Level 2 Study Pathway
Clinical presentations, diagnosis, management, and osteopathic integration organized specifically for Level 2 study.
Try the free Level 2 practice assessment · 160 questions; independent practice, not an official COMLEX-USA exam or score predictor.
USMLE and COMLEX-USA are separate examination programs. This map is organized for students preparing for COMLEX-USA Level 2-CE. Use the USMLE pathway if that is the examination program you are preparing for. Open the other exam pathway.
Mock exams for COMLEX-USA Level 2-CE: full-length and half-length forms
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OMM and osteopathic principles
Keep structural diagnosis, autonomics, regional mechanics, and treatment selection in a dedicated lane for this Level exam.
Spine, ribs, and regional mechanics
Pelvis and sacrum
Extremities
Cranial and treatment techniques
- Cranial Parasympathetic Techniques: Anatomy, Contact and Clinical Judgment
- Cranial Dysfunction: Axes, Landmarks, and Clinical Limits
- Cranial Strain Patterns
- HVLA principles: judge the tissue before the thrust
- Lumbar and Pelvic Counterstrain: Landmarks Before Positions
- Muscle Contraction Types
- Soft Tissue OMT: Stretch, Traction & Inhibition
- Thoracic Counterstrain Tenderpoints
Additional OMM study pages
Complete study map
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OMM and Osteopathic Principles
34 pages
- OMM Fundamentals: From Examination to Treatment Choice
- Cranial Parasympathetic Techniques: Anatomy, Contact and Clinical Judgment
- Lymphatics: Fluid, Anatomy, and Safe Technique Selection
- Special tests: load the anatomy, then choose the action
- Upper and Lower Extremity Findings: Anatomy, Autonomics and Manual Medicine
- Autonomic Spinal Levels: Trace the Pathway Before the Pattern
- Brachial Plexus and Upper Extremity Nerve Injuries
- Cervical OMM
- Chapman Points
- Cranial Dysfunction: Axes, Landmarks, and Clinical Limits
- Cranial Strain Patterns
- Fascial Subtypes: Why the Joint Capsule Is Deep Fascia
- Fibular Head Somatic Dysfunction
- Fryette's Principles: From Examination to Direction
- HVLA principles: judge the tissue before the thrust
- Innominate Rotations: Position, Direction, and Clinical Judgment
- Innominate Shears, Flares, and Pubic Shears
- L5 Diagnosis Trainer and Sacral Torsions
- Low Back Pain: Clinical Patterns and Osteopathic Reasoning
- Lower Extremity Nerve Injuries: Localize by Function
- Lumbar and Pelvic Counterstrain: Landmarks Before Positions
- Lumbar Dysfunctions: From Palpatory Findings to a Coherent Diagnosis
- Muscle Contraction Types
- Piriformis and Deep Gluteal Pain
- Psoas syndrome: assess the restriction, then the cause
- Radial Head: Rotation, Examination, and Safe Decisions
- Rib mechanics and respiratory dysfunction
- Sacral diagnosis from landmarks and motion
- Scoliosis
- Soft Tissue OMT: Stretch, Traction & Inhibition
- Thoracic Counterstrain Tenderpoints
- Thoracic Somatic Dysfunction
- Viscerosomatic reflexes: pathways, patterns and limits
- Zink Patterns
Hematology and Oncology
19 pages
- Anemias: explain cell size and marrow response
- Bleeding and Coagulation Disorder Decoder
- Cancer Translocations: t(9;22), t(8;14) & More
- Clotting cascade: localize the defect, then explain the phenotype
- Coagulation: connect assays to bleeding and thrombosis
- Hemolytic anemias: locate the destruction
- Hemophilia & the Coag Cascade
- Hemophilic arthropathy: from joint bleed to target joint
- Hemostasis: Primary vs Secondary & Platelet Plug
- Iron Deficiency Anemia Workup
- Lead Poisoning
- Leukemias: ALL vs AML vs CLL vs CML
- Lymphomas: read the lineage before the label
- Macrocytic, Normocytic Anemias & PNH
- Microcytic Anemias
- Multiple Myeloma & MGUS
- Platelet disorders: number, function and clinical pattern
- Platelets & Hemostasis
- Drugs of the Clotting Cascade
Cardiovascular
26 pages
- Abdominal Aortic Branches in Anatomy and Clinical Decisions
- Cardiac Myocyte Action Potential
- EKG Lead I: Vector from RA to LA
- Frank-Starling
- Hemodynamics
- Abdominal Aortic Aneurysm
- Aortic Dissection
- Cardiomyopathies. Shape, tissue and clinical decisions
- Chronic Venous Insufficiency
- Congenital heart defects through blood flow
- Diastolic Rumble
- EKG Interpretation
- Heart murmurs. Timing, pressure and bedside decisions
- Infective Endocarditis: Vegetations, Duke Criteria & the Peripheral Signs
- Inferior MI, right ventricular failure, and AV block
