COMLEX Level 3 Exam-Questions with 100%
Correct Answers
Describe the differences between Alcoholic Hallucinosis and Delirium Tremens
- Alcoholic Hallucinosis = occurs within 12-48 hrs after last drink resulting in hallucination, but
with NORMAL vitals
- Delirium Tremens = occurs 48-96 hrs (2-3 days) after last drink with psychomotor agitation,
tachycardia, hypertension, fever, and/or diaphoresis
What does the Superior Laryngeal Nerve innervate?
Cricothyroid Muscle
What innervates the vocal cords?
Recurrent Laryngeal Nerve
Headache with unilateral lacrimation
Cluster Headache
Aminoglycoside MOA, risks/side effects, and what an increase incidence of these risks?
- 30s subunit inhibitor
- Ototoxicity (hearing loss), Nephrotoxicity (acute tubular necrosis)
- Concurrent administration of loop diuretics increases risk of these side effects
6 laboratory findings in Primary Biliary Sclerosis (PBS)
1) Increased bilirubin
2) Increased cholesterol
3) Increased ALP
4) Increased GGT
5) Increased IgM
6) Positive anti-mitochondrial antibodies
,Treatment of PBS
Ursodeoxycholic Acid = decreases cholesterol content of bile and bile stones by reducing
secretion of cholesterol from the liver and the fractional reabsorption of cholesterol by the
intestines (MOA in PBC not clearly defined)
Duodenal atresia finding on ultrasound
Double bubble sign
What virus is associated with nasopharyngeal carcinoma?
What other disease is this virus associated with?
EBV; also, associated with Burkitt's Lymphoma (B-cell lymphoma)
What causes transient ST-elevation in contiguous or precordial leads?
What is the treatment?
- Prinzmetal Angina
- Tx: nitrates and CCBs
Vitamin C deficiency presentation and coagulation studies
- Scurvy = gingival hemorrhage and petechiae
- Normal PT, normal PTT, normal bleeding time, normal platelets
*NOTE: vitamin C = ascorbic acid
What protein in involved in Down's Syndrome associated Alzheimer's?
Protein involved in familial Alzheimer's?
- Down's Syndrome = Amyloid Precursor Gene
- Familial = Tau Protein
Best initial management for chemical burns with intact airway and stable patient
Copious irrigation with tap water followed by application of calcium gluconate gel
*NOTE: important to start IV with fluids, but has been shown that initial irrigation of burns has
better clinical outcome than starting fluids
,What electrolyte abnormality can Lisinopril cause? Why?
Hyperkalemia = inhibits ACE, which inhibits aldosterone release leading to hyperkalemia
*REMEMBER: aldosterone WASTES K+
Na+ low or high in DKA?
"Low" = pseudo-hyponatremia due to hyperglycemia pulling water out of cells
What can be caused by lithium use in an infant? What occurs?
What test is used to check this?
- Epstein's Anomaly = apical placement of the posterior and septal tricuspid valves ->
atrialization of the right ventricle
- Level-II Ultrasound = targeted scan/anatomy scan
What is a predictor of good response to medication in schizophrenia?
What are predictors of poor response to medication?
- Positive symptoms = "positive" response to meds (delusions, disordered patterns of thought,
tactile, auditory, visual, olfactory, or gustatory hallucinations
- Early age of onset, no precipitating stressor, and negative symptoms (5 A's = alogia, apathy,
asociality, avolution, and affect blunting)
What to r/o and what tests to order in patient presenting with enlarged prostate on PE
BMP to check kidney function and UA for infection
Name and describe the 5 types of abortion
- Incomplete = partial passage of products of conception (POC), therefore will need D&C
- Inevitable = uterine bleeding with cervical dilation and no passage of POC; management is
expectant
- Missed = fetus dies, but is retained within the uterus
- Complete = expulsion of all POC
- Threatened = passage of blood BEFORE 20 wks gestation, WITHOUT cervical dilation
, What causes vulva with wrinkled parchment-like paper appearance?
What are 3 other common presentations?
What can this progress to?
What are the 1st and 2nd line treatment and their MOA?
- Lichen Sclerosis et Atrophicus (LSA)
- Vulvar pruritus, dysuria, dysparunia
- Can progress to Squamous Cell Carcinoma
- 1st-line = Clobetasol (MOA = topical corticosteroid)
- 2nd-line = Tacrolimus (MOA = Calcineurin inhibitor)
5 lab findings in Klinefelter's Syndrome and why
1) Increased FSH (dysgenesis of Seminiferous Tubules -> decreased inhibin -> increased FSH)
2) Increased LH (abnormal Leydig Cell function -> decreased testosterone -> increased LH ->
increased estrogen)
3) Increased Gonadotropin (decreased testosterone -> increased gonadotropin)
4) Increased Estradiol (abnormal Leydig Cell function -> decreased testosterone -> increased LH
-> increased estrogen)
4) Decreased bone mineral density
Lidocaine with Epinephrine commercial dilution
1:100,000 - 1:400,000
What diseases is S. pneumoniae the most common cause of?
