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) Ch. 1 — Disease Prevention & Health Promotion —
Hypertension: confirmatory testing
Stem: A 48-year-old man with obesity presents after two clinic
visits where seated blood pressures averaged 148/92 mm Hg.
He is asymptomatic, on no medications, and has no end-organ
signs. Which next step most appropriately confirms the
diagnosis before initiating long-term therapy?
A. Start low-dose thiazide and recheck clinic BP in 4 weeks.
B. Arrange ambulatory blood pressure monitoring (ABPM) or
validated home BP measurements.
C. Order basic metabolic panel and TSH and schedule repeat
,clinic BP in 6 months.
D. Diagnose hypertension and refer for immediate
echocardiography.
Correct answer: B
Rationale — Correct (B): CMDT emphasizes confirming elevated
clinic BPs with out-of-office measurements (ABPM preferred;
validated home monitoring acceptable) to exclude white-coat
hypertension and to guide treatment decisions. ABPM provides
multiple daytime/nighttime readings and better predicts
cardiovascular risk. AccessMedicine
Rationale — Incorrect:
A: Starting therapy without out-of-office confirmation risks
overtreatment for white-coat hypertension.
C: Labs are reasonable for workup but waiting 6 months delays
diagnosis; confirmatory BP measurement should occur sooner.
D: Echocardiography is not required to confirm simple
outpatient hypertension and is reserved for suspected
secondary causes or end-organ disease.
Teaching point: Confirm elevated clinic BP with ABPM or
validated home monitoring before lifelong therapy.
Citation: Papadakis, M. A., McPhee, S. J., & Rabow, M. W.
(2026). Current Medical Diagnosis & Treatment (65th ed.). Ch.
1. AccessMedicine
,2) Ch. 1 — Disease Prevention & Health Promotion — Primary
prevention: statin initiation
Stem: A 52-year-old woman with treated hypertension and LDL-
C 140 mg/dL has a calculated 10-year ASCVD risk of 12%. She is
asymptomatic and asks whether to start a statin for primary
prevention. What is the best approach?
A. Defer statin; treat only with lifestyle modification because
LDL is <160 mg/dL.
B. Initiate high-intensity statin immediately without further
discussion.
C. Offer moderate-intensity statin after shared decision-making
given intermediate ASCVD risk.
D. Start aspirin for primary prevention and reassess LDL in 1
year.
Correct answer: C
Rationale — Correct (C): CMDT and contemporary guidelines
recommend considering moderate-intensity statin therapy for
adults with intermediate (≈7.5–20%) 10-year ASCVD risk after
shared decision-making about risks/benefits, particularly with
additional risk factors. Shared decision-making incorporates
patient preferences and risk enhancers. AHA Journals+1
Rationale — Incorrect:
A: Lifestyle is foundational but withholding statin in an
intermediate-risk patient without shared decision-making may
miss prevention opportunity.
B: High-intensity statin is reserved for higher risk (eg, >20% or
, known ASCVD); moderate intensity is appropriate here.
D: Routine aspirin for primary prevention is not recommended
for most adults and is no substitute for statin therapy.
Teaching point: Use shared decision-making to start moderate-
intensity statin for intermediate ASCVD risk.
Citation: Papadakis, M. A., McPhee, S. J., & Rabow, M. W.
(2026). Current Medical Diagnosis & Treatment (65th ed.). Ch.
1. AHA Journals+1
3) Ch. 1 — Disease Prevention & Health Promotion — Aspirin
for primary prevention
Stem: A 67-year-old man with well-controlled diabetes and LDL
110 mg/dL asks whether he should start daily low-dose aspirin
to prevent a first myocardial infarction. He has no prior GI
bleeding and is on no anticoagulants. What do you
recommend?
A. Start low-dose aspirin because age >65 increases ASCVD risk.
B. Do not initiate aspirin for primary prevention because age
≥60 favors against initiation.
C. Start aspirin only if a coronary calcium score is zero.
D. Begin aspirin plus statin for combined primary prevention.
Correct answer: B
Rationale — Correct (B): CMDT summarizes current preventive
guidance that routine initiation of low-dose aspirin for primary
prevention is generally not recommended in adults ≥60 years
TREATMENT 2026
65TH EDITION
Author(s)Maxine A. Papadakis; Michael
W. Rabow; Kenneth R. McQuaid; Paul L.
Nadler; Erika Leemann Price
TEST BANK
1) Ch. 1 — Disease Prevention & Health Promotion —
Hypertension: confirmatory testing
Stem: A 48-year-old man with obesity presents after two clinic
visits where seated blood pressures averaged 148/92 mm Hg.
