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 — Influenza
vaccination in older adults
Stem
A 72-year-old man with well-controlled type 2 diabetes and no
egg allergy presents for routine care in October. He asks which
influenza vaccine is most appropriate this season. He previously
,received standard-dose inactivated influenza vaccine last year.
Vital signs and exam are normal.
A. Standard-dose inactivated influenza vaccine (IIV)
B. Live attenuated influenza vaccine (LAIV; intranasal)
C. High-dose inactivated influenza vaccine (HD-IIV)
D. Adjuvanted inactivated influenza vaccine (aIIV)
Correct answer
C
Rationales
✅ C (Correct): CMDT recommends high-dose inactivated
influenza vaccine or adjuvanted IIV for older adults (≥65 years)
because they produce greater immunogenicity and better
protection against influenza-related complications in this age
group. HD-IIV has been shown to reduce influenza and its
complications in older adults.
❌ A: Standard-dose IIV provides less immunogenicity in ≥65-
year-olds and is not preferred over HD-IIV or aIIV for routine use
in this age group.
❌ B: LAIV is contraindicated in older adults and in many with
chronic medical conditions; intranasal live vaccine is not
appropriate for a 72-year-old with diabetes.
❌ D: Adjuvanted IIV (aIIV) is an acceptable alternative to HD-
IIV for adults ≥65, but HD-IIV is the preferred single best answer
here because CMDT highlights high-dose as a primary option.
,Teaching Point
Use high-dose or adjuvanted influenza vaccine for adults ≥65 to
improve protection.
Citation
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 —
Pneumococcal vaccination in adults with chronic disease
Stem
A 68-year-old woman with chronic obstructive pulmonary
disease (COPD) and well-controlled diabetes has no prior
pneumococcal vaccines. She asks which pneumococcal
immunization strategy is recommended now.
A. Single dose PPSV23 now only
B. PCV20 now (single dose)
C. PCV13 followed by PPSV23 in 6 months
D. No pneumococcal vaccine recommended for COPD
Correct answer
B
Rationales
✅ B (Correct): CMDT endorses use of the newer conjugate
, vaccines (e.g., PCV20) as a single dose for adults ≥65 or younger
adults with chronic lung disease when indicated, simplifying
prior PCV13+PPSV23 sequences. For a 68-year-old with COPD
and diabetes, PCV20 now is appropriate.
❌ A: PPSV23 alone provides broader serotype coverage but
lacks the stronger immunologic response of conjugate vaccines;
current guidance favors PCV20 when available.
❌ C: The historical PCV13→PPSV23 sequence is largely
superseded by single-dose PCV20 or PCV15+PPSV23 strategies
in many patients; routine PCV13 is not always required.
❌ D: COPD and diabetes are indications for pneumococcal
vaccination; doing nothing is inconsistent with prevention
recommendations.
Teaching Point
Prefer a single-dose conjugate pneumococcal vaccine (e.g.,
PCV20) in adults with chronic disease.
Citation
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 — Zoster
vaccination
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 — Influenza
vaccination in older adults
Stem
A 72-year-old man with well-controlled type 2 diabetes and no
egg allergy presents for routine care in October. He asks which
influenza vaccine is most appropriate this season. He previously
,received standard-dose inactivated influenza vaccine last year.
Vital signs and exam are normal.
A. Standard-dose inactivated influenza vaccine (IIV)
B. Live attenuated influenza vaccine (LAIV; intranasal)
C. High-dose inactivated influenza vaccine (HD-IIV)
D. Adjuvanted inactivated influenza vaccine (aIIV)
Correct answer
C
Rationales
✅ C (Correct): CMDT recommends high-dose inactivated
influenza vaccine or adjuvanted IIV for older adults (≥65 years)
because they produce greater immunogenicity and better
protection against influenza-related complications in this age
group. HD-IIV has been shown to reduce influenza and its
complications in older adults.
❌ A: Standard-dose IIV provides less immunogenicity in ≥65-
year-olds and is not preferred over HD-IIV or aIIV for routine use
in this age group.
❌ B: LAIV is contraindicated in older adults and in many with
chronic medical conditions; intranasal live vaccine is not
appropriate for a 72-year-old with diabetes.
❌ D: Adjuvanted IIV (aIIV) is an acceptable alternative to HD-
IIV for adults ≥65, but HD-IIV is the preferred single best answer
here because CMDT highlights high-dose as a primary option.
,Teaching Point
Use high-dose or adjuvanted influenza vaccine for adults ≥65 to
improve protection.
Citation
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 —
Pneumococcal vaccination in adults with chronic disease
Stem
A 68-year-old woman with chronic obstructive pulmonary
disease (COPD) and well-controlled diabetes has no prior
pneumococcal vaccines. She asks which pneumococcal
immunization strategy is recommended now.
A. Single dose PPSV23 now only
B. PCV20 now (single dose)
C. PCV13 followed by PPSV23 in 6 months
D. No pneumococcal vaccine recommended for COPD
Correct answer
B
Rationales
✅ B (Correct): CMDT endorses use of the newer conjugate
, vaccines (e.g., PCV20) as a single dose for adults ≥65 or younger
adults with chronic lung disease when indicated, simplifying
prior PCV13+PPSV23 sequences. For a 68-year-old with COPD
and diabetes, PCV20 now is appropriate.
❌ A: PPSV23 alone provides broader serotype coverage but
lacks the stronger immunologic response of conjugate vaccines;
current guidance favors PCV20 when available.
❌ C: The historical PCV13→PPSV23 sequence is largely
superseded by single-dose PCV20 or PCV15+PPSV23 strategies
in many patients; routine PCV13 is not always required.
❌ D: COPD and diabetes are indications for pneumococcal
vaccination; doing nothing is inconsistent with prevention
recommendations.
Teaching Point
Prefer a single-dose conjugate pneumococcal vaccine (e.g.,
PCV20) in adults with chronic disease.
Citation
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 — Zoster
vaccination
