Harrison's Principles of Internal Medicine
(Vol.1 & Vol.2)
21st Edition Newer Edition
Author(s)Joseph Loscalzo; Anthony S. Fauci;
Dennis L. Kasper; Stephen Hauser; Dan Longo;
J. Larry Jameson
TEST BANK
1
Reference
Ch. 1 — The Practice of Medicine
Question Stem
A 68-year-old man with multiple chronic conditions asks
whether to pursue an aggressive diagnostic workup for a slowly
progressive cough. Which clinician action best reflects the
principles of high-value care?
Options
A. Order comprehensive imaging and broad infectious and
,autoimmune panels to avoid missing rare causes.
B. Prioritize shared decision-making, review likely diagnoses,
weigh harms/benefits, and align action with patient goals.
C. Defer all testing because the cough is likely age-related and
investigations will not change management.
D. Refer immediately to multiple specialists to expedite
diagnosis.
Correct Answer
B
Rationales
• Correct (B): High-value practice emphasizes shared
decision-making, estimating probability of disease,
balancing benefits/harms, and aligning investigations with
the patient’s goals and prognosis.
• A (incorrect): Blanket comprehensive testing increases
costs and risk of incidental findings without necessarily
improving outcomes.
• C (incorrect): Automatic deferral ignores clinical judgment
and patient preferences; some evaluations may be
appropriate.
• D (incorrect): Immediate multi-specialty referral can
fragment care and increase unnecessary testing; referral
should be targeted.
,Teaching Point
High-value care = shared decision-making + benefit-harm
appraisal aligned with patient goals.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
2
Reference
Ch. 2 — Promoting Good Health
Question Stem
A primary care nurse sees a 52-year-old man with BMI 34 kg/m²
and prediabetes. Which intervention most effectively reduces
his long-term cardiometabolic risk according to prevention
frameworks?
Options
A. Prescribe metformin immediately as the first-line preventive
step.
B. Recommend structured lifestyle intervention (diet, exercise,
weight loss) with periodic follow-up.
C. Advise annual lipid testing only and reassess in five years.
D. Suggest over-the-counter weight-loss supplements as first-
line.
Correct Answer
B
, Rationales
• Correct (B): Population and individual-level prevention
models prioritize lifestyle interventions (diet, exercise,
weight loss) to reduce progression from prediabetes to
diabetes and reduce cardiovascular risk.
• A (incorrect): Metformin can be helpful in select patients
but is not the universal first-line preventive strategy over
lifestyle modification.
• C (incorrect): Mere surveillance without active
intervention misses an opportunity to modify risk
trajectory.
• D (incorrect): OTC supplements lack robust evidence and
can be unsafe; structured programs are superior.
Teaching Point
Intensive lifestyle change is first-line prevention for obesity-
related cardiometabolic risk.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 2.
3
Reference
Ch. 3 — Vaccine Opposition and Hesitancy
(Vol.1 & Vol.2)
21st Edition Newer Edition
Author(s)Joseph Loscalzo; Anthony S. Fauci;
Dennis L. Kasper; Stephen Hauser; Dan Longo;
J. Larry Jameson
TEST BANK
1
Reference
Ch. 1 — The Practice of Medicine
Question Stem
A 68-year-old man with multiple chronic conditions asks
whether to pursue an aggressive diagnostic workup for a slowly
progressive cough. Which clinician action best reflects the
principles of high-value care?
Options
A. Order comprehensive imaging and broad infectious and
,autoimmune panels to avoid missing rare causes.
B. Prioritize shared decision-making, review likely diagnoses,
weigh harms/benefits, and align action with patient goals.
C. Defer all testing because the cough is likely age-related and
investigations will not change management.
D. Refer immediately to multiple specialists to expedite
diagnosis.
Correct Answer
B
Rationales
• Correct (B): High-value practice emphasizes shared
decision-making, estimating probability of disease,
balancing benefits/harms, and aligning investigations with
the patient’s goals and prognosis.
• A (incorrect): Blanket comprehensive testing increases
costs and risk of incidental findings without necessarily
improving outcomes.
• C (incorrect): Automatic deferral ignores clinical judgment
and patient preferences; some evaluations may be
appropriate.
• D (incorrect): Immediate multi-specialty referral can
fragment care and increase unnecessary testing; referral
should be targeted.
,Teaching Point
High-value care = shared decision-making + benefit-harm
appraisal aligned with patient goals.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
2
Reference
Ch. 2 — Promoting Good Health
Question Stem
A primary care nurse sees a 52-year-old man with BMI 34 kg/m²
and prediabetes. Which intervention most effectively reduces
his long-term cardiometabolic risk according to prevention
frameworks?
Options
A. Prescribe metformin immediately as the first-line preventive
step.
B. Recommend structured lifestyle intervention (diet, exercise,
weight loss) with periodic follow-up.
C. Advise annual lipid testing only and reassess in five years.
D. Suggest over-the-counter weight-loss supplements as first-
line.
Correct Answer
B
, Rationales
• Correct (B): Population and individual-level prevention
models prioritize lifestyle interventions (diet, exercise,
weight loss) to reduce progression from prediabetes to
diabetes and reduce cardiovascular risk.
• A (incorrect): Metformin can be helpful in select patients
but is not the universal first-line preventive strategy over
lifestyle modification.
• C (incorrect): Mere surveillance without active
intervention misses an opportunity to modify risk
trajectory.
• D (incorrect): OTC supplements lack robust evidence and
can be unsafe; structured programs are superior.
Teaching Point
Intensive lifestyle change is first-line prevention for obesity-
related cardiometabolic risk.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 2.
3
Reference
Ch. 3 — Vaccine Opposition and Hesitancy
