COMLEX Level 1 TrueLearn COMBank ASSESSMENT 2 [ACTUAL EXAM]
LATEST VERSION [QUESTIONS AND ANSWERS] WITH PRACTICE
EXAM DETAILED AND VERIFIED FOR GUARANTEED PASS- LATEST
UPDATE 2025 GRADED A
What are the risk factors of placental accreta spectrum - CORRECT ANSWER Hx
of c-section
Hx of uterine procedures (dilation, curettage, myomectomy, uterine ablation, Asherman
syndrome)
Placental previa
What is included in placenta accreta spectrum and describe each - CORRECT
ANSWER Placenta accreta: placental villi attach to the surface of the myometrium
Placenta increta: chorionic villi penetrate into the myometrium
Placenta precreta: chorionic villi penetrate through the myometrium to the uterine
serosa or adjacent organs
Secondary amenorrhea (absence of periods for 3 cycles) following a dilation and
curettage (D&C) - CORRECT ANSWER Asherman syndrome
- Trauma to stratum basalis --> absence of the stratum basalis layer of the endometrium
Etiology of secondary amenorrhea - CORRECT ANSWER Hypothalamic:
Functional hypothalamic amenorrhea
Pituitary: Hyperprolactinemia, empty sella syndrome, Sheehan syndrome
Ovary: Plycystic ovary syndrome, premature ovarian failure
Uterus: Asherman syndrome
Other: Congenital adrenal hyperplasia, hypothyroidism, adrenal tumors
List the disease for each histology:
1. Abscent stratum basalis in an endometrial biopsy
2. Benign keratinocytes within the epidermis
3. Enlarged ovaries w/ multiple cystic follicles
4. Hyperplasia of lactotroph cells within the anterior pituitary
,5. Numerous corpora albicans and a fibrotic cortex - CORRECT ANSWER 1.
Asherman syndrome
2. Imperforate hymen
3. Polycystic ovary syndrome
4. Prolactinoma
5. Atrophic ovary
Diagnosed in infants (< 1 year)
M > F predominance
Most common in Caucasian populations
Symptoms of severe anemia --> pallor, fatigue, cyanosis
Webbed neck (can be confused for Turner syndrome)
Cleft pallet
Triphalangeal thumbs
Macrocytic anemia (nonmegaloblastic)
Decreased reticulocyte count (< 1% in infants)
Normal leukocytes and platelets
Bone marrow biopsy --> absence of erythroid precursors
Increased HbF on electrophoresis
Nonmegaloblastic macrocytic anemia - CORRECT ANSWER Diamond-Blackfan
anemia
- Turner syndrome does not cause macrocytic anemia
Treatment for Diamond-Blackfan anemia - CORRECT ANSWER Corticosteroids
Transfusion
Hematopoietic stem cell transplant
Defect in erythropoiesis --> Pure Red Cell Aplasia (PRCA)
Erythroblasts in bone marrow undergo premature apoptosis
Common mutations result in ribosome protein synthesis defect --> TP53 activation -->
increased apoptosis - CORRECT ANSWER Diamond-Blackfan anemia
,Megaloblastic macrocytic anemias (3) - CORRECT ANSWER B12 deficiency
Folate deficiency
Orotic aciduria
Nonmegaloblastic macrocytic anemias (4) - CORRECT ANSWER Diamond-
Blackfan anemia
Alcohol use
Liver disease
Thyroid disease
Normocytic anemia
Maybe due to: viral infections (eg., parvovirus), radiation, medications (eg,
antimetabolites), and toxin exposure
Pncytopenia (anemia, thrombocytopenia, leukopenia) - CORRECT ANSWER
Aplastic anemia
Autosomal recessive
Defect in DNA repair mechanisms
Either normocytic or macrocytic anemia
Pancytopenia (labs show anemia, thrombocytopenia, leukopenia) - CORRECT
ANSWER Fanconi anemia
Autosomal recessive
Defect in uridine monophosphate (UMP) synthase that leads to elevated orotic acid in
the serum
FTT
Delayed development
megaloblastic macrocytic anemia that does not improve w/ supplementation of folate
and vitamin B12
Hypersegmented neutrophils present - CORRECT ANSWER Orotic aciduria
Megaloblastic macrocytic anemia
Hypersegmented neutrophils
, Causes include vegan diet, pernicious anemia, gastrectomy, gastric bypass surgery,
and ileal disease (eg, Chrohn disease)
No congenital structural defect - CORRECT ANSWER Vitamin B12 deficiency
Microcytic anemia in young children - CORRECT ANSWER Lead poisoning
Sideroblastic anemia
Thalassemias
Normocytic anemia in young children - CORRECT ANSWER Aplastic anemia
Hereditary spherocytosis
Leukemia
Microangiopathic hemolytic anemia (eg, HUS)
Pyruvate kinase deficiency
Rh incompatibility
Sickle-cell anemia
Macrocytic anemia in young children - CORRECT ANSWER Orotic aciduria
Diamond-Blackfan anemia
NSAIDs-induced peptic ulcer
Dark sools (melena)
Microcytic, hypochromic RBCs, some elongated (pencil cells) - CORRECT ANSWER
Iron deficiency anemia
Microcytic, hypochromic red blood cells, some w/ coarse basophilic stippling -
CORRECT ANSWER Lead poisoning
Beta thalassemia (major or minor)
Oval macrocytic red cells, some hypersegmented granulocytes - CORRECT
