{"id":118739,"date":"2023-09-05T20:33:11","date_gmt":"2023-09-05T20:33:11","guid":{"rendered":"https:\/\/learnexams.com\/blog\/?p=118739"},"modified":"2023-09-05T20:33:13","modified_gmt":"2023-09-05T20:33:13","slug":"usmle-step-3-verified-answers-latest-2023","status":"publish","type":"post","link":"https:\/\/www.learnexams.com\/blog\/2023\/09\/05\/usmle-step-3-verified-answers-latest-2023\/","title":{"rendered":"USMLE Step 3 verified answers latest 2023"},"content":{"rendered":"\n<p>Pseudogout associations &#8211; correct answer hemochromatosis, hyperparathyroidism,<br>acromegaly, hypothyroidism<br>Gout crystals &#8211; correct answer negatively birefringent needles<br>Pseudogout crystals &#8211; correct answer positively birefringent needles<br>Vasculitis associated with chronic Hep B &#8211; correct answer polyarteritis nodosa<br>Vasculitis associated with chronic Hep C &#8211; correct answer cryoglobulinemia<br>Best blood test for polyarteritis nodosa &#8211; correct answer There is none. Get abdominal<br>angiography first, then biopsy of muscle, skin, or sural nerve.<br>Churg-Strauss &#8211; correct answer vasculitis + eosinophilia + asthma<br>Takayasu&#8217;s arteritis &#8211; correct answer young asian female with diminished pulses (usually<br>preceeded by fatigue, weight loss, arthralgia, anemia, elevated ESR)<br>Best test for Takayasu&#8217;s &#8211; correct answer aortic angiography or MRA<br>Bite cells on blood smear &#8211; correct answer G6PD<br>Burr\/Spur cells on blood smear &#8211; correct answer liver disease<br>Acanthocytes on blood smear (looks like spur cell but with more rounded spurs) &#8211;<br>correct answer liver disease, hypothyroidism, alcoholism<br>Basophilic stippling on blood smear &#8211; correct answer lead poisoning<br>Schistocytes on blood smear &#8211; correct answer TTP-HUS, DIC, prosthetic heart valve,<br>malignant htn, sepsis<br>Target cells on blood smear &#8211; correct answer thalassemia, other hemoglobinopathies,<br>liver disease<br>5 causes of microcytic anemia &#8211; correct answer iron deficiency, lead poisoning, anemia<br>of chronic disease (but usually normocytic), thalassemia, sideroblastic anemia (can also<br>have high MCV<\/p>\n\n\n\n<p>Antibody test for celiac disease &#8211; correct answer anti-endomysial, tissue<br>transglutaminase (small bowel bx is best though)<br>Antibiotics for MRSA &#8211; correct answer IV: vanc, linezolid, daptomycin, tigecycline;<br>if minor infection, can use oral: TMP\/SMX, doxy, minocycline, or maybe clindamycin<br>(there is inducible resistance to clinda though)<br>Antibiotics for MSSA &#8211; correct answer Oxacillin\/nafcillin, dicloxacillin (IV and oral),<br>cefazolin (IV), cephalexin (oral)<br>Can you use cephalosporins in pt allergic to PCN? &#8211; correct answer yes, if the rxn is<br>rash only; no if pt has true anaphylaxis<br>Antibiotics to use for Staph with PCN allergy &#8211; correct answer cephalosporins if rash<br>only; macrolides, clindamycin, vancomycin, linezolid, daptomycin, TMP\/SMX<br>Antibiotics for strep &#8211; correct answer PCN, ampicillin, amoxicillin<br>Antibiotics for GNRs &#8211; correct answer Cephalosporins: cefepime, ceftazidime<br>PCNs: piperacillin, ticaricillin<br>Monobactam: Aztreonam<br>Quinolones: cipro, levo, gati, moxi<br>Aminoglycs: gentamicin, tobramycin, amikacin<br>Carbapenems: imipenem, mero, erta<br>Limitation of ertapenem &#8211; correct answer does NOT cover pseudomonas<br>Piperacillin and ticarcillin &#8211; correct answer GNRs<br>strep<br>anaerobes<br>Carbapenems &#8211; correct answer good anaerobic coverage<br>strep<br>MSSA<br>Tigecycline &#8211; correct answer MRSA<br>good GNR coverage<br>Anaerobes &#8211; correct answer -metronidazole is BEST for abdominal anaerobes<br>(carbapenems, piperacillin, and ticarcillin have equal efficacy)<br>-cefoxitin and cefotetan are the ONLY cephalosporins<br>-respiratory anaerobes: clindamycin<br>Abx with NO anaerobic coverage &#8211; correct answer aminoglycs, aztreonam,<br>fluoroquinolones, oxacillin\/nafcillin, all cephalosporins EXCEPT cefoxitin and cefotetan<\/p>\n\n\n\n<p>Red man syndrome &#8211; correct answer red, flushed skin from histamine release,<br>associated with rapid infusion of vancomycin (so slow down the infusion rate)<br>Osteomyelitis &#8211; correct answer -most common is staph: oxacillin or nafcillin IV for 4-6<br>wks for MSSA; vanc, linezolid or dapto for MRSA<br>-GNRs: salmonella or pseudomonas, can use orals, but must cx org. first and make<br>sure it is sensitive (BONE bx and cx)<br>Cellulitis tx &#8211; correct answer -minor infection: oral dicloxacillin or cephalexin<br>-severe: IV oxacillin, nafcillin or cefazolin<br>-PCN allergy: if rash, then cephalosporin; if anaphylaxis, then vanc, linezolid, dapto<br>(macrolides or clinda for minor infection)<br>Sequelae of strep infection &#8211; correct answer -throat: rheumatic fever AND<br>glomerulonephritis<br>-skin: ONLY glomerulonephritis<br>Gonorrhea tx &#8211; correct answer -ceftriaxone IM<br>-cefixime oral<br>-cefpodoxime oral<br>-ciprofloxacin oral (2d line)<br>-if pregnant, then ceftriaxone IM<br>-ALSO treat for chlamydia<br>Chlamydia tx &#8211; correct answer -azithromycin (single dose)<br>-doxycycline (for 1 wk)<br>-if pregnant, then azithro<br>-ALSO treat for gonorrhea<br>Recurrent gonorrhea associated with\u2026 &#8211; correct answer terminal complement deficiency<br>(predisposes to any Neisseria infection)<br>PID tx &#8211; correct answer -outpatient: ceftriaxone (IM) and oral doxy<br>-inpatient: cefoxitin or cefotetan IV + doxy + (maybe) metronidazole<br>Abx safe in pregnancy &#8211; correct answer -PCNs<br>-cephalosporins<br>-aztreonam<br>-erythromycin<br>-azithromycin<br>Epidydimo-orchitis tx &#8211; correct answer -if &lt;35 yo, then ceftriaxone + doxy -if &gt;35 yo, then fluoroquinolone<br>Chancroid &#8211; correct answer -PAINFUL ulcer caused by Hemophilus ducreyi<br>-swab for gram stain and culture (on Nairobi medium or Mueller-Hinton agar)<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Pseudogout associations &#8211; correct answer hemochromatosis, hyperparathyroidism,acromegaly, hypothyroidismGout crystals &#8211; correct answer negatively birefringent needlesPseudogout crystals &#8211; correct answer positively birefringent needlesVasculitis associated with chronic Hep B &#8211; correct answer polyarteritis nodosaVasculitis associated with chronic Hep C &#8211; correct answer cryoglobulinemiaBest blood test for polyarteritis nodosa &#8211; correct answer There is none. Get abdominalangiography first, [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-118739","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/118739","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=118739"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/118739\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=118739"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=118739"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=118739"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}