- Mitral Regurgitation
- Paradoxical S2 Split
- Post-MI complications through rhythm, flow, and tissue failure
- Systolic Murmur Localizer
- Wide S2 Split
- Antiarrhythmics
- Atrial Fibrillation: Rate, Rhythm, and Stroke Prevention
- Dyslipidemia and Lipid Management
- Heart failure through pressure, perfusion and treatment
- Hypertension: Staging, First-Line Drugs, and the Crisis Rule
- MI ED Meds: MONA-BAH
Respiratory
13 pages
- Lung cancers: tissue, physiology, and treatment decisions
- Pulmonary Physiology: Air, Blood and Pressure
- Squamous lung carcinoma: tissue, calcium and local anatomy
- Acid-base disorders
- ARDS and the lung that needs protection
- Asthma and COPD
- Centriacinar vs Panacinar Emphysema
- Cystic Fibrosis
- Lung abscess: follow the route, locate the collection
- Pneumonias: from airspace findings to targeted care
- Tension pneumothorax
- PE and DVT from probability to treatment
- Sarcoidosis: diagnosis, organ risk, and treatment
Renal and Genitourinary
13 pages
- Ureter Blood Supply: Preserve the Connections
- AKI and CKD. Read the timeline, perfusion, and urine together
- Electrolyte Emergencies: Crisis Orders
- Electrolytes in clinical context
- IgA nephropathy. From urinary findings to kidney protection
- Nephrolithiasis: protect drainage, explain the chemistry
- Nephrotic and nephritic syndromes. Find the injured compartment
- Renal artery stenosis and RAAS
- Renal tubular acidosis
- Sodium and Osmolality: Follow the Water
- Urinary Tract Infections
- Diuretics and the nephron
- Drug-induced kidney injury
Gastrointestinal
20 pages
- Celiac Trunk and Foregut Vascular Anatomy
- Diverticular disease: anatomy, inflammation and the next decision
- Acute Appendicitis
- Acute Cholecystitis and Biliary Disease
- Acute Pancreatitis
- Cirrhosis and Portal Hypertension
- Colon polyps: tissue, complete removal and follow-up
- Crohn Disease vs Ulcerative Colitis
- Dubin-Johnson and Rotor Syndromes
- Gallstone Ileus
- GERD, Erosive Esophagitis, and Peptic Ulcer Disease
- Hepatitis serologies: what the result can actually tell you
- Hepatocellular carcinoma: the tumor and the liver
- Jaundice: Build the Differential
- Liver Enzymes, AST/ALT Ratio, and Synthetic Function
- Liver Metastases and Secondary Tumors
- PPI-associated hypergastrinemia: read the hormone beside the acid
- Primary Sclerosing Cholangitis versus Primary Biliary Cholangitis
- Small-Bowel Obstruction
- Zinc Deficiency
Endocrine
19 pages
- Cortisol physiology: timing, feedback, and stress adaptation
- Adrenal Insufficiency
- Adrenal masses: hormones, feedback, and the incidentaloma fork
- Congenital adrenal hyperplasia: read the blocked steroid pathway
- Cushing Syndrome: Confirm, Classify, Localize
- DKA and HHS: Ketones, Acidosis, and Hyperosmolality
- Gigantism (GH Excess)
- Glucagonoma Syndrome: NME, Catabolism, and Pancreatic NET Reasoning
- Insulinoma and the hypoglycemia critical sample
- Jod-Basedow: Iodine, Autonomy, and Thyroid Hormone Synthesis
- MEN Syndromes: MEN1 vs MEN2A vs MEN2B
- Pancreatic Neuroendocrine Tumors: VIPoma & Friends
- Pheochromocytoma and paraganglioma: follow the catecholamine signal
- Pituitary tumors and the logic of water balance
- The Calcium, PTH, and Vitamin D Axis
- Type 1 vs Type 2 Diabetes: Production, Resistance, and Crisis
- Medication Adherence: Exposure, Barriers and Safe Treatment
- Osteoporosis: read the fracture, DXA, risk, and treatment sequence
- Thyroid disorders from hormone source to treatment
Reproductive
15 pages
- Pregnancy physiology: what changes, and why
- Sexual differentiation: anatomy, hormones, and response
- Bartholin Cysts and Abscesses
- Cervical Cancer Screening, HPV and Dysplasia
- Contraception
- Ectopic Pregnancy
- Gynecologic infections: localize, test and treat
- Placenta accreta spectrum: when the separation interface fails
- Placenta previa and placental abruption
- Polycystic Ovary Syndrome
- Preeclampsia, Eclampsia and HELLP
- Primary amenorrhea: locate the problem and choose the next step
- Umbilical Cord Vessels: Two Arteries, One Vein
- Varicocele: Dilation of the Pampiniform Plexus
- Breast Neoplasms from Finding to Treatment
Musculoskeletal and Rheumatology
12 pages
- Artery of the Ligamentum Teres and Femoral-Head Perfusion
- Deep Femoral Artery: Trace the Supply, Find the Injury
- Inferior gluteal artery
- Medial Circumflex Femoral Artery: Routes to the Femoral Head
- Superior gluteal artery: vessel, nerve, or joint?
