USMLE Step 3 Latest 2023-2024 /258 Questions And
Answers Graded (A+)
Quiz :Pseudogout associations - Answer :hemochromatosis,
hyperparathyroidism, acromegaly, hypothyroidism
Quiz :Gout crystals - Answer :negatively birefringent needles
Quiz :Pseudogout crystals - Answer :positively birefringent needles
Quiz :Vasculitis associated with chronic Hep B - Answer :polyarteritis nodosa
Quiz :Vasculitis associated with chronic Hep C - Answer :cryoglobulinemia
Quiz :Best blood test for polyarteritis nodosa - Answer :There is none. Get
abdominal angiography first, then biopsy of muscle, skin, or sural nerve.
Quiz :Churg-Strauss - Answer :vasculitis + eosinophilia + asthma
Quiz :Takayasu's arteritis - Answer :young asian female with diminished pulses
(usually preceeded by fatigue, weight loss, arthralgia, anemia, elevated ESR)
Quiz :Best test for Takayasu's - Answer :aortic angiography or MRA
Quiz :Bite cells on blood smear - Answer :G6PD
,Quiz :Burr/Spur cells on blood smear - Answer :liver disease
Quiz :Acanthocytes on blood smear (looks like spur cell but with more rounded
spurs) - Answer :liver disease, hypothyroidism, alcoholism
Quiz :Basophilic stippling on blood smear - Answer :lead poisoning
Quiz :Schistocytes on blood smear - Answer :TTP-HUS, DIC, prosthetic heart
valve, malignant htn, sepsis
Quiz :Target cells on blood smear - Answer :thalassemia, other
hemoglobinopathies, liver disease
Quiz :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)
Quiz :Antibody test for celiac disease - Answer :anti-endomysial, tissue
transglutaminase (small bowel bx is best though)
Quiz :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)
Quiz :Antibiotics for MSSA - Answer :Oxacillin/nafcillin, dicloxacillin (IV and oral),
cefazolin (IV), cephalexin (oral)
Quiz :Can you use cephalosporins in pt allergic to PCN? - Answer :yes, if the rxn is
rash only; no if pt has true anaphylaxis
Quiz :Antibiotics to use for Staph with PCN allergy - Answer :cephalosporins if
rash only; macrolides, clindamycin, vancomycin, linezolid, daptomycin, TMP/SMX
Quiz :Antibiotics for strep - Answer :PCN, ampicillin, amoxicillin
Quiz :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
Quiz :Limitation of ertapenem - Answer :does NOT cover pseudomonas
Quiz :Piperacillin and ticarcillin - Answer :GNRs
strep
anaerobes
Quiz :Carbapenems - Answer :good anaerobic coverage
strep
MSSA
Quiz :Tigecycline - Answer :MRSA
good GNR coverage
Quiz :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
Quiz :Abx with NO anaerobic coverage - Answer :aminoglycs, aztreonam,
fluoroquinolones, oxacillin/nafcillin, all cephalosporins EXCEPT cefoxitin and
cefotetan
Quiz :Red man syndrome - Answer :red, flushed skin from histamine release,
associated with rapid infusion of vancomycin (so slow down the infusion rate)
Quiz :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)
Quiz :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)
Quiz :Sequelae of strep infection - Answer :-throat: rheumatic fever AND
glomerulonephritis
-skin: ONLY glomerulonephritis
Quiz :Gonorrhea tx - Answer :-ceftriaxone IM
-cefixime oral
-cefpodoxime oral
-ciprofloxacin oral (2d line)
-if pregnant, then ceftriaxone IM
-ALSO treat for chlamydia
Quiz :Chlamydia tx - Answer :-azithromycin (single dose)
-doxycycline (for 1 wk)
-if pregnant, then azithro
-ALSO treat for gonorrhea
Quiz :Recurrent gonorrhea associated with... - Answer :terminal complement
deficiency (predisposes to any Neisseria infection)
Quiz :PID tx - Answer :-outpatient: ceftriaxone (IM) and oral doxy
-inpatient: cefoxitin or cefotetan IV + doxy + (maybe) metronidazole
Quiz :Abx safe in pregnancy - Answer :-PCNs
-cephalosporins
-aztreonam
-erythromycin
-azithromycin
Quiz :Epidydimo-orchitis tx - Answer :-if <35 yo, then ceftriaxone + doxy
-if >35 yo, then fluoroquinolone
Quiz :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