©SOPHIABENNET@2024/2025 Tuesday, August 20, 2024 10:21 AM
USMLE Step 3 Practice Exam Questions and
Answers (100% Pass)
Pseudogout associations - Answer✔️✔️-hemochromatosis,
hyperparathyroidism, acromegaly, hypothyroidism
Gout crystals - Answer✔️✔️-negatively birefringent needles
Pseudogout crystals - Answer✔️✔️-positively birefringent needles
Vasculitis associated with chronic Hep B - Answer✔️✔️-polyarteritis nodosa
Vasculitis associated with chronic Hep C - Answer✔️✔️-cryoglobulinemia
Best blood test for polyarteritis nodosa - Answer✔️✔️-There is none. Get
abdominal angiography first, then biopsy of muscle, skin, or sural nerve.
Churg-Strauss - Answer✔️✔️-vasculitis + eosinophilia + asthma
Takayasu's arteritis - Answer✔️✔️-young asian female with diminished
pulses (usually preceeded by fatigue, weight loss, arthralgia, anemia,
elevated ESR)
Best test for Takayasu's - Answer✔️✔️-aortic angiography or MRA
Bite cells on blood smear - Answer✔️✔️-G6PD
Burr/Spur cells on blood smear - Answer✔️✔️-liver disease
Acanthocytes on blood smear (looks like spur cell but with more rounded
spurs) - Answer✔️✔️-liver disease, hypothyroidism, alcoholism
1
, ©SOPHIABENNET@2024/2025 Tuesday, August 20, 2024 10:21 AM
Basophilic stippling on blood smear - Answer✔️✔️-lead poisoning
Schistocytes on blood smear - Answer✔️✔️-TTP-HUS, DIC, prosthetic heart
valve, malignant htn, sepsis
Target cells on blood smear - Answer✔️✔️-thalassemia, other
hemoglobinopathies, liver disease
5 causes of microcytic anemia - Answer✔️✔️-iron deficiency, lead poisoning,
anemia of chronic disease (but usually normocytic), thalassemia,
sideroblastic anemia (can also have high MCV)
Antibody test for celiac disease - Answer✔️✔️-anti-endomysial, tissue
transglutaminase (small bowel bx is best though)
Antibiotics for MRSA - Answer✔️✔️-IV: vanc, linezolid, daptomycin,
tigecycline;
if minor infection, can use oral: TMP/SMX, doxy, minocycline, or maybe
clindamycin (there is inducible resistance to clinda though)
Antibiotics for MSSA - Answer✔️✔️-Oxacillin/nafcillin, dicloxacillin (IV and
oral), cefazolin (IV), cephalexin (oral)
Can you use cephalosporins in pt allergic to PCN? - Answer✔️✔️-yes, if the
rxn is rash only; no if pt has true anaphylaxis
Antibiotics to use for Staph with PCN allergy - Answer✔️✔️-cephalosporins
if rash only; macrolides, clindamycin, vancomycin, linezolid, daptomycin,
TMP/SMX
2
, ©SOPHIABENNET@2024/2025 Tuesday, August 20, 2024 10:21 AM
Antibiotics for strep - Answer✔️✔️-PCN, ampicillin, amoxicillin
Antibiotics for GNRs - Answer✔️✔️-Cephalosporins: cefepime, ceftazidime
PCNs: piperacillin, ticaricillin
Monobactam: Aztreonam
Quinolones: cipro, levo, gati, moxi
Aminoglycs: gentamicin, tobramycin, amikacin
Carbapenems: imipenem, mero, erta
Limitation of ertapenem - Answer✔️✔️-does NOT cover pseudomonas
Piperacillin and ticarcillin - Answer✔️✔️-GNRs
strep
anaerobes
Carbapenems - Answer✔️✔️-good anaerobic coverage
strep
MSSA
Tigecycline - Answer✔️✔️-MRSA
good GNR coverage
Anaerobes - Answer✔️✔️--metronidazole is BEST for abdominal anaerobes
(carbapenems, piperacillin, and ticarcillin have equal efficacy)
-cefoxitin and cefotetan are the ONLY cephalosporins
3
, ©SOPHIABENNET@2024/2025 Tuesday, August 20, 2024 10:21 AM
-respiratory anaerobes: clindamycin
Abx with NO anaerobic coverage - Answer✔️✔️-aminoglycs, aztreonam,
fluoroquinolones, oxacillin/nafcillin, all cephalosporins EXCEPT cefoxitin
and cefotetan
Red man syndrome - Answer✔️✔️-red, flushed skin from histamine release,
associated with rapid infusion of vancomycin (so slow down the infusion
rate)
Osteomyelitis - Answer✔️✔️--most common is staph: oxacillin or nafcillin IV
for 4-6 wks for MSSA; vanc, linezolid or dapto for MRSA
-GNRs: salmonella or pseudomonas, can use orals, but must cx org. first
and make sure it is sensitive (BONE bx and cx)
Cellulitis tx - Answer✔️✔️--minor infection: oral dicloxacillin or cephalexin
-severe: IV oxacillin, nafcillin or cefazolin
-PCN allergy: if rash, then cephalosporin; if anaphylaxis, then vanc,
linezolid, dapto (macrolides or clinda for minor infection)
Sequelae of strep infection - Answer✔️✔️--throat: rheumatic fever AND
glomerulonephritis
-skin: ONLY glomerulonephritis
Gonorrhea tx - Answer✔️✔️--ceftriaxone IM
-cefixime oral
4
USMLE Step 3 Practice Exam Questions and
Answers (100% Pass)
Pseudogout associations - Answer✔️✔️-hemochromatosis,
hyperparathyroidism, acromegaly, hypothyroidism
Gout crystals - Answer✔️✔️-negatively birefringent needles
Pseudogout crystals - Answer✔️✔️-positively birefringent needles
Vasculitis associated with chronic Hep B - Answer✔️✔️-polyarteritis nodosa
Vasculitis associated with chronic Hep C - Answer✔️✔️-cryoglobulinemia
Best blood test for polyarteritis nodosa - Answer✔️✔️-There is none. Get
abdominal angiography first, then biopsy of muscle, skin, or sural nerve.
