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MKSAP Quiz: Recent worsening of balance in Parkinson disease

A 76-year-old man is evaluated for recent worsening of balance. He has no dizziness or lightheadedness. The patient has an 8-year history of Parkinson disease treated with carbidopa-levodopa and entacapone. Findings from physical, cognitive, cerebellar, and sensory examinations are unremarkable. Which of the following is the most appropriate test to determine the patient's risk of falling backward?
https://immattersacp.org/weekly/archives/2020/11/03/3.htm
3 Nov 2020

MKSAP Quiz: 2-month history of nonproductive cough

A 62-year-old man is evaluated for a 2-month history of nonproductive cough, progressive dyspnea, and fatigue. He reports a 6.8-kg (15-lb) weight loss during this time. He has a 30-pack-year history of smoking. He worked in a navy ship yard 32 years ago. Following a physical exam, chest radiograph, and thoracentesis, what is the most appropriate next step?
https://immattersacp.org/weekly/archives/2020/11/10/3.htm
10 Nov 2020

MKSAP Quiz: 2-month history of foot pain

A 42-year-old woman is evaluated for a 2-month history of left foot pain between the third and fourth toes, accompanied by a burning sensation and the sensation of walking on a pebble. She has not experienced any trauma in the area, and she does not have edema or erythema. Following a physical exam, what is the most likely diagnosis?
https://immattersacp.org/weekly/archives/2021/01/26/3.htm
26 Jan 2021

MKSAP Quiz: Lower extremity edema, rash

A 31-year-old woman is evaluated for lower extremity edema, a rash over both legs, and fatigue that have worsened during the past 3 months. She has no other medical problems and takes no medications. Following a physical exam and lab studies, what viral study will support the most likely diagnosis?
https://immattersacp.org/archives/2023/02/mksap-quiz-lower-extremity-edema-rash.htm
1 Feb 2023

MKSAP Quiz: Evaluation of abnormal thyroid laboratory results

A 29-year-old woman is seen in follow-up for evaluation of abnormal thyroid laboratory results. She is currently 26 weeks pregnant. She was originally evaluated 1 week ago for concerns about lack of weight gain during pregnancy, palpitations, anxiety, and insomnia. After a physical exam and considering lab results, what is the most likely diagnosis?
https://immattersacp.org/weekly/archives/2020/09/29/3.htm
29 Sep 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: 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

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