COMLEX-USA Study Guide 2026

Everything you need to pass the COMLEX-USA exam in one place: the exam format, every topic to study, real practice questions with explanations, flashcards, and full-length practice tests. Free, no sign-up needed.

📋 COMLEX-USA Exam Format at a Glance

352
Questions
480 min
Time Limit
70.00%
Passing Score

📚 COMLEX-USA Topics to Study (22)

✍️ Sample COMLEX-USA Questions & Answers

1. Which condition causes an anion gap metabolic acidosis with a normal osmol gap?
Lactic acidosis

Lactic acidosis causes an elevated anion gap metabolic acidosis; isopropanol causes elevated osmol gap without anion gap; methanol and ethylene glycol cause both gaps.

2. A 19-year-old woman at 18 weeks gestation presents with painless cervical dilation to 4 cm and no uterine contractions. Membranes are intact. Which diagnosis is most likely?
Cervical insufficiency

Cervical insufficiency (incompetent cervix) presents with painless cervical dilation in the second trimester without uterine contractions.

3. The Galbreath technique is a mandibular drainage technique primarily used to treat dysfunction of which structure?
Eustachian tube / middle ear

The Galbreath technique uses rhythmic mandibular traction to open the Eustachian tube and facilitate middle ear drainage.

4. Which enzyme is deficient in Tay-Sachs disease, leading to accumulation of GM2 ganglioside?
Hexosaminidase A

Tay-Sachs disease results from deficiency of hexosaminidase A, causing GM2 ganglioside accumulation in lysosomes.

5. A patient appears with an absent triceps tendon reflex and weakness in the extensors of the hand, wrist, and elbow due to a neurological deficiency. Which nerve is the most likely to be affected?
Radial

Explanation: The radial nerve innervates the extensors of the upper extremity (elbow, triceps, wrist & hand). An absent triceps (C7) reflex & wrist drop will indicate radial nerve pathology

6. Okazaki fragments are synthesized on which strand during DNA replication?
Lagging strand

Okazaki fragments are short DNA segments synthesized discontinuously on the lagging strand, which runs antiparallel to the direction of replication fork movement.

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Your COMLEX-USA Study Path
1. Learn with Flashcards → 2. Drill Practice Tests → 3. Take the Full Exam Simulation