MKSAP Questions of the Week

Gastroenterology Question 61

A 57-year-old man is evaluated during a routine examination. His medical history is notable for chronic hepatitis C infection with cirrhosis, which was diagnosed 3 years ago. He undergoes surveillance ultrasound for hepatocellular carcinoma every 6 months. What is the most appropriate next step in management?

Publish date: 04/04/2019

 
Hematology Oncology Question 103

A 44-year-old woman is evaluated for a 2-month history of a painless right neck mass. Medical history is unremarkable, and she takes no medications. She is a lifelong nonsmoker. An initial CT scan of the neck shows a 4.5-cm, partially necrotic, right-sided lymph node. What study should be performed next?

Publish date: 03/28/2019

 
Infectious Diseases Question 36

A 30-year-old woman is evaluated in follow-up after being recently diagnosed with HIV infection. She is asymptomatic. Medical history is unremarkable, and she takes no medications; she has not yet started antiretroviral therapy. What immunizations should this patient receive today?

Publish date: 03/21/2019

 
Nephrology Question 71

A 50-year-old man is evaluated in the hospital for fatigue, joint pain, and skin lesions. His symptoms started 2 weeks ago with fever and sore throat, which subsided in 2 days. Four days after the onset of symptoms, he noted dark red spots on his ankles and shins, which spread to involve his legs, thighs, and buttocks; the skin lesions were not painful or itchy. What is the most likely diagnosis?

Publish date: 03/21/2019

 
General Internal Medicine Question 53

A 28-year-old man is evaluated for right knee pain that began 2 days ago. He was playing football when he stopped suddenly and pivoted to make a catch. The right knee is swollen with a palpable effusion. What is the most likely diagnosis?

Publish date: 03/07/2019

 
Neurology Question 58

A 26-year-old woman is evaluated for progressively worsening headaches that began intermittently 6 months ago and became daily 3 months ago. The patient describes bilateral “vise-like” pain that is steady, moderate in intensity, and unaffected by physical activity. What is the most appropriate treatment?

Publish date: 02/28/2019

 
Rheumatology Question 46

A 52-year-old man is evaluated during a follow-up visit for a 2-year history of progressively symptomatic rheumatoid arthritis. He reports increased difficulty with his job due to persistent pain and swelling in the first proximal interphalangeal joints, second and third metacarpophalangeal joints, and bilateral wrists. What is the most appropriate next step in management?

Publish date: 02/21/2019

 
Pulmonary Question 48

A 72-year-old man is evaluated for a 2-year history of cough and a 1-year history of increasing dyspnea. He describes the cough as nonproductive, and his shortness of breath is worse with exertion. Chest radiograph shows increased interstitial markings at the bases; calcified parietal pleural plaques are noted bilaterally. What is the most likely diagnosis?

Publish date: 02/14/2019

 
Neurology Question 46

A 53-year-old man is evaluated for persistent right-sided facial weakness. Bell palsy was diagnosed, and he began a 10-day course of prednisone. What is the most appropriate next step in management?

Publish date: 02/07/2019

 
Nephrology Question 75

A 28-year-old man is evaluated for recurrent nephrolithiasis. Medical history is significant for Crohn disease complicated by multiple small bowel strictures requiring resection. He began developing kidney stones 3 years ago following his last bowel surgery. What is the most appropriate additional treatment for this patient?

Publish date: 01/31/2019

 
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