Comlex USA Level 3

8 Questions | Total Attempts: 30

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Studying for the COMLEX 3 and going to start writing questions


Questions and Answers
  • 1. 
    • A. 

      PO txment with Linezolid

    • B. 

      Treatment empirically with IV Vancomycin with culture and sensitivity to follow

    • C. 

      IV treatment with Oxacillin 500mg IV q 6 hours for 30 days

    • D. 

      Order an MRI

    • E. 

      Order a blood culture and a bone scan STAT

  • 2. 
    A 42 year old man with a 20 year hx of Type I DM presents with a dime-sized ulcer on lateral aspect of his left lower extremity. On physical exam you notice a swollen area around the wound that is tender and red. An initial X-ray exam demonstrates periosteal elevation of the distal fibula of the left lower extremity. If cultures demonstrated MRSA and txment is initiated, of the treatments listed below, which would be the most likely to succeed?
    • A. 

      IV Vancomycin for 1 week

    • B. 

      IV oxacillin for 4-6 weeks

    • C. 

      IV linezolid for 2 weeks

    • D. 

      PO daptomycin for 6 months.

    • E. 

      BOTH A and C

  • 3. 
    A 42 year old man presents with a painful left leg that has progressively become worse over the last 3 days. An initial cbc shows 18000 wbc. On physical exam a quarter-sized ulcer is noted on the plantar surface of his left foot. On physical exam you notice a swollen area around the wound that is tender and red. An initial X-ray exam demonstrates no periosteal elevation of the distal fibula of the left lower extremity. What is the next step in the managment of this man's problem?
    • A. 

      Obtain blood cultures and start IV Vancomycin

    • B. 

      Obtain MRI ,order blood cultures and begin IV vancomycin

    • C. 

      Obtain a bone scan and start IV Oxacillin

    • D. 

      Obtain a bone scan and start IV Vancomycin

  • 4. 
    A 49 year old type II diabetic who recently had a knee replacement presents with a very painful erythematous area surrounding his prosthesis. His temp by mouth is 102 F. . What is the next step in the managment of this man's problem? He declares that in no uncertain terms is going to go into surgery again. I'm tired of this whole mess; either fix it or let me die.
    • A. 

      Obtain blood cultures and start IV vancomycin

    • B. 

      Prepare for immediate surgical removal of prosthesis in spite of his insistence

    • C. 

      Obtain blood cultures, obtain X-ray, and start antibiotic therapy with IV Vancomycin

    • D. 

      Admit to hospital, start IV vancomycin + Rifampin 300 mg PO

  • 5. 
    78 year old white male with a history of decubitus ulcers presents with a painful red spot on his left buttock.  After obtaining a bone biopsy and culture, you discover the culture you would expect with the presentation as described. What is the most likely diagnosis?
    • A. 

      Gram positive cocci in chains

    • B. 

      Coagulase positive organisms

    • C. 

      Gram negative bacilli

    • D. 

      A bacteria that is sensitive to Vancomycin

  • 6. 
    A 7 year old black male who is an avid swimmer at the local Y is brought to the office by his mother after complaints by the child of difficulty hearing from his left ear. On physical exam he is afebrile, of average ht. and weight and has no significant past medical hx including no ear infections in the past. What is the most likely diagnosis?
    • A. 

      Otitis Media

    • B. 

      Malignant Otitis Externa

    • C. 

      Otitis Externa

    • D. 

      A viral induced Otitis Media

  • 7. 
    A 7 year old black male who is an avid swimmer at the local Y is brought to the office by his mother after complaints by the child of difficulty hearing from his left ear. On physical exam he is afebrile, of average ht. and weight and has no significant past medical hx including no ear infections in the past. What is the best explanation for this infection and what is a good first line treatment?
    • A. 

      The ear was infected after swimming because swimming can wash out the acidic environment found in the external auditory canal and the best initial treatment is reassurance it will most likely resolve in 5 days with no treatment

    • B. 

      The ear was infected because of the immune compromise that swimming does to the external ear environment and the best initial treatment is PO Metronidazole

    • C. 

      Normal Acidity of the external ear gets washed out by swimming and the best treatment is a topical antibiotic along with topical hydrocortisone

    • D. 

      Inflammation caused by excessive water in the ear..High dose steroids PO for 5 days and then a taper

  • 8. 
    A 78 year old white male with respiratory problems presents with a fever of 102 degrees and abdominal pain of 3 days duration. What is the best choice of treatment to cover anaerobic bacteria.
    • A. 

      Clindamycin

    • B. 

      Metronidazole

    • C. 

      Piperacillin

    • D. 

      Aztreonam