COMLEX level 2 Test of choice, special maneuvers, weird names

iliapas97's version from 2017-12-06 07:24

Test of Choice

Condition Test
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
Test to Lumbar Spinal stenosis MRI
The gold standard imaging test for diagnosing an aortic dissectionCT angiography or MRI
First imaging study for suspected AenomyosisTransvaginal ultrasound
Definitive diagnosis AdenomyosisHysterectomy and histology
Diagnosis of EndometriosisDirect visualization with Laparoscopy or Laparotomy
gold standard for the diagnoses of nephrolithiasis spiral CT without contrast.
serum-ascites albumin gradient SAAG score > 1.1 g/d Portal hypertension SAAG = serum albumin - albumin in ascitic fluid
Initial imaging for suspected Ankle injury X-ray
best initial study for identifying deep venous thrombosis (DVT).Duplex ultrasonography
gold-standard test for pulmonary embolism diagnosisPulmonary angiography
evaluate centrally located lung lesions (Squamous cell or small cell) Fiberoptic bronchoscopy
evaluation of peripheral lung lesions (Adenocarcinoma or Large cell)CT guided biopsy
gold standard for the diagnosis of kidney stones noncontrast abdominal CT scan
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)

Special Maneuvers

Question Answer
venous air embolism is suspectedplace in lateral position with left side down. "First aspirate catheter and give 100% O2"

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

High Yield Pediatrics

Question Answer
Laryngotracheobronchitis CROUP parainfluenza virus, barking cough, Steeple sign, Low fever, Give steroids or epinephrine
Epiglottitis Haemophilus influenza type B, Drooling,Muffled voice, tripod position, Respiratory distress, High fever, Thumbprint sign (on lateral film), Intubate~

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

Question Answer
Most common predisposing risk factor for Aortic DissectionHTN
Most common risk factor for developing abdominal aortic aneurismSmoking
most common cause of endometrial carcinomaObesity
Highest risk factor for Rickets in infants Mothers not supplementing vitamin D in breastmilk
Most common leukemia in elderlyCLL
Kidney stone size with a good chance of spontaneous passage> 4 mm in diameter
Most important step to reduce recurrence of kidney stonesHydration
Most common cause of shoulder pain worse with overhead activitiesrotator cuff tear
Most common tendon torn in Rotator Cuff Tear Supraspinatus
most common cause of post-partum hemorrhageUterine Atony
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 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 pathogen transmitted through blood transfusion Bacteria
most common cause of malignant mesothelioma asbestos exposure
most common type of lung cancer in people exposed to asbestos bronchogenic carcinoma.


cervical cancer screening age 21-30Pap smear every 3 years only
cervical cancer screening age 30-65HPV and cytology co-testing every 5 years OR Pap smear every 3 years
Women with total hysterectomy

Classification criteria



Question Answer
JNC8 Target blood pressure
< 60 years old < 140/90
> 60 years old < 150/90
> Diabetic patients >130/80
New York Heart Association (NYHA) classificationClassifies heart failure into 4 groups
New York Heart Association (NYHA) Class I heart failure with no limitation
New York Heart Association (NYHA) Class IIsymptoms with strenuous physical activity.
New York Heart Association (NYHA) Class IIIsymptoms with little physical activity
New York Heart Association (NYHA) Class IVsymptoms of heart failure, even at rest.
Debakey SystemClassifies Aortic Dissection by types 3 types (I, II, III)
Type Iinvolves the ascending aorta, arch and descending thoracic aorta.
Type IIAscending Aorta only
Type IIIaIIIa involves the descending thoracic aorta distal to the left subclavian artery and proximal to the celiac artery
Type IIIbinvolves the thoracic and abdominal aorta distal to the left subclavian artery.
Stanford SystemClassifies Aortic Dissection as either type A or B
Type ADissection of the Ascending Aorta
Type BAll others
Rai staging systemused to stage leukemia
Rai stage 0Lmphocytosis greater than 15,000
stage I lymphocytosis + lymphadenopathy
stage IIlymphocytosis + splenomegaly
stage IIIlymphocytosis + anemia
stage IV is lymphocytosis + thrombocytopenia
Ottowa rule Determines of X-ray is needed.
Criteria for X-rayCan't bear weight after injury and on presentation, Tenderness to palpation around medial and lateral malleoli

Inheritance patterns of disease

Pattern of InheritanceDisease
X-linked recessiveFragile X, Duchenne’s muscular dystrophy, hemophilia A and B, Fabry’s disease, G6PD-deficiency, Hunter’s syndrome, and Wiskott-Aldrich syndrome.
Mitochondrialprogressive external ophthalmoplegia and myoclonus
Autosomal recessive cystic fibrosis, albinism, alpha-1 antitrypsin deficiency, phenylketonuria, thalassemias, sickle-cell, glycogen storage diseases, and hemochromatosis.
Autosomal dominantadult polycystic disease, familial hypercholesterolemia (Type IIa), Marfan’s , neurofibromatosis (Types 1 and 2), Von Hippel-Lindau, Huntington’s disease, familial adenomatous polyposis, and hereditary spherocytosis.