USMLE Step 3 Exams With Complete .Solutions Questions and Answers Graded A+

USMLE Step 3 Exams With Complete
.Solutions Questions and Answers Graded
A+

Pseudogout associations - Correct answer-hemochromatosis, hyperparathyroidism,

acromegaly, hypothyroidism

Gout crystals - Correct answer-negatively birefringent needles

Pseudogout crystals - Correct answer-positively birefringent needles

Vasculitis associated with chronic Hep B - Correct answer-polyarteritis nodosa

Vasculitis associated with chronic Hep C - Correct answer-cryoglobulinemia

Best blood test for polyarteritis nodosa - Correct answer-There is none. Get

abdominal angiography first, then biopsy of muscle, skin, or sural nerve.

Churg-Strauss - Correct answer-vasculitis + eosinophilia + asthma

Takayasu's arteritis - Correct answer-young asian female with diminished pulses

(usually preceeded by fatigue, weight loss, arthralgia, anemia, elevated ESR)

Best test for Takayasu's - Correct answer-aortic angiography or MRA

,Bite cells on blood smear - Correct answer-G6PD

Burr/Spur cells on blood smear - Correct answer-liver disease

Acanthocytes on blood smear (looks like spur cell but with more rounded spurs) -

Correct answer-liver disease, hypothyroidism, alcoholism

Basophilic stippling on blood smear - Correct answer-lead poisoning

Schistocytes on blood smear - Correct answer-TTP-HUS, DIC, prosthetic heart

valve, malignant htn, sepsis

Target cells on blood smear - Correct answer-thalassemia, other

hemoglobinopathies, liver disease

5 causes of microcytic anemia - Correct 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 - Correct answer-anti-endomysial, tissue

transglutaminase (small bowel bx is best though)

Antibiotics for MRSA - Correct 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 - Correct answer-Oxacillin/nafcillin, dicloxacillin (IV and

oral), cefazolin (IV), cephalexin (oral)

Can you use cephalosporins in pt allergic to PCN? - Correct answer-yes, if the rxn

is rash only; no if pt has true anaphylaxis

Antibiotics to use for Staph with PCN allergy - Correct answer-cephalosporins if

rash only; macrolides, clindamycin, vancomycin, linezolid, daptomycin,

TMP/SMX

Antibiotics for strep - Correct answer-PCN, ampicillin, amoxicillin

Antibiotics for GNRs - Correct 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 - Correct answer-does NOT cover pseudomonas

Piperacillin and ticarcillin - Correct answer-GNRs

strep

, anaerobes

Carbapenems - Correct answer-good anaerobic coverage

strep

MSSA

Tigecycline - Correct answer-MRSA

good GNR coverage

Anaerobes - Correct answer--metronidazole is BEST for abdominal anaerobes

(carbapenems, piperacillin, and ticarcillin have equal efficacy)

-cefoxitin and cefotetan are the ONLY cephalosporins

-respiratory anaerobes: clindamycin

Abx with NO anaerobic coverage - Correct answer-aminoglycs, aztreonam,

fluoroquinolones, oxacillin/nafcillin, all cephalosporins EXCEPT cefoxitin and

cefotetan

Red man syndrome - Correct answer-red, flushed skin from histamine release,

associated with rapid infusion of vancomycin (so slow down the infusion rate)

Osteomyelitis - Correct answer--most common is staph: oxacillin or nafcillin IV

for 4-6 wks for MSSA; vanc, linezolid or dapto for MRSA