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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: 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-day history of left knee pain, swelling

A 43-year-old woman is evaluated for a 3-day history of left knee pain and swelling. Similar episodes have occurred in either knee as well as the left wrist during the past 2 years. Following a physical exam, radiographs, and joint aspiration of the left knee, what laboratory study will most likely identify the cause of this patient's symptoms?
https://immattersacp.org/weekly/archives/2021/03/16/3.htm
16 Mar 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: 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: 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: 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

MKSAP Quiz: 6 months of exertional dyspnea

A 46-year-old man is evaluated for 6 months of exertional dyspnea, fatigue, and ankle edema. Recently he experienced near-syncope walking up two flights of stairs. He has no other medical problems and takes no medications. Following a physical exam, transthoracic echocardiogram, and other tests, what is the most appropriate treatment?
https://immattersacp.org/weekly/archives/2020/06/09/3.htm
9 Jun 2020

MKSAP Quiz: 1-week history of chest pressure

A 35-year-old woman is evaluated for a 4-month history of exertional dyspnea and a 1-week history of chest pressure. She has no sputum production, cough, or wheezes. She has never smoked. Following a physical examination, laboratory studies, electrocardiogram, and chest radiograph, what is the most appropriate initial test?
https://immattersacp.org/weekly/archives/2020/03/17/3.htm
17 Mar 2020

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