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USMLE Step 3 Practice Exam Questions and Answers (100% Pass)

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USMLE Step 3 Practice Exam Questions and Answers (100% Pass) Pseudogout associations - Answer️️ -hemochromatosis, hyperparathyroidism, acromegaly, hypothyroidism Gout crystals - Answer️️ -negatively birefringent needles Pseudogout crystals - Answer️️ -positively birefringent needle...

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  • August 28, 2024
  • 55
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • USMLE
  • USMLE
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SophiaBennett
©SOPHIABENNET@2024/2025 Tuesday, August 20, 2024 10:21 AM



USMLE Step 3 Practice Exam Questions and
Answers (100% Pass)
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


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, ©SOPHIABENNET@2024/2025 Tuesday, August 20, 2024 10:21 AM

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



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, ©SOPHIABENNET@2024/2025 Tuesday, August 20, 2024 10:21 AM

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


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, ©SOPHIABENNET@2024/2025 Tuesday, August 20, 2024 10:21 AM

-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




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