Der USMLE Step 3 testet Ihre Fähigkeiten, medizinisches Wissen anzuwenden und Ihr Wissen in Biomedizin und klinischer Forschung. Der Fokus der Fragen liegt auf dem Umgang mit Patienten in ambulanter Behandlung
Anleitung:
Versuchen die untenstehenden USMLE Step 3 Fragen zu lösen, indem Sie die eine, am besten passende Antwort aus den möglichen Antwortalternativen auswählen.
Anschließend können Sie Ihre Antwort überprüfen, wenn Sie auf den „get answer“ Button klicken und Kaplans Antworten und Erklärungen kostenlos herunterladen.
Question
A 60-year-old man of Irish descent is admitted to the hospital for an acute exacerbation of chronic obstructive pulmonary disease. You have been taking care of him for the past few years and have managed to convince him to abandon a 40-year-long cigarette smoking habit only last summer after a prolonged hospital stay for his pulmonary disease. He has also been treated with liquid nitrogen application for multiple actinic keratoses on his face and arms, a souvenir of many years spent in the sun during his naval career. During morning rounds you note a small, ulcerated nodule on his lower lip covered with an adherent hemorrhagic crust. The patient says it has appeared only recently and he thought he had cut himself shaving. On palpation of this 3-mm lesion the base is firm and fixed to the underlying soft tissue. There are no palpable lymph nodes in the area of lymphatic drainage of the lower lip. The surrounding vermilion border shows signs of chronic actinic damage. A biopsy of the lesion will most likely show
A. Hyperkeratosis, wedge shaped hypergranulosis, acanthosis with “saw toothing” of the dermoepidermal junction, and a dense lichenoid infiltrate in the papillary dermis
B. Irregular nests of pleomorphic epidermal cells with horn pearl formation invading the dermis to varying degrees
C. Many aggregations of sebaceous lobules directly communicating with the overlying epidermis
D. Nests of darkly staining polyhedral cells in the dermis with columnar cells characteristically arranged in a palisade at the periphery
E. Pagetoid spread of atypical melanocytes in the epidermis
