CompTIA
Checkpoint
ISC
HP
Dell
EC-Council
EXIN
Fortinet
ITIL®
Juniper
PMI
Microsoft
VMware
Avaya
Google
Salesforce
Amazon
Palo Alto Networks
Certiport
ISC2
All Vendors
  2. Home
  3. Exams
  4. USMLE
  5. STEP3

Free STEP3 Exam Braindumps (page: 63)

Page 62 of 202
PDF with 804 Questions

Which of the following is the most common site for a gastrinoma?

  1. gastric antrum
  2. duodenum
  3. pancreas
  4. spleen
  5. gallbladder

Answer(s): C

Explanation:

A gastrinoma, a gastrin-secreting tumor, produces Zollinger-Ellison syndrome, which is associated with markedly elevated gastric acid secretion and ulcer disease of the upper GI tract. The most common location for these tumors is the pancreas. However, they can be found in the gastric antrum, duodenum, spleen, and ovary. Removal of the gastrinoma can result in a cure. Athorough search must be made at the time of surgical exploration to locate the tumor, which in early stages will be small. The gastrinoma triangle, where 90% of gastrinomas are located, is defined as the area between the junction of the cystic and common bile ducts, the junction of the second and third portions of the duodenum, and the junction of the pancreatic neck and body



Avascular necrosis is most likely to occur in fracture dislocations involving which of the following?

  1. the femoral head
  2. the shaft of the femur
  3. the shaft of the humerus
  4. the scapula
  5. the clavicle

Answer(s): A

Explanation:

Avascular necrosis occurs following a fracture when the blood supply to a bone fragment is disrupted. The femoral head, humeral head, scaphoid, and talus are particularly vulnerable to this complication because of their precarious blood supply. A dense appearance of the bone on x-ray is a diagnostic clue. Radioisotope scanning can detect avascular necrosis at an earlier stage than is possible with roentgenography.



A38-year-old man, previously in good health, suddenly develops severe abdominal pain radiating from the left loin to the groin and associated with nausea, perspiration, and frequent urination. He is restless, tossing in bed, but has no abnormal findings. The most likely diagnosis is which of the following?

  1. herpes zoster
  2. left ureteral calculus
  3. sigmoid diverticulitis
  4. torsion of the left testicle
  5. retroperitoneal hemorrhage

Answer(s): B

Explanation:

Contraction of hollow organs against obstruction or excessive contraction causes colic. Typical ureteral colic is severe, sudden in onset, radiates from the loin to the groin, and is associated with an urge to urinate. Blood clots and calculi in the ureter can cause colic, the latter being more common. Urine examination demonstrates macroscopic or microscopic hematuria



A 50-year-old man comes to the emergency room (ER) with a history of vomiting of 3 days' duration. His past history reveals that for approximately 20 years he has been experiencing epigastric pain that lasts for 23 weeks during spring and autumn. He remembers getting relief from pain by taking milk and antacids. Physical examination showed fullness in the epigastric area with visible peristalsis, absence of tenderness, and normal active bowel sounds.

What is the most likely diagnosis?

  1. gastric outlet obstruction
  2. small bowel obstruction
  3. volvulus of the colon
  4. incarcerated umbilical hernia
  5. cholecystitis

Answer(s): A

Explanation:

In a patient who is known to have had symptoms of peptic ulcer disease for many years and presents with nausea and vomiting, one should consider gastric outlet obstruction. The bstruction can be the result of an exacerbation of the ulcer and subsequent edema or it can be secondary to scar tissue formation. These patients typically describe the sensation of epigastric fullness and demonstrate visible peristalsis going from left to right. A succussion splash may be audible. The history of periodicity and pain relief by taking antacids also favors a diagnosis of previous peptic ulcer disease. Patients with an umbilical hernia will have a mass in the region of the umbilicus. Patients with acute cholecystitis usually present with the sudden onset of pain, radiating to the back, with fever and chills. Volvulus of the sigmoid colon presents with constipation and abdominal distention but vomiting is a late feature. Small bowel obstruction would be associated with a history of colicky abdominal pain, nausea, and vomiting. Additionally, patients with small bowel obstruction usually have hyperactive highpitched bowel sounds on examination.






Post your Comments and Discuss USMLE STEP3 exam with other Community members:

STEP3 Discussions & Posts