Skip to main content
Sign in Create a free account
Varsity Tutors
Sign in Sign up

Practice Test 9 - USMLE Step 3

20 questions. Answer them in any order, then submit to see your score and every explanation.

  1. Which of the following is the most appropriate next step to improve his glycemic management?
  2. A 60-year-old man with new diagnosis of HCV is managed by PCP and hepatology. Background: On multiple meds; occasional missed appointments; no cirrhosis on imaging. Current status/Plan: Starting direct-acting antiviral therapy; needs adherence support and lab monitoring. Team: PCP, hepatologist, pharmacist, clinic RN, social worker. Coordination: Hepatology prescribes antivirals; PCP manages comorbidities and vaccines. Transition plan: Shared lab schedule established. Which team member is primarily responsible for medication reconciliation and interaction screening before starting HCV therapy?
  3. A 45-year-old woman presents to your office for follow-up 10 days after an open appendectomy. She reports that over the last two days, her incisional pain has worsened, and the area has become red and swollen. On examination, her temperature is 37.9°C (100.2°F). The inferior aspect of her incision is erythematous, indurated, and fluctuant over a 3-cm area. There is no significant surrounding cellulitis.
  4. At 4 weeks postpartum, BP 154/102, new headache, no proteinuria. Most likely diagnosis?
  5. What is the most appropriate recommendation for colorectal cancer surveillance?
  6. Which of the following is the strongest predictor of a poor neurologic outcome in this patient?
  7. Which of the following medications is the most appropriate addition to her regimen?
  8. In addition to aggressive management of vascular risk factors, which of the following is the most appropriate initial intervention for his cognitive deficits?
  9. History & Lifestyle: 70-year-old man with hypertension and hyperlipidemia at annual visit. • Meds: losartan, thiazide, atorvastatin; adherent. • Former smoker: quit 5 years ago; 40 pack-years. • Walks daily. Family History: Father had AAA repair. Preventive Care Review: Never had abdominal aortic aneurysm screening; no abdominal symptoms. Physical exam normal. Based on the vignette, which screening test is recommended for this patient?
  10. Which of the following is the most accurate interpretation of these results?
  11. Which of the following describes the correct procedure for transitioning from buprenorphine to methadone?
  12. A 64-year-old woman has CKD stage 3b for 4 years due to hypertensive nephrosclerosis; she follows a low-sodium diet and checks home BP. Medications include losartan 100 mg daily, chlorthalidone 25 mg daily, metoprolol succinate 50 mg daily, and atorvastatin 20 mg nightly. She feels well and denies dysuria, flank pain, or recent illness. BP is 128/74 mm Hg. Exam is unremarkable. Labs: creatinine 1.8 mg/dL (baseline 1.7), eGFR 34 mL/min/1.73 m², K 5.6 mEq/L, HCO3 23 mEq/L, Ca 9.0 mg/dL. Urine albumin-to-creatinine ratio is 420 mg/g. ECG shows normal sinus rhythm without peaked T waves. Renal ultrasound last year shows normal-sized kidneys with increased cortical echogenicity. Which medication adjustment is most appropriate for this patient?
  13. Which of the following is the most appropriate management?
  14. A 62-year-old woman on postoperative day 7 from a total knee arthroplasty develops the acute onset of pleuritic chest pain and dyspnea. She has been receiving prophylactic enoxaparin. Her heart rate is 110/min, respiratory rate is 24/min, and oxygen saturation is 90% on room air. Her lungs are clear to auscultation. Her surgical incision is clean.
  15. What is the most appropriate next step to assess her need for osteoporosis screening?
  16. What is the primary focus of management for this patient's pulmonary hypertension?
  17. What is the most appropriate recommendation for de-escalating his therapy?
  18. A 52-year-old woman with recurrent PE on warfarin (target INR 2.0–3.0) presents with new unilateral leg swelling and mild dyspnea. She reports adherence but recently began a strict low-carbohydrate diet with increased leafy greens. Vitals: HR 104, SpO2 94% RA. Labs: INR 1.5, Hgb 13.8 g/dL, platelets 240k, creatinine 0.8 mg/dL (eGFR 96 mL/min/1.73 m²). What is the most appropriate next step in management for this patient?
  19. Compared to idiopathic Parkinson's disease, this patient's condition is most likely associated with which of the following outcomes?
  20. What is the most critical preventive intervention to discuss with this patient?

Practice tests