COMLEX Level 1 Assessment 1,2,3 LATEST VERSION
[QUESTIONS AND ANSWERS] WITH PRACTICE EXAM
DETAILED AND VERIFIED FOR GUARANTEED PASS-
LATEST UPDATE 2025 GRADED A
superior mesenteric artery - CORRECT ANSWER supplies the lower portion of the
duodenum, jejunum, ileum, cecum, ascending colon, and transverse colon to the
splenic flexure
pancreatic cancer - CORRECT ANSWER -usually arises in the *head* of the
pancreas
-is associated with *jaundice and pain* due to obstruction of the common bile duct
- it is the *4th* most common cause of cancer
-has a very poor prognosis
1. Calcium channel blockers--> specifically smooth muscle antagonists--> SM dilation
2. Alpha adrenergic receptor blockers --> cause dilation of vessels instead of
constriction
3. Beta 2 agonists: causes dilation of smooth muscle vessels - CORRECT ANSWER
Patients with GERD normally have a dysfunction with LES sphincter tone that allows
acid to reflux into the esophagus, thus drugs that affect sphincter tone would make
GERD worse. What are the name of three drug categories that do this?
celiac disease - CORRECT ANSWER malabsorption syndrome caused by an
immune reaction to gliadian protein in gluten
-Tissue transglutaminase
-results in villous atrophy of small intestine mucosa and causes steatorrhea, diarrhea,
bloating and abdominal pain
-*also associated with other autoimmune disorders like hashimotos thyroiditis*
make NPO, Place on an NG tube and suction obstruction out--> this will usually resolve
obstruction - CORRECT ANSWER after a patient comes to the ER with sudden
onset of pain and abdominal distention W/O peritoneal signs and after x-ray you
diagnose her with a small bowel obstruction. What do you do next?
Low total calcium due to low albumin levels from cirrhosis (95% of Ca2+ is bound to
albumin) and normal ionized Ca2+ because PTH regulates free ionized Ca2+
independently--> that is why there are no signs go hypocalcemia - CORRECT
ANSWER In a patient with liver cirrhosis what calcium levels would you expect to
see?
Would there be signs of hypocalcemia--> tetany, paresthesias, abdominal cramps?
,T5-T11 - CORRECT ANSWER where would you find a viserosomatic reflex
resulting in placatory changes of the pancreas?
Deferoxamine (Desferal) - CORRECT ANSWER iron chelating agent used in the
treatment of iron intoxication
short leg syndrome - CORRECT ANSWER when a patient presents with a flexible
scoliotic curve it is important to evaluate for...
inferior trunk--> encompasses broadmann areas 22,39,40 which are in the temporal
region - CORRECT ANSWER Infarct to what trunk of the Left MCA results in
Wernicke's aphasia?
Superior division--> encompasses brooks area, frontal eye field, primary motor cortex
and primary somatosensory cortex - CORRECT ANSWER Infarct to what trunk of
the Left MCA results in Broca's aphasia?
Osteosarcoma - CORRECT ANSWER bone tumor that is present in young adult
males that involves the metaphysis of the long bones
Ewing's sarcoma t(11;22) - CORRECT ANSWER bone tumor that is present in
young adult males that involves the *diaphysis(mid-shaft)* of the long bones.
fibrosarcoma - CORRECT ANSWER malignant fibroblasts within a collagenous
matrix
chondrosarcoma - CORRECT ANSWER osseous sarcomas that affect older
patients and has a predilection for flat bones in the *shoulders and pelvis*
tyrosine, due to a defect in phenylalanine hydroxylase - CORRECT ANSWER PKU
presents as failure to thrive, mental retardation, gapped teeth, etc. What is the amino
acid that needs to be supplemented due to a defect in what enzyme?
Rib 2 - CORRECT ANSWER where does the posterior scalene attach to?
Paclitaxel - CORRECT ANSWER used in the treatment of breast and ovarian
cancer
MOA: hyper stabilization of polymerized microtubules--> prevents the breakdown of the
mitotic spindle
restrictive barrier - CORRECT ANSWER maximum distance a patient can actually
move a joint, can be pathologic
,narcissistic personality disorder - CORRECT ANSWER patterns of grandiosity,
need for admiration, lack of empathy for others
A carotid massage causes an increase in stretch of the carotid baroreceptors which
causes a reflexive PARASYM response which slows down the conduction velocity
through the AV node this slowing down Heart Rate--> used in paroxysmal supra
ventricular tachycardia - CORRECT ANSWER what does a carotid massage do
and how does it affect the AV node?
