USMLE STEP 3 REVIEW EXAM 2024 WITH 100% CORRECT ANSWERS
5 views 0 purchase
Course
USMLE STEP 3
Institution
USMLE STEP 3
USMLE STEP 3 REVIEW EXAM 2024 WITH 100% CORRECT ANSWERS
Tx of IBS - correct answer Best initial therapy: *Fiber*
Antispasmodic/Anticholingergics: dicyclomine, Hyoscyamine
Second line- TCAs (amitryptiline)
CCS, What test should you order for IBS? - correct answer 1. Stool: stool guiac, leu...
USMLE STEP 3 REVIEW EXAM 2024 WITH 100% CORRECT ANSWERS
Tx of IBS - correct answer ✔✔ Best initial therapy: *Fiber*
Antispasmodic/Anticholingergics: dicyclomine, Hyoscyamine
Second line- TCAs (amitryptiline)
CCS, What test should you order for IBS? - correct answer ✔✔ 1. Stool: stool guiac, leukocytes, cultures, ova & parasites.
2. Colonoscopy
3. Abdominal CT scan
Umbilical hernia in newborns is associated with? - correct answer ✔✔ Congenital hypothyroidism Screen with TSH (you should screen for TSH anyway)
What three metabolic conditions do most states require newborn screening? - correct answer ✔✔ 1. Phenylketonuria 2. Galactosemia 3. Hypothyroidism
Antibiotics of choice in IBD - correct answer ✔✔ Ciprofloxacin + Metrodinazole (they have some kind of immune modulatory effect)
Middle-aged woman with itching and xanthelesmas = primary biliary cirrhosis. What is the best initial test, and the most accurate test? - correct answer ✔✔ Initial: elevated ALP, normal bilirubin
Accurate: antimitochondrial antibodies
Liver Biopsy
Antimitochondrial antibodies? - correct answer ✔✔ Primary biliary cirrhosis Antismooth muscle antibody? - correct answer ✔✔ Primary sclerosing cholangitis
What condition accounts for most causes of primary sclerosing cholangitis? - correct answer ✔✔ IBD
What is the best initial test for primary sclerosing cholangitis? Most accurate? - correct answer ✔✔ Initial: elevated ALP, *elevated bilirubin*
Best: ERCP (beading of biliary system)
Others: antismooth muscle antibody, ANCA positive
Treatment for both primary biliary cirrhosis and primary sclerosing cholangitis? - correct answer ✔✔ Ursodeoxycholic acid
Young woman with hepatitis with thyroiditis or ITP, autoimmune hepatitis. Best initial test, and most accurate? - correct answer ✔✔ Initial: ANA & antismooth muscle positive
Best: Liver biopsy
Other: liver/kidney microsomL antibody, SPEP (serum protein electrophoresis) with hypergammaglobulinemia
Best initial test for hemochromatosis - correct answer ✔✔ Serum iron, iron binding capacity (low), ferritin (high)
Most accurate test for hemochromatosis - correct answer ✔✔ MRI of liver + genetic testing for HFe gene
mutation
(Spares liver biopsy)
Last two indications for amphotericin - correct answer ✔✔ Cryptococcus and mucormycosis
Best drug for aspergillus - correct answer ✔✔ Voriconazole
Best fungal drug for neutropenic fever - correct answer ✔✔ Caspofungin Best drug for candida - correct answer ✔✔ Fluconazole
Heberden's nodule - correct answer ✔✔ DIP and osteoarthritis
Bouchard's nodule - correct answer ✔✔ PIP and both RA and osteoarthritis
Squamous cell carcinoma of the lung is associated with production of what hormone? - correct answer✔✔ parathyroid like hormone (look for patient with a cavitary lesions near a bronchus who has hypercalcemia)
Small cell carcinoma of the lung is associated with production of what hormone - correct answer ✔✔ ADH (causes SIADH)
Look for normovolemic hyponatremia (sodium loss tends to be much higher than water retention)
Treatment of SIADH? - correct answer ✔✔ Water restriction
If hyponatremia is severe then use hypertonic saline and loop diuretics. Persistent hyponatremia should be treated with demeclocycline or conivaptan
Best therapy for hairy cell leukemia? - correct answer ✔✔ Cladribine
Rulonoxitib - correct answer ✔✔ Jak2 inhibitor used as adjunct in myelofibrosis
Bortezomib
What is it used for?
What specific indication does it have for that disease?
What should be done before administration? - correct answer ✔✔ Used for MM
Indicated for renal failure in MM
Acyclovir should be given before administration due to reactivation of varicella (shingles) Best treatment for MM - correct answer ✔✔ If young autologous BM transplant (<70)
Allogenic only for <50 (increased graft vs host in older pts
Best chemotherapy for MM - correct answer ✔✔ 1. Melphalan + steroids 2. Thalidomide or lenalidomide
3. Bortezomib
Best Tx for symptomatic Waldenostrom's (high IgM, hyperviscosity) - correct answer ✔✔ Plasmapheresis
Best chemotherapy for Waldenostrom's - correct answer ✔✔ Rituximab (if CD20 positive)
Fludarabine
Chlorambucil
(All used in CLL)
Aplastic anemia best tx if bone marrow transplant is unavailable - correct answer ✔✔ Antithymocytw globulin and cyclosporine
Causes of aplastic anemia - correct answer ✔✔ Chronic hep C and B
Mostly idiopathic however
What makes Hodgkin's lymphoma different from nonhodgkin's? - correct answer ✔✔ Reed-Sternberg Cells
Best next step in lymphoma? - correct answer ✔✔ Excisional biopsy
After you confirm the diagnosis with excisional biopsy (lymphoma) best next step? - correct answer ✔✔ Determine stage with:
CXR
CT scan of chest, abd., pelvis, and head
Bone marrow biopsy
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller PREPWISE. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.99. You're not tied to anything after your purchase.
