Exam (elaborations)
USMLE STEP 3 UWORLD PRACTICE TEST 2 QUESTIONS WITH CORRECT ANSWERS.
USMLE STEP 3 UWORLD PRACTICE TEST 2 QUESTIONS WITH CORRECT ANSWERS.
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Usmle Step 3
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Usmle Step 3
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USMLE STEP 3 UWORLD PRACTICE
TEST 2 QUESTIONS WITH CORRECT
ANSWERS
3 yyyo yyM yyhas yya yy8 yyday yyhx yyof yy3-4 yydaily yyepisodes yyof yysoft, yy*foul-smelling
yydiarrhea*. yyIncreased yybelching yy& yyFlatus, yydecreased yyappetite yybut yydrinks
yyliquids yywithout yydifficulty. yy6 yyyr yyold yysister yyhas yysame yysx. yyFam yywent yyon
yycruise yyto yyMexico yylast yymonth yyso yyhe yytried yynew yyfoods yyand yywent yyswimming
yyat yybeach&in yycruise yyship yypool. yyWent yyon yywkd yycamping yytrip yy3 yywks yyago
yyand yyate yythe yyfresh yyfish. yyAfter yyvacation, yyhe yywent yyback yyto yyreg yydiet yyfruits,
yyveggies yy7 yymeats. yyP yy108, yyhyperactive yybowel yysounds. yynegative yystool yyoccult
yyblood. yyCAUSE yyof yysx? yy- yyAnswer yy*giardia yylamblia*
-greasy, yyfoul-smelling yydiarrhea, yybloating, yyflatus/belching, yyweight yyloss
-transmitted yythru yy*fecal-oral yyroute* yyor yythru yy*contaminated yyfood yyor yywater*
-ingestion yyof yyunfiltered yywater yywhile yy*camping* yyor yyhiking yy
--drinking, yyswimming yyor yyconsuming yyfood yyfrom yycontaminated yywater
-sx yyDON't yypresent yyASAP yyb/c yytakes yytime yyfor yycysts yyto yymature yyinto
yytrophozoites yyin yyhost yyintestines
-tx: yy*metronidazole*
norovirus yy- yyAnswer yy-causes yyviral yygastroenteritis
-*cruise-ship* yyoutbreaks
-BRIEF yyduration: yyresolves yywithin yydays
-*VOMITING yymore yycommon*rota
rotavirus yy- yyAnswer yy*watery yydiarrhea* yyin yykids yyage yy2 yyand yyunder
-within yy1-2 yyDAYS yyof yyexposure
-also yyemesis, yyabd yypain
meta-analysis yy- yyAnswer yy-combines yyresults yyof yy*several yystudies* yyto yy*increase
yystatistical yypower* yythru yyan yy*increased yysample yysize*
-ideally, yythe yyresults yyare yythe yysame yyas yyproduced yyby yysingle yystudy yyw/larger
yysample yysize
-BUT yy*increase yyin yystatistical yypower yymay yylead yyto yy*statistically yySIGNIFICANT*
yyeffect yysizes yythat yymaybe yy*CLINICALLY yyIRRELEVANT*=detects yya yyvery yysmall
yyeffect(eg yyrisk yyratio)--not yypractical
---also, yy*validity yydepends yyon yythe yydesign*-metanalysis yyisn't yyalways yymore yyvalid
yythan yyother yystudy yydesigns
,cephalohematoma yyvs yycaput yysuccedaneum yy- yyAnswer yycephalohematoma:
yyDOESN'T yycross yysuture yylines yy& yyresolves yywithin yyWEEKS, yy*can yylead yyto
yyjaundice* yyb/c yyRBC yybreakdown&Calcification yyafter yyresolution-located yyUNDER
yyperiosteum
Caput yysuccedaneum: yylike yya yyCAP yycrosses yysuture yylines&resolves yyDAYS yyafter
yybirth-serosanuineous yyfluid yycollection yyabove yyperiosteum/beneath yyscalp
subgaleal yyhemorrhage yy- yyAnswer yy-bleeding yyunder yygalea yyaponeurotica
-fatal yycomplication yyof yyvacuum-assisted yydeliveries
-rapidly yyexpanding yyswelling yyleading yyto yyhypovolemic yyshock yyfrom yyblood yyloss
2 yyweek yyold yygirl yyhas yy*asymmetric yygluteal yyskinfolds&increased yy# yythigh
yycreases yyon yyright>left*. yywhat yyelse yywould yybe yyfound? yy- yyAnswer yy*Apparent
yyleg-length yydiscrepancy* yywhen yypt yylies yysupine yyw/knees yyflexed: yyaffected yyleg
yylooks yyshorter(Galeazzi yytest)
DX: yydevelopmental yydysplasia yyof yyhip
-abnormal yydevelopment yyof yyhip yyjoint yytht yyprevents yyfemoral yyhead yyfrom yysitting
yyproperly yyin yyacetabulum
-RF: yy*females, yybreech yyposition, yyFH yyDDH, yyexcessively yytight yyswaddling*
-instability yyduring yyattempted yydislocation&reduction yyif yypalpable yyclunk yyheard
yy(Barlow yyand yyOrtolani yymaneuvers)
