1
USMLE
USMLE Step 3 Exam Questions with
Correct Verified Solutions 100%
Guaranteed Pass
1. Bioterrorism - ANS ✓Bacillus anthracis, Yersenia pestis, Francisella
tularensis
2. Only cephalosporins with anaerobic coverage - ANS ✓cefoxitin
and cefotetan
3. Side effect of dapto - ANS ✓rhabdomyolysis
4. Uses for dapto - ANS ✓-gram positive ONLY
-skin and soft tissue infections (MRSA coverage)
-S. aureus bacteremia and endocarditis
-do NOT use for PNA b/c it binds with surfactant and doesn't work
5. Adequacy of sputum sample - ANS ✓<10 squamous cells and >25
leuks per LPF
6. Q fever - ANS ✓-Coxiella burnetti
-exposure to infected cattle or other livestock, placental products, ingestion
of unpasteurized milk
USMLE Step 3
, 2
USMLE
-ranges from influenza-like illness to PNA, diffuse pulmonary infiltrates,
elevated LIVER enzymes
7. Coccidioidomycosis - ANS ✓-endemic in south central CA (San
Joaquin Valley), NM, AZ
-transmitted through inhalation of arthroconidia
-peak incidence in summer and in October
-symptoms appear 7-21 days after exposure
-cough, fever, rash (erythema nodosum, erythema multiforme are immune
rxns, can also have general maculopapular rash)
-joint pain
-multifocal inflitrates, hilar LAD, pleural effusion, nodules, cavitation
-eosinophilia (hypersensitivity rxn)
-tx with itraconazole
8. Lymphogranuloma venereum - ANS ✓-large tender nodes + ulcer
-caused by Chlamydia trachomatis
-treat with doxy
9. Herpes simplex - ANS ✓-clear, painful vesicles = herpes (no need for
testing)
-treat with acyclovir, valacyclovir, or famciclovir for 7-10 days
-if roofs have come off vesicles so not clear what they are, send tzanck
smear or (more accurate) viral culture
10. Syphillus - ANS ✓-treponema pallidum
USMLE Step 3
, 3
USMLE
-in primary syphillus (firm, painless ulcer), darkfield microscopy is dx test
of choice b/c RPR and VDRL have 25% false negative rate
-primary: chancre, adenopathy
-secondary: generalized copper-colored rash that is worse on palms and
soles, mucous patch, alopecia areata, condylomata lata
-tertiary: tabes dorsalis, Argyll-Robertson pupil, general paresis, gumma,
aortitis; get an LP and check CSF
-treat with single IM shot of PCN or doxy for PCN allergic in primary and
secondary, use IV PCN (desensitize if necessary) in tertiary and pregnant
women
11. Granuloma inguinale - ANS ✓-rare, beefy red genital lesion
that ulcerates
-get a bx or "touch prep"
-treat with doxy or bactrim
12. Asymptomatic bacteriuria - ANS ✓only treat in pregnant
women
13. Pyelonephritis treatment - ANS ✓outpt: cipro
inpt: amp + gent
14. Leukocyte esterase in urine means: - ANS ✓presence of
WBCs
15. Nitrites in urine means: - ANS ✓presences of gram NEGATIVE
bacteria
USMLE Step 3
, 4
USMLE
16. Perinephric abscess - ANS ✓-pt. with pyelo who doesn't
respond to abx in 5-7 days
-ultrasound or CT of kidneys will show fluid collection
-bx to dx and determine which bacteria are present
-treat with FQ + staph coverage (oxacillin, nafcillin)
17. Prostatitis - ANS ✓-bactrim or ciprofloxacin for 4-6 weeks
18. Duke criteria - ANS ✓for endocarditis (need 2 major, 1 major
+ 3 minor, or 5 minor)
MAJOR:
1. 2 positive blood cx with staph aureus, viridans strep, strep
bovis/epidermidis, enterococci, GNRs, Candida (HACEK orgs are generally
cx negative!)