- Forearm Flexors & FDS Injury
- Rotator Cuff Disease and Subacromial Impingement
- Scoliosis
- Seronegative Spondyloarthropathies: The 4 Compared
- Spondylitis, Spondylosis, Spondylolysis & Spondylolisthesis
- The Big 5 Autoimmune Diseases
- Thoracic Outlet Syndrome: Neurogenic, Venous & Arterial
Dermatology
3 pages
Nervous System
58 pages
- Autonomic failure from standing physiology to treatment choices
- Basal ganglia anatomy, circuits, and clinical localization
- CNS Embryology: From Tissue Origins to Clinical Anatomy
- Craniopharyngioma: anatomy, hormones and function
- Maxillary dental nerves
- Neurodegeneration Decoder: Anatomy, Circuits and Tempo
- 4 Dopamine Pathways, Antipsychotic Effects
- Abnormal Gait Recognition: Visual Neuro Localizer
- AIDS Dementia Complex, HIV Encephalopathy
- ALS, Upper + Lower Motor Neuron Signs
- Aphasias: Test the Pattern, Localize the Network, Plan the Care
- Bell Palsy and Facial Localization
- Brain Tumors
- Brainstem Stroke Syndromes: Trace the Pathway, Test the Pattern
- Cerebral Cortex: Brodmann Areas, Lobes, Aphasias & Visual Fields
- Cervical Radiculopathy: Localize Before You Label
- Charcot-Bouchard Aneurysm: From Small-Vessel Injury to Deep Hemorrhage
- Chiari malformations and syringomyelia
- Conus Medullaris + Cauda Equina + LP Landmarks
- Cortical Stroke Syndromes: Localize the Dysfunction
- Cranial nerves and clinical localization
- Cribriform Plate & CN I, Anosmia from Trauma
- Dandy-Walker Malformation
- Dementias: Timing, Networks, and Treatable Contributors
- Dermatomes and Root Localization
- Ependymoma, Fourth Ventricle Tumor
- Extraocular Muscles, Gaze and Visual Fields
- Extremity Nerves: Lesion to Deficit
- Femoral Nerve & Hip Flexor Spasticity
- Guillain-Barre syndrome
- Headaches
- Huntington Disease, CAG Repeats & Chorea
- Idiopathic Intracranial Hypertension
- Intracranial Hemorrhages
- Lenticulostriate Strokes
- Medulloblastoma: Cerebellar PNET in Kids
- Movement Disorders: Parkinson, Huntington, Tremors
- Neural Tube Defects: when the neuropore won't close
- Neurofibromatosis Type 1: Cafe-au-Lait & Lisch
- Neurofibromatosis Type 2: Bilateral Schwannomas
- Neuromuscular Junction Disorders: MG, LEMS and Botulism
- Olfactory Nerve and Cribriform Plate
- Parkinson Disease
- Peripheral Vertigo and BPPV
- Phakomatoses: Neurocutaneous Syndromes Compared
- Pilocytic Astrocytoma: Rosenthal Fibers
- Restless Leg Syndrome
- Sciatica Localizer: Root, Nerve, Plexus, or Canal?
- Seizures and epilepsy
- Spinal Cord Tracts and Syndromes
- Spinal Stenosis: When the Canal Squeezes the Cord
- Spinal Tracts: DCML vs Spinothalamic vs Corticospinal
- Stroke Syndromes
- Wernicke Encephalopathy and Korsakoff Syndrome
- Wilson Disease
- Acute Ischemic Stroke Management
- Demyelinating diseases: localization, timing and treatment
- Normal pressure hydrocephalus: from gait to a treatment decision
Psychiatry and Behavioral
11 pages
- Antidepressants
- Antipsychotics, Mood Stabilizers, and Anxiolytics
- Anxiety, OCD, and Related Disorders
- Eating disorders
- Grief vs Major Depression: Where to Draw the Line
- Personality disorders
- Schizophrenia and mood disorders
- Somatic Symptoms, Health Anxiety and Functional Neurologic Disorder
- Substance Intoxication and Withdrawal
- The Agitated Patient
- Trauma and PTSD Disorders: Criteria, Context and Care
Pediatrics
10 pages
- Bronchiolitis and RSV: Supportive Care and Palivizumab
- Croup vs Epiglottitis
- Immunization schedules: make every dose count
- Intussusception: Currant Jelly Stool and the Air Enema
- Kawasaki Disease: Fever, Mucocutaneous Findings and Coronary Aneurysms
- Neonatal Jaundice and Hyperbilirubinemia: Timing, Kernicterus and Biliary Atresia
- Neuroblastoma: N-myc & Dancing Eyes
- Newborn Screening: The 48-Hour Heel Stick
- Pyloric Stenosis
- Tanner Staging: All 5 Stages of Puberty
Ethics and Professionalism
5 pages
Internal-Medicine
1 pages
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