USMLE STEP 3 EXAM FINAL MOCK EXAM WITH
VERIFIED ANSWERS 2026
◉ LCIS treatment. Answer: Tamoxifen for 5 years (don't need
surgery)
◉ DCIS treatment. Answer: Lumpectomy + radiation, then tamoxifen
for 5 years
◉ Management of pancreatic pseudocyst (painless vs painful).
Answer: Painless - do not drain
Painful drain if:
>6cm and >6 weeks with surgical internal drainage or endoscopic
drainage
*if infected do percutaneous external drainage*
◉ Factorial design study. Answer: A study that utilizes more than
one intervention and also a combination (for example one drugs vs
another drug and then also both)
◉ Crossover study. Answer: subjects are exposed to different
treatments sequentially
,the subjects cross over from one study arm to another serving as
their own controls
◉ Nested study. Answer: retrospective observational study in which
subsets of controls are matched to cases and analyzed for variables
of interests
◉ Pragmatic study. Answer: seeks to determine wether an
intervention works in real-life conditions
◉ Pregnant patient with severe bipolar mania treat with. Answer: IV
haloperidol
(ECT is for depression OR patients who fail haloperidol treatment
with mania)
◉ How should you treat their urinary retention if they present with
UTI + Urinary retention + BPH?. Answer: *Suprapubic catheter*
Men with BPH who have UTI most likely have prostatitis. Foley
catheterization can cause bacteremia.
,◉ Indications for antibiotic therapy of an abscess after I&D. Answer:
1. Large >5 cm diameter
2. Multiple
3. Extensive surrounding cellulitis
4. Signs of systemic infection
5. Immunocompromised patients
6. Age <6 months
◉ Diagnosis and treatment of acalculous (no gallstones on imaging)
biliary colic symptoms. Answer: Cholecystokinin-stimulated
cholescintigraphy to evaluate for functional gallbladder disorder
If patient has low gallbladder ejection perform elective
cholecystectomy ("vesicula vaga")
◉ Treatment of eczema (pruritic scaly, blanching, erythematous
lesions - atopic dermatitis). Answer: Emollients and topical steroids
◉ Depression can increase the risk of developing what medical
condition?. Answer: MI or CAD
◉ Spontaneous repeated leg movements that provide relief with
unpleasant sensations that occur while at rest (patient that becomes
, agitated when remaining still, and has to stand and move to feel
relief). Answer: Restless leg syndrome
◉ Causes of restless leg syndrome. Answer: 1. Heridetary
(autosomal dominant)
2. *Iron deficiency anemia*
3. Uremia (look for ESRD or CKD)
4. MS or Parkinson's
5. Pregnancy
6. Drugs (antidepressants, metoclopramide
◉ Treatment of restless leg syndrome. Answer: 1. Avoiding
aggravating factors (sleep deprivation, medications)
2. Iron supplementation *get a ferritin level in these patients*
3. Pharmacotherapy: pramipexole or ropinorole (dopamine
agonists), second-line gabapentin.
◉ Post-extubation stridor treatment. Answer: Due to laryngeal
edema after extubation from direct mechanical damage to laryngela
mucosa from intubation.
Give glucocorticoids before extubation, and can give nebulized
epinephrine. *If this fails then reintubate*
VERIFIED ANSWERS 2026
◉ LCIS treatment. Answer: Tamoxifen for 5 years (don't need
surgery)
◉ DCIS treatment. Answer: Lumpectomy + radiation, then tamoxifen
for 5 years
◉ Management of pancreatic pseudocyst (painless vs painful).
Answer: Painless - do not drain
Painful drain if:
>6cm and >6 weeks with surgical internal drainage or endoscopic
drainage
*if infected do percutaneous external drainage*
◉ Factorial design study. Answer: A study that utilizes more than
one intervention and also a combination (for example one drugs vs
another drug and then also both)
◉ Crossover study. Answer: subjects are exposed to different
treatments sequentially
,the subjects cross over from one study arm to another serving as
their own controls
◉ Nested study. Answer: retrospective observational study in which
subsets of controls are matched to cases and analyzed for variables
of interests
◉ Pragmatic study. Answer: seeks to determine wether an
intervention works in real-life conditions
◉ Pregnant patient with severe bipolar mania treat with. Answer: IV
haloperidol
(ECT is for depression OR patients who fail haloperidol treatment
with mania)
◉ How should you treat their urinary retention if they present with
UTI + Urinary retention + BPH?. Answer: *Suprapubic catheter*
Men with BPH who have UTI most likely have prostatitis. Foley
catheterization can cause bacteremia.
,◉ Indications for antibiotic therapy of an abscess after I&D. Answer:
1. Large >5 cm diameter
2. Multiple
3. Extensive surrounding cellulitis
4. Signs of systemic infection
5. Immunocompromised patients
6. Age <6 months
◉ Diagnosis and treatment of acalculous (no gallstones on imaging)
biliary colic symptoms. Answer: Cholecystokinin-stimulated
cholescintigraphy to evaluate for functional gallbladder disorder
If patient has low gallbladder ejection perform elective
cholecystectomy ("vesicula vaga")
◉ Treatment of eczema (pruritic scaly, blanching, erythematous
lesions - atopic dermatitis). Answer: Emollients and topical steroids
◉ Depression can increase the risk of developing what medical
condition?. Answer: MI or CAD
◉ Spontaneous repeated leg movements that provide relief with
unpleasant sensations that occur while at rest (patient that becomes
, agitated when remaining still, and has to stand and move to feel
relief). Answer: Restless leg syndrome
◉ Causes of restless leg syndrome. Answer: 1. Heridetary
(autosomal dominant)
2. *Iron deficiency anemia*
3. Uremia (look for ESRD or CKD)
4. MS or Parkinson's
5. Pregnancy
6. Drugs (antidepressants, metoclopramide
◉ Treatment of restless leg syndrome. Answer: 1. Avoiding
aggravating factors (sleep deprivation, medications)
2. Iron supplementation *get a ferritin level in these patients*
3. Pharmacotherapy: pramipexole or ropinorole (dopamine
agonists), second-line gabapentin.
◉ Post-extubation stridor treatment. Answer: Due to laryngeal
edema after extubation from direct mechanical damage to laryngela
mucosa from intubation.
Give glucocorticoids before extubation, and can give nebulized
epinephrine. *If this fails then reintubate*
