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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: 3-year history of severe rheumatoid arthritis

A 67-year-old woman is evaluated for a 3-year history of severe rheumatoid arthritis. After some changes in therapy, she has done well with tocilizumab and methotrexate over the past year. She notes several months of prominent fatigue. Lab studies demonstrate anemia. What is its most likely cause?
https://immattersacp.org/weekly/archives/2020/09/01/5.htm
1 Sep 2020

MKSAP Quiz: Aspirin management before polypectomy

A 58-year-old man is counseled before undergoing colonoscopy and polypectomy in 10 days' time. Two years earlier, he had an inferior wall myocardial infarction. His medications are low-dose aspirin, atorvastatin, metoprolol, and enalapril. What is the most appropriate management of his aspirin therapy?
https://immattersacp.org/weekly/archives/2021/04/13/3.htm
13 Apr 2021

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: Peripheral 9-mm solid pulmonary nodule

A 72-year-old woman is evaluated during a routine visit. She has a 30-pack-year smoking history and quit 5 years ago. A screening low-dose chest CT scan shows a peripheral 9-mm solid pulmonary nodule in the left upper lobe and emphysema. What is the most appropriate management?
https://immattersacp.org/weekly/archives/2020/08/25/4.htm
25 Aug 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: 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: 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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