORTEN the muscle)
3. Fine tune until 70% tenderness reduction
4. Maintain position for 90 seconds
5. Slowly return to neutral
6. Recheck TP (no more than 30% tenderness should remain)
Phases of Clinical Trails - Correct Answers -- I: Testing on a small number of healthy
volunteers to determine SE, metabolism, excretion etc
- II: Testing on a small number of pts suffering from the disease to be treated
- III: Large scale trial to test against placebo
- IV: After release; surveillance
RUQ pain, jaundice, ascites...Dx? Initial test? Diagnostic test? - Correct Answers -Budd-
Chiari Syndrome: thrombosis of hepatic vein or IVC
- DX: initially Ultrasound, Venography to confirm
- TX: Thrombolytics
Most common cause of Post-Partum Fever? - Correct Answers -Endometritis (will also
have uterine tenderness)
- TX: broad spectrum abx
,Contraindications for breast feeding - Correct Answers -- Mothers with HIV, untreated
TB, HSV lesions on breast, chemo, radioactive isotope administration
- Infants with galactosemia
- *Soy based formula instead
Supplementation for exclusively breast-fed infants - Correct Answers -- Vitamin D: 400
IU daily soon after birth
- Iron: 1 mg/lg oral starting at 4 months
Woman is exclusively breast feeding, present with pain in breast...shiny skin of nipple
with peeling at the areola...likely organism? - Correct Answers -Candida albicans
Woman presents with straw colored discharge from nipple...likely dx? - Correct Answers
-Intraductal papilloma
Mgmt of Lobular Carcinoma In Situ - Correct Answers -Observation
Mgmt of Ductal Carcinoma In Situ - Correct Answers -Excision with post op Radiation
Mgmt of Invasive Lobular/Ductal Ca. - Correct Answers -Lumpectomy + Sentinal LN Bx
+ post op Radiation
Procedures requiring IE PPX - Correct Answers -Procedures involving:
- Respiratory tract
- Major dental work
- Infected skin, tissues just under skin, musculoskeletal tissue
Who gets IE PPX? - Correct Answers -- Artificial heart valve or heart valve repaired with
articificial material
- History of endocarditis
- Heart transplant with abnormal heart fx
- Unrepaired cyanotic congenital heart dz
Thrust of Rib HVLA - Correct Answers -For Inhaled Ribs: directly downwards
For Exhaled Ribs: 45 degrees cephalad
How to Dx BPPV - Correct Answers -Dix-Hallpike Maneuver
How to Tx BPPV - Correct Answers -Epley Maneuver
Intussusception: Dx? Tx? - Correct Answers -Dx: Ultrasound in non-classic
presentations
Tx: Pneumatic Enema
Sx of Opioid withdrawal - Correct Answers -Lacrimation, Rhinorrhea
, Sx of Cocaine/Amphetamine withdrawal - Correct Answers -Dysphoria, Excessive
Sleep, Hunger
Sx of Alcohol withdrawal - Correct Answers -Seizure
What is the most appropriate initial test for Urolithiasis - Correct Answers -Ultrasound
What is the most sensitive and specific test for Urolithiasis - Correct Answers -Non-
contrast Helical CT
Causes of Transitional Cell Carcinoma - Correct Answers -"Pee SAC"
- Phenacetin
- Smoking
- Aniline Dyes
- Cyclophosphamide
Initial diagnostic test for Boerhaave's Syndrome - Correct Answers -CXR →
pneumomediastinum
Tx for Boerhaave's Syndrome - Correct Answers -Contained Perf: NPO, NG suction, IV
fluids, IV abx
Free Perf: Surgery
MEN I - Correct Answers -3 Ps: Pancreatic, Parathyroid, Pituitary Tumors
MEN IIa - Correct Answers -1 M 2 Ps: Medullary Thyroid Ca, Pheochromocytoma,
Parathyroid Tumors
MEN IIb - Correct Answers -2 Ms 1 P: Medullary Thyroid Ca, Pheochromocytoma,
Marfanoid Habitus/Mucosal Neuromas
Pt presents with a thyroid nodule... - Correct Answers -1. Order TSH
2. If normal/high → FNA
If low → Scintigraphy
3. Hypofunctional → Surgery
Female of reproductive age who has been using OCPs has a hepatic tumor. Likely dx? -
Correct Answers -Hepatic Adenoma
- Benign, associated with OCPs, anabolic steroids, and glycogen storage dz
- Surgical resection if symptomatic
Female of reproductive age has a hepatic tumor with a central scar on imaging. Dx?
