COMLEX Level 3 Exam-Questions with 100%
Correct Answers
What does a high risk ratio mean?
Higher the risk ratio, the greater the chance it is the cause of disease/illness
changes to the top of the tongue in and otherwise healthy patient - including development
of glossy red patches that change appearance and locations every few days
Geographic tongue
What vaccines should HIV positive individuals receive?
influenza each year, Tdap once then Td every 10 years, pneumococcal series
once, meningococcal series, hepatitis B series once, and HPV series once if the patient is 26 or
younger.
What vaccines can be considered in HIV positive individuals with CD4 > 200
Varicella and MMR
What are the HIV-prophylaxis for the following CD4 cell count: CD4 < 200, CD4 < 100, CD4 < 50
Where are duplex ultrasounds usually performed? And if you suspect a clot what else should
you do?
TOPIC: rule out DVT
This test is performed by visualizing the veins of the lower extremity and pressing down with
the ultrasound probe. Patent veins should compress easily. If they do not, something must be
within the lumen, such as a clot. If a clot is suspected, flow can also be assessed with Doppler,
which will generally show an absence of flow.
Commonly, the ultrasound is performed only from the thigh proximal. Proximal DVTs are more
likely to progress and embolize than an isolated distal DVT.
, If DVT is still suspected despite normal proximal duplex US. Then get a whole leg venous duplex
US
Not every patient with a distal DVT will need treatment. If a whole leg ultrasound is performed
and is negative, no further testing for DVT is needed unless an iliac DVT is suspected and the
iliac veins are not visualized. In this case, iliac vein ultrasonography should be performed.
Explain steps in adult cardiac arrest?
if a patient is found down without a pulse, cardiopulmonary resuscitation (CPR) is immediately
started.
Then the rhythm is analyzed once the pads are attached.
If the patient is in a shockable rhythm (ie, Vfib or ventricular tachycardia [Vtach])
ACLS sequence is shock -> CPR -> shock (if shockable) -> epinephrine -> shock (if shockable) ->
amiodarone/treat reversible causes.
Note that epinephrine is administered after the second shock, and amiodarone is considered
after the third shock, in which Vfib or Vtach is considered refractory.
What is the MOST important step in adult cardiac arrest?
Early defibrillation therapy
HLA antigens that are commonly associated with juvenile diabetes
Gilbert syndrome is a relatively common autosomal recessive mutation in the promoter
region of the gene encoding uridine - what is the gene?
diphosphoglucuronate-glucuronosyltransferase 1A1 (UGT1A1)
What test would you order for new-onset vitiligo?
Vitiligo is associated with autoimmune disease, particularly thyroid disease. Therefore, thyroid
function testing (thyroid-stimulating hormone) is recommended in all patients with new-onset
vitiligo, regardless of symptoms.
Correct Answers
What does a high risk ratio mean?
Higher the risk ratio, the greater the chance it is the cause of disease/illness
changes to the top of the tongue in and otherwise healthy patient - including development
of glossy red patches that change appearance and locations every few days
Geographic tongue
What vaccines should HIV positive individuals receive?
influenza each year, Tdap once then Td every 10 years, pneumococcal series
once, meningococcal series, hepatitis B series once, and HPV series once if the patient is 26 or
younger.
What vaccines can be considered in HIV positive individuals with CD4 > 200
Varicella and MMR
What are the HIV-prophylaxis for the following CD4 cell count: CD4 < 200, CD4 < 100, CD4 < 50
Where are duplex ultrasounds usually performed? And if you suspect a clot what else should
you do?
TOPIC: rule out DVT
This test is performed by visualizing the veins of the lower extremity and pressing down with
the ultrasound probe. Patent veins should compress easily. If they do not, something must be
within the lumen, such as a clot. If a clot is suspected, flow can also be assessed with Doppler,
which will generally show an absence of flow.
Commonly, the ultrasound is performed only from the thigh proximal. Proximal DVTs are more
likely to progress and embolize than an isolated distal DVT.
, If DVT is still suspected despite normal proximal duplex US. Then get a whole leg venous duplex
US
Not every patient with a distal DVT will need treatment. If a whole leg ultrasound is performed
and is negative, no further testing for DVT is needed unless an iliac DVT is suspected and the
iliac veins are not visualized. In this case, iliac vein ultrasonography should be performed.
Explain steps in adult cardiac arrest?
if a patient is found down without a pulse, cardiopulmonary resuscitation (CPR) is immediately
started.
Then the rhythm is analyzed once the pads are attached.
If the patient is in a shockable rhythm (ie, Vfib or ventricular tachycardia [Vtach])
ACLS sequence is shock -> CPR -> shock (if shockable) -> epinephrine -> shock (if shockable) ->
amiodarone/treat reversible causes.
Note that epinephrine is administered after the second shock, and amiodarone is considered
after the third shock, in which Vfib or Vtach is considered refractory.
What is the MOST important step in adult cardiac arrest?
Early defibrillation therapy
HLA antigens that are commonly associated with juvenile diabetes
Gilbert syndrome is a relatively common autosomal recessive mutation in the promoter
region of the gene encoding uridine - what is the gene?
diphosphoglucuronate-glucuronosyltransferase 1A1 (UGT1A1)
What test would you order for new-onset vitiligo?
Vitiligo is associated with autoimmune disease, particularly thyroid disease. Therefore, thyroid
function testing (thyroid-stimulating hormone) is recommended in all patients with new-onset
vitiligo, regardless of symptoms.
