Step3 Qbank

USMLE STEP 3 RECALLS Please encourage others to post their Step 3 recalls including CCS cases.

1. In which of the following patients is pregnancy not contraindicated? a. Eisenmenger's syndrome b. Mitral valve prolapse with severe mitral regurgitation c. Severe asymptomatic aortic stenosis d. Previous history of peripartum cardiomyopathy with persistent mild left ventricular dysfunction e. Marfan's syndrome, with the aortic sinuses at 42 mm, a normal mitral valve, and no aortic valve regurgitation

2. Which of the following are causes of false-positive test results regarding maternal serum alpha-fetoprotein (MSAFP)?

A. The mother is carrying twins or triplets. B. The estimated gestational age of the fetus is inaccurate. C. The concentration of MSAFP is higher than normal because of individual variation. D. All of the above

'''3. A 20-year-old woman calls you 1 day after you discharged her from a 2-day hospital stay for acute pyelonephritis associated with 24 hours of nausea and vomiting. She is feeling much better and tolerating her trimethoprim–sulfamethoxazole but now realizes that she has missed 3 days of her oral contraceptive and wants to know what to do. Her last menstrual period was 14 days ago, and the last pill that she took was number 10 in the packet. Which of the following is the best course of action?'''

A. Dispose of this packet and rely on condoms or abstinence for the rest of this cycle and then restart with a new packet. B. Prescribe ethinyl estradiol, 100 µg, and levonorgestrel, 0.5 mg, to be taken now and again in 12 hours; restart the packet the next day. C. Take the three missed pills now and resume the usual schedule tomorrow. D. Take the most recent missed pill now, discard any earlier missed pills, and resume the usual schedule, but take extra precautions (condoms or abstinence) for the next 7 days. E. Take two pills each day for the next 3 days, then resume the usual schedule but use extra precautions (condoms or abstinence) for those 3 days.