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USMLE STEP 3 REVIEW QUESTIONS WITH COMPLETE ANSWERS LATEST UPDATE.
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USMLE STEP 3 REVIEW QUESTIONS WITH COMPLETE ANSWERS LATEST UPDATE.
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USMLE STEP 3 REVIEW QUESTIONSWITH COMPLETE ANSWERS LATEST
UPDATE
Tx yyof yyIBS yy- yyAnswer yyBest yyinitial yytherapy: yy*Fiber*
If yyfiber yyfails: yyAntispasmodic/anticholinergic yyagents.
First yyline:
1. yyDicyclomine
2. yyHyoscyamine
Secondline:
1. yyTCA's yy(amitriptyline)
CCS, yyWhat yytest yyshould yyyou yyorder yyfor yyIBS? yy- yyAnswer yy1. yyStool: yystool
yyguiac, yyleukocytes, yycultures, yyova yy& yyparasites.
2. yyColonoscopy
3. yyAbdominal yyCT yyscan
Umbilical yyhernia yyin yynewborns yyis yyassociated yywith? yy- yyAnswer yyCongenital
yyhypothyroidism yy
Screen yywith yyTSH yy(you yyshould yyscreen yyfor yyTSH yyanyway)
What yythree yymetabolic yyconditions yydo yymost yystates yyrequire yynewborn yyscreening?
yy- yyAnswer yy1. yyPhenylketonuria yy
2. yyGalactosemia yy
3. yyHypothyroidism
Antibiotics yyof yychoice yyin yyIBD yy- yyAnswer yyCiprofloxacin yy+ yyMetrodinazole yy(they
yyhave yysome yykind yyof yyimmune yymodulatory yyeffect)
Middle-aged yywoman yywith yyitching yyand yyxanthelesmas yy= yyprimary yybiliary
yycirrhosis. yyWhat yyis yythe yybest yyinitial yytest, yyand yythe yymost yyaccurate yytest? yy-
yyAnswer yyInitial: yyelevated yyALP, yynormal yybilirubin
Accurate: yyantimitochondrial yyantibodies
Liver yyBiopsy
Antimitochondrial yyantibodies? yy- yyAnswer yyPrimary yybiliary yycirrhosis
,Antismooth yymuscle yyantibody? yy- yyAnswer yyPrimary yysclerosing yycholangitis
What yycondition yyaccounts yyfor yymost yycauses yyof yyprimary yysclerosing yycholangitis?
yy- yyAnswer yyIBD
What yyis yythe yybest yyinitial yytest yyfor yyprimary yysclerosing yycholangitis? yyMost
yyaccurate? yy- yyAnswer yyInitial: yyelevated yyALP, yy*elevated yybilirubin*
Best: yyERCP yy(beading yyof yybiliary yysystem)
Others: yyantismooth yymuscle yyantibody, yyANCA yypositive
Treatment yyfor yyboth yyprimary yybiliary yycirrhosis yyand yyprimary yysclerosing
yycholangitis? yy- yyAnswer yyUrsodeoxycholic yyacid
Young yywoman yywith yyhepatitis yywith yythyroiditis yyor yyITP, yyautoimmune yyhepatitis.
yyBest yyinitial yytest, yyand yymost yyaccurate? yy- yyAnswer yyInitial: yyANA yy& yyantismooth
yymuscle yypositive
Best: yyLiver yybiopsy
Other: yyliver/kidney yymicrosomL yyantibody, yySPEP yy(serum yyprotein yyelectrophoresis)
yywith yyhypergammaglobulinemia
Best yyinitial yytest yyfor yyhemochromatosis yy- yyAnswer yySerum yyiron, yyiron yybinding
yycapacity yy(low), yyferritin yy(high)
Most yyaccurate yytest yyfor yyhemochromatosis yy- yyAnswer yyMRI yyof yyliver yy+ yygenetic
yytesting yyfor yyHFe yygene yymutation
(Spares yyliver yybiopsy)
Last yytwo yyindications yyfor yyamphotericin yy- yyAnswer yyCryptococcus yyand
yymucormycosis
Best yydrug yyfor yyaspergillus yy- yyAnswer yyVoriconazole
Best yyfungal yydrug yyfor yyneutropenic yyfever yy- yyAnswer yyCaspofungin
Best yydrug yyfor yycandida yy- yyAnswer yyFluconazole
Heberden's yynodule, yywhere yyis yyit yyand yywhat yydisease yyis yyit yyassociated yywith? yy-
yyAnswer yyDIP yyand yyosteoarthritis
Bouchard's yynodule, yywhere yyis yyit yyand yywhat yydisease yyis yyit yyassociated yywith? yy-
yyAnswer yyPIP yyand yyboth yyRA yyand yyosteoarthritis