who yyhas yyasymmetric yymoro yyreflex? yy- yyAnswer yyerb yypalsy yy(seen yyin yylarge yyfor
yygestational yyage yyinfants)
who yyhas yysacral yydimple? yy- yyAnswer yyneural yytube yydefect yy(myelomeningocele)
what's yythe yynext yystep yyafter yyu/s yyshows yydislocated yyright yyhip yyw/flat yyacetabulum
yyand yypositive yybarlow yyand yyortolani yytests? yy- yyAnswer yy*Consult yyorthopedic
yysurgeon*
--when yyID yywithin yyfirst yy6 yymonths yyof yylife, yytreat yyby yymaintaining yyhip yyin
yy*flexed&abducted yyposition yyin yyPavlik yyharness yyfor yy3 yymonths*
-when yyhip yyextension yy& yyadduction yyare yylimited, yythe yydislocated yyhip yyis yyreduced
yyand/or yystabilized yyand yynormal yyacetabular yydevelopment yyis yypromoted
--monitor yypavlik yyharness yyclosely yyby yyorthopedic yysurgeon yyb/c yyassociated
yyrisks( yyavascular yynecrosis, yyfemoral yynerve yypalsy) yyw/excessive yyhip yyflexion yy&
yyabduction
>hip yyradiograph yyif yy>4 yymonths yyold
prognosis yyfor yydevelopment yydysplasia yyof yyhip yy- yyAnswer yy*most yyinfants yywho
yyare yytreated yyearly yyhave yyno yylong-term yysequelae*
-the yyneed yyfor yysurgical yycorrection yyfor yyDDH yycorrelates yyw/increased yyage yyat
yydiagnosis: yy<5% yyof yypts yydx yy& yytreated yyw/pavlik yyharness yyin yyearly yyinfancy
yyrequire yysurgery
, vestibular yyneuritis(labyrinthitis) yy- yyAnswer yy-*single yyepisode* yyof yysevere yyvertigo
yythat yycan yylast yyfor yydays yy& yyis yyself-limited
-*labyrinthitis yywhen yyassociated yyw/unilateral yyhearing yyloss*
-normal yyMRI
-after yyviral yyinfection
-feeling yyof yyimabalnce yyand yyunsteady yygait
-*positive yyhead-thrust yytest*:pt yyfocuses yyon yyexaminer's yynose yywhile yyexaminer
yyquickly yyrotates yytheir yyhead yy10-15 yydegrees yyto yythe yyside; yynormally yythe yyeyes
yyremain yyfixed yyon yythe yytarget yybut yyin yypt yyw/peripheral yyvestibular yyd/o, yythe
yyeyes yyinitially yyrotate yyw/the yyhead yybefore yyvoluntarily yyredirecting yyback yyto yythe
yytarget yy(corrective yysaccade)
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yydepressed, yypsychotic, yysuicidal, yyrefusing yyto yyeat yy&Drink) yy- yyAnswer yyECT!!!
-not yymirtazapine yy-its yynot yyenuf yyalone yyto yytreat yyMDD yyw/psychotic yyfeatures yy-
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yyare yymore yysevere yythan yyusual yy&persistent. yyPale yynasal yymucosa. yyStarted yyon
yythe yymost yyeffective yysingle yytreatment yybut yywhat's yya yycomplication? yy- yyAnswer
yy*epistaxis*
dx: yyallergic yyrhinitis
tx: yy*intranasal yycorticosteroids* yy(not yyantihistamines)-fluticasone, yymometasone,
yybudesonide
-also yygive yynasal yysaline yyrinses yyb/c yythey yyhydrate yynasal yymucosa yy&Can
yyprotect yyfrom yysteroid yyeffect yyof yyepistaxis
-second yyline: yyoral yyantihistamines(side yyeffects yyacute yyangle-closure yyglaucoma,
yyurinary yyretention, yyconstipation, yydry yymouth)
interstitial yycystitis yy- yyAnswer yyidipathic yybladder/suprapubic yypain yy>=6 yyweeks
-worse yyw/full yybladder
-relieved yyw/urination
AN yyactive yystudy yyof yy30 yypts yyw/spinal yydeformity yyunderwent yy3 yycolumn
yyosteotomy yyprocedures yyfor yydeformity yycorrection yyis yyevaluating yythe yyfollowing
yyoutcomes yyat yy3,6,12 yymonths. yyResearch yyproposal yywas yyapproved yyby yyIRB yybut
yyon yyweek yy2, yyhealth-related yyquality-of-life yyquestionnaire yywhich yyserves yyto
yyevaluate yyadditional yystudy yyoutcomes yyis yyadded yyto yythe yyprotocol. yyWhat's yytrue
yyregarding yyneed yyto yyresubmit yystudy yyprotocol yyto yyIRB? yy- yyAnswer yy*Required
yyb/c yyall yymodifications yyto yyan yyalready-approved yyresearch yyprotocol yyneed yynew
yyIRB yyapproval*
This yyincludes: yystudy yydesign, yystudy yyprotocols, yyinformed yyconsent yyprocedures,
yyprincipal yyinvestigator yyteam(new yyresearch yyassistants)