USMLE Step 3 Questions and Guide Answers
100% Verified Graded A+
1. Pseudogout associations:
Answer: hemochromatosis, hyperparathyroidism, acromegaly, hypothyroidism
2. Gout crystals:
Answer: negatively birefringent needles
3. Pseudogout crystals:
Answer: positively birefringent needles
4. Vasculitis associated with chronic Hep B:
Answer: polyarteritis nodosa
5. Vasculitis associated with chronic Hep C:
Answer: cryoglobulinemia
6. Best blood test for polyarteritis nodosa:
Answer: There is none. Get abdominal angiography first, then biopsy of muscle, skin, or sural nerve.
,7. Churg-Strauss:
Answer: vasculitis + eosinophilia + asthma
8. Takayasu's arteritis:
Answer: young asian female with diminished pulses (usually preceeded by fatigue, weight loss,
arthralgia, anemia, elevated ESR)
9. Best test for Takayasu's:
Answer: aortic angiography or MRA
10. Bite cells on blood smear:
Answer: G6PD
11. Burr/Spur cells on blood smear:
Answer: liver disease
12. Acanthocytes on blood smear (looks like spur cell but with more rounded
spurs):
Answer: liver disease, hypothyroidism, alcoholism
13. Basophilic stippling on blood smear:
Answer: lead poisoning
14. Schistocytes on blood smear:
Answer: TTP-HUS, DIC, prosthetic heart valve, malignant htn, sepsis
,15. Target cells on blood smear:
Answer: thalassemia, other hemoglobinopathies, liver disease
16. 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)
17. Antibody test for celiac disease:
Answer: anti-endomysial, tissue transglutaminase (small bowel bx is best though)
18. Antibiotics for MRSA IV:
Answer: vanc, linezolid, daptomycin, tigecycline;
if minor infection, can use oral TMP/SMX, doxy, minocycline, or maybe clindamycin (there is inducible resistance to
clinda though)
19. Antibiotics for MSSA:
Answer: Oxacillin/nafcillin, dicloxacillin (IV and oral), cefazolin (IV), cephalexin (oral)
20. Can you use cephalosporins in pt allergic to PCN?:
Answer: yes, if the rxn is rash only; no if pt has true anaphylaxis
21. Antibiotics to use for Staph with PCN allergy:
Answer: cephalosporins if rash only; macrolides, clindamycin, vancomycin, linezolid,
daptomycin, TMP/SMX
22. Antibiotics for strep:
, Answer: PCN, ampicillin, amoxicillin
23. 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
24. Limitation of ertapenem:
Answer: does NOT cover pseudomonas
25. Piperacillin and ticarcillin:
Answer: GNRs strep
anaerobes
26. Carbapenems:
Answer: good anaerobic coverage strep
MSSA
27. Tigecycline:
Answer: MRSA good
100% Verified Graded A+
1. Pseudogout associations:
Answer: hemochromatosis, hyperparathyroidism, acromegaly, hypothyroidism
2. Gout crystals:
Answer: negatively birefringent needles
3. Pseudogout crystals:
Answer: positively birefringent needles
4. Vasculitis associated with chronic Hep B:
Answer: polyarteritis nodosa
5. Vasculitis associated with chronic Hep C:
Answer: cryoglobulinemia
6. Best blood test for polyarteritis nodosa:
Answer: There is none. Get abdominal angiography first, then biopsy of muscle, skin, or sural nerve.
,7. Churg-Strauss:
Answer: vasculitis + eosinophilia + asthma
8. Takayasu's arteritis:
Answer: young asian female with diminished pulses (usually preceeded by fatigue, weight loss,
arthralgia, anemia, elevated ESR)
9. Best test for Takayasu's:
Answer: aortic angiography or MRA
10. Bite cells on blood smear:
Answer: G6PD
11. Burr/Spur cells on blood smear:
Answer: liver disease
12. Acanthocytes on blood smear (looks like spur cell but with more rounded
spurs):
Answer: liver disease, hypothyroidism, alcoholism
13. Basophilic stippling on blood smear:
Answer: lead poisoning
14. Schistocytes on blood smear:
Answer: TTP-HUS, DIC, prosthetic heart valve, malignant htn, sepsis
,15. Target cells on blood smear:
Answer: thalassemia, other hemoglobinopathies, liver disease
16. 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)
17. Antibody test for celiac disease:
Answer: anti-endomysial, tissue transglutaminase (small bowel bx is best though)
18. Antibiotics for MRSA IV:
Answer: vanc, linezolid, daptomycin, tigecycline;
if minor infection, can use oral TMP/SMX, doxy, minocycline, or maybe clindamycin (there is inducible resistance to
clinda though)
19. Antibiotics for MSSA:
Answer: Oxacillin/nafcillin, dicloxacillin (IV and oral), cefazolin (IV), cephalexin (oral)
20. Can you use cephalosporins in pt allergic to PCN?:
Answer: yes, if the rxn is rash only; no if pt has true anaphylaxis
21. Antibiotics to use for Staph with PCN allergy:
Answer: cephalosporins if rash only; macrolides, clindamycin, vancomycin, linezolid,
daptomycin, TMP/SMX
22. Antibiotics for strep:
, Answer: PCN, ampicillin, amoxicillin
23. 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
24. Limitation of ertapenem:
Answer: does NOT cover pseudomonas
25. Piperacillin and ticarcillin:
Answer: GNRs strep
anaerobes
26. Carbapenems:
Answer: good anaerobic coverage strep
MSSA
27. Tigecycline:
Answer: MRSA good
