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.
AccessMedicine
Stem
A healthy 58-year-old man with an estimated 10-year ASCVD
risk of 9% asks whether he should start daily low-dose aspirin to
prevent a first myocardial infarction. He has no history of
,bleeding, peptic ulcer disease, or anticoagulant use. Which is
the best evidence-based recommendation?
A. Start daily low-dose aspirin for primary prevention.
B. Do not start aspirin routinely; individualize after shared
decision-making.
C. Start aspirin only if he has a coronary calcium score >100.
D. Start aspirin plus a PPI to reduce bleeding risk.
Correct answer: B
Rationale — Correct (B)
CMDT advises against routine aspirin for primary prevention in
most adults because bleeding risk often offsets modest ASCVD
benefit; use individualized shared decision-making considering
ASCVD vs bleeding risks. For intermediate risk (≈7.5–20%),
clinicians should discuss potential benefits and harms rather
than reflexively start aspirin. AccessMedicine
Rationale — Incorrect
A. Routine primary prevention with aspirin is generally not
recommended because net benefit is uncertain and bleeding
risk is nontrivial. AccessMedicine
C. Coronary calcium can refine risk but CMDT does not
recommend aspirin solely based on CAC without shared
decision-making.
D. Adding a PPI addresses upper GI bleeding risk but does not
change net benefit calculus enough to justify routine aspirin in
primary prevention.
,Teaching point:
Do not prescribe aspirin routinely for primary prevention;
individualize by ASCVD and bleeding risks.
Citation (Simplified APA)
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. 1.
AccessMedicine
2
Reference
Ch. 1 — Disease Prevention & Health Promotion.
AccessMedicine
Stem
A 46-year-old woman with hypertension and LDL 140 mg/dL has
a calculated 10-year ASCVD risk of 12%. She asks whether to
start a statin now. What is the next best step?
A. No statin; recheck lipids in 5 years.
B. Begin moderate-intensity statin after shared decision-
making.
C. Start high-intensity statin because LDL >130 mg/dL.
D. Recommend dietary measures only and defer
pharmacotherapy until risk >20%.
Correct answer: B
, Rationale — Correct (B)
CMDT recommends offering moderate-intensity statin therapy
for adults with intermediate 10-year ASCVD risk (≈7.5–20%)
after shared decision-making; discuss benefits, risks, and
patient preferences. Immediate lifestyle measures are
important but do not preclude statin initiation when indicated.
AccessMedicine
Rationale — Incorrect
A. Rechecking in 5 years delays prevention for an intermediate-
risk patient; more timely discussion is warranted.
C. High-intensity statin is reserved for high ASCVD risk (≥20%) or
known atherosclerotic disease.
D. Diet alone is insufficient when pharmacotherapy is indicated
by calculated risk and comorbidities.
Teaching point:
Offer moderate-intensity statin for intermediate ASCVD risk
after shared decision-making.
Citation (Simplified APA)
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. 1.
AccessMedicine
3
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.
AccessMedicine
Stem
A healthy 58-year-old man with an estimated 10-year ASCVD
risk of 9% asks whether he should start daily low-dose aspirin to
prevent a first myocardial infarction. He has no history of
,bleeding, peptic ulcer disease, or anticoagulant use. Which is
the best evidence-based recommendation?
A. Start daily low-dose aspirin for primary prevention.
B. Do not start aspirin routinely; individualize after shared
decision-making.
C. Start aspirin only if he has a coronary calcium score >100.
D. Start aspirin plus a PPI to reduce bleeding risk.
Correct answer: B
Rationale — Correct (B)
CMDT advises against routine aspirin for primary prevention in
most adults because bleeding risk often offsets modest ASCVD
benefit; use individualized shared decision-making considering
ASCVD vs bleeding risks. For intermediate risk (≈7.5–20%),
clinicians should discuss potential benefits and harms rather
than reflexively start aspirin. AccessMedicine
Rationale — Incorrect
A. Routine primary prevention with aspirin is generally not
recommended because net benefit is uncertain and bleeding
risk is nontrivial. AccessMedicine
C. Coronary calcium can refine risk but CMDT does not
recommend aspirin solely based on CAC without shared
decision-making.
D. Adding a PPI addresses upper GI bleeding risk but does not
change net benefit calculus enough to justify routine aspirin in
primary prevention.
,Teaching point:
Do not prescribe aspirin routinely for primary prevention;
individualize by ASCVD and bleeding risks.
Citation (Simplified APA)
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. 1.
AccessMedicine
2
Reference
Ch. 1 — Disease Prevention & Health Promotion.
AccessMedicine
Stem
A 46-year-old woman with hypertension and LDL 140 mg/dL has
a calculated 10-year ASCVD risk of 12%. She asks whether to
start a statin now. What is the next best step?
A. No statin; recheck lipids in 5 years.
B. Begin moderate-intensity statin after shared decision-
making.
C. Start high-intensity statin because LDL >130 mg/dL.
D. Recommend dietary measures only and defer
pharmacotherapy until risk >20%.
Correct answer: B
, Rationale — Correct (B)
CMDT recommends offering moderate-intensity statin therapy
for adults with intermediate 10-year ASCVD risk (≈7.5–20%)
after shared decision-making; discuss benefits, risks, and
patient preferences. Immediate lifestyle measures are
important but do not preclude statin initiation when indicated.
AccessMedicine
Rationale — Incorrect
A. Rechecking in 5 years delays prevention for an intermediate-
risk patient; more timely discussion is warranted.
C. High-intensity statin is reserved for high ASCVD risk (≥20%) or
known atherosclerotic disease.
D. Diet alone is insufficient when pharmacotherapy is indicated
by calculated risk and comorbidities.
Teaching point:
Offer moderate-intensity statin for intermediate ASCVD risk
after shared decision-making.
Citation (Simplified APA)
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. 1.
AccessMedicine
3