Chronic myelogenous leukemia t(9;22)--> Philly chx - CORRECT ANSWER a form
of leukemia characterized by the accumulation of abnormal, mature granulocytes
(granulocytes are a type of white blood cell), mild anemia, thrombocytosis and
basophilia. What is the associated chromosomal translocation?
Burkitt's lymphoma t(8;14) - CORRECT ANSWER germinal B celll lymphoma that
is associated with a translocation between c-MYC and the Ig heavy chain on which two
chromosomes? It is endemic in the continent of Africa which produces this
follicular lymphoma t(14;18) - CORRECT ANSWER second most common
lymphoma in the US, arises from germinal center B-cells. Presents with painless
peripheral lymphadenopathy w/ a history of lymph node enlargement . Positive for CD
10, CD 19 and CD 20 expression. Results in what chromosomal translocation evolving
the BCL-2 gene?
Acute promyelocytic leukemia t(15;17) - CORRECT ANSWER PML/RARA fusion
gene
associated with DIC, characteristic folded, bilobed nuclei are found in these certain type
of cells. Coarse azurorophilic granules and multiple Auer rods are also present on histo
Clopidogrel - CORRECT ANSWER inhibits platelet aggregation by irreversibly
blocking the P2Y12 component of ADP receptors
Bacillus anthracis, tendonopathy - CORRECT ANSWER textile industry worker
that develops a low-grade fever, non-productive cough and substernal chest pain have
what bug? Treatment is with a fluroquinolone and why are frequently associated with
what ADR?
G-6-PD deficiency - CORRECT ANSWER X-linked recessive disorder present in
AAs and Mediterraneans that cause an inability to generate reduced glutathione and
lead to acute hemolysis when stress occurs. You will see bite cells and Heinz bodies on
peripheral blood smear.
Itranuclear opthalmoplegia - CORRECT ANSWER seen in those with MS, causes
impaired horizontal eye movement w/ weak adduction of the affected eye and abduction
, nystagmus of the contralateral eye. Due to a lesion in the MLF in the dorsomedial
brainstem tegmentum of wither the pons or the midbrain
lead poisoning - CORRECT ANSWER causes lethargy, seizures, or coma--> can
also develop distal motor neuropathies.
-leads to denaturation of the enzyme ribonuclease which causes ribosomes to persist in
the the RBCs and lead to basophilic stippling
myofasical release, BLT, FPR, counterstain - CORRECT ANSWER what are
indirect OMM techniques?
Articulatory technique - CORRECT ANSWER OMM technique classified as low
velocity, moderate to high amplitude
pericarditis - CORRECT ANSWER EKG presents with PR depression, ST
segment elevation and PR elevation in lead II. They also have sharp, midsternal, non-
radiating chest pain and mild lethargy. What do they have?
Bottom rib in ISD/ Top rib in ESD - CORRECT ANSWER BITE mnemonic is used
for rib dysfunction treatments, what is it?
pectoralis minor muscle - CORRECT ANSWER what muscle connects to ribs 3-5?
rib dysfunctions are named by where they are stuck while rib restrictions are named by
which motion they do not experience! - CORRECT ANSWER how are rib
dysfunctions named and how do they differ from rib restrictions?
decreases due to decreased transport - CORRECT ANSWER In Wilson's disease
there is a decrease in copper exportation which results in low biliary copper, what
happens to the transport protein ceruloplasmin?
Digoxin - CORRECT ANSWER positive inotrope for a failing heart
inhibits Na/K Atpase pumps and causes an increase in intracellular Ca2+ while also
causing parasympathetic effects
ADR: has a narrow therapeutic window and can cause GI distress, visual disturbances,
AV Block and bradycardia
Mercury poisoning - CORRECT ANSWER Patient went on a seafood binge for a
few days at a shady restaurant and present to the hospital with neurotoxicity and acute
renal injury which presents as tremors or oliguria and elevated creatinine
methanol poisoning - CORRECT ANSWER * Symptoms: *Severe metabolic
acidosis, retinal damage (blindness).* Lab Values: ** Pathophysiology: *Toxicity via
formic acid. Severe acidosis, retinal damage.* Treatment: *Ethanol, dialysis, fomepizole.
