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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: Follow-up for Barrett esophagus

A 65-year-old man is evaluated with upper endoscopy in follow-up for Barrett esophagus. He has had heartburn for more than 15 years, but his symptoms have been well controlled with daily omeprazole. Biopsies confirm evidence of Barrett esophagus with low-grade dysplasia. What is the most appropriate next step in management?
https://immattersacp.org/weekly/archives/2020/10/06/3.htm
6 Oct 2020

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: Epilepsy management

A 35-year-old man is evaluated for a 3-year history of epilepsy. Seizures typically occur twice monthly. Treatment with oxcarbazepine and lamotrigine, although initially reducing seizure frequency, has been largely ineffective. What is the most appropriate next step in management?
https://immattersacp.org/weekly/archives/2021/03/02/3.htm
2 Mar 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: Follow-up visit for a kidney transplant

A 40-year-old man is evaluated during a follow-up visit for a kidney transplant he received 2 years ago. History is also significant for hypertension. Medications are tacrolimus, mycophenolate mofetil, prednisone, and nifedipine. Which treatment should be added?
https://immattersacp.org/weekly/archives/2021/02/23/4.htm
23 Feb 2021

MKSAP Quiz: Managing a congenital heart defect in an adult

A 24-year-old woman diagnosed with a ventricular septal defect at age 7 months undergoes routine examination. The S1 and S2 are masked by a loud holosystolic murmur noted at the left lower sternal border. A transthoracic echocardiogram demonstrates a membranous ventricular septal defect with a small left-to-right shunt. After review of additional results from cardiac testing, what is the appropriate management?
https://immattersacp.org/weekly/archives/2020/11/24/3.htm
24 Nov 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: 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: 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

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