COMLEX Level 1 case studies
COMLEX Level 1 · Put your knowledge to work in context.
COMLEX-USA Level 1 is the first examination in the COMLEX-USA series, produced by the National Board of Osteopathic Medical Examiners (NBOME). It is taken by osteopathic medical students, and passing it indicates that a candidate has demonstrated competence in the foundational biomedical sciences together with osteopathic principles and the related physician competency domains - the level of competence required to enter supervised patient care settings and to continue lifelong learning. The COMLEX Level 1 case studies are 5 cases and about 4,816 words.
1Third-Trimester Low Back Pain: Naming the Dysfunction and Choosing a Technique
A 31-year-old G1P0 at 30 weeks' gestation presents with 3 weeks of worsening low back pain that radiates into the right buttock. Pain is worse with standing and prolonged sitting and is relieved by lying on her left side.
906 words, about 5 min2Suspected Bacterial Meningitis in an Anticoagulated Patient: Sequence, Reversal, and the LP Decision
A 58-year-old man on warfarin for a mechanical mitral valve presents with 12 hours of fever (39.1 °C), severe headache, and neck stiffness. He is drowsy but arousable, follows simple commands, and has no focal motor deficit; GCS is 14.
897 words, about 4 min3DKA With a High Normal Potassium: Sequencing Fluids, Insulin, and Potassium
A 23-year-old woman with type 1 diabetes presents with 2 days of vomiting and abdominal pain. She stopped her insulin pump because of nausea.
897 words, about 4 min4Did the Diabetes Quality Improvement Project Work? Reading a Pre–Post Improvement Report
A family medicine residency clinic with 4 attendings and 900 adults with type 2 diabetes starts a registry with pharmacist-led outreach. At baseline, 61% of patients had an A1c <8%; at 12 months, 74% did.
987 words, about 5 min5Informed Refusal of Amputation in a Spanish-Speaking Patient Whose Daughter Holds Power of Attorney
A 78-year-old man who speaks only Spanish is admitted with a necrotic right forefoot and underlying osteomyelitis. Vascular surgery recommends a below-knee amputation; without it, they estimate a high risk of progression to sepsis and death within weeks, although he is currently afebrile and hemodynamically stable.
1,129 words, about 6 min