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 — Immunizations (Adult)
Physician-Level Stem
A 68-year-old man with well-controlled type 2 diabetes
presents for routine care in October. He received influenza
vaccine two years ago, has never received pneumococcal
conjugate vaccine, and asks which vaccines are most important
,now to reduce his risk of severe respiratory infection this
season.
Options
A. Live attenuated intranasal influenza vaccine and PPSV23
(polysaccharide) now.
B. Inactivated (IIV) influenza vaccine this season and
pneumococcal conjugate vaccine (PCV20 or PCV15 → PPSV23
per schedule).
C. No influenza vaccine this season; administer only PPSV23
now.
D. Single dose of PPSV23 only, postpone influenza vaccination
to next year.
Correct answer: B
Rationale — Correct (B)
CMDT recommends annual inactivated influenza vaccination for
adults ≥65 and pneumococcal vaccination according to current
adult schedules: either PCV20 alone or PCV15 followed by
PPSV23 as indicated for adults with chronic conditions (eg,
diabetes). This combination provides broader serotype
coverage and seasonal influenza protection. Vaccine timing
(influenza annually, pneumococcus as indicated) reduces risk of
severe disease.
Rationale — Incorrect
A. Live intranasal influenza vaccine is contraindicated in adults
≥50 and in those with chronic medical conditions; not
recommended here.
,C. Omitting current-season influenza vaccine leaves him
unprotected; both influenza and pneumococcal vaccines are
recommended.
D. PPSV23 alone provides narrower pneumococcal coverage
than a PCV strategy and delaying influenza vaccination is not
appropriate.
Teaching point
Give annual inactivated influenza vaccine; use PCV20 or
PCV15→PPSV23 for older adults with chronic disease.
Citation (APA)
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. 1.
AccessMedicine
2
Reference
Ch. 1 — Colorectal Cancer Screening
Physician-Level Stem
A 72-year-old woman with no family history of colorectal cancer
and no prior colonoscopies asks whether she should begin
screening now. She is independent in activities of daily living
and has a life expectancy >10 years.
Options
A. Do not screen—stop all colorectal cancer screening after age
70.
, B. Offer screening; colonoscopy every 10 years or stool-based
testing yearly/intervals per modality.
C. Screen only with flexible sigmoidoscopy now, repeat every 5
years.
D. Screen only if she develops symptoms—otherwise avoid
testing because of age.
Correct answer: B
Rationale — Correct (B)
CMDT aligns with guidelines that average-risk adults aged 45–
75 should be screened; in older adults screening 76–85 is
individualized based on comorbidity and life expectancy. This
72-year-old with >10-year life expectancy should be offered
screening; colonoscopy every 10 years is an acceptable option,
as are stool-based tests with appropriate intervals.
Rationale — Incorrect
A. Absolute cutoff at 70 is incorrect; decisions should be
individualized.
C. Flexible sigmoidoscopy alone is less sensitive than
colonoscopy or appropriate stool tests and is not preferred as
sole option for average-risk screening.
D. Waiting for symptoms misses asymptomatic, screen-
detectable cancers.
Teaching point
Offer screening through age 75; individualize 76–85 by health
status and life expectancy.
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 — Immunizations (Adult)
Physician-Level Stem
A 68-year-old man with well-controlled type 2 diabetes
presents for routine care in October. He received influenza
vaccine two years ago, has never received pneumococcal
conjugate vaccine, and asks which vaccines are most important
,now to reduce his risk of severe respiratory infection this
season.
Options
A. Live attenuated intranasal influenza vaccine and PPSV23
(polysaccharide) now.
B. Inactivated (IIV) influenza vaccine this season and
pneumococcal conjugate vaccine (PCV20 or PCV15 → PPSV23
per schedule).
C. No influenza vaccine this season; administer only PPSV23
now.
D. Single dose of PPSV23 only, postpone influenza vaccination
to next year.
Correct answer: B
Rationale — Correct (B)
CMDT recommends annual inactivated influenza vaccination for
adults ≥65 and pneumococcal vaccination according to current
adult schedules: either PCV20 alone or PCV15 followed by
PPSV23 as indicated for adults with chronic conditions (eg,
diabetes). This combination provides broader serotype
coverage and seasonal influenza protection. Vaccine timing
(influenza annually, pneumococcus as indicated) reduces risk of
severe disease.
Rationale — Incorrect
A. Live intranasal influenza vaccine is contraindicated in adults
≥50 and in those with chronic medical conditions; not
recommended here.
,C. Omitting current-season influenza vaccine leaves him
unprotected; both influenza and pneumococcal vaccines are
recommended.
D. PPSV23 alone provides narrower pneumococcal coverage
than a PCV strategy and delaying influenza vaccination is not
appropriate.
Teaching point
Give annual inactivated influenza vaccine; use PCV20 or
PCV15→PPSV23 for older adults with chronic disease.
Citation (APA)
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. 1.
AccessMedicine
2
Reference
Ch. 1 — Colorectal Cancer Screening
Physician-Level Stem
A 72-year-old woman with no family history of colorectal cancer
and no prior colonoscopies asks whether she should begin
screening now. She is independent in activities of daily living
and has a life expectancy >10 years.
Options
A. Do not screen—stop all colorectal cancer screening after age
70.
, B. Offer screening; colonoscopy every 10 years or stool-based
testing yearly/intervals per modality.
C. Screen only with flexible sigmoidoscopy now, repeat every 5
years.
D. Screen only if she develops symptoms—otherwise avoid
testing because of age.
Correct answer: B
Rationale — Correct (B)
CMDT aligns with guidelines that average-risk adults aged 45–
75 should be screened; in older adults screening 76–85 is
individualized based on comorbidity and life expectancy. This
72-year-old with >10-year life expectancy should be offered
screening; colonoscopy every 10 years is an acceptable option,
as are stool-based tests with appropriate intervals.
Rationale — Incorrect
A. Absolute cutoff at 70 is incorrect; decisions should be
individualized.
C. Flexible sigmoidoscopy alone is less sensitive than
colonoscopy or appropriate stool tests and is not preferred as
sole option for average-risk screening.
D. Waiting for symptoms misses asymptomatic, screen-
detectable cancers.
Teaching point
Offer screening through age 75; individualize 76–85 by health
status and life expectancy.
