USMLE WORLD STEP 3 EXAM
USMLE WORLD STEP 3 EXAM STUDY MATERIAL WITH GUARANTEED ACCURATE
ANSWERS
Which is compatible with brain death:
-absence of respiratory drive for 3 mins off the ventilator
- irreversible absence of cerebral and brain stem reflexes - ACCURATE
ANSWER✅✅irreversible absence of cerebral and brain stem reflexes; the
absence of respiratory drive must be for 8 minutes
brain death criteria - ACCURATE ANSWER✅✅- neuro exam showing absent
cerebral and brainstem reflexes - pupillary, corneal, oculocephalic, oculovestibular
(caloric), sucking, swallowing, and extensor posturing
- absence of confounding factors aka intoxication with drugs or major endocrine/
electrolyte disturbances
- evidence of a devastating cause via brain imaging
is it possible to see spontaneous limb movements in people with brain death? -
ACCURATE ANSWER✅✅YES
,Saw palmetto is an alternative medicine most commonly used to treat -
ACCURATE ANSWER✅✅BPH; there's no evidence it works, however
Ginseng, garlic, ginkgo biloba, and saw palmetto all have the risk of the side effect
of ___________ - ACCURATE ANSWER✅✅bleeding
"non-ejection click" is a buzzword for which valvular murmur - ACCURATE
ANSWER✅✅mitral valve prolapse
typical sound of mitral valve prolapse - ACCURATE ANSWER✅✅non ejection
click followed by systolic murmur (which is mitral regurgitation)
The click and murmur occur later in systole if the L ventricular end diastolic
volume increases, and it may disappear entirely if the LVEDV is large enough (i.e.,
squatting, supine leg raise)
in botulism, are sensations intact? what about reflexes? - ACCURATE
ANSWER✅✅sensations are intact (botulism inhibits release of acetylcholine, so
it spares sensory tracts)
reflexes are diminished or absent
a child is diagnosed with night terrors. they recently moved to a new city. best
advice for mother is:
- he will likely experience these nightmares until he adjusts to his new home
,- his condition will most likely resolve spontaneously over 1-2 years
- these episodes should resolve as soon as he gets adequate sleep - ACCURATE
ANSWER✅✅his condition will most likely resolve spontaneously over 1-2
years
do sleep terrors have REM sleep? - ACCURATE ANSWER✅✅No; it is a non-
rapid eye movement arousal disorder
describe sleep terrors epidemiology and symptoms - ACCURATE
ANSWER✅✅they occur between ages 4-12. it is self-limiting, resolving over 1-
2 years.
it arises during the first third of sleep. the child awakens abruptly with a scream, a
frightened expression, and signs of autonomic arousal.
the child is unable to recall the episode in the morning
are you allowed to accept travel compensation from pharmaceuticals? what about
an honorarium (a payment)? what about pre-made slides at a presentation? -
ACCURATE ANSWER✅✅Yes to travel compensation and an honorarium
No to pre-made slides
44 yo M comes in for concern for hepatitis infection. he donated blood at an office
event and received a letter a few days later saying that hepatitis performed on his
sample was positive. he used injection drugs in his 20s but not since then.
