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Summary USMLE Step 3 Review Exam Study Gide (Latest Update 2024)
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USMLE Step 3 Review Exam Study Gide (Latest Update 2024)
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USMLE Step 3 Review Exam Study Gide(Latest Update 2024)
Tx of IBS - Correct Answer ✅ Best initial therapy: *Fiber*
If fiber fails: Antispasmodic/anticholinergic agents.
First line:
1. Dicyclomine
2. Hyoscyamine
Secondline:
1. TCA's (amitriptyline)
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)
,USMLE Step 3 Review Exam Study Gide
(Latest Update 2024)
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
,USMLE Step 3 Review Exam Study Gide
(Latest Update 2024)
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
, USMLE Step 3 Review Exam Study Gide
(Latest Update 2024)
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
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