Usmle Step 3 Random Deck 3

Front 1

Bigesnus pulse means?

Bisferiens pulse means?

Back 1

Bigesnus = HCOM “Big”

Bisferiens = Aortic Regurge “makes a sound like 'bissssss'”

Front 2

Tardus Et Parvus means?

Irregular Irregular pulse means?

Back 2

Tradus Et Parvus = Aortic Stenosis (“Late Pulse” due to stenosis)

Irregular Irregular = Atrial Fibrillation

Front 3

Pulsus Paradoxus means(2)?

Back 3

1) Cardiac Tamponade
2) Pneumothroax

Picture: Cardiac Tamponade

Front 4

“CCHARGE” syndrome?

Back 4

“CCHARGE”
1) Coloboma/CNS Abnormalities
2) Heart Defect
3) Atresia of Choane
4) Retradation
5) Genital Defect
6) Ear Anomaly/Deafness

Front 5

VACTREL syndrome?

Back 5

Vertebral Anomalies
Anal Antresia
Cardiovascular Anomalies
Tracheoesopahgeal Fistula
Renal Anomalies
Esophageal Atresia
Limb Abnormalities

Front 6

List GI(3) and Cardiac(1) manifestation of Down Syndrome

Back 6

Duodenal Atresia
Imperforate Anus
Hirschburg Megacolon
VSD

Front 7

Diabetic Moms Baby Fetal Risks(Non Endocrine)

Back 7

Macrosomia
Polycythemia
Smaller Left Colon Syndrome
Cardiac Asymmetric Septal Hypertrophy due to LV lumen obliteration → Decreased CO2
Renal Vien Thrombosis

Front 8

Diabetic Moms Baby Fetal Risks(ONLY Endocrine)

Back 8

HypO MAGnesemia
HypO PARAthryodism
HypO Calcemia
HYPER BiLirubinemia

Front 9

CT Scan shoes multiple ring enhancing lesions....you suspect Toxoplasmosis....what is Rx?

Back 9

Pyrimethamine and Sulfadiazine

Front 10

CT Scan shows periventricular calcifications....you suspect CMV.....what is Rx?

Back 10

Gancyclovir

Front 11

Steeple sign in seen on X-ray....patient has a suspicion of Croup caused by RSV virus. What is the Rx?

Back 11

Steroids and Epinephrine

Front 12

Thumb Print sign seen on X-ray...suspect Epiglotitis...patient is toxic...Rx?

Back 12

1) Intubate
2) Ceftrixone
3) Give Rifampin prophylaxis to peers

Front 13

Butterfuly on Chest X-ray...you suspect B. Pertussis.....Rx?

Back 13

1) Isolate
2) Erythromycin/Azithromycin
3) Give Macrolide prophylaxis

Front 14

Congenital Hip Dysplasia Rx?

Back 14

Pavlik Harness

Front 15

Legg-Calve Perthes Rx?

Back 15

Surgery of Both Hips/NSAID

Front 16

SCFE Rx?

Back 16

Internal Fixation and Pinning

Front 17

Language Development Level “social smile”?

Back 17

2 Month old has a Social Smile

Front 18

Language Development Level “babbles”?

Back 18

6 Month old can babble

Front 19

Language Development Level “2 words and follows 1 step command”?

Back 19

1 year old can speak 2 words and follows1 step command

Front 20

Language Development Level “2-3 words spoken and follow 2-3 step command”?

Back 20

2 Year old can speak 2-3 words and follow 2-3 step command

Front 21

GROSS Motor Development:

3 Month
4 Month
6 Month

Back 21

Gross Motor:


3 Month: Hold head up
4 Month: Rolls back to forward
6 Month: Sit up Unsupported

Front 22

GROSS Motor Development:

12 Month:
2 Years:

Back 22

Gross Motor

12 Month: Walks Alone
2 Years: Up and down stairs

Front 23

Fine Motor Development:

Raking Grasp:
Throw Object:

Back 23

Fine Motor:

Raking Grasp is 6 month
Throw Object is 12 months

Front 24

Fine Motor Development:

Build 2 Tower Block:
Builds 6 Tower Block:

Back 24

Build 2 Tower Block is 15 months
Builds 6 Tower Block is 24 months

Front 25

Social Development:

Recognize Parents?
Recognize Strangers?

