USMLE UWorld Step 3 High Yield Facts complete test
with all correct answers
,USMLE UWorld Step 3 High Yield Facts complete test
with all correct answers
What is the genetic inheritance pattern of Hemophilia A? - ANSWER-X-linked recessive:
women born to fathers with X linked recessive disorder will be carriers. Males are 50%
carriers if born to an affected mother.
What is tx of Lewy body dementia? - ANSWER-Dopamine agonist therapy (PD) & AchE
inhibitors (Alzeihmer's) - watch for dopamine agonist therapy causing complex visual
hallucinations.
A patient treated for LTBI and now has positive PPD. Asymptomatic and also has
negative CXR. - ANSWER-Asymptomatic patients without radiographic evidence of
active TB who have been treated previously for active TB or LTBI need no further
treatment.
Initial tx of lupus? - ANSWER-- steroids + hydroxychloroquine - remember that
hydroxychloroquine reduces the risk of arthralgias and serositis
- you use steroids to bridge until hydroxychloroquine takes affect
- MTX if u have organ damage.
- Rituximab causes PML.
What is the IGRA used for? - ANSWER-Another means of diagnosing LTBI - cannot tell
the difference between latent and active TB just like the TST. They are advantage when
you have BCG vaccinated patient.
Isotretinoin in a boy what do you look for? - ANSWER-- hyperglycemia, triglyceridemia,
hepatotoxicity, mucocuteanous reaction, blood dyscrasias, and ocular toxicity.
-tell them to avoid alcohol bc of pancreatitis.
Pt with keratoconjunctivitis sicca (engorgement of eye BV, and stringey discharge), who
has caries and submandibular mass. NBS? - ANSWER-Ro/La antibody for Sjogren's .
50% will be negative.
A patient undergoing UGI and has mechanical valve. No active infection foci. What is
the likely abx prophylaxis for endocarditis? - ANSWER-Valve + ONGOING GI/GU
manipulation tract procedure gets SBE prophylaxis prior to procedure - if they did, you
would give them ampicillin.
What do you do to monitor the disease progression in patients with AS? - ANSWER-
Radiographs of hip/chest/and pelvis + ESR markers Q3 months
What is the relationship between alcoholics and pancreatitis? - ANSWER-Alcoholics -
decreased Vit D, and alcohol itself damages proximal tubule reabsorption.
,USMLE UWorld Step 3 High Yield Facts complete test
with all correct answers
- Alcholic compensates by pushing PO4 out of the cell, however once refed/hydrated -
PO4 becomes intracellular and you get HYPOPO4 which can cause rhabdomyolasis
and myopathy.
- Especially in the setting of respiratory alkalosis
What are the only requirements to hospice care? - ANSWER-only requirements of
hospice are prognosis <6 months and the patient's willingness to forgo life sustaining
treatment.
What is verification bias? - ANSWER-AKA workup bias. It is when a study only
SELECTIVELY uses the gold standard test in order to confirm a positive result of
preliminary testing. This can result in overestimates and increase in sensitivity.
How do you overcome this bias? - ANSWER-Use the gold standard in a control
population as well.
African man with UTI + blood on dipstick microhematuria and anemia. What is NBS? -
ANSWER-The diagnosis of schistomiasis is demonstration of parasite eggs in the stool
or urine.
Patient with esophageal variceal bleed x 2 after banding. What is the NBS? - ANSWER-
Repeat upper GI endoscopy to do treatment with sclerotherapy or banding. If not, then
you should do shunt or TIPS.
What is chance of adult who gets Hep B of going to chronic HBV? - ANSWER-Adults
have <5% chance of chronic Hep B infection - however perinatal transmission is 90%.
After starting HAART what do you expect VL of HIV in 6 months? - ANSWER-<200
copies / mL otherwise resistance or non-compliance.
Preventive management of a cluster headache? - ANSWER-Verapamil is the only
preventative measure in RCT.
What epidemiological parameter does not vary with disease prevalence and is based on
Sn, and Sp? - ANSWER-Likelihood ratio
For a positive test result: sensitivity / (1-specificity).
For a negative test result: (1-sensitivity) / specificity.
What is the definition of likelihood ratio? - ANSWER-Probability of a given test result
occurring in a patient with a disorder compared to the probability of the same result
occurring in a patient without the disorder.