[QUESTIONS AND ANSWERS] WITH PRACTICE EXAM
DETAILED AND VERIFIED FOR GUARANTEED PASS-
LATEST UPDATE 2025 GRADED A
superior mesenteric artery - CORRECT ANSWER supplies the lower portion of the
duodenum, jejunum, ileum, cecum, ascending colon, and transverse colon to the
splenic flexure
pancreatic cancer - CORRECT ANSWER -usually arises in the *head* of the
pancreas
-is associated with *jaundice and pain* due to obstruction of the common bile duct
- it is the *4th* most common cause of cancer
-has a very poor prognosis
1. Calcium channel blockers--> specifically smooth muscle antagonists--> SM dilation
2. Alpha adrenergic receptor blockers --> cause dilation of vessels instead of
constriction
3. Beta 2 agonists: causes dilation of smooth muscle vessels - CORRECT ANSWER
Patients with GERD normally have a dysfunction with LES sphincter tone that allows
acid to reflux into the esophagus, thus drugs that affect sphincter tone would make
GERD worse. What are the name of three drug categories that do this?
celiac disease - CORRECT ANSWER malabsorption syndrome caused by an
immune reaction to gliadian protein in gluten
-Tissue transglutaminase
-results in villous atrophy of small intestine mucosa and causes steatorrhea, diarrhea,
bloating and abdominal pain
-*also associated with other autoimmune disorders like hashimotos thyroiditis*
make NPO, Place on an NG tube and suction obstruction out--> this will usually resolve
obstruction - CORRECT ANSWER after a patient comes to the ER with sudden
onset of pain and abdominal distention W/O peritoneal signs and after x-ray you
diagnose her with a small bowel obstruction. What do you do next?
Low total calcium due to low albumin levels from cirrhosis (95% of Ca2+ is bound to
albumin) and normal ionized Ca2+ because PTH regulates free ionized Ca2+
independently--> that is why there are no signs go hypocalcemia - CORRECT
ANSWER In a patient with liver cirrhosis what calcium levels would you expect to
see?
Would there be signs of hypocalcemia--> tetany, paresthesias, abdominal cramps?
,T5-T11 - CORRECT ANSWER where would you find a viserosomatic reflex
resulting in placatory changes of the pancreas?
Deferoxamine (Desferal) - CORRECT ANSWER iron chelating agent used in the
treatment of iron intoxication
short leg syndrome - CORRECT ANSWER when a patient presents with a flexible
scoliotic curve it is important to evaluate for...
inferior trunk--> encompasses broadmann areas 22,39,40 which are in the temporal
region - CORRECT ANSWER Infarct to what trunk of the Left MCA results in
Wernicke's aphasia?
Superior division--> encompasses brooks area, frontal eye field, primary motor cortex
and primary somatosensory cortex - CORRECT ANSWER Infarct to what trunk of
the Left MCA results in Broca's aphasia?
Osteosarcoma - CORRECT ANSWER bone tumor that is present in young adult
males that involves the metaphysis of the long bones
Ewing's sarcoma t(11;22) - CORRECT ANSWER bone tumor that is present in
young adult males that involves the *diaphysis(mid-shaft)* of the long bones.
fibrosarcoma - CORRECT ANSWER malignant fibroblasts within a collagenous
matrix
chondrosarcoma - CORRECT ANSWER osseous sarcomas that affect older
patients and has a predilection for flat bones in the *shoulders and pelvis*
tyrosine, due to a defect in phenylalanine hydroxylase - CORRECT ANSWER PKU
presents as failure to thrive, mental retardation, gapped teeth, etc. What is the amino
acid that needs to be supplemented due to a defect in what enzyme?
Rib 2 - CORRECT ANSWER where does the posterior scalene attach to?
Paclitaxel - CORRECT ANSWER used in the treatment of breast and ovarian
cancer
MOA: hyper stabilization of polymerized microtubules--> prevents the breakdown of the
mitotic spindle
restrictive barrier - CORRECT ANSWER maximum distance a patient can actually
move a joint, can be pathologic
,narcissistic personality disorder - CORRECT ANSWER patterns of grandiosity,
need for admiration, lack of empathy for others
A carotid massage causes an increase in stretch of the carotid baroreceptors which
causes a reflexive PARASYM response which slows down the conduction velocity
through the AV node this slowing down Heart Rate--> used in paroxysmal supra
ventricular tachycardia - CORRECT ANSWER what does a carotid massage do
and how does it affect the AV node?