He is asymptomatic, on no medications, and has no end-organ
signs. Which next step most appropriately confirms the
diagnosis before initiating long-term therapy?
A. Start low-dose thiazide and recheck clinic BP in 4 weeks.
B. Arrange ambulatory blood pressure monitoring (ABPM) or
validated home BP measurements.
C. Order basic metabolic panel and TSH and schedule repeat
,clinic BP in 6 months.
D. Diagnose hypertension and refer for immediate
echocardiography.
Correct answer: B
Rationale — Correct (B): CMDT emphasizes confirming elevated
clinic BPs with out-of-office measurements (ABPM preferred;
validated home monitoring acceptable) to exclude white-coat
hypertension and to guide treatment decisions. ABPM provides
multiple daytime/nighttime readings and better predicts
cardiovascular risk. AccessMedicine
Rationale — Incorrect:
A: Starting therapy without out-of-office confirmation risks
overtreatment for white-coat hypertension.
C: Labs are reasonable for workup but waiting 6 months delays
diagnosis; confirmatory BP measurement should occur sooner.
D: Echocardiography is not required to confirm simple
outpatient hypertension and is reserved for suspected
secondary causes or end-organ disease.
Teaching point: Confirm elevated clinic BP with ABPM or
validated home monitoring before lifelong therapy.
Citation: Papadakis, M. A., McPhee, S. J., & Rabow, M. W.
(2026). Current Medical Diagnosis & Treatment (65th ed.). Ch.
1. AccessMedicine
,2) Ch. 1 — Disease Prevention & Health Promotion — Primary
prevention: statin initiation
Stem: A 52-year-old woman with treated hypertension and LDL-
C 140 mg/dL has a calculated 10-year ASCVD risk of 12%. She is
asymptomatic and asks whether to start a statin for primary
prevention. What is the best approach?
A. Defer statin; treat only with lifestyle modification because
LDL is <160 mg/dL.
B. Initiate high-intensity statin immediately without further
discussion.
C. Offer moderate-intensity statin after shared decision-making
given intermediate ASCVD risk.
D. Start aspirin for primary prevention and reassess LDL in 1
year.
Correct answer: C
Rationale — Correct (C): CMDT and contemporary guidelines
recommend considering moderate-intensity statin therapy for
adults with intermediate (≈7.5–20%) 10-year ASCVD risk after
shared decision-making about risks/benefits, particularly with
additional risk factors. Shared decision-making incorporates
patient preferences and risk enhancers. AHA Journals+1
Rationale — Incorrect:
A: Lifestyle is foundational but withholding statin in an
intermediate-risk patient without shared decision-making may
miss prevention opportunity.
B: High-intensity statin is reserved for higher risk (eg, >20% or
, known ASCVD); moderate intensity is appropriate here.
D: Routine aspirin for primary prevention is not recommended
for most adults and is no substitute for statin therapy.
Teaching point: Use shared decision-making to start moderate-
intensity statin for intermediate ASCVD risk.
Citation: Papadakis, M. A., McPhee, S. J., & Rabow, M. W.
(2026). Current Medical Diagnosis & Treatment (65th ed.). Ch.
1. AHA Journals+1
3) Ch. 1 — Disease Prevention & Health Promotion — Aspirin
for primary prevention
Stem: A 67-year-old man with well-controlled diabetes and LDL
110 mg/dL asks whether he should start daily low-dose aspirin
to prevent a first myocardial infarction. He has no prior GI
bleeding and is on no anticoagulants. What do you
recommend?
A. Start low-dose aspirin because age >65 increases ASCVD risk.
B. Do not initiate aspirin for primary prevention because age
≥60 favors against initiation.
C. Start aspirin only if a coronary calcium score is zero.
D. Begin aspirin plus statin for combined primary prevention.
Correct answer: B
Rationale — Correct (B): CMDT summarizes current preventive
guidance that routine initiation of low-dose aspirin for primary
prevention is generally not recommended in adults ≥60 years