,(key yyis yyto yyremember yyHeberden;s yyis yyDIP yyand yyis yyonly yyassociated yywith
yyosteoarthritis)
Heberden's yynodule, yywhere yyis yyit yyand yywhat yydisease yyis yyit yyassociated yywith? yy-
yyAnswer yyDIP yyand yyosteoarthritis
Bouchard's yynodule, yywhere yyis yyit yyand yywhat yydisease yyis yyit yyassociated yywith? yy-
yyAnswer yyPIP yyand yyboth yyRA yyand yyosteoarhtitis
Heberden's yynodule yy(where yyis yyit yyand yywhat yydisease yyis yyit yyassociated yywith) yy-
yyAnswer yyDIP yyand yyosteoarthritis
Squamous yycell yycarcinoma yyof yythe yylung yyis yyassociated yywith yyproduction yyof
yywhat yyhormone? yy- yyAnswer yyparathyroid yylike yyhormone yy(look yyfor yypatient yywith
yya yycavitary yylesions yynear yya yybronchus yywho yyhas yyhypercalcemia)
Small yycell yycarcinoma yyof yythe yylung yyis yyassociated yywith yyproduction yyof yywhat
yyhormone yy- yyAnswer yyADH yy(causes yySIADH)
Look yyfor yynormovolemic yyhyponatremia yy(sodium yyloss yytends yyto yybe yymuch
yyhigher yythan yywater yyretention)
Treatment yyof yySIADH? yy- yyAnswer yywater yyrestriction
If yyhyponatremia yyis yysevere yythen yyuse yyhypertonic yysaline yyand yyloop yydiuretics. yy
Persistent yyhyponatremia yyshould yybe yytreated yywith yydemeclocycline yyor yyconivaptan
Best yytherapy yyfor yyhairy yycell yyleukemia? yy- yyAnswer yyCladribine
Rulonoxitib yy- yyAnswer yyJak2 yyinhibitor yyused yyas yyadjunct yyin yymyelofibrosis
Bortezomib
What yyis yyit yyused yyfor?
What yyspecific yyindication yydoes yyit yyhave yyfor yythat yydisease?
What yyshould yybe yydone yybefore yyadministration? yy- yyAnswer yyUsed yyfor yyMM
Indicated yyfor yyrenal yyfailure yyin yyMM
Acyclovir yyshould yybe yygiven yybefore yyadministration yydue yyto yyreactivation yyof
yyvaricella yy(shingles)
Best yytreatment yyfor yyMM yy- yyAnswer yyIf yyyoung yyautologous yyBM yytransplant yy(<70)
Allogenic yyonly yyfor yy<50 yy(increased yygraft yyvs yyhost yyin yyolder yypatients
Best yychemotherapy yyfor yyMM yy- yyAnswer yy1. yyMelphalan yy+ yysteroids yy
, 2. yyThalidomide yyor yylenalidomide
3. yyBortezomib
Best yyTx yyfor yysymptomatic yyWaldenostrom's yy(high yyIgM, yyhyperviscosity) yy-
yyAnswer yyPlasmapheresis
Best yychemotherapy yyfor yyWaldenostrom's yy- yyAnswer yyRituximab yy(if yyCD20
yypositive)
Fludarabine
Chlorambucil
(All yyused yyin yyCLL)
Aplastic yyanemia yybest yytx yyif yybone yymarrow yytransplant yyis yyunavailable yy- yyAnswer
yyAntithymocytw yyglobulin yyand yycyclosporine
Causes yyof yyaplastic yyanemia yy- yyAnswer yyChronic yyhep yyC yyand yyB
Mostly yyidiopathic yyhowever
What yymakes yyHodgkin's yylymphoma yydifferent yyfrom yynonhodgkin's? yy- yyAnswer
yyReed-Sternberg yyCells
Best yynext yystep yyin yylymphoma? yy- yyAnswer yyExcisional yybiopsy
After yyyou yyconfirm yythe yydiagnosis yywith yyexcisional yybiopsy yy(lymphoma) yybest
yynext yystep? yy- yyAnswer yyDetermine yystage yywith:
CXR
CT yyscan yyof yychest, yyabd., yypelvis, yyand yyhead
Bone yymarrow yybiopsy
Asymptomatic yylymphoma yyStage yy1 yyand yy2 yy(1-2 yyLN yyonly yyone yyside) yybest yytx
yy- yyAnswer yyRadiation yy+ yylow yydose yychemo
Symptomatic yyor yyadvanced yydx yylymphoma yytx yy- yyAnswer yyChemotherapy
Chemotherapy yyfor yyHodgkin's yylymphoma yy- yyAnswer yyABVD
Adriamycin
Bleomycin
Vinblastine
Dacarbazine
Chemotherapy yyfor yynon-Hodgkin's yy- yyAnswer yyCHOP
Cyclophosphamide yy
Hydroxyadriamycin
Oncovin yy(vincristine)
Prednisone
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