What is cataplexy treated with? - ANSWER-SNRI (venlafaxine)
SSRI or sodium oxybate.
, USMLE UWorld Step 3 High Yield Facts complete test
with all correct answers
When a patient has a stroke - dysphagia and aspiration causes in an increased risk of
death. What is NBS? - ANSWER-Make sure to do a quick swallow evaluation (water
swallow test or Toronto Bedside Swallowing Screening test).
What is the insulin administration in DKA? - ANSWER-Continuous insulin.
What is the fluid management in DKA? - ANSWER-Add K to fluids if K is less than <5.2
meQ/L.
How long should IV insulin be continued in DKA? - ANSWER-Until anion gap
normalized.
DKA patient with glucose <200 but still elevated anion gap. What do you do? -
ANSWER-Half the rate of continuous insulin and add dextrose to the fluids.
What is first step in pheochromocytoma work up? - ANSWER-Get MRI of abdomen - if
this is negative, you get MIBG - control BP for 10-14 days with alpha blocker.
What has best long term outcome when behavior modifications fail for enuresis? -
ANSWER-Enuresis alarm.
Cocaine ingestion patient with persistent chest pain and new neurologic finding of right
sided weakness in upper arm. What is suspicion and what is NBS? - ANSWER-Suspect
acute dissection of aorta, and get CT angiography of the chest.
A patient with hypermobility, h/o velevty hyperextensible skin with easy bruisability and
atrophic scars and has hyperdynamic precordium. What is the suspicion? - ANSWER-
Acute mitral regurgitation, with myxomatous degeneration and rupture of chordae.
Later life depression (occuring after age 65) has been found to be a significant risk
factor for the development of what condition? - ANSWER-Alzeihmer's disease.
A pt with asymptomatic high TSH and normal t4 NBS? - ANSWER-TPO Ab testing.
warranted tx if:
- +antithyroid ab
- abnormal lipid profile
- sx of hypothyroidism
- ovulatory dysfunction.
What should you assess for in the days following a stroke? - ANSWER-After stroke
make sure you also assess for DVT prophylaxis - risk of DVT is highest2-7 days
following a stroke and particularly high in patients with hemiparessis. Subsequent PE is
MCC death after this.
with all correct answers
,USMLE UWorld Step 3 High Yield Facts complete test
with all correct answers
What is the genetic inheritance pattern of Hemophilia A? - ANSWER-X-linked recessive:
women born to fathers with X linked recessive disorder will be carriers. Males are 50%
carriers if born to an affected mother.
What is tx of Lewy body dementia? - ANSWER-Dopamine agonist therapy (PD) & AchE
inhibitors (Alzeihmer's) - watch for dopamine agonist therapy causing complex visual
hallucinations.
A patient treated for LTBI and now has positive PPD. Asymptomatic and also has
negative CXR. - ANSWER-Asymptomatic patients without radiographic evidence of
active TB who have been treated previously for active TB or LTBI need no further
treatment.
Initial tx of lupus? - ANSWER-- steroids + hydroxychloroquine - remember that
hydroxychloroquine reduces the risk of arthralgias and serositis
- you use steroids to bridge until hydroxychloroquine takes affect
- MTX if u have organ damage.
- Rituximab causes PML.
What is the IGRA used for? - ANSWER-Another means of diagnosing LTBI - cannot tell
the difference between latent and active TB just like the TST. They are advantage when
you have BCG vaccinated patient.
Isotretinoin in a boy what do you look for? - ANSWER-- hyperglycemia, triglyceridemia,
hepatotoxicity, mucocuteanous reaction, blood dyscrasias, and ocular toxicity.
-tell them to avoid alcohol bc of pancreatitis.
Pt with keratoconjunctivitis sicca (engorgement of eye BV, and stringey discharge), who
has caries and submandibular mass. NBS? - ANSWER-Ro/La antibody for Sjogren's .
50% will be negative.
A patient undergoing UGI and has mechanical valve. No active infection foci. What is
the likely abx prophylaxis for endocarditis? - ANSWER-Valve + ONGOING GI/GU
manipulation tract procedure gets SBE prophylaxis prior to procedure - if they did, you
would give them ampicillin.
What do you do to monitor the disease progression in patients with AS? - ANSWER-
Radiographs of hip/chest/and pelvis + ESR markers Q3 months
What is the relationship between alcoholics and pancreatitis? - ANSWER-Alcoholics -
decreased Vit D, and alcohol itself damages proximal tubule reabsorption.