2. abnormal echo (mass/vege, abscess, new partial dehiscense of prosthetic
valve)
MINOR:
1. fever >38 degrees
2. risk factors (IV drug use, structural heart disease, prosthetic valve, dental
procedures involving bleeding, h/o endocarditis)
3. vascular findings (janeway lesions, septic pulmonary infarcts, arterial
emboli, mycotic aneurysm, conjunctival hemorrhage)
4. immunologic findings (roth spots, osler's nodes, GN)
5. micro findings (positive blood cx that doesn't meet major criteria)
19. HACEK orgs - ANS ✓-Haemophilus
aphrophilus/parainfluenzae
USMLE Step 3
USMLE
USMLE Step 3 Exam Questions with
Correct Verified Solutions 100%
Guaranteed Pass
1. Bioterrorism - ANS ✓Bacillus anthracis, Yersenia pestis, Francisella
tularensis
2. Only cephalosporins with anaerobic coverage - ANS ✓cefoxitin
and cefotetan
3. Side effect of dapto - ANS ✓rhabdomyolysis
4. Uses for dapto - ANS ✓-gram positive ONLY
-skin and soft tissue infections (MRSA coverage)
-S. aureus bacteremia and endocarditis
-do NOT use for PNA b/c it binds with surfactant and doesn't work
5. Adequacy of sputum sample - ANS ✓<10 squamous cells and >25
leuks per LPF
6. Q fever - ANS ✓-Coxiella burnetti
-exposure to infected cattle or other livestock, placental products, ingestion
of unpasteurized milk
USMLE Step 3
, 2
USMLE
-ranges from influenza-like illness to PNA, diffuse pulmonary infiltrates,
elevated LIVER enzymes
7. Coccidioidomycosis - ANS ✓-endemic in south central CA (San
Joaquin Valley), NM, AZ
-transmitted through inhalation of arthroconidia
-peak incidence in summer and in October
-symptoms appear 7-21 days after exposure
-cough, fever, rash (erythema nodosum, erythema multiforme are immune
rxns, can also have general maculopapular rash)
-joint pain
-multifocal inflitrates, hilar LAD, pleural effusion, nodules, cavitation
-eosinophilia (hypersensitivity rxn)
-tx with itraconazole
8. Lymphogranuloma venereum - ANS ✓-large tender nodes + ulcer
-caused by Chlamydia trachomatis
-treat with doxy
9. Herpes simplex - ANS ✓-clear, painful vesicles = herpes (no need for
testing)
-treat with acyclovir, valacyclovir, or famciclovir for 7-10 days
-if roofs have come off vesicles so not clear what they are, send tzanck
smear or (more accurate) viral culture
10. Syphillus - ANS ✓-treponema pallidum
USMLE Step 3
, 3
USMLE
-in primary syphillus (firm, painless ulcer), darkfield microscopy is dx test
of choice b/c RPR and VDRL have 25% false negative rate
-primary: chancre, adenopathy
-secondary: generalized copper-colored rash that is worse on palms and
soles, mucous patch, alopecia areata, condylomata lata
-tertiary: tabes dorsalis, Argyll-Robertson pupil, general paresis, gumma,
aortitis; get an LP and check CSF
-treat with single IM shot of PCN or doxy for PCN allergic in primary and
secondary, use IV PCN (desensitize if necessary) in tertiary and pregnant
women
11. Granuloma inguinale - ANS ✓-rare, beefy red genital lesion
that ulcerates
-get a bx or "touch prep"
-treat with doxy or bactrim
12. Asymptomatic bacteriuria - ANS ✓only treat in pregnant
women
13. Pyelonephritis treatment - ANS ✓outpt: cipro
inpt: amp + gent
14. Leukocyte esterase in urine means: - ANS ✓presence of
WBCs
15. Nitrites in urine means: - ANS ✓presences of gram NEGATIVE
bacteria
USMLE Step 3
, 4
USMLE
16. Perinephric abscess - ANS ✓-pt. with pyelo who doesn't
respond to abx in 5-7 days
-ultrasound or CT of kidneys will show fluid collection
-bx to dx and determine which bacteria are present
-treat with FQ + staph coverage (oxacillin, nafcillin)
17. Prostatitis - ANS ✓-bactrim or ciprofloxacin for 4-6 weeks
18. Duke criteria - ANS ✓for endocarditis (need 2 major, 1 major
+ 3 minor, or 5 minor)
MAJOR:
1. 2 positive blood cx with staph aureus, viridans strep, strep
bovis/epidermidis, enterococci, GNRs, Candida (HACEK orgs are generally
cx negative!)
2. abnormal echo (mass/vege, abscess, new partial dehiscense of prosthetic
valve)
MINOR:
1. fever >38 degrees
2. risk factors (IV drug use, structural heart disease, prosthetic valve, dental
procedures involving bleeding, h/o endocarditis)
3. vascular findings (janeway lesions, septic pulmonary infarcts, arterial
emboli, mycotic aneurysm, conjunctival hemorrhage)
4. immunologic findings (roth spots, osler's nodes, GN)
5. micro findings (positive blood cx that doesn't meet major criteria)
19. HACEK orgs - ANS ✓-Haemophilus
aphrophilus/parainfluenzae
USMLE Step 3
