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
Q1
Reference: Ch. 1 — Disease Prevention & Health Promotion —
Pneumococcal vaccination in older adults
Stem: A 68-year-old man with well-controlled type 2 diabetes
and prior receipt of PPSV23 eight years ago presents for routine
care. He reports no prior conjugate pneumococcal vaccine.
Which is the single best next step in pneumococcal vaccination?
A. Administer PCV20 now, no further pneumococcal vaccine
needed.
,B. Administer PCV13 now followed by PPSV23 in 6 months.
C. Administer PPSV23 now (repeat) since prior dose was >5
years ago.
D. No further pneumococcal vaccines indicated because prior
PPSV23 was within 10 years.
Answer: A
Rationale — Correct (A): Current guidance supports giving a
pneumococcal conjugate (e.g., PCV20) to adults ≥65 or at-risk
adults who have not received a conjugate vaccine; a single dose
of PCV20 alone completes conjugate-based protection and
obviates additional PPSV23. This aligns with CDC/ACIP-informed
CMDT recommendations for adults who previously received
PPSV23 but not a conjugate vaccine. CDC
Rationale — Incorrect:
B. PCV13 is no longer preferred as the sole conjugate in many
adult algorithms; PCV20 provides broader serotype coverage
and a single-dose strategy.
C. Repeating PPSV23 alone is not optimal if the patient has not
received a conjugate vaccine; conjugate vaccine provides
improved immunogenicity.
D. Prior PPSV23 >5 years ago does not obviate the need for
conjugate vaccination in an older adult; additional conjugate is
recommended when previously missing.
Teaching point: Give an appropriate pneumococcal conjugate
(eg, PCV20) to older adults lacking prior conjugate vaccine.
Citation: Papadakis, M. A., McPhee, S. J., & Rabow, M. W.
,(2026). Current Medical Diagnosis & Treatment (65th ed.). Ch.
1. AccessMedicine
Q2
Reference: Ch. 1 — Disease Prevention & Health Promotion —
Influenza vaccine in egg allergy
Stem: A 42-year-old woman with history of hives after eating
eggs asks whether she should receive the annual inactivated
influenza vaccine during the upcoming season. She has no
history of anaphylaxis to vaccines. What is the best
recommendation?
A. Defer influenza vaccination because egg allergy is a
contraindication.
B. Give standard inactivated influenza vaccine in primary care
with 30 minutes observation.
C. Administer live attenuated intranasal influenza vaccine
instead.
D. Refer to allergist for skin testing before vaccination.
Answer: B
Rationale — Correct (B): Egg allergy limited to hives is not a
contraindication to receiving standard inactivated influenza
vaccine; administration in any setting with usual post-vaccine
observation is appropriate. CMDT summarizes that severe
vaccine reactions (anaphylaxis to vaccine components) are the
true contraindications. AccessMedicine+1
, Rationale — Incorrect:
A. Egg allergy is not an absolute contraindication to inactivated
influenza vaccine.
C. Live attenuated intranasal vaccine has separate
indications/contraindications and is not preferred for persons
with certain comorbidities; it is not indicated solely because of
egg allergy.
D. Routine allergist testing before influenza vaccine is
unnecessary for most egg-allergic patients.
Teaching point: Egg allergy alone rarely precludes inactivated
influenza vaccination; usual administration is acceptable.
Citation: Papadakis et al. (2026). Ch. 1. CDC
Q3
Reference: Ch. 1 — Disease Prevention & Health Promotion —
HPV vaccination in adults
Stem: A 31-year-old man who has sex with men reports
multiple recent partners and inconsistent condom use; he has
not previously received HPV vaccine. He asks whether HPV
vaccination may benefit him now. Best next step?
A. Vaccinate now (3-dose series) because shared decision-
making supports vaccination through age 45.
B. Do not vaccinate; HPV vaccine is contraindicated after age 26.
C. Offer vaccination only if he has evidence of high-risk HPV on
testing.
