Posted by: theparamount | June 14, 2010


Let me just start off by saying that I’m happy to be done but I don’t know what to do with myself.  Next I’ll outline what I thought of each of the above “C”s.

COMBANK: Very similar question style.  Most of these questions seemed to me to be on par with COMLEX questions.  The difference between COMBANK vs COMLEX is that COMLEX employed many more 2 and 3 step questions than are represented by the COMBANK.  Most of COMBANK seemed 1st or 2nd order to me.  I found that to be a major difference between the COMBANK and the COMLEX.  My COMLEX lacked a serious focus in microbiology so I cannot comment on how that stacked up but the COMLEX questions were very straightforward anyways.  Pharmacology is about the same as it is on COMLEX, know the MOA and the major side effects.  I would say that if you are scoring in the 60%’s on COMBANK that you should be good to go.  Another thing, that I pointed out in an earlier COMBANK review is that on COMBANK you must choose an answer before moving on (you get a stupid button if you don’t choose an answer).  This is NOT the case on the COMLEX.  You may choose to not answer a question and then come back later and choose.  The Review at the end of sections is the same.  Another difference is that there is no question list on the side of the questions during the COMLEX as there is on COMBANK.  Finally you can cross out answers on COMLEX but not in COMBANK (this is very useful to focus).

Overall COMBANK impression: Quality choice as a question bank for the COMLEX.

COMSAE: The testing format is EXACTLY the same as the COMLEX.  I’m talking EXACTLY.  The only thing thats different is that the COMLEX gives you a 10 minute break screen (still counts down your overall time) after 2 sections, and the COMSAE does not give you that screen.  The questions are very similar as well.  Even more so than the COMBANK.  Taking a COMSAE is definitely worth $50 dollars.  I took COMSAE A, COMSAE B and COMSAE C and I would recommend using COMSAE B or COMSAE C to test your knowledge.  COMSAE A is a little bit more off of what was tested.  The COMSAE is certainly worth $50 dollars and you would be a fool not to buy one in my opinion.  NBOME has stated that students generally score ~20 points better on the COMLEX than the COMSAE but I am not sure if that holds in my opinion.  In general, a lot of my exam was on par with the COMSAE questions.  There were probably 50 questions that were harder than COMSAE and 25 questions that were much harder than COMSAE.  Most of the questions were about the same or a little easier than COMSAE.

Overall COMSAE impression: TAKE A COMSAE NOW!

COMLEX: Whew, it was a beast.  I walked out of the test angry.  I thought man, that was an OB/GYN shelf exam.  After talking with a few people, I realized that I probably got alot of questions right and I was just focusing on the negative.  Anyways some topics that I had on my test is below.

OMM:  Mostly spinal levels.  I had one cranial question.  I had about 5 chapmans points that were odd chapmans points, not covered in Savarese.  I also had a sequencing question or two.  Probably totaled about 70 questions, so if you know OMM, you’re well on your way to passing.

Anatomy:  Mostly upper arm, nerves and brachial plexus injuries.  Though it was pretty heavy on alot of musculoskeletal.

Embryology:  Very low yield.  Only had a few teratogen questions.

Microbiology:  My test was very simple.  Probably only had about 20 pure microbiology questions.  Only remember 2 things on viruses. I would still study your brains out for microbiology as some people got hit HARD with micro.

Pharmacology: Simple as well, nothing spectacular.  Mostly MOA’s and side effects.  Also my favorite question of the test which I had no idea of the correct answer on the test.  Probably about 30 questions.

Neurology:  Super simple on my test. Cranial Nerve lesions. Some peoples tests were very heavy in neuro so be careful.  I personally love neurology and was very upset to see only about 20 questions on it.

Cardiology:  Lots of cardiac murmurs, know the sounds and the locations of the valves.  The EKGs presented were straightforward.

Endocrine:  Pretty big subject on my test.

Heme/Onc:  Normal bleeding disorders, the anticoagulants, etc

GI:  IBD questions etc.

Respiratory: A few on obstructive lung disease that’s about it.

Renal:  I don’t remember much renal.

Reproductive:  Don’t get me started on this one.  Lots of OB questions that I couldn’t look up the answer to without a resident or OBGYN attending.  Lots of uterine bleeding in all ages of women.

Dermatology:  Carcinomas and various other dermal lesions.

Things that I didn’t have on COMLEX that suprised me: No sickle cell, No cystic fibrosis, No paraneoplastic syndromes,  No systemic fungal  infections (coccidio, blasto, histo).


  1. Penicillamine–> drug CI in myesthenia gravis…Was that a choice??

    Btw thanks for all this great info!!!

  2. No that was not a choice.

    • According to Lippincott, aminoglycosides causes neuromuscular paralysis by decreasing ACh release so perhaps gentamicin was the answer. Tough question!

  3. It must’ve been gentamicin. I remember the Kaplan pharm guy saying that aminoglycosides cause a decrease in acetylcholine release.

  4. aminoglycosides can cause complete NMJ blockade and hence decrease Ach.

  5. I think you got a junk question. Penicillamine is an absolute CI. Cipro, Erythromycin and Gentamicin are relative CI.

  6. Gentamycin will prolong depolarization and thus block transmission. That would have been my quess.

  7. Thank you so much for this post. I’m literally freaking out about this exam…and I’m hoping that I can pool together everything that people have been saying about this exam and really focus the rest of my studying on the certain subjects before my exam (monday).

    As for the question…this website says:

    Gentamicin, erythromycin, and cipro are all relative contraindications.

  8. I have a quick question. How were you doing on the combank??? I have a 63% over 570 questions so far, and I have a 58% over 500 questions on uworld… I have my exam on Tuesday, and I’m kinda worried about passing. And for the omm stuff, would knowing the things in the grey boxes be sufficient?? Thanks for your input!!!

  9. [My Name]….thanks for the input….youre a good man! Enjoy your time away from studying!

  10. Got this exact question on the Kaplan USMLE Qbank. Hope this explanation helps.

    The correct answer is D. Myasthenia gravis (MG) is an autoimmune disease in which antibodies are directed against specific human body proteins It is characterized by fluctuating weakness of commonly used voluntary muscles, leading to the development of skeletal muscle weakness, ptosls, and difficulty in swallowing Physical activity exacerbates muscle weakness The primary pathologic effect of MG is a dramatic decrease in nicotinic acetyicholine receptors on the motor endplate where nerves form neuromuscular junctions with skeletal muscees It has recently been discovered that a second category of MG is due to autoantiboclies against MusK (muscle-specific kinase). which is a tyrosine kinase receptor required for the formation of the neuromuscular junction Antibodies against MuSK inhibit the signaling of MuSK normally induced by its nerve-derived ligand. agrin. The result isa decrease in patency ot the neuromuscular junction, and the consequent symptoms of MG. MG is improved with drugs that inhibit acetyicholinesterase and is worsened by medications that have anti-nicotinic side effects Gentamicin is an aminoglycoside antibiotic Aminoglycosides may have curare-like side effects, and therefore could potentially worsen the symptoms of MG.

  11. […] theparamount пишет: MG is improved with drugs that inhibit acetyicholinesterase and is worsened by medications that have anti-nicotinic side effects Gentamicin is an aminoglycoside antibiotic Aminoglycosides may have curare-like side effects, and therefore … […]

  12. […] Level 1: COMBANK Original Review COMBANK Thoughts after COMSAE Recent COMBANK Upgrades to GUI and Layout COMLEX Level 1 Study Journey Post-COMLEX Level 1 COMBANK Review […]

  13. Wow, this post is good, my younger sister is analyzing such things, therefore I am going
    to inform her.

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