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MKSAP Quiz: Episodic nausea, bloating, epigastric pain

A 45-year-old woman is evaluated for episodic nausea, bloating, and epigastric pain of 5 years' duration, with occasional vomiting in the past 3 months, as well as near-daily heartburn symptoms that have not responded to daily omeprazole. She has a 10-year history of type 2 diabetes mellitus treated with metformin and glyburide. After physical exam, laboratory tests, and upper endoscopy, what is the next appropriate step in management?
https://immattersacp.org/weekly/archives/2021/01/12/4.htm
12 Jan 2021

MKSAP Quiz: Evaluation for a changing mole

A 26-year-old woman is evaluated for a changing mole on her left lower leg. She says it is getting bigger and darker. The patient is 5 weeks pregnant. Her only medication is a prenatal vitamin. Following a physical exam, what is the most appropriate next step in management?
https://immattersacp.org/weekly/archives/2020/04/07/3.htm
7 Apr 2020

MKSAP Quiz: Midsystolic ejection click and systolic murmur

A 54-year-old man is evaluated during a routine examination. He is asymptomatic, and he exercises regularly without any limitations. Cardiac examination reveals a midsystolic ejection click and a grade 2/6 crescendo-decrescendo systolic murmur at the second right intercostal space. Following a transthoracic echocardiogram, what is the most appropriate management?
https://immattersacp.org/weekly/archives/2020/09/15/3.htm
15 Sep 2020

MKSAP Quiz: 6 months of exertional dyspnea

A 46-year-old man is evaluated for 6 months of exertional dyspnea, fatigue, and ankle edema. Recently he experienced near-syncope walking up two flights of stairs. He has no other medical problems and takes no medications. Following a physical exam, transthoracic echocardiogram, and other tests, what is the most appropriate treatment?
https://immattersacp.org/weekly/archives/2020/06/09/3.htm
9 Jun 2020

MKSAP Quiz: Heaviness, swelling of breast

A 50-year-old woman is evaluated for heaviness and swelling of her right breast of 3 weeks' duration. One week ago, she noticed that her outer breast had a pink appearance. Following a physical and breast exams and complete blood count, what is the most likely diagnosis?
https://immattersacp.org/archives/2023/03/mksap-quiz-heaviness-swelling-of-breast.htm
1 Mar 2023

MKSAP Quiz: 1-year history of weight gain, fatigue, easy bruising

A 48-year-old woman who works the night shift presents with a one-year history of gaining 25 pounds, as well as fatigue, easy bruising, and difficulty remembering things. Medical history is significant for hypertension, type 2 diabetes, and menopausal hot flushes. After medication review and physical exam, what is the most appropriate next step in evaluation?
https://immattersacp.org/weekly/archives/2020/12/15/3.htm
15 Dec 2020

MKSAP Quiz: Evaluation for erythema and tenderness

A 71-year-old man is evaluated for erythema and tenderness of the left lower leg for 1 week's duration. This is the second similar episode of the left lower leg. The last episode was 2 months ago. He was previously treated successfully with antibiotics. Following tissue findings on a physical exam and starting antibiotics, what is the most appropriate management?
https://immattersacp.org/weekly/archives/2020/12/08/3.htm
8 Dec 2020

MKSAP Quiz: Evaluation of an elevated serum creatinine level

A 71-year-old man is evaluated in the hospital for an elevated serum creatinine level. He was hospitalized 2 days ago for a 4-day history of progressive right lower leg cellulitis. History is also significant for type 2 diabetes mellitus with prior episodes of cellulitis. Following a physical exam, lab studies, and a kidney biopsy, what is the most likely cause of this patient's kidney disease?
https://immattersacp.org/weekly/archives/2020/08/11/3.htm
11 Aug 2020

MKSAP Quiz: Decreased libido, fatigue

A 32-year-old man is evaluated for decreased libido and fatigue. His symptoms have increased over the last 6 months. Following a physical exam and visual exam, what is the most appropriate diagnostic test to perform next?
https://immattersacp.org/weekly/archives/2020/07/07/3.htm
7 Jul 2020

MKSAP Quiz: Acne breakout for 6 months

A 16-year-old woman is evaluated for an acne breakout on her face of 6 months' duration. She has been using over-the-counter benzoyl peroxide products, but the acne is not improving. After a history and physical, what is the most appropriate treatment?
https://immattersacp.org/weekly/archives/2020/06/30/3.htm
30 Jun 2020

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