USMLE STEP 3 QUESTION ON DEMAND

Which of the following statements is true regarding smoking during pregnancy?

A) Smoking increases the risk of attention-deficit disorder in the child.
B) Nicotine patches are a safe alternative during pregnancy.
C) Bupropion (Zyban) should be avoided during pregnancy.
D) Regardless of when she stops smoking, infants born to mothers with a smoking history are more at risk for neonatal complications.
E) When compared to total abstinence, reducing the number of cigarettes smoked has no effect on fetal outcomes.

SENT BY: DR. SANJAY

USMLE STEP 3 QUESTION ON DEMAND

An 18-year-old woman presents with swelling, warmth, and spreading redness at the upper part of her ear, where she recently underwent an ear piercing. Appropriate antibiotic coverage includes

A) cephalexin
B) ciprofloxacin
C) azithromycin
D) penicillin
E) tetracycline

SENT BY: ANONYMOUS

USMLE STEP 3 QUESTION ON DEMAND

The use of benzodiazepines during pregnancy has been associated with

A) polydactily
B) cleft lip
C) spina bifida
D) growth retardation
E) developmental delay

SENT BY: DR. KAVITA KUMARI, DELHI

USMLE STEP 3 QUESTION ON DEMAND

A 26-year-old woman who is 30 weeks' pregnant is involved in a motor vehicle accident. She has suspected neck trauma and is in need of transport. You suggest placing her

A) in the left lateral decubitus position
B) in the Trendelenberg position
C) prone position on a backboard
D) supine on a backboard with her right hip elevated
E) supine on a backboard

SENT BY: DR. KAVITA KUMARI, DELHI

USMLE STEP 3 QUESTION OF THE DAY

Which of the following statements is true regarding seatbelt use in pregnancy?

A) The use of seatbelts can increase the risk of fetal injury.
B) The lap belt should be placed under the gravid uterus and over the thighs with the shoulder harness placed between the breast and over the uterus.
C) The air bag should be disabled.
D) Seat belt-restrained women who are in motor vehicle crashes have the same fetal mortality rate as women who are not in motor vehicle crashes.
E) The shoulder harness should not be used during pregnancy.

USMLE STEP 2 QUESTION ON DEMAND

An 18-year-old woman comes to the clinic for an annual gynecologic examination. She has no complaints. Her last menstrual period was 1 week ago and cycles have been normal lasting 5 days with minimal cramping. She has had 2 sexual partners in her lifetime, and currently has a boyfriend of 6 months. She has no history of sexually transmitted diseases (STDs), abnormal Papanicolaou (pap) smears, or other medical problems. Her only medication is oral contraceptives and she does not take any supplements. Sterile speculum examination reveals thin white vaginal discharge and no cervical lesions or discoloration. Cervical ectropion is present surrounding the external os. She has no cervical motion tenderness, but a small amount of contact bleeding during the endocervical sampling for the Pap smear. There are no adnexal or uterine masses with the pelvic examination and no elicited pelvic pain. Pap smear, chlamydia, and gonorrhea cultures are sent to the laboratory. Laboratory results are reviewed when completed and reveal negative endocervical chlamydia and gonorrhea tests, and a Pap smear positive for atypical squamous cells of undetermined significance (ASC-US). What ASC-US management options would be best advice for this patient?


A. Follow-up in 1 year for repeat Pap smear
B. Follow-up in 6 months with liquid based cytology and human papillomavirus (HPV) DNA testing
C. Have a colposcopy with directed biopsy performed
D. Have the atypical squamous cells removed by loop electrosurgical excision procedure (LEEP)
E. Undergo a cone biopsy to assess for malignancy

SENT BY- DR. ISMAIL, LUCKNOW

USMLE STEP 2 QUESTION OF THE DAY

A 17-year-old boy presents to an outpatient psychiatry clinic with the chief complaint of facial tics and verbal outbursts. He reports that he experienced his first tic at 5 years of age, when he developed a repetitive nonrhythmic throat clearing in response to the persistent sensation that he had an unrelieved itch in the back of his throat. By 7 years of age, the throat-clearing persists, joined by forceful nasal exhalations and eye-blinking. As a teenager, he has all the old tics present together plus occasional bursts of shouted obscenities, racial slurs, and vulgarities that cause him great psychological distress as they often occur in the public setting. What is true of the verbal and motor tics that characterize this individual’s illness?

A. Increased frequency of tics occurs when patients are asleep
B. The majority of tics take the form of coprolalia (swearing or vulgarity)
C. There is a higher incidence of tics in females than males
D. There is a strong link between tics and obsessive-compulsive disorder (OCD)
E. Tics are exacerbated by use of dopaminergic agents

USMLE STEP 1 QUESTION ON DEMAND

The LDL cholesterol of baby with known familial hypercholesterolemia is 605mg/dl,although baby's plasma triglyceride levels are normal.Molecular genetic studies of cells isolated from baby indicate 10% LDL receptor activity and 10% of normal amount of LDL receptors on the cell surface.Further in vitro studies with receptor indicate a normal equilibrium B/W bound and free LDL at PH=7.0,but an unusually high amount of bound LDL at PH=6.0.Which of the following mutation best explain these data

