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USMLE Step 3 Sample Question 1

A 64-year-old man with alcoholic cirrhosis presents to the ED after 1 week of increasing fatigue and confusion. The patient’s past medical history is significant for numerous hospital admissions for variceal bleeding and symptomatic ascites. Over the past 2 days, he has been urinating very little. On physical exam, the patient is jaundiced. He has a distended abdomen and hepatomegaly. Laboratory analysis reveals abnormal liver function tests, a BUN of 40mg/dL, and a Cr of 3.1mg/dL. What is the definitive management of this patient?

  • ATransjugular intrahepatic portosystemic shunt (TIPS)
  • BHemodialysis
  • CLiver transplant
  • DKidney transplant
  • EParacentesis
USMLE Step 3 Sample Question 2

63-year-old male presents with new-onset dysuria. History is significant for prostatic hyperplasia. The patient endorses occasional urinary hesitancy and nocturia. He is afebrile, and vital signs are normal. Physical exam is remarkable for suprapubic tenderness. Urinalysis is positive for leukocyte esterases and nitrites. What is the next step in management?

  • AStart 1-week course of oral antibiotics
  • BAdmit for intravenous antibiotic therapy
  • CPerform renal ultrasound
  • DPerform abdominal CT
  • ENo further treatment necessary


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