USMLE STEP 3 HIGH YIELD FACTS 2 EXAM
questions with expert verified correct
answers latest updated version 2025
A 45-year-old woman has an acute coronary occlusion. Within
secondary, the ischemic region shows mitochondrial swelling &
depletion of glcyogen granules. What metabolic events is the most
likely cause of these cellular changes? --- correct precise answer ---
*ATP depletion*
A 50-year-old man has a 10-year history of poorly controlled HT. Vital
signs are:
Pulse = 96/min
Respirations = 16/min
BP:
left arm = 226/120 mmHg
right arm = 218/118 mmHg
With the patient in the left lateral decubitus position, a late diastolic
sound is heard best with the bell at the apex. What is the most likely
,explanation for this auscultatory finding? --- correct precise answer --
-*S4*
- in *late* diastole (atrial kick)
- best heard at apex with patient in left lateral decubitus position
- high atrial pressure
- associated with ventricular noncompliance (hypertrophy)
- left atrium must push against stiff LV wall
- considered abnormal, regardless of patient age
In gout, hyperuricemia resulting from overproduction of urate is most
likely to result from a lack of feedback inhibition by ADP or GDP at
what enzyme? --- correct precise answer ---
*Phosphoribosylpyrophosphate synthetase*
A female neonate has profound hypotonia. The only known
complication of pregnancy was polyhydramnios. The mother has a
lack of facial expression & weak muscles; she says she did not have
any problems as a infant or child. What best explains the difference in
presentations in the mother & child? --- correct precise answer ---
*Anticipation*
,Myotonic dystrophy
- baby had polyhydramnios because any hypotonic baby has
polyhydramnios (they don't swallow properly)
- *inherited as AD --> manifests anticipation phenomenon because it's
one of the trinucleotide repeat disorders*
A 35-year-old woman comes to the physician for an initial visit. She
refuses to fill out a questionnaire form about personal data & her
medical history, then sits silently in the waiting room with her fists
clenched. When the physician greets her in the exam room, she says,
"Let's get this over with." What questions is most likely to facilitate
communication with the patient? --- correct precise answer ---"I can
see that you are upset. Please tell me what is bother you."
An 80-year-old woman comes to the physician because of a 2-week
history of mild constipation & occasional inability to completely empty
the bladder. She takes over-the-counter medications frequently. Vital
signs are normal. Evaluation shows bladder distention & mild
confusion. What drugs is the most likely cause her symptoms? ---
correct precise answer ---*Diphenhydramine*
sedation
*antimuscarinic*
, - tachycardia
- mydriasis
- *decreased gastric motility*
- agitation
- hot, dry skin
- dry mouth
anti-alpha-adrenergic
Relative to the normal values for parameters that govern capillary
exchange, what is the most likely cause of the edema that results from
use of a venous occlusive tourniquet? --- correct precise answer ---
*Increased mean capillary hydrostatic pressure*
Capillary hydrostatic pressure (Pc)
- drives fluid out of capillary
A 50-year-old man with anginal pain takes nitroglycerin. The pain is
rapidly relieved because of --- correct precise answer ---stimulation of
cyclic GMP formation
questions with expert verified correct
answers latest updated version 2025
A 45-year-old woman has an acute coronary occlusion. Within
secondary, the ischemic region shows mitochondrial swelling &
depletion of glcyogen granules. What metabolic events is the most
likely cause of these cellular changes? --- correct precise answer ---
*ATP depletion*
A 50-year-old man has a 10-year history of poorly controlled HT. Vital
signs are:
Pulse = 96/min
Respirations = 16/min
BP:
left arm = 226/120 mmHg
right arm = 218/118 mmHg
With the patient in the left lateral decubitus position, a late diastolic
sound is heard best with the bell at the apex. What is the most likely
,explanation for this auscultatory finding? --- correct precise answer --
-*S4*
- in *late* diastole (atrial kick)
- best heard at apex with patient in left lateral decubitus position
- high atrial pressure
- associated with ventricular noncompliance (hypertrophy)
- left atrium must push against stiff LV wall
- considered abnormal, regardless of patient age
In gout, hyperuricemia resulting from overproduction of urate is most
likely to result from a lack of feedback inhibition by ADP or GDP at
what enzyme? --- correct precise answer ---
*Phosphoribosylpyrophosphate synthetase*
A female neonate has profound hypotonia. The only known
complication of pregnancy was polyhydramnios. The mother has a
lack of facial expression & weak muscles; she says she did not have
any problems as a infant or child. What best explains the difference in
presentations in the mother & child? --- correct precise answer ---
*Anticipation*
,Myotonic dystrophy
- baby had polyhydramnios because any hypotonic baby has
polyhydramnios (they don't swallow properly)
- *inherited as AD --> manifests anticipation phenomenon because it's
one of the trinucleotide repeat disorders*
A 35-year-old woman comes to the physician for an initial visit. She
refuses to fill out a questionnaire form about personal data & her
medical history, then sits silently in the waiting room with her fists
clenched. When the physician greets her in the exam room, she says,
"Let's get this over with." What questions is most likely to facilitate
communication with the patient? --- correct precise answer ---"I can
see that you are upset. Please tell me what is bother you."
An 80-year-old woman comes to the physician because of a 2-week
history of mild constipation & occasional inability to completely empty
the bladder. She takes over-the-counter medications frequently. Vital
signs are normal. Evaluation shows bladder distention & mild
confusion. What drugs is the most likely cause her symptoms? ---
correct precise answer ---*Diphenhydramine*
sedation
*antimuscarinic*
, - tachycardia
- mydriasis
- *decreased gastric motility*
- agitation
- hot, dry skin
- dry mouth
anti-alpha-adrenergic
Relative to the normal values for parameters that govern capillary
exchange, what is the most likely cause of the edema that results from
use of a venous occlusive tourniquet? --- correct precise answer ---
*Increased mean capillary hydrostatic pressure*
Capillary hydrostatic pressure (Pc)
- drives fluid out of capillary
A 50-year-old man with anginal pain takes nitroglycerin. The pain is
rapidly relieved because of --- correct precise answer ---stimulation of
cyclic GMP formation