A.complete blockade of transport of LDL receptor B/w endoplasmic reticulum and golgi apparatus
B.increased lysosomal degradation of LDL receptor
C.nonfunctional promoter in LDL receptor gene
D.poor interaction with coated pit,resulting in poor internalization of LDL receptor_LDL complex
E.reduced binding of LDL to its receptor

SENT BY: DR. D MANJUNATHA, BANGALORE

USMLE STEP 1 QUESTION OF THE DAY

Which of the following statements about allosteric enzymes is true?
A) Positive cooperativity desensitizes the enzyme to small changes in substrate concentration
B) Allosteric regulation requites a quaternary level of protein structure
C) The allosteric site must be on a different subunit from the catalytic site
D) The binding of a ligand to the allosteric site induces a conformational change in the active site
E) They have substrate saturation curves that frequently show just-order kinetics

USMLE STEP 3 QUESTION ON DEMAND

A 50 year old African American Man comes to the ER because his left leg is bothering him a lot.He has vague and generalised pain in his left leg.This is present both at rest and activity.There is also marked swelling of the left leg as compared to right lower extremity.He was recently discharged from the hopsital after being diagnosed and treated for DVT of left leg.Since his discharge he has been taking Warfarin 2.5mg daily in the morning.His INR in the ED is 1.4.Venogram recurrent venous thrombosis extending into IVC and internal iliac vein.He does not have any other illnesses or he is not taking any medications.At thsi point which of the following will you recommend for this patient?

(A) IVC filter
(B) Increase the dose of warfarin and bring INR to therapeutic range.
(C) Ask him to take warfarin dose at bed time.
(D) Discontinue warfarin and start thrombolytic therapy

sent by: DR. JASMINE, KARNATAKA, INDIA

USMLE STEP 3 QUESTION ON DEMAND

An asymptomatic previously healthy 60-year-old man comes to the office because he is found to have a liver mass. Recently, he had epigastric and right upper quadrant pain, which was investigated by means of ultrasound. Sonography demonstrated a lesion in the right lobe of the liver, but no gallstones or evidence of cholecystitis. Further investigations by means of endoscopy revealed gastritis from Helicobacter pylori, for which he was treated. He is concerned about this liver mass and hence, comes to the office. The liver mass is described as an 8-cm solitary lesion within the right lobe of the liver. No enterohepatic biliary ductal dilatation was noticed. A CT scan of the abdomen performed with contrast demonstrated a progressive peripheral to central prominent enhancement and a central hypodense region. An MRI shows a dense T2 weighted image. The most appropriate next step in the management of this patient's liver lesion is
A. celiac arteriography
B. observation
C. percutaneous needle biopsy
D. radiation therapy
E. resection

ASKED BY: DR. DEEPAK KUMAR, MATHURA

USMLE STEP 1 QUESTION ON DEMAND

An adult male undergoing chemotherapy for RCC ;the drug used inhibits tyrosine kinases that are necessary for tumor cell growth and angiogenesis .HTN ;rash and fatigue are adverse effects associated with this drug. additinally this drug shudnt b given with doxorubin .Which of the following is the most likely therapeutic agent in this case?
a] etoposide
b] flutamide
c] imatinib
d] leuprolide
e] sorafenib

Sent by: DR. KAPIL

USMLE STEP 3 QUESTION OF THE DAY

A 31-year-old man who enjoys scuba diving presents to your office after a dive complaining of severe back pain, loss of sensation around the trunk, and numbness of the legs. Appropriate management consists of
A) administration of acetazolamide
B) furosemide (Lasix) and fluid restriction
C) NSAIDs and narcotic pain medication
D) intravenous steroids
E) transfer to a facility with a recompression chamber

USMLE STEP 2 QUESTION OF THE DAY

A 72-year-old professor emeritus comes to the office saying, "I am worried that I have Alzheimer's or small strokes or something." During the past year, he has noted increasing difficulty with his memory, especially for names, which has created several awkward moments professionally and socially. He adds, "I'll be doing fine, when all of a sudden my mind goes blank. I can't recall something I should easily know, and then suddenly it will come back to me a couple of minutes later." He complains that he frequently misplaces items like his keys, which is very unlike him. He also complains that his sleep is not restful anymore and that he tosses and turns all night. His wife has told him that she is not sleeping either, because he snores loudly. He says, "I'm tired much of the time, and I doze off whenever I try to read." He also complains of frequent headaches in the morning. Past medical history includes hypertension, which is well-controlled with diltiazem; peptic ulcer disease for which he takes ranitidine; and lumbar osteoarthritis, for which he takes ibuprofen. Height is 175 cm (5 ft 9 in) and weight is 72 kg (160 lb). Vital signs are: temperature 36.9°C (98.4°F), pulse 80/min and regular, respirations 12/min and blood pressure 158/100 mm Hg. Physical examination, including neurologic examination, is normal. He scores 29 out of 30 on the Mini-mental state test. Which of the following is the most appropriate next step?

A) Order CT scan of the head
B) Order electroencephalography
C) Reassure him that his symptoms are probably normal
D) Refer him for neuropsychological testing
E) Refer him for polysomnography

USMLE STEP 1 QUESTION OF THE DAY

	The clearances of several substances is measured at constant GFR and urine flow rate, but at increasing plasma concentration of the substance. Under these conditions, clearance will increase at high plasma cocentrations for which of the following.... A) CREATININE B) MANNITOL C) PENICILLIN D) PHOSPHATE E) UREA