United States Medical Examination (USMLE) Step 3 Preparatory Review Course

By Palm Desert Resuscitation Education LLC (PDRE)

Prepare Smarter for USMLE® Step 3: PDRE’s New USMLE Step 3 Preparatory Review Course

Build the clinical reasoning, test-taking confidence, and CCS strategy you need for USMLE Step 3 through a structured and personalized review experience.

PDRE’s comprehensive preparatory program combines competitive pricing, flexible scheduling, live instruction, and self-paced learning options. Choose the course format and intensity that best fit your preparation needs.

Course Options

• 3-Week Intensive Review — $2,000
• Extended Programs Available Through 9 Weeks — Up to $6,000
• Live online instruction
• In-person classes
• Self-paced review options
• Rapid-review and extended-preparation formats
• Personalized tutoring and individualized feedback
• Flexible scheduling for working professionals

What You Will Review

• Clinical reasoning and patient-management principles
• High-yield Step 3 concepts and question-solving strategies
• Diagnosis, treatment, prevention, and follow-up planning
• Biostatistics, epidemiology, and medical ethics
• Time-management and multiple-choice test-taking techniques
• Computer-based Case Simulations (CCS)
• CCS case sequencing, timing, orders, and case-closure strategies
• Identification and correction of individual knowledge gaps

Why Choose PDRE?

Whether you need a focused three-week intensive course or a more comprehensive nine-week preparation plan, PDRE provides a structured pathway with personalized guidance. Our program is designed for candidates seeking flexibility without sacrificing instructor support, accountability, or focused preparation.

Choose Your Format. Strengthen Your Strategy. Prepare with Confidence.

Enrollment is now available for PDRE’s USMLE Step 3 Preparatory Review Course.

Contact PDRE today for scheduling, enrollment, and personalized course-placement information.

Course participation does not guarantee a passing examination score. USMLE® is a registered trademark of the Federation of State Medical Boards and the National Board of Medical Examiners. PDRE is not affiliated with or endorsed by the USMLE program, FSMB, or NBME.

Psychiatry Sample Questions

Original USMLE-Style Question — PCP Intoxication

A 23-year-old man is evaluated in the emergency department after becoming severely agitated and physically aggressive in a public setting. His family reports that over the past several weeks he has developed unusual behavioral changes and episodes of poor coordination, frequently appearing unsteady while walking. He has no known history of similar behavior.

On arrival, his temperature is 38.2°C (100.8°F), blood pressure is 132/82 mm Hg, pulse is 78/min, and respiratory rate is 19/min. He is sweating heavily and remains combative. Examination of the eyes reveals prominent vertical nystagmus. Shortly afterward, he develops a generalized seizure.

Which of the following most likely explains this patient’s presentation?

A. Withdrawal from cocaine
B. Acute opioid intoxication
C. Opioid withdrawal
D. Acute cannabis intoxication
E. Acute phencyclidine (PCP) intoxication

Correct answer:

• E. Acute phencyclidine (PCP) intoxication

Educational objective:

• PCP intoxication should be strongly suspected when severe agitation or violent behavior occurs with nystagmus (particularly vertical nystagmus) and neurologic abnormalities such as ataxia or seizures. Hyperthermia and diaphoresis can also occur.

High-yield Step 3 clue:

• Aggression + ataxia + vertical nystagmus ± seizures → PCP intoxication.
• The strongest clue is vertical nystagmus, which is highly characteristic of PCP intoxication. The overall syndrome also fits: violent/aggressive behavior + altered mental status + ataxia/stumbling + diaphoresis + hyperthermia + seizures/convulsions.

A useful Step 3 pattern is:

• PCP → psychosis/aggression + nystagmus (especially vertical) + analgesia + ataxia + autonomic activation ± seizures.
• The alternatives don’t fit nearly as well. Cocaine withdrawal generally causes fatigue, depression, increased appetite, and sleep disturbance rather than hyperthermia, violent behavior, vertical nystagmus, and seizures. Heroin intoxication causes the classic opioid picture of CNS depression, respiratory depression, and miosis. Heroin withdrawal causes lacrimation, rhinorrhea, diarrhea, mydriasis, piloerection, and autonomic symptoms but typically isn’t life-threatening and doesn’t produce this characteristic nystagmus. Marijuana intoxication more commonly causes euphoria, impaired coordination, conjunctival injection, and increased appetite.

USMLE pearl:

• When a drug-intoxication question gives you violent behavior + vertical nystagmus, think PCP immediately.

USMLE Step 3 Summary — PCP Intoxication

Correct answer:

• E. Phencyclidine (PCP) intoxication

The presentation is classic for PCP intoxication, particularly because of the combination of violent/aggressive behavior, ataxia, vertical nystagmus, diaphoresis, fever, and seizures.

USMLE Step 3 Practice Question — Psychotic Disorders

A 27-year-old woman is brought to the emergency department by her sister because of increasingly unusual behavior. Over the past 8 months, the patient has become socially withdrawn and stopped attending graduate school. She frequently spends hours alone in her room and shows little interest in activities she previously enjoyed.

During the past several months, she has also become convinced that her neighbors are monitoring her through electronic devices hidden in her apartment. She occasionally hears two unfamiliar voices discussing her actions when no one else is present. Her sister reports that the patient sometimes speaks in ways that are difficult to follow.

On examination, the patient has poor eye contact and minimal facial expression. Her speech is sparse, and she appears internally preoccupied. Urine toxicology is negative. There is no history of manic or major depressive episodes, and medical evaluation reveals no condition that would explain her symptoms.

Which of the following is the most likely diagnosis?

A. Brief psychotic disorder
B. Schizoaffective disorder
C. Schizophrenia
D. Schizophreniform disorder
E. Delusional disorder

Correct answer:

• C. Schizophrenia

Educational objective:

• The decisive clue is the duration: 8 months. The patient also has both positive symptoms (auditory hallucinations, persecutory delusions, disorganized speech) and negative symptoms (social withdrawal, diminished emotional expression (flat affect), apathy (a lack of feeling, emotion, interest, or concern about important matters or life in general), avolition/anhedonia (the inability to feel pleasure or a reduced interest in activities that you used to enjoy), accompanied by substantial functional decline.

High-yield distinction:

Step 3 takeaway:

• For psychosis questions, look at duration early:

1 day–1 month → brief psychotic disorder
1–6 months → schizophreniform disorder
≥6 months → schizophrenia

• Then check for prominent mood episodes. If substantial mood pathology accompanies the illness, consider schizoaffective disorder or a mood disorder with psychotic features rather than automatically choosing schizophrenia.
• Memory hook: “Schizophrenia = six or more.”