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Friday, January 28, 2011

USMLE STEP 3 MCQ 1

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Question:
A 10-year-old girl develops rhinorrhoea and nasal pruritus after visiting a friend who has a kitten The most appropriate treatment would include



a) Antigen avoidance
b) immunotherapy against the known offending antigen
c) Antihistamine-decongestant preparation
d) Topical adrenergic agonist
e) oral adrenergic agonist




Correct Answer: A

Explanation:

Antigen avoidence is most successful when a single antigen can be identified as the causative agent. Since the 10-year-old girl developed symptoms only after being exposed to her friend's kitten, it is likely that avoiding cats will alleviate her symptoms. Antigen avoidence is not feasible for all patients, however. For example, while a patient may be able to avoid animal dander indoors, the avoidance of multiple outdoor antigens is likely to prove difficult, if not impossible. Nonetheless, sensible enviornmental precautions will help to limit excerbation of symptoms.

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