COMLEX Level 2-CE Form 119 Exam
With Actual 120 Questions & Verified
Answers,Plus Rationales/Expert
Verified For Guaranteed Pass Graded
A+/ 2025/2026 /Latest Update/Instant
Download Pdf
1. A 45-year-old man presents with progressive fatigue and shortness of breath. Labs
show hemoglobin 8 g/dL, MCV 70 fL, ferritin 8 ng/mL. What is the most likely
diagnosis?
A. Vitamin B12 deficiency
B. Iron deficiency anemia
C. Anemia of chronic disease
D. Thalassemia
B. Iron deficiency anemia
Microcytic anemia with low ferritin is most consistent with iron deficiency anemia.
B12 deficiency is macrocytic, anemia of chronic disease typically has normal/high
ferritin, and thalassemia usually has normal iron studies.
2. A 30-year-old woman has a 2-month history of palpitations, heat intolerance, and
weight loss despite increased appetite. Exam shows tremor and diffuse goiter. Which
lab is most likely elevated?
A. TSH
B. Free T4
C. Anti-thyroid peroxidase antibodies
D. Cortisol
B. Free T4
Symptoms suggest hyperthyroidism. Free T4 is elevated, while TSH is suppressed.
Anti-TPO antibodies are more associated with Hashimoto’s thyroiditis.
3. A 65-year-old man presents with sudden-onset right-sided weakness and slurred
speech. CT shows no hemorrhage. What is the first-line treatment?
A. Aspirin
, B. IV alteplase
C. Heparin
D. Clopidogrel
B. IV alteplase
Acute ischemic stroke within 3–4.5 hours of onset is treated with IV thrombolysis
(alteplase), provided there are no contraindications.
4. A 24-year-old woman has recurrent urinary tract infections. Urinalysis shows
bacteriuria and pyuria. Which is the most likely organism?
A. Staphylococcus aureus
B. Escherichia coli
C. Pseudomonas aeruginosa
D. Enterococcus faecalis
B. Escherichia coli
E. coli is the most common cause of community-acquired urinary tract infections.
5. A 50-year-old man with type 2 diabetes has proteinuria and hypertension. Best initial
therapy to slow progression of nephropathy is:
A. Loop diuretic
B. ACE inhibitor
C. Calcium channel blocker
D. Thiazide diuretic
B. ACE inhibitor
ACE inhibitors reduce intraglomerular pressure and proteinuria, slowing
progression of diabetic nephropathy.
6. A 7-year-old boy presents with fever, sore throat, and a sandpaper-like rash on the
trunk. What is the causative agent?
A. Staphylococcus aureus
B. Streptococcus pyogenes
C. Epstein-Barr virus
D. Measles virus
B. Streptococcus pyogenes
Scarlet fever is caused by Group A Streptococcus, presenting with pharyngitis and a
characteristic rash.
7. A 32-year-old woman presents with fatigue, pallor, and paresthesias. Labs show
macrocytic anemia and low B12. Best next step in management is:
A. Oral iron
B. Intramuscular B12
C. Folate supplementation
D. Blood transfusion
B. Intramuscular B12
, Vitamin B12 deficiency requires parenteral supplementation, especially if
neurological symptoms are present.
8. A 70-year-old man has sudden severe chest pain radiating to the back. BP difference
between arms, CXR shows widened mediastinum. Most likely diagnosis?
A. Myocardial infarction
B. Aortic dissection
C. Pulmonary embolism
D. Pericarditis
B. Aortic dissection
Acute tearing chest pain with inter-arm BP difference and widened mediastinum is
classic for aortic dissection.
9. A 28-year-old woman presents with recurrent oral and genital ulcers and uveitis.
Which test is most likely positive?
A. ANA
B. HLA-B51
C. Anti-dsDNA
D. Anti-Ro
B. HLA-B51
Behçet’s disease is associated with HLA-B51 and characterized by recurrent
mucocutaneous ulcers and uveitis.
10. A 60-year-old man with COPD presents with worsening dyspnea and purulent
sputum. Which is the most appropriate empiric antibiotic?
A. Amoxicillin
B. Azithromycin
C. Ceftriaxone
D. Levofloxacin
D. Levofloxacin
For acute exacerbation of COPD with purulent sputum, a respiratory
fluoroquinolone like levofloxacin covers likely pathogens including H. influenzae
and S. pneumoniae.
11. A 4-year-old boy presents with acute onset of high fever, drooling, and stridor. Best
initial management is:
A. Oral amoxicillin
B. Inhaled albuterol
C. Secure airway in controlled environment
D. IV corticosteroids
C. Secure airway in controlled environment
Acute epiglottitis can rapidly obstruct the airway. Immediate airway management
in a controlled setting is critical.