Lab results are:
, AST 15
ALT 16
Hep A IgG +
Hep C AB +
Hep B sAg neg
Hep B s AB neg
HIV ab neg
next best step:
- initiate antiviral therapy because the patient has chronic hep C
- it is unclear if the patient has hep c; further investigation is required -
ACCURATE ANSWER✅✅it is unclear if the patient has hep c; further
investigation is required
2 other scenarios besides his having hep c are possible:
1) he USED to have hep C but CLEARED IT spontaneously (that happens)
2) it's a false positive result
You need HCV RNA to DEFINITIVELY DIAGNOSE ACTIVE HEP C
Are patients with proven Hep C via RNA in the blood candidates for antiviral
treatment? - ACCURATE ANSWER✅✅Yes
Which one has vaginal pH > 4.5; trichomonas or gardnerella ? - ACCURATE
ANSWER✅✅BOTH
USMLE WORLD STEP 3 EXAM STUDY MATERIAL WITH GUARANTEED ACCURATE
ANSWERS
Which is compatible with brain death:
-absence of respiratory drive for 3 mins off the ventilator
- irreversible absence of cerebral and brain stem reflexes - ACCURATE
ANSWER✅✅irreversible absence of cerebral and brain stem reflexes; the
absence of respiratory drive must be for 8 minutes
brain death criteria - ACCURATE ANSWER✅✅- neuro exam showing absent
cerebral and brainstem reflexes - pupillary, corneal, oculocephalic, oculovestibular
(caloric), sucking, swallowing, and extensor posturing
- absence of confounding factors aka intoxication with drugs or major endocrine/
electrolyte disturbances
- evidence of a devastating cause via brain imaging
is it possible to see spontaneous limb movements in people with brain death? -
ACCURATE ANSWER✅✅YES
,Saw palmetto is an alternative medicine most commonly used to treat -
ACCURATE ANSWER✅✅BPH; there's no evidence it works, however
Ginseng, garlic, ginkgo biloba, and saw palmetto all have the risk of the side effect
of ___________ - ACCURATE ANSWER✅✅bleeding
"non-ejection click" is a buzzword for which valvular murmur - ACCURATE
ANSWER✅✅mitral valve prolapse
typical sound of mitral valve prolapse - ACCURATE ANSWER✅✅non ejection
click followed by systolic murmur (which is mitral regurgitation)
The click and murmur occur later in systole if the L ventricular end diastolic
volume increases, and it may disappear entirely if the LVEDV is large enough (i.e.,
squatting, supine leg raise)
in botulism, are sensations intact? what about reflexes? - ACCURATE
ANSWER✅✅sensations are intact (botulism inhibits release of acetylcholine, so
it spares sensory tracts)
reflexes are diminished or absent
a child is diagnosed with night terrors. they recently moved to a new city. best
advice for mother is:
- he will likely experience these nightmares until he adjusts to his new home
,- his condition will most likely resolve spontaneously over 1-2 years
- these episodes should resolve as soon as he gets adequate sleep - ACCURATE
ANSWER✅✅his condition will most likely resolve spontaneously over 1-2
years
do sleep terrors have REM sleep? - ACCURATE ANSWER✅✅No; it is a non-
rapid eye movement arousal disorder
describe sleep terrors epidemiology and symptoms - ACCURATE
ANSWER✅✅they occur between ages 4-12. it is self-limiting, resolving over 1-
2 years.
it arises during the first third of sleep. the child awakens abruptly with a scream, a
frightened expression, and signs of autonomic arousal.
the child is unable to recall the episode in the morning
are you allowed to accept travel compensation from pharmaceuticals? what about
an honorarium (a payment)? what about pre-made slides at a presentation? -
ACCURATE ANSWER✅✅Yes to travel compensation and an honorarium
No to pre-made slides
44 yo M comes in for concern for hepatitis infection. he donated blood at an office
event and received a letter a few days later saying that hepatitis performed on his
sample was positive. he used injection drugs in his 20s but not since then.
Lab results are:
, AST 15
ALT 16
Hep A IgG +
Hep C AB +
Hep B sAg neg
Hep B s AB neg
HIV ab neg
next best step:
- initiate antiviral therapy because the patient has chronic hep C
- it is unclear if the patient has hep c; further investigation is required -
ACCURATE ANSWER✅✅it is unclear if the patient has hep c; further
investigation is required
2 other scenarios besides his having hep c are possible:
1) he USED to have hep C but CLEARED IT spontaneously (that happens)
2) it's a false positive result
You need HCV RNA to DEFINITIVELY DIAGNOSE ACTIVE HEP C
Are patients with proven Hep C via RNA in the blood candidates for antiviral
treatment? - ACCURATE ANSWER✅✅Yes
Which one has vaginal pH > 4.5; trichomonas or gardnerella ? - ACCURATE
ANSWER✅✅BOTH
