COMLEX level 2 Most Common, Most likely, Best Treatment and Buzz words

iliapas97's version from 2018-01-29 06:04

Most common risk factors, most likely conditions, most likely outcome

Most common Answer
Highest risk factor for Rickets in infants Mothers not supplementing vitamin D in breastmilk
Most common leukemia in elderlyCLL
What age does pyloric stenosis most commonly present First month of life
Most common type of congenital adrenal hyperplasia 21-hydroxylase deficiency
most common infection of the deep neck in children 10 years and older Peritonsillar abscess
most common infection of the deep neck in children 2 to 4 years of age Retropharyngeal abscess
most common type of colonic volvulusSigmoid volvulus
most commonly a pediatric complication presenting with midgut volvulusMalrotation of the gut
Most common cause of sigmoid volvulus Chronic constipation
Most common pathogen transmitted through blood transfusion Bacteria
Most common cause of shoulder pain worse with overhead activitiesrotator cuff tear
Most common tendon torn in Rotator Cuff Tear Supraspinatus
Most common location of coarctation of the aorta Distal to the left subclavian artery
Most common risk factor for developing abdominal aortic aneurysmSmoking
Most common predisposing risk factor for Aortic DissectionHTN
Arrhythmia that is most commonly associated with pulmonary disease Multifocal Atrial Tachycardia
Most common primary tumor of the heart Myxoma
Most common congenital heart defect in Marfan’s syndrome Mitral valve prolapse
Most common valve abnormality in Rheumatic Heart Disease Mitral Stenosis
Most likely diagnosis in a patient with SVT alternating with ventricular tachycardia or SVT that gets worse after diltiazem or digoxin Wolff-Parkinson-White Syndrome
most common causes of asystole ischemia and severe underlying cardiac disease
Most common cause of A-fib chronic hypertension (most common)
Most common valvulopathy that leads to A-fib mitral valve pathology
most common causes of early prosthetic valve endocarditis (prior to 12 months post-operative Staph aureus and Staph epidermidis
most common cause of late (after 12 months) prosthetic valve endocarditis Streptococcus viridans
most common causes of native valve endocarditis Streptococcal species (Strep viridans, Strep bovis, and enterococci)
most common cause of endocarditis associated with intravenous drug abuse Staphylococcus aureus
most common cause of malignant mesothelioma asbestos exposure
most common type of lung cancer in people exposed to asbestos bronchogenic carcinoma.
Most common site of an ectopic pregnancy Ampulla of the fallopian tube
Most common cause of secondary amenorrhea Endometriosis
most common cause of postpartum hemorrhageUterine Atony
Most common risk factors for breast cancer Age ( 35 or older) race (Caucasian), Early menarche, Late menopause, nulliparity , Family history in 1st degree relative of BRACA1 and Braca 2
most common cause of endometrial carcinomaObesity
Kidney stone size with a good chance of spontaneous passage> 4 mm in diameter
Most important step to reduce recurrence of kidney stonesHydration

Test of Choice

Condition Test
Musculoskeletal conditions Musculoskeletal Tests
Initial imaging for suspected Ankle injury X-ray
Test to Lumbar Spinal stenosis MRI
GI conditions GI Tests
preferred test in evaluation of PUD.Esophagogastroduodenoscopy with biopsy
The only test that can diagnose H. Pylori Esophagogastroduodenoscopy with biopsy
Tests for eradication of H. Pylori Stool antigen assay or urea breath test
Initial test for Zollinger-Ellison syndrome Fasting serum gastrin levels
confirmatory test of choice in Zollinger-Ellison secretin stimulation test (Somatostatin receptor scintigraphy is used to evaluate metastasis)
serum-ascites albumin gradient SAAG score > 1.1 g/d Portal hypertension SAAG = serum albumin - albumin in ascitic fluid
OBGYN conditions OBGYN Tests
First imaging study for suspected AenomyosisTransvaginal ultrasound
Definitive diagnosis AdenomyosisHysterectomy and histology
Diagnosis of EndometriosisDirect visualization with Laparoscopy or Laparotomy
first-line test in women with a palpable breast mass Diagnostic mammogram
first-line test in women with a palpable breast mass who are pregnant or breastfeeding Ultrasound


