Comprehensive Osteopathic Medical Licensing Examination (COMLEX USA) Practice

A DTR Grade of 3 corresponds to which reflex status?

1. Normal

2. Hyperactive w/ clonus

3. Slightly hyperactive

4. Diminished

The correct answer is: Hyperactive w/ clonus

A deep tendon reflex (DTR) grade of 3 indicates that the reflex is hyperactive, and when it is graded as such with the additional presence of clonus, it suggests a significant neurological response. The term "hyperactive" implies that there is an exaggerated response compared to what is considered normal, and the presence of clonus denotes a rhythmic contraction and relaxation of the muscle that is elicited after the initial reflex. In contrast, a normal reflex, typically graded as a 2, represents a standard, expected response without exaggeration. A slightly hyperactive reflex might be graded as 1 or 2+, implying that it is somewhat above normal but not to the extent of clonus. A diminished reflex would be graded less than 2, indicating a weaker or absent response that is not consistent with a typical or exaggerated reaction. Thus, the classification aligns well with typical neurological assessments where DTR grades are utilized to evaluate the integrity of the reflex arc and possible central or peripheral nervous system issues. Therefore, a grade of 3, characterized by hyperactivity and clonus, accurately reflects the correct status of the reflex.