,USMLE UWorld Step 3 High Yield Facts complete test
with all correct answers
- Alcholic compensates by pushing PO4 out of the cell, however once refed/hydrated -
PO4 becomes intracellular and you get HYPOPO4 which can cause rhabdomyolasis
and myopathy.
- Especially in the setting of respiratory alkalosis
What are the only requirements to hospice care? - ANSWER-only requirements of
hospice are prognosis <6 months and the patient's willingness to forgo life sustaining
treatment.
What is verification bias? - ANSWER-AKA workup bias. It is when a study only
SELECTIVELY uses the gold standard test in order to confirm a positive result of
preliminary testing. This can result in overestimates and increase in sensitivity.
How do you overcome this bias? - ANSWER-Use the gold standard in a control
population as well.
African man with UTI + blood on dipstick microhematuria and anemia. What is NBS? -
ANSWER-The diagnosis of schistomiasis is demonstration of parasite eggs in the stool
or urine.
Patient with esophageal variceal bleed x 2 after banding. What is the NBS? - ANSWER-
Repeat upper GI endoscopy to do treatment with sclerotherapy or banding. If not, then
you should do shunt or TIPS.
What is chance of adult who gets Hep B of going to chronic HBV? - ANSWER-Adults
have <5% chance of chronic Hep B infection - however perinatal transmission is 90%.
After starting HAART what do you expect VL of HIV in 6 months? - ANSWER-<200
copies / mL otherwise resistance or non-compliance.
Preventive management of a cluster headache? - ANSWER-Verapamil is the only
preventative measure in RCT.
What epidemiological parameter does not vary with disease prevalence and is based on
Sn, and Sp? - ANSWER-Likelihood ratio
For a positive test result: sensitivity / (1-specificity).
For a negative test result: (1-sensitivity) / specificity.
What is the definition of likelihood ratio? - ANSWER-Probability of a given test result
occurring in a patient with a disorder compared to the probability of the same result
occurring in a patient without the disorder.
What is cataplexy treated with? - ANSWER-SNRI (venlafaxine)
SSRI or sodium oxybate.
, USMLE UWorld Step 3 High Yield Facts complete test
with all correct answers
When a patient has a stroke - dysphagia and aspiration causes in an increased risk of
death. What is NBS? - ANSWER-Make sure to do a quick swallow evaluation (water
swallow test or Toronto Bedside Swallowing Screening test).
What is the insulin administration in DKA? - ANSWER-Continuous insulin.
What is the fluid management in DKA? - ANSWER-Add K to fluids if K is less than <5.2
meQ/L.
How long should IV insulin be continued in DKA? - ANSWER-Until anion gap
normalized.
DKA patient with glucose <200 but still elevated anion gap. What do you do? -
ANSWER-Half the rate of continuous insulin and add dextrose to the fluids.
What is first step in pheochromocytoma work up? - ANSWER-Get MRI of abdomen - if
this is negative, you get MIBG - control BP for 10-14 days with alpha blocker.
What has best long term outcome when behavior modifications fail for enuresis? -
ANSWER-Enuresis alarm.
Cocaine ingestion patient with persistent chest pain and new neurologic finding of right
sided weakness in upper arm. What is suspicion and what is NBS? - ANSWER-Suspect
acute dissection of aorta, and get CT angiography of the chest.
A patient with hypermobility, h/o velevty hyperextensible skin with easy bruisability and
atrophic scars and has hyperdynamic precordium. What is the suspicion? - ANSWER-
Acute mitral regurgitation, with myxomatous degeneration and rupture of chordae.
Later life depression (occuring after age 65) has been found to be a significant risk
factor for the development of what condition? - ANSWER-Alzeihmer's disease.
A pt with asymptomatic high TSH and normal t4 NBS? - ANSWER-TPO Ab testing.
warranted tx if:
- +antithyroid ab
- abnormal lipid profile
- sx of hypothyroidism
- ovulatory dysfunction.
What should you assess for in the days following a stroke? - ANSWER-After stroke
make sure you also assess for DVT prophylaxis - risk of DVT is highest2-7 days
following a stroke and particularly high in patients with hemiparessis. Subsequent PE is
MCC death after this.