Chronic myelogenous leukemia t(9;22)--> Philly chx - CORRECT ANSWER a form
of leukemia characterized by the accumulation of abnormal, mature granulocytes
(granulocytes are a type of white blood cell), mild anemia, thrombocytosis and
basophilia. What is the associated chromosomal translocation?
Burkitt's lymphoma t(8;14) - CORRECT ANSWER germinal B celll lymphoma that
is associated with a translocation between c-MYC and the Ig heavy chain on which two
chromosomes? It is endemic in the continent of Africa which produces this
follicular lymphoma t(14;18) - CORRECT ANSWER second most common
lymphoma in the US, arises from germinal center B-cells. Presents with painless
peripheral lymphadenopathy w/ a history of lymph node enlargement . Positive for CD
10, CD 19 and CD 20 expression. Results in what chromosomal translocation evolving
the BCL-2 gene?
Acute promyelocytic leukemia t(15;17) - CORRECT ANSWER PML/RARA fusion
gene
associated with DIC, characteristic folded, bilobed nuclei are found in these certain type
of cells. Coarse azurorophilic granules and multiple Auer rods are also present on histo
Clopidogrel - CORRECT ANSWER inhibits platelet aggregation by irreversibly
blocking the P2Y12 component of ADP receptors
Bacillus anthracis, tendonopathy - CORRECT ANSWER textile industry worker
that develops a low-grade fever, non-productive cough and substernal chest pain have
what bug? Treatment is with a fluroquinolone and why are frequently associated with
what ADR?
G-6-PD deficiency - CORRECT ANSWER X-linked recessive disorder present in
AAs and Mediterraneans that cause an inability to generate reduced glutathione and
lead to acute hemolysis when stress occurs. You will see bite cells and Heinz bodies on
peripheral blood smear.
Itranuclear opthalmoplegia - CORRECT ANSWER seen in those with MS, causes
impaired horizontal eye movement w/ weak adduction of the affected eye and abduction
, nystagmus of the contralateral eye. Due to a lesion in the MLF in the dorsomedial
brainstem tegmentum of wither the pons or the midbrain
lead poisoning - CORRECT ANSWER causes lethargy, seizures, or coma--> can
also develop distal motor neuropathies.
-leads to denaturation of the enzyme ribonuclease which causes ribosomes to persist in
the the RBCs and lead to basophilic stippling
myofasical release, BLT, FPR, counterstain - CORRECT ANSWER what are
indirect OMM techniques?
Articulatory technique - CORRECT ANSWER OMM technique classified as low
velocity, moderate to high amplitude
pericarditis - CORRECT ANSWER EKG presents with PR depression, ST
segment elevation and PR elevation in lead II. They also have sharp, midsternal, non-
radiating chest pain and mild lethargy. What do they have?
Bottom rib in ISD/ Top rib in ESD - CORRECT ANSWER BITE mnemonic is used
for rib dysfunction treatments, what is it?
pectoralis minor muscle - CORRECT ANSWER what muscle connects to ribs 3-5?
rib dysfunctions are named by where they are stuck while rib restrictions are named by
which motion they do not experience! - CORRECT ANSWER how are rib
dysfunctions named and how do they differ from rib restrictions?
decreases due to decreased transport - CORRECT ANSWER In Wilson's disease
there is a decrease in copper exportation which results in low biliary copper, what
happens to the transport protein ceruloplasmin?
Digoxin - CORRECT ANSWER positive inotrope for a failing heart
inhibits Na/K Atpase pumps and causes an increase in intracellular Ca2+ while also
causing parasympathetic effects
ADR: has a narrow therapeutic window and can cause GI distress, visual disturbances,
AV Block and bradycardia
Mercury poisoning - CORRECT ANSWER Patient went on a seafood binge for a
few days at a shady restaurant and present to the hospital with neurotoxicity and acute
renal injury which presents as tremors or oliguria and elevated creatinine
methanol poisoning - CORRECT ANSWER * Symptoms: *Severe metabolic
acidosis, retinal damage (blindness).* Lab Values: ** Pathophysiology: *Toxicity via
formic acid. Severe acidosis, retinal damage.* Treatment: *Ethanol, dialysis, fomepizole.
