CURRENT Medical Diagnosis and Treatment 2026 Test Bank | Internal Medicine MCQs with Rationales | Full 65th Edition

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
Part A — Disease Prevention & Health Promotion (5 items)
1) Reference
Ch. 1 — Health Maintenance & Disease Prevention —
Immunizations for Adults. accessmedicine.mhmedical.com
Question Stem
A 68-year-old man with well-controlled type 2 diabetes
presents for a routine visit. He received influenza vaccination
last year. Which vaccine should be prioritized now to reduce his
risk of severe pneumococcal disease?

,Options
A. PPSV23 (23-valent pneumococcal polysaccharide vaccine)
alone
B. PCV20 (20-valent pneumococcal conjugate vaccine) alone
C. PCV13 followed by PPSV23 in 6–12 months
D. No pneumococcal vaccine is indicated for adults ≥65 with
diabetes
Correct Answer
B. PCV20 (20-valent pneumococcal conjugate vaccine) alone
Rationales
• Correct (B): CMDT recommends conjugate vaccines (newer
higher-valency PCVs) for older adults to provide broader
coverage and better immune memory; PCV20 is an
acceptable single-dose option for adults ≥65 or adults with
comorbidities. accessmedicine.mhmedical.com
• Incorrect (A): PPSV23 alone provides broad serotype
coverage but lacks the conjugate-induced T-cell dependent
response; current guidance favors PCV20 as a single-dose
option in many adults. accessmedicine.mhmedical.com
• Incorrect (C): The PCV13→PPSV23 schedule was
historically used, but with higher-valency PCVs
(PCV15/PCV20), sequential scheduling is not always
required and PCV20 alone is preferred in many cases.
accessmedicine.mhmedical.com

, • Incorrect (D): Adults ≥65 or those with chronic diseases
(eg, diabetes) are indicated for pneumococcal vaccination;
deferral is inappropriate. accessmedicine.mhmedical.com
Teaching Point
Use high-valency PCV (eg, PCV20) for older adults/comorbid
patients when indicated.
Citation (Simplified APA)
Papadakis et al. (2025). CURRENT Medical Diagnosis &
Treatment 2026 (65th Ed.). Ch. 1.
accessmedicine.mhmedical.com


2) Reference
Ch. 1 — Health Maintenance & Disease Prevention —
Cardiovascular Risk Screening. accessmedicine.mhmedical.com
Question Stem
A 52-year-old woman with a family history of premature
coronary artery disease asks which screening test most
improves cardiovascular risk estimation beyond standard lipids.
Which CMDT-recommended adjunct test best refines short-
term risk?
Options
A. Coronary artery calcium (CAC) scoring by CT
B. Routine hs-CRP measurement in all adults
C. Resting echocardiography for asymptomatic adults
D. Routine ankle-brachial index in patients without symptoms

, Correct Answer
A. Coronary artery calcium (CAC) scoring by CT
Rationales
• Correct (A): CMDT notes CAC scoring refines risk
stratification (especially when risk decision is uncertain)
and helps guide preventive therapies.
accessmedicine.mhmedical.com
• Incorrect (B): hs-CRP can be useful selectively but is not
recommended as routine for all adults to refine risk.
accessmedicine.mhmedical.com
• Incorrect (C): Resting echocardiography is not a screening
tool for asymptomatic adults to refine coronary risk.
accessmedicine.mhmedical.com
• Incorrect (D): Ankle-brachial index is for peripheral arterial
disease assessment or symptomatic patients, not routine
coronary risk refinement in asymptomatic patients.
accessmedicine.mhmedical.com
Teaching Point
Use CAC scoring when risk is uncertain to guide preventive
therapy decisions.
Citation (Simplified APA)
Papadakis et al. (2025). CURRENT Medical Diagnosis &
Treatment 2026 (65th Ed.). Ch. 1.
accessmedicine.mhmedical.com