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COMLEX Level 1 Questions and Verified
Answers
cysteine stone
Ans: - *Hexagonal* stones
- *Ground, glass appearance*
- *(+) urinary cyanide nitroprusside test
- Defect in renal transport of COLA: Cysteine, Ornithine, Lysine, Arginine
- Does NOT respond to shock wave therapy
angiodysplasia
Ans: most common cause of lower GI bleeding in pt's >60
superior mesenteric artery
Ans: supplies the lower portion of the duodenum, jejunum, ileum, cecum, ascending
colon, and transverse colon to the splenic flexure
pancreatic cancer
Ans: -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
Ans: 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
, Page | 2
Ans: 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
Ans: 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
Ans: 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
Ans: where would you find a viserosomatic reflex resulting in placatory changes of
the pancreas?
Deferoxamine (Desferal)
Ans: iron chelating agent used in the treatment of iron intoxication
short leg syndrome
Ans: 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
Ans: Infarct to what trunk of the Left MCA results in Wernicke's aphasia?
, Page | 3
Superior division--> encompasses brooks area, frontal eye field, primary motor cortex
and primary somatosensory cortex
Ans: Infarct to what trunk of the Left MCA results in Broca's aphasia?
Osteosarcoma
Ans: bone tumor that is present in young adult males that involves the metaphysis
of the long bones
Ewing's sarcoma t(11;22)
Ans: bone tumor that is present in young adult males that involves the
*diaphysis(mid-shaft)* of the long bones.
fibrosarcoma
Ans: malignant fibroblasts within a collagenous matrix
chondrosarcoma
Ans: 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
Ans: 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
Ans: where does the posterior scalene attach to?
Paclitaxel
Ans: used in the treatment of breast and ovarian cancer
MOA: hyper stabilization of polymerized microtubules--> prevents the breakdown of
the mitotic spindle
restrictive barrier
Ans: maximum distance a patient can actually move a joint, can be pathologic
narcissistic personality disorder
, Page | 4
Ans: 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
Ans: what does a carotid massage do and how does it affect the AV node?
Chronic myelogenous leukemia t(9;22)--> Philly chx
Ans: 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)
Ans: 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)
Ans: 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)
Ans: 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
Ans: inhibits platelet aggregation by irreversibly blocking the P2Y12 component of
ADP receptors
Bacillus anthracis, tendonopathy
COMLEX Level 1 Questions and Verified
Answers
cysteine stone
Ans: - *Hexagonal* stones
- *Ground, glass appearance*
- *(+) urinary cyanide nitroprusside test
- Defect in renal transport of COLA: Cysteine, Ornithine, Lysine, Arginine
- Does NOT respond to shock wave therapy
angiodysplasia
Ans: most common cause of lower GI bleeding in pt's >60
superior mesenteric artery
Ans: supplies the lower portion of the duodenum, jejunum, ileum, cecum, ascending
colon, and transverse colon to the splenic flexure
pancreatic cancer
Ans: -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
Ans: 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
, Page | 2
Ans: 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
Ans: 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
Ans: 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
Ans: where would you find a viserosomatic reflex resulting in placatory changes of
the pancreas?
Deferoxamine (Desferal)
Ans: iron chelating agent used in the treatment of iron intoxication
short leg syndrome
Ans: 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
Ans: Infarct to what trunk of the Left MCA results in Wernicke's aphasia?
, Page | 3
Superior division--> encompasses brooks area, frontal eye field, primary motor cortex
and primary somatosensory cortex
Ans: Infarct to what trunk of the Left MCA results in Broca's aphasia?
Osteosarcoma
Ans: bone tumor that is present in young adult males that involves the metaphysis
of the long bones
Ewing's sarcoma t(11;22)
Ans: bone tumor that is present in young adult males that involves the
*diaphysis(mid-shaft)* of the long bones.
fibrosarcoma
Ans: malignant fibroblasts within a collagenous matrix
chondrosarcoma
Ans: 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
Ans: 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
Ans: where does the posterior scalene attach to?
Paclitaxel
Ans: used in the treatment of breast and ovarian cancer
MOA: hyper stabilization of polymerized microtubules--> prevents the breakdown of
the mitotic spindle
restrictive barrier
Ans: maximum distance a patient can actually move a joint, can be pathologic
narcissistic personality disorder
, Page | 4
Ans: 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
Ans: what does a carotid massage do and how does it affect the AV node?
Chronic myelogenous leukemia t(9;22)--> Philly chx
Ans: 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)
Ans: 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)
Ans: 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)
Ans: 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
Ans: inhibits platelet aggregation by irreversibly blocking the P2Y12 component of
ADP receptors
Bacillus anthracis, tendonopathy