Back 25

Social Development:

Recognize Parents at 2 month
Recognize Strangers 6 month

Front 26

Social Development:

Immitates actions?
Plays with children?
Parallel Play?

Back 26

Immitates actions 12 month
Plays with children 18 month
Parallel Play children 24 month

Front 27

Empiric Rx of meningitis?

Back 27

Emperic Rx of meningitis: Ceftriaxone + Vancomycin + Steroids

Note: Add ampicillin for immunocompromised

Front 28

Nesseria Meningitis Prophylaxis:

Back 28

Rifampin and Ciprofloxacin

Front 29

Giardiax Rx?

Back 29

Metronidazole

Front 30

Cryptosporidiosis Rx?

Back 30

Nitazoxanide

Front 31

Hepatitis B Rx?

Back 31

Entecavir
Adefovir
Lamuvidine
Telibivudine
Interferon
Tenofivir

Front 32

Rifampin uses(3)

Back 32

1) Add for prosthetic valve endocarditis
2) Prophylaxis Nesseria Menigitidis(Alt choice for Cipro)
3) Prophylaxis Epiglotitis

Front 33

Wiskott Aldrich “WALET”

Back 33

WALET

Wiskot Aaldrich
Low Lymphoctes
Eczema
Thrombocytopenia

Front 34

Treatment of Vasovagal (Neurocardiogenic Syncope) (5)?

Back 34

1) Lie down if pre-syncope
2) Adequate salt and fluid intake
3) SSRI(Paroxitine 20 mg po daily)
4) Vasoconstridctor(midodrine 2.5-10mg PO daily)
5) Permanant cardiac pacing if recurrent

Front 35

Basic investigation of Syncope which labs and images to order?

Labs(5)?
Imagining(4)?

Special(1)?

Back 35

Labs: 1) CBC 2) Lytes 3) Cr/urea 4) CK 5)Troponin

Imaging: 1) CXR 2) Echo 3) Cardio doppler 4) CT head

Special: ECG

Front 36

SYNCOPE Special Tests(3)

1) ?
2) Suspect seizures?
3) Confirm Vasovagal Syncope?

Back 36

1) Stress test

2) Suspect Seizures --> EEG

3) Confirm vasovagal --> Tilt Table Test

Front 37

Acute management of Syncope(3)?

Back 37

1) ABC
2) O2
3) IV

Front 38

Lower GI Bleed....acute management(4) before scoping?

Back 38

1) ABC
2) O2
3) IV Hydration(2 large bore IV Needles)
4) Hold antihypertensives and diuretic therapy

Front 39

Lower GI Bleed....what hematocrit do you transfuse at?

Back 39

Hct<30%

Front 40

Lower GI bleed...prolonged Pt/PTT but NOT on unfractioned heparin...(3)?

Back 40

1) Vitamin K 10mg IV and or
2) FFP 2-4 U IV or
3) Prothrombin Complex Concentrate

Front 41

Lower GI bleed...prolonged Pt/PTT AND on Unfractioned Heparin...?

Back 41

Protamine Infusion

Front 42

Black stool that may mimic melena(4)

Back 42

1) Bismuth Subsalicylate
2) Iron
3) Spinach
4) Charcoal

Front 43

Labs to order for upper or lower GI bleed(7)?

Back 43

1) CBC
2) Lytes
3) Creatine/Urea
4) Type/cross-match
5) PTT, INR
6) Liver: AST, ALT, ALP, bilirubin, albumin,
7) Fecal occult blood

Front 44

Imaging to order for upper GI bleed?

Back 44

1) CXR
2) AXR
3) Gastroscopy

Front 45

Tsakayasu Arteritis?

Most accurate test


Rx?

Back 45

Aortic Arteriography or
Magnetic Resonance Angiography... NOT biopsy


Rx: Steroids

Front 46

Young asian female with a dimished pulse

Diagnosis?

What is she at risk for?

Back 46

Diagnosis: Takayasu Arteritis

She is at risk for Stroke or TIA

Front 47

Age>50 + Proximal Muscle Pain + Elevated ESR


Diagnosis?

Back 47

Polymyalgia Rheumatica

Note: Pain is worse in the morning

Front 48

Best initial therapy for Fibromyalgia?

What is 2nd line treatment?

Back 48

BIT: Milnacipran, Duloxetine or Pregablin

2nd Line: Amytryptiline(TCA)