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MKSAP Quiz: 5-year history of recurrent gout

A 53-year-old man is evaluated for a 5-year history of recurrent gout attacks involving the base of the great toes, mid feet, and ankles. Episodes are becoming more frequent and severe. History is also significant for hypertension and stage 3 chronic kidney disease. Following a physical exam and lab studies, what is the most appropriate next step in management?
https://acpinternist.org/weekly/archives/2018/12/11/3.htm
11 Dec 2018

MKSAP Quiz: 1-year history of progressive weakness

A 52-year-old man is evaluated for a 1-year history of progressive weakness that began as right foot drop and bilateral tingling in the feet. Within the past 2 months, the patient has developed progressive weakness, which makes walking difficult. Following a physical exam and other tests, what is the most likely diagnosis?
https://acpinternist.org/weekly/archives/2018/12/04/3.htm
4 Dec 2018

Test yourself case study: hepatic mass

ACP Internist has brought back its MKSAP quiz. This popular feature was so heavily requested by our readers that we're restoring it in our print edition and ACP Internist Weekly e-mail updates.
https://acpinternist.org/archives/2008/10/mksap.htm
1 Oct 2008

MKSAP quiz: Evaluation during a routine examination

A 59-year-old man is evaluated during a routine examination. He feels well and has no symptoms. Medical history is significant for hypertension. On physical examination, the patient is afebrile, blood pressure is 122/74 mm Hg, and pulse rate is 76/min. Cardiac examination is unremarkable. What is the most appropriate next step in management?
https://acpinternist.org/weekly/archives/2019/12/17/3.htm
17 Dec 2019

MKSAP Quiz: 5-month history of exertional chest discomfort

A 60-year-old man with hypertension and hyperlipidemia is evaluated for a 5-month history of exertional chest discomfort that improves with rest but has progressively worsened and reduced his activity. Medications are low-dose aspirin, losartan, hydrochlorothiazide, and atorvastatin. Based on physical and cardiac exam and results of a stress echocardiogram and coronary angiogram, what is the most appropriate next step in the patient's management?
https://acpinternist.org/weekly/archives/2019/12/10/3.htm
10 Dec 2019

MKSAP Quiz: Progressive malaise and weakness, aches, and stiffness

A 79-year-old man is evaluated for a 2-month history of progressive malaise and weakness, aching bilateral shoulders and hips, and stiffness. He recently noted aching in his jaw when chewing and reports new left-sided headaches. His erythrocyte sedimentation rate is elevated. What is the most appropriate initial management?
https://acpinternist.org/weekly/archives/2019/11/26/3.htm
26 Nov 2019

MKSAP Quiz: Evaluation for irregular menstrual cycles

A 19-year-old woman is evaluated for irregular menstrual cycles since menarche at 12 years of age, increasing amount of coarse facial hair, and acne. Symptoms have worsened since she stopped playing high school sports and subsequently gained weight. Following a physical exam and lab studies, in addition to exercise and weight loss, what is the most appropriate next step in management?
https://acpinternist.org/weekly/archives/2019/04/02/3.htm
2 Apr 2019

MKSAP Quiz: Follow-up for primary membranous glomerulopathy

A 38-year-old woman is evaluated during a follow-up visit for primary membranous glomerulopathy diagnosed by kidney biopsy 4 months ago. She was found to be positive for anti–phospholipase A2 receptor (PLA2R) antibodies. Vital signs are normal and there is pitting lower extremity edema to the mid shins bilaterally. What complication is she at risk for developing?
https://acpinternist.org/weekly/archives/2019/11/05/3.htm
5 Nov 2019

MKSAP Quiz: Follow-up on pre-employment physical exam

A 28-year-old woman has a follow-up consultation for a pre-employment physical examination. She reports feeling well, with no recent illness. Medical history is notable for gastroesophageal reflux disease. Her only medication is omeprazole. She is black. Following a physical exam and lab studies showing decreased neutrophils, what is the most likely diagnosis?
https://acpinternist.org/weekly/archives/2019/10/22/3.htm
22 Oct 2019

MKSAP Quiz: Evaluation for a firm, flesh-colored lesion

A 40-year-old man is evaluated for a firm, flesh-colored lesion that has been growing on the back for several months. Foul-smelling material can be expressed from the lesion. Following a physical exam, what is the most appropriate treatment for this patient?
https://acpinternist.org/weekly/archives/2019/09/17/3.htm
17 Sep 2019

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