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ChapterCCS Cases Ordering tests

Initial diagnostic workup approach

Free notes, MCQs, tables & flowcharts for USMLE Step 3 CCS Cases

9Questions
2Tables & Flowcharts

Sample Questions

1

A 35-year-old woman with a medical history significant for asthma, hypertension, and occasional IV drug use comes to the emergency department with fever. On physical exam, there are findings depicted in figure A, for which the patient cannot account. What test will be most helpful to establish the diagnosis?

AEchocardiography

BElectrocardiogram (EKG)

CChest X-ray

DCT pulmonary angiography

EPulmonary function tests

2

A 65-year-old man is brought to the emergency department from his home. He is unresponsive. His son requested a wellness check because he had not heard from his father in 2 weeks. He reports that his father was sounding depressed during a telephone call. The paramedics found a suicide note and a half-empty bottle of antifreeze near the patient. The medical history includes hypertension and hyperlipidemia. The vital signs include: blood pressure 120/80 mm Hg, respiratory rate 25/min, heart rate 95/min, and temperature 37.0°C (98.5°F). He is admitted to the hospital. What do you expect the blood gas analysis to show?

ANon-anion gap metabolic acidosis

BMetabolic alkalosis

CRespiratory acidosis

DAnion gap metabolic acidosis

EMixed acid-base disorder

3

A 36-year-old male is taken to the emergency room after jumping from a building. Bilateral fractures to the femur were stabilized at the scene by emergency medical technicians. The patient is lucid upon questioning and his vitals are stable. Pain only at his hips was elicited. Cervical exam was not performed. What is the best imaging study for this patient?

AAP and lateral radiographs of hips

BLateral radiograph (x-ray) of hips

CMagnetic resonance imaging (MRI) of hips, knees, lumbar, and cervical area

DAnterior-posterior (AP) and lateral radiographs of hips, knees, lumbar, and cervical area

EComputed tomography (CT) scan of cervical spine, hips, and lumbar area

+ 6 more in the PDF

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