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
Placental villi attach to the surface of the myometrium - CORRECT ANSWER
Placenta accreta
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
ASSESSMENT 2 [ACTUAL EXAM]
LATEST VERSION [QUESTIONS AND
ANSWERS] WITH PRACTICE EXAM
DETAILED AND VERIFIED FOR
GUARANTEED PASS- LATEST
UPDATE 2025 GRADED A
Placental villi attach to the surface of the myometrium - CORRECT ANSWER
Placenta accreta
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
