USMLE Exam Questions with 100%
Verified Answers 2024
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
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
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
-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
-cefpodoxime oral
-ciprofloxacin oral (2d line)
-if pregnant, then ceftriaxone IM
-ALSO treat for chlamydia
Chlamydia tx - ANSWER--azithromycin (single dose)
-doxycycline (for 1 wk)
-if pregnant, then azithro
-ALSO treat for gonorrhea
Recurrent gonorrhea associated with... - ANSWER-terminal complement deficiency
(predisposes to any Neisseria infection)
PID tx - ANSWER--outpatient: ceftriaxone (IM) and oral doxy
-inpatient: cefoxitin or cefotetan IV + doxy + (maybe) metronidazole
Abx safe in pregnancy - ANSWER--PCNs
-cephalosporins
-aztreonam
-erythromycin
-azithromycin
Epidydimo-orchitis tx - ANSWER--if <35 yo, then ceftriaxone + doxy
-if >35 yo, then fluoroquinolone
Chancroid - ANSWER--PAINFUL ulcer caused by Hemophilus ducreyi
-swab for gram stain and culture (on Nairobi medium or Mueller-Hinton agar)
-treat with ceftriaxone IM or single dose azithromycin
Verified Answers 2024
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
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
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
-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
-cefpodoxime oral
-ciprofloxacin oral (2d line)
-if pregnant, then ceftriaxone IM
-ALSO treat for chlamydia
Chlamydia tx - ANSWER--azithromycin (single dose)
-doxycycline (for 1 wk)
-if pregnant, then azithro
-ALSO treat for gonorrhea
Recurrent gonorrhea associated with... - ANSWER-terminal complement deficiency
(predisposes to any Neisseria infection)
PID tx - ANSWER--outpatient: ceftriaxone (IM) and oral doxy
-inpatient: cefoxitin or cefotetan IV + doxy + (maybe) metronidazole
Abx safe in pregnancy - ANSWER--PCNs
-cephalosporins
-aztreonam
-erythromycin
-azithromycin
Epidydimo-orchitis tx - ANSWER--if <35 yo, then ceftriaxone + doxy
-if >35 yo, then fluoroquinolone
Chancroid - ANSWER--PAINFUL ulcer caused by Hemophilus ducreyi
-swab for gram stain and culture (on Nairobi medium or Mueller-Hinton agar)
-treat with ceftriaxone IM or single dose azithromycin