"MOPS"
Meningitis
Otitis media
Pneumonia (typical)
Sinusitis
Disease associated with Philadelphia chromosome
Correct Answers
Describe the differences between Alcoholic Hallucinosis and Delirium Tremens
- Alcoholic Hallucinosis = occurs within 12-48 hrs after last drink resulting in hallucination, but
with NORMAL vitals
- Delirium Tremens = occurs 48-96 hrs (2-3 days) after last drink with psychomotor agitation,
tachycardia, hypertension, fever, and/or diaphoresis
What does the Superior Laryngeal Nerve innervate?
Cricothyroid Muscle
What innervates the vocal cords?
Recurrent Laryngeal Nerve
Headache with unilateral lacrimation
Cluster Headache
Aminoglycoside MOA, risks/side effects, and what an increase incidence of these risks?
- 30s subunit inhibitor
- Ototoxicity (hearing loss), Nephrotoxicity (acute tubular necrosis)
- Concurrent administration of loop diuretics increases risk of these side effects
6 laboratory findings in Primary Biliary Sclerosis (PBS)
1) Increased bilirubin
2) Increased cholesterol
3) Increased ALP
4) Increased GGT
5) Increased IgM
6) Positive anti-mitochondrial antibodies
,Treatment of PBS
Ursodeoxycholic Acid = decreases cholesterol content of bile and bile stones by reducing
secretion of cholesterol from the liver and the fractional reabsorption of cholesterol by the
intestines (MOA in PBC not clearly defined)
Duodenal atresia finding on ultrasound
Double bubble sign
What virus is associated with nasopharyngeal carcinoma?
What other disease is this virus associated with?
EBV; also, associated with Burkitt's Lymphoma (B-cell lymphoma)
What causes transient ST-elevation in contiguous or precordial leads?
What is the treatment?
- Prinzmetal Angina
- Tx: nitrates and CCBs
Vitamin C deficiency presentation and coagulation studies
- Scurvy = gingival hemorrhage and petechiae
- Normal PT, normal PTT, normal bleeding time, normal platelets
*NOTE: vitamin C = ascorbic acid
What protein in involved in Down's Syndrome associated Alzheimer's?
Protein involved in familial Alzheimer's?
- Down's Syndrome = Amyloid Precursor Gene
- Familial = Tau Protein
Best initial management for chemical burns with intact airway and stable patient
Copious irrigation with tap water followed by application of calcium gluconate gel
*NOTE: important to start IV with fluids, but has been shown that initial irrigation of burns has
better clinical outcome than starting fluids
,What electrolyte abnormality can Lisinopril cause? Why?
Hyperkalemia = inhibits ACE, which inhibits aldosterone release leading to hyperkalemia
*REMEMBER: aldosterone WASTES K+
Na+ low or high in DKA?
"Low" = pseudo-hyponatremia due to hyperglycemia pulling water out of cells
What can be caused by lithium use in an infant? What occurs?
What test is used to check this?
- Epstein's Anomaly = apical placement of the posterior and septal tricuspid valves ->
atrialization of the right ventricle
- Level-II Ultrasound = targeted scan/anatomy scan
What is a predictor of good response to medication in schizophrenia?
What are predictors of poor response to medication?
- Positive symptoms = "positive" response to meds (delusions, disordered patterns of thought,
tactile, auditory, visual, olfactory, or gustatory hallucinations
- Early age of onset, no precipitating stressor, and negative symptoms (5 A's = alogia, apathy,
asociality, avolution, and affect blunting)
What to r/o and what tests to order in patient presenting with enlarged prostate on PE
BMP to check kidney function and UA for infection
Name and describe the 5 types of abortion
- Incomplete = partial passage of products of conception (POC), therefore will need D&C
- Inevitable = uterine bleeding with cervical dilation and no passage of POC; management is
expectant
- Missed = fetus dies, but is retained within the uterus
- Complete = expulsion of all POC
- Threatened = passage of blood BEFORE 20 wks gestation, WITHOUT cervical dilation
, What causes vulva with wrinkled parchment-like paper appearance?
What are 3 other common presentations?
What can this progress to?
What are the 1st and 2nd line treatment and their MOA?
- Lichen Sclerosis et Atrophicus (LSA)
- Vulvar pruritus, dysuria, dysparunia
- Can progress to Squamous Cell Carcinoma
- 1st-line = Clobetasol (MOA = topical corticosteroid)
- 2nd-line = Tacrolimus (MOA = Calcineurin inhibitor)
5 lab findings in Klinefelter's Syndrome and why
1) Increased FSH (dysgenesis of Seminiferous Tubules -> decreased inhibin -> increased FSH)
2) Increased LH (abnormal Leydig Cell function -> decreased testosterone -> increased LH ->
increased estrogen)
3) Increased Gonadotropin (decreased testosterone -> increased gonadotropin)
4) Increased Estradiol (abnormal Leydig Cell function -> decreased testosterone -> increased LH
-> increased estrogen)
4) Decreased bone mineral density
Lidocaine with Epinephrine commercial dilution
1:100,000 - 1:400,000
What diseases is S. pneumoniae the most common cause of?
"MOPS"
Meningitis
Otitis media
Pneumonia (typical)
Sinusitis
Disease associated with Philadelphia chromosome
