Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 38-year-old man is evaluated in follow-up after a diagnosis of ulcerative colitis. Ten days ago he was started on prednisone, 60 mg/d, but his symptoms have not improved. He has six to nine bloody bowel movements per day and moderate abdominal pain. He has decreased his oral intake ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 19-year-old woman is seen for counseling regarding contraceptives. Medical history is unremarkable; she is nulliparous and has never taken prescription contraceptives. Her father had a pulmonary embolism at age 47 years, which was associated with arthroscopic knee surgery, and her 23-year-old sister experienced a deep venous thrombosis 3 ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 62-year-old man is evaluated during a routine visit. He is asymptomatic and walks 1 mile most days of the week. Medical history is significant for aortic stenosis, type 2 diabetes mellitus, hypertension, and hyperlipidemia. Medications are aspirin, metformin, lisinopril, metoprolol, and rosuvastatin. On physical examination, the patient is afebrile, ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 28-year-old man is evaluated for right knee pain that began 2 days ago. He was playing football when he stopped suddenly and pivoted to make a catch. He heard a popping sound and immediately developed severe pain in his right knee. Within 30 minutes, the knee became swollen. ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 41-year-old woman is evaluated in follow-up after presenting to the emergency department 1 week ago for burning epigastric and chest pain. In the emergency department, a complete blood count and liver chemistry studies were normal, but a radiograph of the chest and upper abdomen demonstrated calcified gallstones. The ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 57-year-old man is evaluated during a routine examination. His medical history is notable for chronic hepatitis C infection with cirrhosis, which was diagnosed 3 years ago. He undergoes surveillance ultrasound for hepatocellular carcinoma every 6 months. On physical examination, temperature is 36.8 °C (98.2 °F), blood pressure is 110/82 ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 62-year-old woman is evaluated for an incidentally discovered left adrenal mass. Two weeks ago, the patient was evaluated in the emergency department for diffuse abdominal pain and vomiting. A CT scan was obtained that was normal except for the adrenal mass. Three hours after presentation to the emergency ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 38-year-old man is evaluated during a periodic health maintenance visit. His friend was recently diagnosed with type 2 diabetes mellitus, and the patient expresses interest in being screened. He is asymptomatic and reports no symptoms of polyuria or polydipsia. He exercises regularly. Medical and family histories are unremarkable. ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 50-year-old man is evaluated for a firm, darkly pigmented papule on his back that has been growing steadily over a period of several months. His medical history is unremarkable, and he takes no medications. On physical examination, vital signs are normal. The skin lesion is a 0.5-cm darkly pigmented, ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 67-year-old woman is evaluated during a routine examination. She has a history of hip and knee pain related to degenerative joint disease. The joint pain is now well controlled with diclofenac, which was started 3 months ago. A previous trial of high-dose acetaminophen was not effective. She does ...

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