COMLEX-USA Cheat Sheet 2026

The 30 highest-yield COMLEX-USA facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Which phase of fever is characterized by peripheral vasoconstriction and shivering? → Chill phase
2. Which sign, elicited by passive right hip flexion with knee extended while supine, suggests peritoneal irritation from appendicitis? → Psoas sign
3. Which of the following motions will be most affected by plexopathy involving the medial chord of the brachial plexus? → Finger abduction
4. Wernicke's area, responsible for language comprehension, is located in which brain region? → Superior temporal gyrus, dominant hemisphere
5. A patient with cirrhosis develops upper GI bleeding with hematemesis. Initial management should include: → IV access, fluid resuscitation, and octreotide drip
6. A 36-week pregnant woman has a positive Group B Streptococcus vaginal-rectal culture. Which antibiotic should be administered intrapartum for prophylaxis? → IV penicillin G or ampicillin
7. A patient presents with cervical somatic dysfunction. On exam, C4 is found to be ERS right. This means C4 is: → Extended, rotated right, side-bent right
8. Which immunoglobulin class is the first to be produced in a primary immune response? → IgM
9. What is the end result of successfully treating a somatic dysfunction using indirect OMT techniques? → Resolution of all four TART criteria
10. Which antiepileptic drug works by blocking sodium channels and is a first-line treatment for partial and generalized tonic-clonic seizures? → Phenytoin
11. Okazaki fragments are synthesized on which strand during DNA replication? → Lagging strand
12. Which enzyme is deficient in Tay-Sachs disease, leading to accumulation of GM2 ganglioside? → Hexosaminidase A
13. Nitric oxide (NO) produces vasodilation primarily by activating which intracellular enzyme? → Soluble guanylyl cyclase
14. A patient presents with projectile vomiting, visible peristaltic waves, and a palpable olive-shaped mass in the epigastrium at 3 weeks of age. The diagnosis is: → Pyloric stenosis
15. A 35-year-old woman presents with right lower quadrant pain, fever, anorexia, and elevated WBC. Rebound tenderness at McBurney's point is present. Diagnosis is: → Acute appendicitis
16. In the TART mnemonic for identifying somatic dysfunction, what does the 'A' represent? → Asymmetry
17. Which beta-blocker is cardioselective (beta-1 selective) and commonly used in heart failure? → Metoprolol succinate
18. Which surgical complication presents with fever, tachycardia, elevated WBC, and rigidity beginning 24–48 hours after bowel surgery? → Anastomotic leak
19. Which sleep stage is characterized by sleep spindles and K-complexes on EEG? → Stage N2 (NREM 2)
20. A trauma patient has absent breath sounds on the left, hypotension, and tracheal deviation to the right. Immediate action is: → Needle decompression of the left chest
21. According to Erikson's stages of psychosocial development, the primary task of adolescence (ages 12–18) is: → Identity vs. role confusion
22. Which muscle energy technique principle involves the patient contracting against the physician's unyielding resistance to mobilize a restricted segment? → Post-isometric relaxation
23. In damage control surgery for a trauma patient with coagulopathy and hypothermia, the correct sequence is: → Initial hemorrhage control → ICU resuscitation → definitive repair
24. Which condition causes an anion gap metabolic acidosis with a normal osmol gap? → Lactic acidosis
25. Facilitated positional release (FPR) combines a position of ease with which additional element to enhance tissue relaxation? → Compressive or torsional activating force
26. At a 24-week prenatal visit, a 1-hour 50g glucose challenge test returns 158 mg/dL. What is the next appropriate step? → Perform a 3-hour 100g oral glucose tolerance test
27. Guyon's canal nerve entrapment is likely to result in: → Weakness in finger abduction
28. Which of the following is regarded the most frequent L-Spine congenital anomaly? → Facet tropism
29. Strain-counterstrain tender points for lumbar flexion dysfunction are typically found: → On the anterior abdominal wall or ASIS region
30. Lithium toxicity is increased by which commonly prescribed drug class due to reduced renal clearance? → NSAIDs