With Actual 120 Questions & Verified
Answers,Plus Rationales/Expert
Verified For Guaranteed Pass Graded
A+/ 2025/2026 /Latest Update/Instant
Download Pdf
1. A 45-year-old man presents with progressive fatigue and shortness of breath. Labs
show hemoglobin 8 g/dL, MCV 70 fL, ferritin 8 ng/mL. What is the most likely
diagnosis?
A. Vitamin B12 deficiency
B. Iron deficiency anemia
C. Anemia of chronic disease
D. Thalassemia
B. Iron deficiency anemia
Microcytic anemia with low ferritin is most consistent with iron deficiency anemia.
B12 deficiency is macrocytic, anemia of chronic disease typically has normal/high
ferritin, and thalassemia usually has normal iron studies.
2. A 30-year-old woman has a 2-month history of palpitations, heat intolerance, and
weight loss despite increased appetite. Exam shows tremor and diffuse goiter. Which
lab is most likely elevated?
A. TSH
B. Free T4
C. Anti-thyroid peroxidase antibodies
D. Cortisol
B. Free T4
Symptoms suggest hyperthyroidism. Free T4 is elevated, while TSH is suppressed.
Anti-TPO antibodies are more associated with Hashimoto’s thyroiditis.
3. A 65-year-old man presents with sudden-onset right-sided weakness and slurred
speech. CT shows no hemorrhage. What is the first-line treatment?
A. Aspirin
, B. IV alteplase
C. Heparin
D. Clopidogrel
B. IV alteplase
Acute ischemic stroke within 3–4.5 hours of onset is treated with IV thrombolysis
(alteplase), provided there are no contraindications.
4. A 24-year-old woman has recurrent urinary tract infections. Urinalysis shows
bacteriuria and pyuria. Which is the most likely organism?
A. Staphylococcus aureus
B. Escherichia coli
C. Pseudomonas aeruginosa
D. Enterococcus faecalis
B. Escherichia coli
E. coli is the most common cause of community-acquired urinary tract infections.
5. A 50-year-old man with type 2 diabetes has proteinuria and hypertension. Best initial
therapy to slow progression of nephropathy is:
A. Loop diuretic
B. ACE inhibitor
C. Calcium channel blocker
D. Thiazide diuretic
B. ACE inhibitor
ACE inhibitors reduce intraglomerular pressure and proteinuria, slowing
progression of diabetic nephropathy.
6. A 7-year-old boy presents with fever, sore throat, and a sandpaper-like rash on the
trunk. What is the causative agent?
A. Staphylococcus aureus
B. Streptococcus pyogenes
C. Epstein-Barr virus
D. Measles virus
B. Streptococcus pyogenes
Scarlet fever is caused by Group A Streptococcus, presenting with pharyngitis and a
characteristic rash.
7. A 32-year-old woman presents with fatigue, pallor, and paresthesias. Labs show
macrocytic anemia and low B12. Best next step in management is:
A. Oral iron
B. Intramuscular B12
C. Folate supplementation
D. Blood transfusion
B. Intramuscular B12
, Vitamin B12 deficiency requires parenteral supplementation, especially if
neurological symptoms are present.
8. A 70-year-old man has sudden severe chest pain radiating to the back. BP difference
between arms, CXR shows widened mediastinum. Most likely diagnosis?
A. Myocardial infarction
B. Aortic dissection
C. Pulmonary embolism
D. Pericarditis
B. Aortic dissection
Acute tearing chest pain with inter-arm BP difference and widened mediastinum is
classic for aortic dissection.
9. A 28-year-old woman presents with recurrent oral and genital ulcers and uveitis.
Which test is most likely positive?
A. ANA
B. HLA-B51
C. Anti-dsDNA
D. Anti-Ro
B. HLA-B51
Behçet’s disease is associated with HLA-B51 and characterized by recurrent
mucocutaneous ulcers and uveitis.
10. A 60-year-old man with COPD presents with worsening dyspnea and purulent
sputum. Which is the most appropriate empiric antibiotic?
A. Amoxicillin
B. Azithromycin
C. Ceftriaxone
D. Levofloxacin
D. Levofloxacin
For acute exacerbation of COPD with purulent sputum, a respiratory
fluoroquinolone like levofloxacin covers likely pathogens including H. influenzae
and S. pneumoniae.
11. A 4-year-old boy presents with acute onset of high fever, drooling, and stridor. Best
initial management is:
A. Oral amoxicillin
B. Inhaled albuterol
C. Secure airway in controlled environment
D. IV corticosteroids
C. Secure airway in controlled environment
Acute epiglottitis can rapidly obstruct the airway. Immediate airway management
in a controlled setting is critical.
