MKSAP Questions of the Week

Neurology Question 79

A 30-year-old woman is evaluated for difficult-to-treat migraine. She has had severe headaches, usually on the first day of menses, since menarche. What is the most appropriate next step in treatment?

Publish date: 09/05/2019

 
Endocrinology Question 46

A 67-year-old man is evaluated for a recent diagnosis of primary hyperparathyroidism after an elevated serum calcium level was incidentally detected on laboratory testing. Medical history is significant only for hypertension, and his only medication is ramipril. What is the most appropriate management of this patient?

Publish date: 08/28/2019

 
Gastroenterology Question 11

A 67-year-old woman is evaluated during a routine examination. She has a history of hip and knee pain related to degenerative joint disease. The joint pain is now well controlled with diclofenac, which was started 3 months ago. What is the most appropriate management?

Publish date: 08/21/2019

 
Hematology Oncology Question 48

A 63-year-old man is evaluated for severe mid-upper back pain following a minor fall 1 day ago. He also notes progressive fatigue of 6 months' duration and a 6.8-kg (15 lb) weight loss. Medical history is notable for an 80-pack-year smoking history, although he is currently a nonsmoker. What is the most appropriate diagnostic test to perform next?

Publish date: 08/15/2019

 
Infectious Diseases Question 90

A 25-year-old man is evaluated in follow-up after HIV testing. He states he has sex with other men and usually uses condoms. He had a negative HIV test result 1 year ago. What is the most appropriate next step in management?

Publish date: 08/08/2019

 
Nephrology Question 39

A 25-year-old man is evaluated for dark-colored urine for 2 days, swelling of the face and hands for 1 day, and severe headaches this morning. He reports having an upper respiratory tract infection 1 week ago with fever, sore throat, and swollen glands, but had otherwise felt well. What is the most likely diagnosis?

Publish date: 08/01/2019

 
General Internal Medicine Question 111

A 52-year-old man is evaluated for the sudden onset of erectile dysfunction that has persisted for 6 months. He reports having erections that are inadequate for vaginal penetration. What is the most likely cause of this patient's erectile dysfunction?

Publish date: 07/25/2019

 
Rheumatology Question 94

A 74-year-old woman is evaluated during a follow-up visit for polymyalgia rheumatica diagnosed 8 weeks ago after developing shoulder and hip girdle pain and morning stiffness. Symptoms resolved on prednisone, 15 mg/d. She feels well and reports no headache, jaw claudication, visual changes, or recurrence of myalgia or stiffness. What is is the most appropriate management at this time?

Publish date: 07/18/2019

 
Neurology Question 9

A 26-year-old woman is evaluated for a 10-year history of recurrent episodes of acute-onset feelings of fear and anxiety. These episodes initially occurred approximately four times per year but for the past 3 months have been occurring once or twice per month, especially when she is under stress. What is the most likely diagnosis?

Publish date: 07/11/2019

 
Rheumatology Question 36

A 61-year-old man is evaluated for a 10-month history of generalized weakness. He reports no pain or myalgia. History is significant for hypercholesterolemia treated with a stable dose of simvastatin for the past 3 years. On physical examination, temperature is normal, blood pressure is 138/74 mm Hg, pulse rate is 70/min, and respiration rate is 16/min. What is the most likely diagnosis?

Publish date: 07/03/2019

 
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