MKSAP Questions of the Week

Gastroenterology Q5

A 75-year-old man is evaluated for progressive dysphagia of 8 months' duration for both solid food and water, and the necessity to induce vomiting several times each month to relieve his symptoms. He also has experienced chest pain and heartburn symptoms. He has lost approximately 6 kg (13 lb) of weight over the preceding 3 months and a total of 9 kg (20 lb) since his symptoms began. He has a long history of cigarette and alcohol use. His medical history and review of systems is otherwise negative. He has no travel history outside the northeastern United States. He takes no medication.

Publish date: 11/01/2019

Dermatology Q3

A 32-year-old man is evaluated for an intermittent pruritic rash of 8 years' duration. Medical history is significant for mild persistent asthma. His only medications are an albuterol inhaler and an inhaled glucocorticoid. What of the following is the most appropriate treatment?

Publish date: 10/25/2019

Cardiovascular Medicine Q12

A 78-year-old man is evaluated for palpitations, worsening fatigue, and exercise intolerance. Two months ago, he was diagnosed with atrial flutter and subsequently underwent cardioversion to normal sinus rhythm. Ambulatory electrocardiographic monitoring following cardioversion demonstrated recurrent atrial flutter with an average ventricular rate of 69/min. What is the most appropriate treatment?

Publish date: 10/18/2019

Hematology Oncology Question 78

A 28-year-old woman is evaluated in the emergency department for a 1-week history of progressive headache associated with nausea and vomiting. Medical history is significant for HIV infection. She is nonadherent to her antiretroviral therapy regimen and takes no other medications. What is the most appropriate next step in management?

Publish date: 10/02/2019

Endocrinology Question 65

A 64-year-old woman is seen for follow-up evaluation. Two weeks ago, she was in a car accident, and an incidental pituitary adenoma was found on a cervical spine CT scan. She has no residual injuries from the car accident. What is the most appropriate management?

Publish date: 09/27/2019

Infectious Diseases Question 70

A 29-year-old woman is evaluated for a 5-day history of nodules over her lower extremities. She reports that she regularly visits a local spa that uses whirlpool footbaths during her pedicure procedures; she always shaves her legs with a razor before these visits. What is the most likely cause of infection?

Publish date: 09/19/2019

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

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