Tx? - Correct Answers -Focal Nodular Hyperplasia
NOT associated with OCPs
No further management required
QUESTIONS AND ANSWERS
Zenker's Diverticulum: Si/Sx? Dx? Tx? - Correct Answers -Si/Sx: Dysphagia, Halitosis,
Regurgitation of
Undigested Food, Throat Clearing, Neck Mass
Dx: Barium Swallow
Tx: Myotomy of Cricopharyngeus +/- Diverticulectomy
Cervical Cancer Screening - Correct Answers -- Pap smears start at age 21
- Age 21-30: Pap q3Y
- Age 30 - 69: Pap q3Y OR Pap + HPV test q5Y
- Age 70: DC if 3 consecutive (-) and no abnormal paps in last 10 years
Breast Cancer Screening - Correct Answers -Mammography q2Y starting at age 50
(USPSTF) or 40 (ACOG)
STD Screening - Correct Answers -- GC and CHL for all sexually active non-pregnant
women 24 y/o and younger
- HIV for all individuals 15-65 y/o
What is a Boxer's Fracture? - Correct Answers -Fracture of the shaft of the 5th
metacarpal
What is Galeazzi's Fracture? - Correct Answers -Diaphyseal fracture of the radius with
derangement of the radioulnar joint (tx: ORIF, cast in supination)
What is Colle's Fracture? - Correct Answers -Dorsally displaced fracture of the distal
radius
What is a Nightstick Fracture? - Correct Answers -Fracture of the shaft of the ulna
Colorectal Cancer Screening - Correct Answers -- Start at 50
- FOBTx3 q1Y OR Sigmoidoscopy q5Y OR Colonoscopy q10Y
- Previous polyp: q3Y until clear, then q5Y
- Previous colon ca: 1Y after resection, then 3Y, then 5Y
- FH in single family member: 10 years earlier than age of dx or age 40
- HNPCC: start at 25, q1-2Y
- FAP: start at 12, q1Y
,AAA Screening - Correct Answers -Men ages 65-75 who have ever smoked should
undergo a one-time abdominal U/S
Guidelines for Pneumovax - Correct Answers -All persons aged 65 y/o and older should
receive a one time pneumococcal vaccination
Booster is recommended if the pt received the vaccine >=5 years previously and was
age <65y/o at time of vaccination
*One time dose for Diabetic patients at time of diagnosis
Adult vaccines - Correct Answers -- Influenza annually for all people over 6 mos
- TDaP once after 11 y/o, Td booster q 10 yrs
- VZV at 60 y/o
Mgmt of pt with FAP - Correct Answers -Total Colectomy (100% risk of developing
colonic adenocarcinoma)
COMQUEST tool for Visceral Innervation - Correct Answers -S 5-9
L 6-9
P 5-11
S 9-11
K 10-11
B 11-2
L 11-2
Counterstrain Technique - Correct Answers -1. Locate and Palpate TP
2. Place pt in position of optimal comfort (SHORTEN the muscle)
3. Fine tune until 70% tenderness reduction
4. Maintain position for 90 seconds
5. Slowly return to neutral
6. Recheck TP (no more than 30% tenderness should remain)
Phases of Clinical Trails - Correct Answers -- I: Testing on a small number of healthy
volunteers to determine SE, metabolism, excretion etc
- II: Testing on a small number of pts suffering from the disease to be treated
- III: Large scale trial to test against placebo
- IV: After release; surveillance
RUQ pain, jaundice, ascites...Dx? Initial test? Diagnostic test? - Correct Answers -Budd-
Chiari Syndrome: thrombosis of hepatic vein or IVC
- DX: initially Ultrasound, Venography to confirm
- TX: Thrombolytics
Most common cause of Post-Partum Fever? - Correct Answers -Endometritis (will also
