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Exemplo de perguntas do Step 3 do USMLE

STEP 3 Test Question Formats

Strategies for Answering One Best Answer Questions (Single Items, Multiple Item Sets, and Cases)

  • Read the patient description and question carefully. It is important to understand what is being asked.
  • Try to generate an answer and then look for it in the option list.
  • Alternatively, read each option carefully, eliminating those that are clearly incorrect.
  • Of the remaining options, select the one that is most correct.
  • If unsure about an answer, it is better to guess since unanswered questions are automatically counted as wrong answers.

Single Items

This is the traditional, most frequently used multiple-choice format. These items usually include a patient vignette followed by four or five response options. The response options for all questions are lettered (eg, A, B, C, D, E). Examinees are required to select the best answer to the question. Other options may be partially correct, but there is only ONE BEST answer.

Example Question 1

A 45-year-old African-American man comes to the office for the first time because he says, “I had blood in my urine when I went to the bathroom this morning.” He reports no other symptoms. On physical examination his kidneys are palpable bilaterally and he has mild hypertension. Specific additional history should be obtained regarding which of the following?

A. Chronic use of analgesics
B. Cigarette smoking
C. A family history of renal disease
D. Occupational exposure to carbon tetrachloride
E. Recent sore throats

(Answer C)

Multiple Item Sets

A single patient-centered vignette may be associated with two or three consecutive questions about the information presented. Each question is linked to the initial patient vignette, but is testing a different point. Questions are designed to be answered independently of each other. You are required to select the one best answer for each question. Other options may be partially correct, but there is only ONE BEST answer.

Example Questions 2 to 4

A 38-year-old white woman, who is a part-time teacher and the mother of three children, comes to the office for evaluation of hypertension. You have been her physician since the birth of her first child 8 years ago. One week ago, an elevated blood pressure was detected during a regularly scheduled examination for entrance into graduate school. Vital signs on examination today are temperature 37.0°C (98.6°F), pulse 100/min, respirations 22/min, and blood pressure 164/100 mm Hg (right arm, supine).

2. The physical examination is most likely to show which of the following?

A. An abdominal bruit
B. Cardiac enlargement
C. Decreased femoral pulses
D. Thyroid enlargement
E. Normal retinas

(Answer E)

3. The most appropriate next step is to order which of the following?

A. Complete blood count
B. Determination of serum electrolyte and creatinine concentrations
C. Determination of serum glucose concentration
D. Determination of serum thyroxine concentration
E. Urine culture

(Answer B)

4. To assess this patient’s risk factors for atherogenesis, the most appropriate test is determination of which of the following?

A. Plasma renin activity
B. Serum cholesterol concentration
C. Serum triglycerides concentration
D. Urinary aldosterone excretion
E. Urinary metanephrine excretion

(Answer B)