CURRENT MEDICAL DIAGNOSIS AND
TREATMENT 2026
65TH EDITION
Author(s)Maxine A. Papadakis; Michael
W. Rabow; Kenneth R. McQuaid; Paul L.
Nadler; Erika Leemann Price
TEST BANK
1
Reference
Ch. 1 — Disease Prevention & Health Promotion — Aspirin for
Primary Prevention. AccessMedicine
Stem
A 58-year-old man with well-controlled hypertension and a 20-
pack-year smoking history asks about daily aspirin to prevent a
first myocardial infarction. His 10-year ASCVD risk (pooled
,cohort) is estimated at 12%. He reports no history of GI
bleeding or peptic ulcer disease. Which approach best aligns
with CMDT 2026 recommendations?
A. Start daily low-dose aspirin (81 mg) for primary prevention.
B. Do not start aspirin routinely; discuss risks and consider only
if ischemic risk clearly outweighs bleeding risk.
C. Recommend high-dose aspirin (325 mg) daily for greater
prevention efficacy.
D. Substitute aspirin with over-the-counter naproxen for
cardioprotection.
Correct answer: B
Rationale — Correct (B)
CMDT 2026 advises against routine aspirin for primary
prevention in most adults because bleeding risk often offsets
modest ASCVD benefit; use individualized shared decision-
making when 10-year ASCVD risk is intermediate and bleeding
risk is low. The patient’s 12% risk falls in an intermediate range
that warrants discussion rather than automatic initiation.
Rationale — Incorrect
A. Routine initiation is not recommended by CMDT due to
bleeding risk; only individualized decisions.
C. High-dose aspirin increases bleeding without added primary
prevention benefit compared with low dose.
D. Naproxen is not cardioprotective and increases
GI/cardiovascular risks; it is not an alternative for prevention.
,Teaching point
Do not prescribe aspirin routinely for primary prevention—use
individualized shared decision-making.
Citation (Simplified APA)
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. 1.
2
Reference
Ch. 1 — Disease Prevention & Health Promotion — Primary
Prevention: Statin Use. AccessMedicine
Stem
A 47-year-old woman with LDL 160 mg/dL, no diabetes, no
clinical ASCVD, and a 10-year ASCVD risk of 9% asks about
starting a statin to prevent cardiovascular disease. She
expresses concern about side effects. What is the most
evidence-based next step per CMDT 2026?
A. Recommend high-intensity statin therapy immediately.
B. Recommend no statin and continue lifestyle measures;
recheck lipids in 5 years.
C. Engage in shared decision-making and consider moderate-
intensity statin given intermediate risk.
D. Prescribe ezetimibe as first-line primary prevention instead
of a statin.
Correct answer: C
, Rationale — Correct (C)
CMDT 2026 supports shared decision-making for adults with
intermediate (≈7.5–20%) 10-year ASCVD risk. For LDL elevation
and intermediate risk, moderate-intensity statin after discussion
of benefits/risks is reasonable; lifestyle modification remains
foundational.
Rationale — Incorrect
A. High-intensity statin is reserved for higher risk (established
ASCVD or >20% risk) or specific indications; not first-line for this
intermediate profile.
B. Waiting 5 years is excessive; re-evaluation and discussion
about statin therapy now is appropriate.
D. Ezetimibe may lower LDL but is adjunctive for statin-
intolerant patients, not first-line for primary prevention.
Teaching point
For intermediate ASCVD risk, use shared decision-making;
consider moderate-intensity statin.
Citation (Simplified APA)
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. 1.
3
Reference
Ch. 1 — Disease Prevention & Health Promotion —
TREATMENT 2026
65TH EDITION
Author(s)Maxine A. Papadakis; Michael
W. Rabow; Kenneth R. McQuaid; Paul L.
Nadler; Erika Leemann Price
TEST BANK
1
Reference
Ch. 1 — Disease Prevention & Health Promotion — Aspirin for
Primary Prevention. AccessMedicine
Stem
A 58-year-old man with well-controlled hypertension and a 20-
pack-year smoking history asks about daily aspirin to prevent a
first myocardial infarction. His 10-year ASCVD risk (pooled
,cohort) is estimated at 12%. He reports no history of GI
bleeding or peptic ulcer disease. Which approach best aligns
with CMDT 2026 recommendations?
A. Start daily low-dose aspirin (81 mg) for primary prevention.
B. Do not start aspirin routinely; discuss risks and consider only
if ischemic risk clearly outweighs bleeding risk.
C. Recommend high-dose aspirin (325 mg) daily for greater
prevention efficacy.
D. Substitute aspirin with over-the-counter naproxen for
cardioprotection.
Correct answer: B
Rationale — Correct (B)
CMDT 2026 advises against routine aspirin for primary
prevention in most adults because bleeding risk often offsets
modest ASCVD benefit; use individualized shared decision-
making when 10-year ASCVD risk is intermediate and bleeding
risk is low. The patient’s 12% risk falls in an intermediate range
that warrants discussion rather than automatic initiation.
Rationale — Incorrect
A. Routine initiation is not recommended by CMDT due to
bleeding risk; only individualized decisions.
C. High-dose aspirin increases bleeding without added primary
prevention benefit compared with low dose.
D. Naproxen is not cardioprotective and increases
GI/cardiovascular risks; it is not an alternative for prevention.
,Teaching point
Do not prescribe aspirin routinely for primary prevention—use
individualized shared decision-making.
Citation (Simplified APA)
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. 1.
2
Reference
Ch. 1 — Disease Prevention & Health Promotion — Primary
Prevention: Statin Use. AccessMedicine
Stem
A 47-year-old woman with LDL 160 mg/dL, no diabetes, no
clinical ASCVD, and a 10-year ASCVD risk of 9% asks about
starting a statin to prevent cardiovascular disease. She
expresses concern about side effects. What is the most
evidence-based next step per CMDT 2026?
A. Recommend high-intensity statin therapy immediately.
B. Recommend no statin and continue lifestyle measures;
recheck lipids in 5 years.
C. Engage in shared decision-making and consider moderate-
intensity statin given intermediate risk.
D. Prescribe ezetimibe as first-line primary prevention instead
of a statin.
Correct answer: C
, Rationale — Correct (C)
CMDT 2026 supports shared decision-making for adults with
intermediate (≈7.5–20%) 10-year ASCVD risk. For LDL elevation
and intermediate risk, moderate-intensity statin after discussion
of benefits/risks is reasonable; lifestyle modification remains
foundational.
Rationale — Incorrect
A. High-intensity statin is reserved for higher risk (established
ASCVD or >20% risk) or specific indications; not first-line for this
intermediate profile.
B. Waiting 5 years is excessive; re-evaluation and discussion
about statin therapy now is appropriate.
D. Ezetimibe may lower LDL but is adjunctive for statin-
intolerant patients, not first-line for primary prevention.
Teaching point
For intermediate ASCVD risk, use shared decision-making;
consider moderate-intensity statin.
Citation (Simplified APA)
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. 1.
3
Reference
Ch. 1 — Disease Prevention & Health Promotion —