Question Answer
Cardiopulmonary Disorders Cardiopulmonary Tests
Test of choice to confirm Cardiac Tamponade Echo
The gold standard imaging test for diagnosing an aortic dissectionCT angiography or MRI
best initial study for identifying deep venous thrombosis (DVT).Duplex ultrasonography
Test of choice to confirm a PE spiral CT
gold-standard test for pulmonary embolism diagnosisPulmonary angiography (use if the CT or V/Q are inconclusive)
evaluate centrally located lung lesions (Squamous cell or small cell) Fiberoptic bronchoscopy
evaluation of peripheral lung lesions (Adenocarcinoma or Large cell)CT guided biopsy
most accurate test for WPW is cardiac electrophysiology (EP) studies.
Best initial test for Aortic dissection Chest x-ray
Best confirmatory test for for Aortic dissection CT with contrast


Question Answer
Genitourinary disorders Genitourinary Tests
gold standard for the diagnosis of kidney stones non-contrast abdominal CT scan
gold standard for the diagnoses of nephrolithiasis spiral CT without contrast.

Pathological buzz words

Question Answer
Cardiac biopsy in Amyloidosis Congo red stain shows apple green birefringence under polarized light.
Cardiac biopsy in Hemochromatosis tissue that stains positive with Prussian blue stain.
Cardiac biopsy in Sarcoidosis granulomatous inflammation.
Cardiac biopsy in Loeffler's endocarditis endomyocardial fibrosis with a prominent eosinophilic infiltrate.
patchy or localized uptake on radioactive iodine testtoxic multinodular goiter "Plummer's disease"
Radioactive iodine uptake test shows increased diffuse uptakeGrave's
Charcot's triadupper quadrant pain, jaundice, fever/chills Acute Cholangitis
Reynold's pentadCharcot's triad plus altered mental status and shock Chronic Cholangitis
small painful raised leasions on hands and feet in Enfective EndocarditisOsler nodes
retinal hemmorhage in Enfective Endocarditis Roth’s spots
small peripheral hemorhages on hands and feet in Enfective Endocarditis Janeway leasions
subunguinal (under the nail) petechiea in Enfective Endocarditis Splinter hemmorhages
bony outgrowths around the PIP seen in osteoarthritis or rheumatoid arthritis Bouchard’s nodes
bony outgrowths around the DIP associated with osteoarthritis Heberden’s nodes
Malodorous; homogenous; clear, white, or gray; fishy odor with clue cells , ph > 4.5 Bacterial vaginosis
Green-yellow, frothy discharge, strawberry cervix, ph 5-6 Trichamonas vaginosis
White, thick, lack of odor, cottage cheese discharge with itchiness, ph < 4.5 Vulvovaginal Candidiasis
increase in jugulovenous pressure on inhalation Kussmaul sign

Disease Markers and translocation patterns

Disease Markers and translocation patterns
SLEANA, Anti-dsDNA (High specificity) Anti-Sm “Anti-Smith” (High specificity)
Drug-induced SLEAntihistone
RAAnti-CCP “(Anti-cyclic citrullinated peptide)”, RF
CREST syndromeAnticentromere
Primary biliary cirrhosisAntimitochondrial
Autoimmune hepatitisAnti–smooth muscle
Systemic sclerosisAnti-Scl-70 Antitopoisomerase I
Graves diseaseAnti-TSHR
Hashimotos anti-thyroid peroxidase antibody (TPOAb) aka anti-microsomal antibodies and Anti-thyroid peroxidase antibody TgAb
Wegenerc-ANCA (perinuclear-Antineutrophil Cytoplasmic Antibodies)
microscopic polyangiitisp-ANCA (cytoplasmic-Antineutrophil Cytoplasmic Antibodies)
Mixed connective tissue diseaseU1RNP antibody
Hepatocellular carcinomaAFP
Yolk Sack tumorAFP
Choriocarcinomab-HCG >1000 IU/L
Seminomab-HCG <1000 IU/L
Ovarian tumorCA-125
mantle cell lymphoma t(11;14) bcl-1
follicular lymphomat(14;18) bcl-2
Burkitt’s lymphoma t(8;14) c-myc.
CML BCR-ABL t(9;22)
Ewing's sarcomat(11;22)