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 — Primary
Prevention: Aspirin for CV Disease
Stem
A 64-year-old man with hypertension and well-controlled type 2
diabetes asks whether he should start daily low-dose aspirin to
prevent a first myocardial infarction. He has no history of
,bleeding, peptic ulcer disease, or prior CV events. Shared
decision-making is requested.
Options
A. Recommend low-dose aspirin for primary prevention
immediately.
B. Recommend against aspirin because age ≥60 favors
withholding for primary prevention.
C. Start aspirin only if 10-year ASCVD risk >20%.
D. Defer aspirin and arrange coronary artery calcium (CAC)
scoring first.
Correct answer
B
Rationale — Correct (B)
CMDT 2026 aligns with USPSTF/CVD guidance that routine
aspirin for primary prevention is generally not recommended
for adults ≥60 because bleeding risk outweighs benefit. Shared
decision-making is needed for some younger high-risk patients,
but at ≥60 routine initiation is discouraged. AccessMedicine+1
Rationale — Incorrect
A. Routine initiation at age ≥60 is discouraged due to net harm
from bleeding.
C. Using a 20% ASCVD cutoff is not the primary CMDT/USPSTF
threshold; age and bleeding risk matter.
D. CAC may inform statin decisions, not routine aspirin
indication; it’s not the standard first step before aspirin in ≥60.
,Teaching point
Avoid starting aspirin for primary prevention in adults ≥60;
individualize only with careful risk–benefit discussion.
Citation
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. 1.
AccessMedicine
2
Reference
Ch. 1 — Disease Prevention & Health Promotion — Lipid
Management & Statin Use
Stem
A 46-year-old man with treated hypertension and BMI 29 has
an estimated 10-year ASCVD risk of 8%. He asks whether to
start a statin for primary prevention. He smokes occasionally,
has no diabetes, and family history is noncontributory.
Options
A. Start high-intensity statin therapy today.
B. Offer moderate-intensity statin after shared decision-making.
C. Recommend aspirin daily instead of statin.
D. Reassess lifestyle only; avoid pharmacotherapy until risk
≥20%.
Correct answer
B
, Rationale — Correct (B)
CMDT/USPSTF recommend statin therapy for primary
prevention in adults 40–75 with ≥1 CVD risk factor and
estimated 10-year risk typically ≥10%; for borderline risks (5–
7.5–10%) shared decision-making about moderate-intensity
statin is recommended. Given risk 8% and presence of risk
factor (hypertension), a shared decision to start moderate-
intensity statin is appropriate. USPSTF+1
Rationale — Incorrect
A. High-intensity statin is reserved for higher risk (e.g.,
established ASCVD or very high estimated risk).
C. Aspirin is not recommended instead of statin for primary
prevention here.
D. Lifestyle alone may be insufficient given existing CVD risk
factor and borderline ASCVD risk; shared decision about statin
is warranted.
Teaching point
Use shared decision-making for statins in adults 40–75 with
borderline-to-intermediate ASCVD risk.
Citation
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. 1.
AccessMedicine
3
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 — Primary
Prevention: Aspirin for CV Disease
Stem
A 64-year-old man with hypertension and well-controlled type 2
diabetes asks whether he should start daily low-dose aspirin to
prevent a first myocardial infarction. He has no history of
,bleeding, peptic ulcer disease, or prior CV events. Shared
decision-making is requested.
Options
A. Recommend low-dose aspirin for primary prevention
immediately.
B. Recommend against aspirin because age ≥60 favors
withholding for primary prevention.
C. Start aspirin only if 10-year ASCVD risk >20%.
D. Defer aspirin and arrange coronary artery calcium (CAC)
scoring first.
Correct answer
B
Rationale — Correct (B)
CMDT 2026 aligns with USPSTF/CVD guidance that routine
aspirin for primary prevention is generally not recommended
for adults ≥60 because bleeding risk outweighs benefit. Shared
decision-making is needed for some younger high-risk patients,
but at ≥60 routine initiation is discouraged. AccessMedicine+1
Rationale — Incorrect
A. Routine initiation at age ≥60 is discouraged due to net harm
from bleeding.
C. Using a 20% ASCVD cutoff is not the primary CMDT/USPSTF
threshold; age and bleeding risk matter.
D. CAC may inform statin decisions, not routine aspirin
indication; it’s not the standard first step before aspirin in ≥60.
,Teaching point
Avoid starting aspirin for primary prevention in adults ≥60;
individualize only with careful risk–benefit discussion.
Citation
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. 1.
AccessMedicine
2
Reference
Ch. 1 — Disease Prevention & Health Promotion — Lipid
Management & Statin Use
Stem
A 46-year-old man with treated hypertension and BMI 29 has
an estimated 10-year ASCVD risk of 8%. He asks whether to
start a statin for primary prevention. He smokes occasionally,
has no diabetes, and family history is noncontributory.
Options
A. Start high-intensity statin therapy today.
B. Offer moderate-intensity statin after shared decision-making.
C. Recommend aspirin daily instead of statin.
D. Reassess lifestyle only; avoid pharmacotherapy until risk
≥20%.
Correct answer
B
, Rationale — Correct (B)
CMDT/USPSTF recommend statin therapy for primary
prevention in adults 40–75 with ≥1 CVD risk factor and
estimated 10-year risk typically ≥10%; for borderline risks (5–
7.5–10%) shared decision-making about moderate-intensity
statin is recommended. Given risk 8% and presence of risk
factor (hypertension), a shared decision to start moderate-
intensity statin is appropriate. USPSTF+1
Rationale — Incorrect
A. High-intensity statin is reserved for higher risk (e.g.,
established ASCVD or very high estimated risk).
C. Aspirin is not recommended instead of statin for primary
prevention here.
D. Lifestyle alone may be insufficient given existing CVD risk
factor and borderline ASCVD risk; shared decision about statin
is warranted.
Teaching point
Use shared decision-making for statins in adults 40–75 with
borderline-to-intermediate ASCVD risk.
Citation
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. 1.
AccessMedicine
3
