USMLE Step 3 High Yield Facts
Exam Questions with Correct Verified
Solutions 100% Guaranteed Pass
1. What should you assess for in the days following a stroke? - ANS
✓After stroke make sure you also assess for DVT prophylaxis - risk of
DVT is highest2-7 days following a stroke and particularly high in
patients with hemiparesis. Subsequent PE is MCC death after this.
2. What are the BP guidelines after stroke? - ANS ✓Permissive htn
(<220/120 mmHg) and aspirin.
If you got thrombolysis then <185/105 BP.
3. A patient with asymptomatic CHF who presents with a low EF
but no sx should have what test? - ANS ✓Cardiac stress test -
because ischemic heart disease is the most common etiology for
heart failure.
4. What is the NBS in a patient with acute coronary syndrome
NSTEMI? - ANS ✓- dual antiplatelet: aspirin + P2Y12 clopidogril
prasugruel or ticagrelor
- beta blocker
- statin,
- anticoagulant therapy. In NSTEMI use heparin not thrombolytics.
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5. Multiple skin tags are associated with what disease? - ANS
✓Insulin resistance.
6. A pt on azithromycin for ngu chlamydia and does not get better
think of other causes of ngu such as trichomonas, ureaplasma,
etc. What is the tx? - ANS ✓Metronidazole.
7. What is the management of somatic symptom disorder? - ANS
✓Regular follow up with provider.
8. A patient who has h/o of papillary and follicular thyroid cancer
that was treated with thyroidectomy and then with RAIU. TSH is
borderline high. What is tx? - ANS ✓Levothyroxine treatment to
normal-ish values of TSH. If highly malignant consider treating TSH
to <0.1 TSH.
9. What is the preferred treatment for botulism toxin? - ANS
✓Equine derived Botox antitoxin is preferred tx of wound and
foodborne botulism however it is usually avoided in infants due to
the risk of lifelong hypersensitivity so use human.
10. If a patient has increasing glucose concentrations, at
bedtime what is the likely treatment? - ANS ✓The most
appropriate insulin adjustment to make in patients who have
hyperglycaemia at bedtime is to increase pre-dinner short-acting
insulin, such as insulin lispro. Other factors, may help like dec meal
size.
11. Entamoeba presents how? - ANS ✓A patient with fever RUQ
and hypoechoic liver lesion - causes liver absess. Watch for recent
travel to SA.
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12. How do you diagnose entameoba? - ANS ✓serology. Dont
aspirate the anchovy paste area.
13. Hydatid cysts are due to what infection? - ANS
✓Echinococcus - no fever without cyst rupture.
14. What is the treatment for a male patient with perineal pain
and weak urinary stream. - ANS ✓Empiric TMPSMX or
Fluroquinolone for 4 to 6 weeks due to poor penetration of abx into
the prostate gland.
Fluoroquinolone ESP, cephalasporin, and clinda most frequently associated
with long term Cdiff infection.
15. A old man afib with high pitched bowel sounds no
leukocytosis, and a small tender mass in the right groin. He has
abdominal cramping and vomiting. NBS? - ANS ✓Surgery -
incarcerated hernia causing SBO.
16. What is the treatment for a spiral femur fracture? - ANS
✓Spica cast - remember that spiral femur fractures are suspicious for
child abuse.
17. A patient who had an MI and is on simvastatin - should be
swtiched to what medication? - ANS ✓Rosuvastatin, and
atorvastatin are HIGH dose statins.
18. What is the most common cause of erythema multiforme? -
ANS ✓Herpes simplex virus.
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19. A patient after surgery who has peripheral wedge shaped
opacity in the lung may have suffered what pathology? - ANS
✓Pulmonary embolism.
20. A patient with normal AFP and high alkphos with history
of hepatitis B who on ultrasound has 3 cm lesion is concerning
for malignancy arising from what structure? - ANS ✓Hepatocyte.
21. What advantage does a patient with high Gleason score
prostate cancer have when undergoing radiation vs
prostatectomy? - ANS ✓Less complication of sexual dysfunction and
urinary incontinence with radiation therapy.
22. When a child has inguinal hernia what is the next best
step? - ANS ✓You need to schedule elective surgery - in infants with
an undescended testicle, it is appropriate to wait until six months of
age before definitive treatment bc the affected testes may descend
spontaneously.
23. When are oral advanced directive honoured? - ANS ✓If a
patient is diagnosed with a terminal or irreversible condition and the
pt.’s wishes are declared to the attending physician in the presence of
two witnesses.
24. Kawasaki disease criteria - ANS ✓Fever greater than 5 days
- conjunctivitis bilateral
- mucositis
- rash erythematous morbilliform with descqumation
- lymphadenopathy cervical with >1.5 cm in size
USMLE Step 3 High Yield Facts
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