Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 67-year-old woman is evaluated for a 1-year history of loose stools. She reports approximately four episodes per day without abdominal pain. She has not had nausea, vomiting, weight loss, bright red blood per rectum, or melena. On physical examination, temperature is 36.7 °C (98.1 °F), blood pressure is 115/85 mm Hg, pulse ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 52-year-old man is evaluated during a routine examination. He is asymptomatic but is concerned about his weight. Medical history is significant for prediabetes and elevated cholesterol levels. He smokes one or two cigars a week. He drinks one or two alcoholic beverages a few nights each week. He does not get ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 78-year-old woman is evaluated for a rapidly enlarging neck mass that has been present for 4 weeks and is associated with neck discomfort, dysphagia, and hoarseness. The patient has had Hashimoto thyroiditis and hypothyroidism since age 24 years and has been taking levothyroxine since that time. Physical examination reveals an older woman ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 60-year-old asymptomatic man is evaluated during a routine examination. He has a long history of heart murmur. With normal daily activities, he has not experienced shortness of breath, chest discomfort, or palpitations. Blood pressure is 138/78 mm Hg, pulse rate is 82/min and regular, and respiration rate is 16/min. BMI is 27. ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 29-year-old woman is evaluated during a routine examination. She seeks advice in reducing her personal risk of developing rheumatoid arthritis, because her mother was recently diagnosed with the disorder. The patient is asymptomatic. She has a 10-pack-year history of smoking and consumes six alcoholic beverages per week, usually on weekends. She ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 40-year-old man is admitted to the emergency department with a 1-day history of headache and epistaxis. He has had type 1 diabetes mellitus requiring insulin for 30 years and two episodes of ketoacidosis in the past year. On physical examination, temperature is 36.0 °C (96.8 °F), blood pressure is 100/70 mm Hg, ...

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shutterstock_248807428 Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 72-year-old woman is evaluated during a routine examination. She has very severe COPD with multiple exacerbations. She has dyspnea at all times with decreased exercise capacity. She does not have cough or any change in baseline sputum production. She is adherent to ...

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shutterstock_109841906 Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 28-year-old man is evaluated for a 5-year history of recurrent headache that occurs several times per month and lasts 12 to 24 hours. He describes the headache as a bilateral frontal pressure associated with nasal congestion and sensitivity to light, sound, and ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. 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. On physical examination, temperature is normal, blood pressure is 134/93 mm Hg, pulse rate is 71/min, and respiration ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 25-year-old woman is evaluated for redness that developed over her right leg at the site of a mosquito bite. She is otherwise healthy and takes no medications. On physical examination, temperature is 37.2 °C (99.0 °F), blood pressure is 120/70 mm Hg, pulse rate is 70/min, and respiration rate is 14/min. There ...

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