Churg-Strauss - Answer✔️✔️-vasculitis + eosinophilia + asthma
Takayasu's arteritis - Answer✔️✔️-young asian female with diminished
pulses (usually preceeded by fatigue, weight loss, arthralgia, anemia,
elevated ESR)
Best test for Takayasu's - Answer✔️✔️-aortic angiography or MRA
Bite cells on blood smear - Answer✔️✔️-G6PD
Burr/Spur cells on blood smear - Answer✔️✔️-liver disease
Acanthocytes on blood smear (looks like spur cell but with more rounded
spurs) - Answer✔️✔️-liver disease, hypothyroidism, alcoholism
1
, ©SOPHIABENNET@2024/2025 Tuesday, August 20, 2024 10:21 AM
Basophilic stippling on blood smear - Answer✔️✔️-lead poisoning
Schistocytes on blood smear - Answer✔️✔️-TTP-HUS, DIC, prosthetic heart
valve, malignant htn, sepsis
Target cells on blood smear - Answer✔️✔️-thalassemia, other
hemoglobinopathies, liver disease
5 causes of microcytic anemia - Answer✔️✔️-iron deficiency, lead poisoning,
anemia of chronic disease (but usually normocytic), thalassemia,
sideroblastic anemia (can also have high MCV)
Antibody test for celiac disease - Answer✔️✔️-anti-endomysial, tissue
transglutaminase (small bowel bx is best though)
Antibiotics for MRSA - Answer✔️✔️-IV: vanc, linezolid, daptomycin,
tigecycline;
if minor infection, can use oral: TMP/SMX, doxy, minocycline, or maybe
clindamycin (there is inducible resistance to clinda though)
Antibiotics for MSSA - Answer✔️✔️-Oxacillin/nafcillin, dicloxacillin (IV and
oral), cefazolin (IV), cephalexin (oral)
Can you use cephalosporins in pt allergic to PCN? - Answer✔️✔️-yes, if the
rxn is rash only; no if pt has true anaphylaxis
Antibiotics to use for Staph with PCN allergy - Answer✔️✔️-cephalosporins
if rash only; macrolides, clindamycin, vancomycin, linezolid, daptomycin,
TMP/SMX
2
, ©SOPHIABENNET@2024/2025 Tuesday, August 20, 2024 10:21 AM
Antibiotics for strep - Answer✔️✔️-PCN, ampicillin, amoxicillin
Antibiotics for GNRs - Answer✔️✔️-Cephalosporins: cefepime, ceftazidime
PCNs: piperacillin, ticaricillin
Monobactam: Aztreonam
Quinolones: cipro, levo, gati, moxi
Aminoglycs: gentamicin, tobramycin, amikacin
Carbapenems: imipenem, mero, erta
Limitation of ertapenem - Answer✔️✔️-does NOT cover pseudomonas
Piperacillin and ticarcillin - Answer✔️✔️-GNRs
strep
anaerobes
Carbapenems - Answer✔️✔️-good anaerobic coverage
strep
MSSA
Tigecycline - Answer✔️✔️-MRSA
good GNR coverage
Anaerobes - Answer✔️✔️--metronidazole is BEST for abdominal anaerobes
(carbapenems, piperacillin, and ticarcillin have equal efficacy)
-cefoxitin and cefotetan are the ONLY cephalosporins
3
, ©SOPHIABENNET@2024/2025 Tuesday, August 20, 2024 10:21 AM
-respiratory anaerobes: clindamycin
Abx with NO anaerobic coverage - Answer✔️✔️-aminoglycs, aztreonam,
fluoroquinolones, oxacillin/nafcillin, all cephalosporins EXCEPT cefoxitin
and cefotetan
Red man syndrome - Answer✔️✔️-red, flushed skin from histamine release,
associated with rapid infusion of vancomycin (so slow down the infusion
rate)
Osteomyelitis - Answer✔️✔️--most common is staph: oxacillin or nafcillin IV
for 4-6 wks for MSSA; vanc, linezolid or dapto for MRSA
-GNRs: salmonella or pseudomonas, can use orals, but must cx org. first
and make sure it is sensitive (BONE bx and cx)
Cellulitis tx - Answer✔️✔️--minor infection: oral dicloxacillin or cephalexin
-severe: IV oxacillin, nafcillin or cefazolin
-PCN allergy: if rash, then cephalosporin; if anaphylaxis, then vanc,
linezolid, dapto (macrolides or clinda for minor infection)
Sequelae of strep infection - Answer✔️✔️--throat: rheumatic fever AND
glomerulonephritis
-skin: ONLY glomerulonephritis
Gonorrhea tx - Answer✔️✔️--ceftriaxone IM
-cefixime oral
4
