TEST BANK For Current Medical Diagnosis And Treatment 2024, 63nd Edition By Papadakis & Mcphee

,Test Bank: CMDT 2024 (63rd Edition)
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1. A 72-year-old man with a 50-pack-
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year smoking history presents with hemoptysis and weight loss. A chest CT shows a 4 c
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m central lung mass with mediastinal lymphadenopathy. Which of the following is the m
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ost appropriate next step for tissue diagnosis?
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• A) CT-guided transthoracic needle biopsy
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• B) Bronchoscopy with endobronchial ultrasound (EBUS)
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• C) Surgical resection for diagnostic and therapeutic purposes
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• D) Sputum cytology
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Correct Answer: B bn bn




*Rationale: For central lung masses with mediastinal lymphadenopathy, EBUS-
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guided transbronchial needle aspiration is the preferred initial diagnostic modality due to its hi
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gh yield and ability to sample both the primary tumor and lymph nodes for staging (CMDT 202
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4, Ch. 9: Lung Cancer).*
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2. A 28-year-
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old woman presents with acute onset of shortness of breath and pleuritic chest pain. Her
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heart rate is 110 bpm, respiratory rate 24 breaths/min, and oxygen saturation 92% on r
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oom air. A CT pulmonary angiogram (CTPA) shows a segmental pulmonary embolism. Sh
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e has no prior history of VTE. Which of the following is the most appropriate initial antic
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oagulation regimen? bn




• A) Aspirin 325 mg daily
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• B) Unfractionated heparin intravenous drip
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• C) Warfarin monotherapy with a target INR of 2-3
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• D) Apixaban 10 mg twice daily for 7 days, then 5 mg twice daily
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Correct Answer: D bn bn




*Rationale: Direct oral anticoagulants (DOACs) such as apixaban are first-
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line therapy for acute PE in hemodynamically stable patients without cancer. Apixaban does no
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t require parenteral bridging (CMDT 2024, Ch. 12: Pulmonary Embolism).*
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,3. A 55-year-
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old woman with type 2 diabetes (HbA1c 8.5%) and a body mass index of 34 kg/m² is on
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metformin 2000 mg daily. She has established atherosclerotic cardiovascular disease (AS
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CVD). Which medication should be added to her regimen to improve both glycemic cont
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rol and cardiovascular outcomes?
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• A) Glipizide
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• B) Pioglitazone
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• C) Empagliflozin
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• D) Insulin glargine
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Correct Answer: C bn bn




*Rationale: SGLT2 inhibitors (e.g., empagliflozin) and GLP-
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1 receptor agonists are recommended in patients with type 2 diabetes and ASCVD to reduce m
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ajor adverse cardiovascular events (CMDT 2024, Ch. 27: Diabetes Mellitus).*
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4. A 45-year-old man with chronic hepatitis C (genotype 1a) and Child-
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Pugh class A cirrhosis presents for treatment. He is treatment-
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naïve. What is the current standard-of-care regimen?
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• A) Peginterferon alfa plus ribavirin
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• B) Sofosbuvir/velpatasvir for 12 weeks
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• C) Glecaprevir/pibrentasvir for 8 weeks
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• D) Sofosbuvir/ledipasvir plus ribavirin for 24 weeks
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Correct Answer: C bn bn




*Rationale: For treatment- bn bn




naïve patients with genotype 1a and compensated cirrhosis, glecaprevir/pibrentasvir for 8 week
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s or sofosbuvir/velpatasvir for 12 weeks are options. Glecaprevir/pibrentasvir is preferred for sh
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ort duration (8 weeks) in this setting (CMDT 2024, Ch. 16: Cirrhosis & Viral Hepatitis).*
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5. A 22-year-
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old previously healthy college student is brought to the emergency department with fev
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er, headache, photophobia, and a petechial rash. Vital signs: T 39.5°C, BP 100/70, HR 120
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. What is the most appropriate immediate step?
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• A) Lumbar puncture (LP) then CT head
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• B) CT head then LP if no mass effect
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, • C) Blood cultures and empiric intravenous ceftriaxone
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• D) Observation and antipyretics
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Correct Answer: C bn bn




Rationale: This presentation is suspicious for meningococcal meningitis with possible sepsis. Antibi
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otics should not be delayed for imaging or LP. Empiric therapy (ceftriaxone or cefotaxime) must b
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e given immediately after blood cultures (CMDT 2024, Ch. 33: Bacterial Infections of the CNS).
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6. A 68-year-
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old man with hypertension and osteoarthritis presents with gradually worsening low bac
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k pain and stiffness that improves with activity and is worse in the morning. X-
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ray of the lumbar spine shows squaring of vertebral bodies and syndesmophytes. Which
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of the following is the most likely diagnosis?
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• A) Lumbar spinal stenosis
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• B) Ankylosing spondylitis
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• C) Diffuse idiopathic skeletal hyperostosis (DISH)
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• D) Osteoporotic compression fracture
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Correct Answer: B bn bn




Rationale: Squaring of vertebral bodies and syndesmophytes are classic radiographic features of a
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nkylosing spondylitis. Inflammatory back pain (improves with activity, morning stiffness) is charac
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teristic (CMDT 2024, Ch. 20: Spondyloarthropathies).
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7. A 62-year-
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old woman is found to have an elevated serum calcium of 11.2 mg/dL (normal 8.5-
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10.2), low phosphorus, and elevated PTH. Which of the following is the most common c
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ause of this presentation?
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• A) Malignancy-associated hypercalcemia
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• B) Primary hyperparathyroidism
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• C) Familial hypocalciuric hypercalcemia
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• D) Vitamin D toxicity
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Correct Answer: B bn bn




Rationale: Elevated serum calcium with elevated PTH is diagnostic of primary hyperparathyroidis
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m, which is the most common cause of hypercalcemia in ambulatory adults (CMDT 2024, Ch. 26:
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Hyperparathyroidism).