have uterine tenderness)
- TX: broad spectrum abx
,Contraindications for breast feeding - Correct Answers -- Mothers with HIV, untreated
TB, HSV lesions on breast, chemo, radioactive isotope administration
- Infants with galactosemia
- *Soy based formula instead
Supplementation for exclusively breast-fed infants - Correct Answers -- Vitamin D: 400
IU daily soon after birth
- Iron: 1 mg/lg oral starting at 4 months
Woman is exclusively breast feeding, present with pain in breast...shiny skin of nipple
with peeling at the areola...likely organism? - Correct Answers -Candida albicans
Woman presents with straw colored discharge from nipple...likely dx? - Correct Answers
-Intraductal papilloma
Mgmt of Lobular Carcinoma In Situ - Correct Answers -Observation
Mgmt of Ductal Carcinoma In Situ - Correct Answers -Excision with post op Radiation
Mgmt of Invasive Lobular/Ductal Ca. - Correct Answers -Lumpectomy + Sentinal LN Bx
+ post op Radiation
Procedures requiring IE PPX - Correct Answers -Procedures involving:
- Respiratory tract
- Major dental work
- Infected skin, tissues just under skin, musculoskeletal tissue
Who gets IE PPX? - Correct Answers -- Artificial heart valve or heart valve repaired with
articificial material
- History of endocarditis
- Heart transplant with abnormal heart fx
- Unrepaired cyanotic congenital heart dz
Thrust of Rib HVLA - Correct Answers -For Inhaled Ribs: directly downwards
For Exhaled Ribs: 45 degrees cephalad
How to Dx BPPV - Correct Answers -Dix-Hallpike Maneuver
How to Tx BPPV - Correct Answers -Epley Maneuver
Intussusception: Dx? Tx? - Correct Answers -Dx: Ultrasound in non-classic
presentations
Tx: Pneumatic Enema
Sx of Opioid withdrawal - Correct Answers -Lacrimation, Rhinorrhea
, Sx of Cocaine/Amphetamine withdrawal - Correct Answers -Dysphoria, Excessive
Sleep, Hunger
Sx of Alcohol withdrawal - Correct Answers -Seizure
What is the most appropriate initial test for Urolithiasis - Correct Answers -Ultrasound
What is the most sensitive and specific test for Urolithiasis - Correct Answers -Non-
contrast Helical CT
Causes of Transitional Cell Carcinoma - Correct Answers -"Pee SAC"
- Phenacetin
- Smoking
- Aniline Dyes
- Cyclophosphamide
Initial diagnostic test for Boerhaave's Syndrome - Correct Answers -CXR →
pneumomediastinum
Tx for Boerhaave's Syndrome - Correct Answers -Contained Perf: NPO, NG suction, IV
fluids, IV abx
Free Perf: Surgery
MEN I - Correct Answers -3 Ps: Pancreatic, Parathyroid, Pituitary Tumors
MEN IIa - Correct Answers -1 M 2 Ps: Medullary Thyroid Ca, Pheochromocytoma,
Parathyroid Tumors
MEN IIb - Correct Answers -2 Ms 1 P: Medullary Thyroid Ca, Pheochromocytoma,
Marfanoid Habitus/Mucosal Neuromas
Pt presents with a thyroid nodule... - Correct Answers -1. Order TSH
2. If normal/high → FNA
If low → Scintigraphy
3. Hypofunctional → Surgery
Female of reproductive age who has been using OCPs has a hepatic tumor. Likely dx? -
Correct Answers -Hepatic Adenoma
- Benign, associated with OCPs, anabolic steroids, and glycogen storage dz
- Surgical resection if symptomatic
Female of reproductive age has a hepatic tumor with a central scar on imaging. Dx?
Tx? - Correct Answers -Focal Nodular Hyperplasia
NOT associated with OCPs
No further management required