D. Vaccinate only if he is HIV positive.
TREATMENT 2026
65TH EDITION
Author(s)Maxine A. Papadakis; Michael
W. Rabow; Kenneth R. McQuaid; Paul L.
Nadler; Erika Leemann Price
TEST BANK
Q1
Reference: Ch. 1 — Disease Prevention & Health Promotion —
Pneumococcal vaccination in older adults
Stem: A 68-year-old man with well-controlled type 2 diabetes
and prior receipt of PPSV23 eight years ago presents for routine
care. He reports no prior conjugate pneumococcal vaccine.
Which is the single best next step in pneumococcal vaccination?
A. Administer PCV20 now, no further pneumococcal vaccine
needed.
,B. Administer PCV13 now followed by PPSV23 in 6 months.
C. Administer PPSV23 now (repeat) since prior dose was >5
years ago.
D. No further pneumococcal vaccines indicated because prior
PPSV23 was within 10 years.
Answer: A
Rationale — Correct (A): Current guidance supports giving a
pneumococcal conjugate (e.g., PCV20) to adults ≥65 or at-risk
adults who have not received a conjugate vaccine; a single dose
of PCV20 alone completes conjugate-based protection and
obviates additional PPSV23. This aligns with CDC/ACIP-informed
CMDT recommendations for adults who previously received
PPSV23 but not a conjugate vaccine. CDC
Rationale — Incorrect:
B. PCV13 is no longer preferred as the sole conjugate in many
adult algorithms; PCV20 provides broader serotype coverage
and a single-dose strategy.
C. Repeating PPSV23 alone is not optimal if the patient has not
received a conjugate vaccine; conjugate vaccine provides
improved immunogenicity.
D. Prior PPSV23 >5 years ago does not obviate the need for
conjugate vaccination in an older adult; additional conjugate is
recommended when previously missing.
Teaching point: Give an appropriate pneumococcal conjugate
(eg, PCV20) to older adults lacking prior conjugate vaccine.
Citation: Papadakis, M. A., McPhee, S. J., & Rabow, M. W.
,(2026). Current Medical Diagnosis & Treatment (65th ed.). Ch.
1. AccessMedicine
Q2
Reference: Ch. 1 — Disease Prevention & Health Promotion —
Influenza vaccine in egg allergy
Stem: A 42-year-old woman with history of hives after eating
eggs asks whether she should receive the annual inactivated
influenza vaccine during the upcoming season. She has no
history of anaphylaxis to vaccines. What is the best
recommendation?
A. Defer influenza vaccination because egg allergy is a
contraindication.
B. Give standard inactivated influenza vaccine in primary care
with 30 minutes observation.
C. Administer live attenuated intranasal influenza vaccine
instead.
D. Refer to allergist for skin testing before vaccination.
Answer: B
Rationale — Correct (B): Egg allergy limited to hives is not a
contraindication to receiving standard inactivated influenza
vaccine; administration in any setting with usual post-vaccine
observation is appropriate. CMDT summarizes that severe
vaccine reactions (anaphylaxis to vaccine components) are the
true contraindications. AccessMedicine+1
, Rationale — Incorrect:
A. Egg allergy is not an absolute contraindication to inactivated
influenza vaccine.
C. Live attenuated intranasal vaccine has separate
indications/contraindications and is not preferred for persons
with certain comorbidities; it is not indicated solely because of
egg allergy.
D. Routine allergist testing before influenza vaccine is
unnecessary for most egg-allergic patients.
Teaching point: Egg allergy alone rarely precludes inactivated
influenza vaccination; usual administration is acceptable.
Citation: Papadakis et al. (2026). Ch. 1. CDC
Q3
Reference: Ch. 1 — Disease Prevention & Health Promotion —
HPV vaccination in adults
Stem: A 31-year-old man who has sex with men reports
multiple recent partners and inconsistent condom use; he has
not previously received HPV vaccine. He asks whether HPV
vaccination may benefit him now. Best next step?
A. Vaccinate now (3-dose series) because shared decision-
making supports vaccination through age 45.
B. Do not vaccinate; HPV vaccine is contraindicated after age 26.
C. Offer vaccination only if he has evidence of high-risk HPV on
testing.
D. Vaccinate only if he is HIV positive.
