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MKSAP Quiz: 7-year history of plaques

A 50-year-old man is evaluated in the hospital for fatigue, joint pain, and skin lesions. His symptoms started 2 weeks ago with fever and sore throat, which subsided in 2 days. Fatigue and joint pain were noted 1 day after the onset of sore throat, which worsened over the subsequent days. Four days after the onset of symptoms, he noted dark red spots on his ankles and shins, which spread to involve his legs, thighs, and buttocks; the skin lesions were not painful or itchy. Following a physical exam and lab studies, what is the most likely diagnosis?
https://immattersacp.org/archives/2018/03/mksap-quiz-7-year-history-of-plaques.htm
1 Mar 2018

DynaMed Plus Quiz: Shortness of breath

A 40-year-old trophy-winning professional knitter reports increasing shortness of breath and dry cough for the past week, as well as hoarseness and throat pain for the past three days. Upon questioning, she reports feeling “feverish” and being unusually tired of late. Following a review of systems, physical exam, and lab tests, what is the most likely diagnosis?
https://immattersacp.org/archives/2017/11/dynamed-plus-quiz-shortness-of-breath.htm
1 Nov 2017

MKSAP Quiz: 6-week history of blisters

A 55-year-old man is evaluated for a 6-week history of blisters on his hands. The blisters are tender, break easily after they develop, and occur in different regions on the backs of his hands. Medical history is notable for alcoholic liver disease. The patient does not use tobacco but drinks 6 beers daily. He takes no medications. Following a physical exam, what is the most likely diagnosis?
https://immattersacp.org/archives/2017/09/mksap-quiz-6-week-history-of-blisters.htm
1 Sep 2017

Fibromyalgia characterized by controversy

There is very clear, objective evidence that fibromyalgia is a real problem. But there remains considerable dissent among the medical community about the condition's cause.
https://immattersacp.org/archives/2016/09/fibromyalgia.htm
1 Sep 2016

MKSAP Quiz: fatigue, anorexia, polyuria, and nocturia

A 54-year-old woman is evaluated for fatigue, anorexia, polyuria, and nocturia of several weeks' duration. She had otherwise felt well until the onset of her current symptoms. Medical history is significant for autoimmune pancreatitis diagnosed 1 year ago, treated with a prednisone taper that was completed 8 months ago with resolution of her symptoms. Following a physical exam and lab studies, what is the most likely diagnosis?
https://immattersacp.org/weekly/archives/2016/06/14/3.htm
14 Jun 2016

Transitioning patients from pediatric to adult care

As adolescents become young adults, there comes a time when pediatricians will no longer see them. For those patients with chronic, sometimes complex, conditions, it can be hard to know how to transition into the adult internal medicine world. ACP, in collaboration with several pediatric and adult subspecialty societies, has developed a toolkit to help patients and practices manage this transition.
https://immattersacp.org/archives/2016/06/tips.htm
1 Jun 2016

MKSAP Quiz: Decreased exercise tolerance

A 62-year-old woman is evaluated for a 4-month history of decreased exercise tolerance, joint stiffness, mild weakness, and a rash on her hands. She has noted increasing difficulty carrying heavy objects and feels exhausted after climbing stairs. Although her joints are stiff, she has not had any joint swelling. Her rash developed around the time of her other symptoms and has not responded to over-the-counter topical agents. She has no other symptoms, including cough or dyspnea. Medical history is unremarkable, and she takes no medications. Follow a physical exam, cardiopulmonary exam, and lab studies, which of the following pulmonary conditions is associated with this patient's clinical presentation?.
https://immattersacp.org/archives/2016/05/mksap.htm
1 May 2016

MKSAP Quiz: 3-month history of rash

A 46-year-old woman is evaluated for a 3-month history of a rash during the summertime. She is otherwise well and takes no medications. Following a physical exam, exam of the rash, and lab studies, what is the most likely diagnosis?.
https://immattersacp.org/archives/2016/03/mksap.htm
1 Mar 2016

MKSAP Quiz: evaluation of painful nodules and rash

A 21-year-old woman is evaluated for a 3-week history of painful nodules and a rash in the lower extremities, along with pain and swelling of the wrists, knees, and ankles. She reports a low-grade fever and a 2.7-kg (6.0-lb) weight loss since the onset of symptoms. She has taken naproxen with some relief. History is significant for gastroesophageal reflux disease and acne. Medications are over-the-counter famotidine as needed and minocycline. Following a physical exam and lab studies, what is the most appropriate next step in management?
https://immattersacp.org/weekly/archives/2015/11/03/3.htm
3 Nov 2015

MKSAP Quiz: 3-month history of swelling of the face, hands, and feet

A 53-year-old woman is evaluated for a 3-month history of swelling of the face, hands, and feet. She has untreated hepatitis C virus infection. She takes lithium for bipolar disorder. She has no additional symptoms. After a physical exam, lab results and kidney biopsy, what is the most likely cause of this patient's nephrotic syndrome?
https://immattersacp.org/weekly/archives/2015/05/19/3.htm
19 May 2015

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