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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: Follow-up evaluation for meningococcal bacteremia

A 28-year-old woman undergoes follow-up evaluation after a recent hospitalization for meningococcal bacteremia. Lumbar puncture results during hospitalization were negative for meningitis. She completed a course of ceftriaxone 1 week ago and reports feeling well since stopping antibiotics. Following a physical exam, what is the most appropriate preventive measure?
https://immattersacp.org/weekly/archives/2020/08/04/3.htm
4 Aug 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: 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: Abdominal aortic aneurysm found during routine examination

A 69-year-old man is evaluated during a routine examination. He is asymptomatic. Medical history is significant for hypertension. On physical examination, vital signs are normal. A bruit is heard over the abdomen, and a pulsatile mass is present in the epigastrium. What is the most appropriate next step in management?
https://immattersacp.org/weekly/archives/2020/03/31/3.htm
31 Mar 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

MKSAP Quiz: Preconception counseling for mitral stenosis

A 26-year-old woman seeks preconception counseling. She has a history of mitral stenosis and underwent mitral valve replacement with a tilting-disc mechanical prosthesis 5 years ago. Following a physical exam, lab studies, and electrocardiogram, what is the most appropriate anticoagulation regimen for this patient during the first trimester?
https://immattersacp.org/weekly/archives/2020/06/23/3.htm
23 Jun 2020

MKSAP Quiz: 3-year history of knee stiffness

A 58-year-old man is evaluated for a 3-year history of left knee stiffness, which was intermittent but has become more persistent in the past 4 months. He reports no daily pain but has knee stiffness for 10 minutes in the morning and when he sits for an extended period of time. Following a physical exam and radiograph, what is the most appropriate management?
https://immattersacp.org/weekly/archives/2020/11/17/3.htm
17 Nov 2020

MKSAP Quiz: Follow-up evaluation of dementia

A 53-year-old woman is brought to the office by her husband for follow-up evaluation of behavioral-variant frontotemporal dementia, which was diagnosed 9 months ago. Her clinical symptoms of occasional aphasia, minor memory impairment, behavioral disinhibition, and obsessive-compulsive behaviors have worsened since diagnosis and have become disruptive. Her husband asks about possible medications to control her symptoms. What is the most appropriate medication to recommend?
https://immattersacp.org/weekly/archives/2021/06/08/3.htm
8 Jun 2021

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