Step 3: Change is Coming

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By Sasmit Sarangi

It is that time of the year again. The time of year that finds many of us looking to schedule our Step 3 exams and complete them before we join residency positions.

There are many advantages to taking your Step 3 exam early, and I will not rehash all of them here. My thinking is that I should try to get it over with as soon as possible while most of the information is still fresh in my mind. This would definitely be easier for me than preparing all over again. There have been some announcements in the last few months about impending changes in several Step exams, and First Aid web team author, Patrick Sylvester, wrote an excellent post on the likely impact of these changes with regard to Step 1. I will be focusing on Step 3 in particular as it can often be neglected.

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Become a First Aid/USMLE-Rx Student Ambassador at UC San Francisco, Washington University, University of Washington, and Pritzker

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THE FIRST AID TEAM NEEDS YOU!

Do you attend one of the following universities? Do you know someone who is a med student at one of these universities?

We need Student Ambassadors at:

University of California, San Francisco SOM

Washington University in St Louis SOM

University of Washington SOM

Pritzker SOM at the University of Chicago

 

Click Here to Apply Now!

Become a First Aid/USMLE-Rx Student Ambassador at Campbell, Sophie Davis, Columbia, or Michigan State

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THE FIRST AID TEAM NEEDS YOU!

Do you attend one of the following universities? Do you know someone who is a med student at one of these universities?

We need Student Ambassadors at:

  • Campbell University Jerry M. Wallace School of Osteopathic Medicine
  • CCNY/CUNY Sophie Davis School of Biomedical Education
  • College of Human Medicine at Michigan State University
  • Columbia University College of Physicians & Surgeons

Click Here to Apply Now!

USMLE-Rx Step 1 Qmax Challenge #3324

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Check out today’s Step 1 Qmax Question Challenge.

Know the answer? Post it below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

USMLE-Rx Step 1 Qmax Challenge #3324A 56-year-old heart transplant recipient presents to the emergency department with shortness of breath and dyspnea at rest. His cardiologist immediately observes that the patient has jugular venous distention and lower extremity edema. However, he eventually lapses into decompensated heart failure and dies. The appearance of his lung at autopsy is shown in the image.

Compared to normal lung tissue, what cells are more prominent in this patient’s lung?

A. Fluid-filled dendritic cells
B. Hemosiderin-laden macrophages
C. T-cells
D. Type I pneumocytes
E. Type II pneumocytes

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Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 1 test bank. For more USMLE Step 1 prep, subscribe to our Flash Facts and Step 1 Express video series. Score the best deal on all three products with a Step 1 Triple Play Bundle.

USMLE-Rx Step 1 Qmax Challenge #3316

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Check out today’s Step 1 Qmax Question Challenge.

Know the answer? Post it below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

USMLE-Rx Step 1 Qmax Challenge #3316A 16-year-old girl comes to the physician concerned that she has not yet begun menstruating. Her blood pressure is 160/100 mm Hg. Physical examination reveals anatomically normal female genitals but a lack of any secondary sexual development including breast buds or pubic hair.

In this patient, hormones from which layer of the adrenal gland shown in the image are overproduced?

A. 1
B. 2
C. 3
D. 4
E. 5

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Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 1 test bank. For more USMLE Step 1 prep, subscribe to our Flash Facts and Step 1 Express video series. Score the best deal on all three products with a Step 1 Triple Play Bundle.

Mnemonic Monday: The 5 Hs and 5 Ts of Cardiac Arrest

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By Michael Spinner

Cardiac arrest, defined by the loss of functional circulation, is a true medical emergency that may rapidly progress to death if not addressed immediately.

Emergent stabilizing measures include defibrillation for patients with a “shockable rhythm” (i.e. ventricular fibrillation or pulseless ventricular tachycardia) and immediate CPR and epinephrine for patients with a “non-shockable rhythm” (i.e. asystole or pulseless electrical activity).

After calling a code and initiating these emergent stabilizing measures, the American Heart Association Advanced Cardiovascular Life Support (ACLS) program states that healthcare providers should assess for any potentially reversible causes of the arrest and treat the patient accordingly. Remember the 5Hs and 5Ts listed below to rapidly recall the causes of cardiac arrest:

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USMLE-Rx Step 2 CK Qmax Challenge #21022

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Check out today’s Step 2 CK Qmax Question Challenge.

Know the answer? Post it in the comments below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

USMLE-Rx Step 2 Qmax Challenge #21022A 2.5-year-old girl was diagnosed with a viral upper respiratory infection last week and now presents to her physician with a brassy cough and purulent airway secretions. Her parents believed that she may have croup and attempted mist therapy without success. The patient has been febrile to 39.0°C (102.2°F) for the past 24 hours and has had difficulty breathing during the past hour. Her review of systems is otherwise negative, and the mother denies that the patient has had any drooling or difficulty/pain when swallowing. Her heart rate is 92/min, blood pressure is 92/60 mm Hg, respiratory rate is 21/min, and temperature is 38.9°C (102°F). A Gram stain of secretions obtained in the office is shown in the image.

What organism is most likely responsible for this patient’s condition?

A. Moraxella catarrhalis
B. Nontypeable Haemophilus influenzae
C. Pseudomonas aeruginosa
D. Staphylococcus aureus
E. Anaerobic organisms

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Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 2 CK test bank. Get more Step 2 CK study help at USMLE-Rx.com.

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