USMLE Step 3 Practice Questions & CCS Cases

Hundreds of practice questions covering clinical management across all 18 Step 3 content areas — plus interactive CCS case simulations. Questions focus on what Step 3 actually tests: independent patient management, ambulatory care decisions, and patient safety.

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Sample Questions

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Question 1 of 3

A 67-year-old man with a history of type 2 diabetes and hypertension presents to his primary care physician for routine follow-up. His HbA1c is 8.4% on metformin 1000 mg twice daily. Blood pressure is 148/92 mmHg on lisinopril 20 mg daily. Serum creatinine is 1.1 mg/dL and urine albumin-to-creatinine ratio is 180 mg/g. Which of the following is the most appropriate addition to his current regimen?

A Glipizide 5 mg daily
B Empagliflozin 10 mg daily
C Pioglitazone 30 mg daily
D Insulin glargine 10 units at bedtime
E Amlodipine 5 mg daily
Question 2 of 3

A 45-year-old woman is brought to the emergency department after a motor vehicle collision. She is alert and oriented with a blood pressure of 88/60 mmHg, heart rate 124 bpm, and respiratory rate 22. Focused Assessment with Sonography in Trauma (FAST) examination is positive for free fluid in the left upper quadrant. After 2 liters of crystalloid, her blood pressure is 92/64 mmHg. Which of the following is the most appropriate next step in management?

A CT abdomen and pelvis with IV contrast
B Diagnostic peritoneal lavage
C Exploratory laparotomy
D Repeat FAST in 30 minutes
E Transfuse 2 units packed red blood cells and reassess
Question 3 of 3

A 72-year-old man is evaluated in the office 2 weeks after hospital discharge for community-acquired pneumonia. He completed a 5-day course of azithromycin and feels well. Review of his records reveals he is due for colorectal cancer screening (never screened), has not received the pneumococcal polysaccharide vaccine, and his last tetanus booster was 12 years ago. Which of the following is the most important preventive measure to address at this visit?

A Schedule colonoscopy
B Administer PPSV23 today
C Administer Tdap booster today
D Order fecal immunochemical test (FIT) today
E Defer all preventive care until 6-week follow-up

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