ANSWER Megaloblastic anemia
LATEST VERSION [QUESTIONS AND ANSWERS] WITH PRACTICE
EXAM DETAILED AND VERIFIED FOR GUARANTEED PASS- LATEST
UPDATE 2025 GRADED A
What are the risk factors of placental accreta spectrum - CORRECT ANSWER Hx
of c-section
Hx of uterine procedures (dilation, curettage, myomectomy, uterine ablation, Asherman
syndrome)
Placental previa
What is included in placenta accreta spectrum and describe each - CORRECT
ANSWER Placenta accreta: placental villi attach to the surface of the myometrium
Placenta increta: chorionic villi penetrate into the myometrium
Placenta precreta: chorionic villi penetrate through the myometrium to the uterine
serosa or adjacent organs
Secondary amenorrhea (absence of periods for 3 cycles) following a dilation and
curettage (D&C) - CORRECT ANSWER Asherman syndrome
- Trauma to stratum basalis --> absence of the stratum basalis layer of the endometrium
Etiology of secondary amenorrhea - CORRECT ANSWER Hypothalamic:
Functional hypothalamic amenorrhea
Pituitary: Hyperprolactinemia, empty sella syndrome, Sheehan syndrome
Ovary: Plycystic ovary syndrome, premature ovarian failure
Uterus: Asherman syndrome
Other: Congenital adrenal hyperplasia, hypothyroidism, adrenal tumors
List the disease for each histology:
1. Abscent stratum basalis in an endometrial biopsy
2. Benign keratinocytes within the epidermis
3. Enlarged ovaries w/ multiple cystic follicles
4. Hyperplasia of lactotroph cells within the anterior pituitary
,5. Numerous corpora albicans and a fibrotic cortex - CORRECT ANSWER 1.
Asherman syndrome
2. Imperforate hymen
3. Polycystic ovary syndrome
4. Prolactinoma
5. Atrophic ovary
Diagnosed in infants (< 1 year)
M > F predominance
Most common in Caucasian populations
Symptoms of severe anemia --> pallor, fatigue, cyanosis
Webbed neck (can be confused for Turner syndrome)
Cleft pallet
Triphalangeal thumbs
Macrocytic anemia (nonmegaloblastic)
Decreased reticulocyte count (< 1% in infants)
Normal leukocytes and platelets
Bone marrow biopsy --> absence of erythroid precursors
Increased HbF on electrophoresis
Nonmegaloblastic macrocytic anemia - CORRECT ANSWER Diamond-Blackfan
anemia
- Turner syndrome does not cause macrocytic anemia
Treatment for Diamond-Blackfan anemia - CORRECT ANSWER Corticosteroids
Transfusion
Hematopoietic stem cell transplant
Defect in erythropoiesis --> Pure Red Cell Aplasia (PRCA)
Erythroblasts in bone marrow undergo premature apoptosis
Common mutations result in ribosome protein synthesis defect --> TP53 activation -->
increased apoptosis - CORRECT ANSWER Diamond-Blackfan anemia
,Megaloblastic macrocytic anemias (3) - CORRECT ANSWER B12 deficiency
Folate deficiency
Orotic aciduria
Nonmegaloblastic macrocytic anemias (4) - CORRECT ANSWER Diamond-
Blackfan anemia
Alcohol use
Liver disease
Thyroid disease
Normocytic anemia
Maybe due to: viral infections (eg., parvovirus), radiation, medications (eg,
antimetabolites), and toxin exposure
Pncytopenia (anemia, thrombocytopenia, leukopenia) - CORRECT ANSWER
Aplastic anemia
Autosomal recessive
Defect in DNA repair mechanisms
Either normocytic or macrocytic anemia
Pancytopenia (labs show anemia, thrombocytopenia, leukopenia) - CORRECT
ANSWER Fanconi anemia
Autosomal recessive
Defect in uridine monophosphate (UMP) synthase that leads to elevated orotic acid in
the serum
FTT
Delayed development
megaloblastic macrocytic anemia that does not improve w/ supplementation of folate
and vitamin B12
Hypersegmented neutrophils present - CORRECT ANSWER Orotic aciduria
Megaloblastic macrocytic anemia
Hypersegmented neutrophils
, Causes include vegan diet, pernicious anemia, gastrectomy, gastric bypass surgery,
and ileal disease (eg, Chrohn disease)
No congenital structural defect - CORRECT ANSWER Vitamin B12 deficiency
Microcytic anemia in young children - CORRECT ANSWER Lead poisoning
Sideroblastic anemia
Thalassemias
Normocytic anemia in young children - CORRECT ANSWER Aplastic anemia
Hereditary spherocytosis
Leukemia
Microangiopathic hemolytic anemia (eg, HUS)
Pyruvate kinase deficiency
Rh incompatibility
Sickle-cell anemia
Macrocytic anemia in young children - CORRECT ANSWER Orotic aciduria
Diamond-Blackfan anemia
NSAIDs-induced peptic ulcer
Dark sools (melena)
Microcytic, hypochromic RBCs, some elongated (pencil cells) - CORRECT ANSWER
Iron deficiency anemia
Microcytic, hypochromic red blood cells, some w/ coarse basophilic stippling -
CORRECT ANSWER Lead poisoning
Beta thalassemia (major or minor)
Oval macrocytic red cells, some hypersegmented granulocytes - CORRECT
ANSWER Megaloblastic anemia
