CURRENT MEDICAL DIAGNOSIS AND TREATMENT, 64TH
EDITION – COMPLETE EXAM BANK
1,000 Questions with Verified Answers & Detailed Clinical Rationales
Based on Papadakis, Rabow, McQuaid & Gandhi | McGraw-Hill Lange | 64th Edition (2025)
CHAPTER 1: DISEASE PREVENTION & HEALTH PROMOTION
Question 1: A 55-year-old man with a 30-pack-year smoking history presents for a routine
physical. According to USPSTF guidelines, which screening test for lung cancer is recommended?
A) Annual chest X-ray
B) Low-dose computed tomography (LDCT) annually
C) Sputum cytology every 6 months
D) No screening is recommended
Answer: B
Rationale: The USPSTF recommends annual LDCT for adults aged 50-80 years with a 20-pack-
year smoking history who currently smoke or have quit within the past 15 years. Chest X-ray is
not recommended for screening. (CMDT 2025, Ch. 1)
Question 2: A 65-year-old woman has no history of abdominal aortic aneurysm (AAA).
According to USPSTF, what is the recommended screening?
A) One-time abdominal ultrasound for men aged 65-75 who have ever smoked
B) Annual abdominal ultrasound for all adults over 65
C) One-time abdominal ultrasound for all women over 65
D) No screening is recommended for this patient
Answer: A
Rationale: The USPSTF recommends one-time screening for AAA with abdominal
ultrasonography in men aged 65-75 years who have ever smoked. Screening is not routinely
recommended for women without a family history or other risk factors. (CMDT 2025, Ch. 1)
Question 3: Which of the following behaviors indicates the highest potential for spreading
infections among clients?
A) Disinfecting dirty hands with antibacterial soap
B) Allowing alcohol-based rub to dry for 10 seconds
,C) Washing hands only after leaving each room
D) Using cold water for medical asepsis
Answer: C
Rationale: The most frequent cause of infection spread among institutionalized patients is the
hands of healthcare workers. Hand washing must be performed before and after all contact
with patients. Washing only after leaving the room fails to prevent transmission between
patients. (CMDT 2025, Ch. 1)
Question 4: A 60-year-old woman with a body mass index of 32 kg/m² and no other risk factors
presents for preventive care. According to USPSTF guidelines, which of the following is
recommended for diabetes screening?
A) Fasting plasma glucose every 3 years
B) Hemoglobin A1c annually
C) Oral glucose tolerance test every 5 years
D) No screening is recommended
Answer: A
Rationale: The USPSTF recommends screening for prediabetes and type 2 diabetes in adults
aged 35-70 years who are overweight or obese. Screening should be done with fasting plasma
glucose, hemoglobin A1c, or oral glucose tolerance test, repeated every 3 years if normal.
(CMDT 2025, Ch. 1)
Question 5: A 50-year-old woman with average risk for breast cancer asks about screening
mammography. According to USPSTF recommendations, what is the appropriate screening
strategy?
A) Annual mammography starting at age 40
B) Biennial mammography starting at age 40
C) Biennial mammography for women aged 50-74
D) No screening until age 65
Answer: C
Rationale: The USPSTF recommends biennial screening mammography for women aged 50-74
years at average risk. The decision to start screening before age 50 should be individualized.
(CMDT 2025, Ch. 1)
Question 6: A 45-year-old man with no symptoms asks about colorectal cancer screening.
Which of the following is an acceptable screening option according to USPSTF?
A) Fecal immunochemical test (FIT) annually
B) Colonoscopy every 15 years
C) Fecal occult blood test (FOBT) every 5 years
D) Sigmoidoscopy every 20 years
,Answer: A
Rationale: The USPSTF recommends screening for colorectal cancer in adults aged 45-75 years.
Acceptable options include annual FIT, stool DNA-FIT every 1-3 years, colonoscopy every 10
years, CT colonography every 5 years, or sigmoidoscopy every 5-10 years. (CMDT 2025, Ch. 1)
Question 7: A 68-year-old woman with a 5-year history of hypertension and hyperlipidemia asks
about aspirin for primary prevention. According to current guidelines, what is the
recommendation?
A) Aspirin 81 mg daily is recommended for all women over 65
B) Aspirin should not be used for primary prevention in this age group
C) Aspirin 325 mg daily is recommended for cardiovascular protection
D) Aspirin is recommended if 10-year cardiovascular risk is >5%
Answer: B
Rationale: Current guidelines generally recommend against aspirin for primary prevention in
adults over 60 years due to increased bleeding risk. For adults 40-59 years with >10% 10-year
cardiovascular risk, the decision should be individualized. (CMDT 2025, Ch. 1)
Question 8: A 55-year-old man with a history of smoking (quit 10 years ago) has no other risk
factors. According to USPSTF, what is the recommendation for abdominal aortic aneurysm
screening?
A) One-time ultrasound screening is recommended
B) Annual ultrasound screening is recommended
C) Screening is not recommended for former smokers
D) Screening is recommended only if family history is positive
Answer: A
Rationale: USPSTF recommends one-time screening for AAA with abdominal ultrasonography in
men aged 65-75 who have ever smoked, including former smokers. This patient meets criteria.
(CMDT 2025, Ch. 1)
Question 9: A 52-year-old woman with no family history of breast or ovarian cancer has a
BRCA1/2 mutation identified through direct-to-consumer genetic testing. What is the most
appropriate next step?
A) Bilateral prophylactic mastectomy
B) Referral for genetic counseling
C) Annual breast MRI only
D) Observation with no further action
Answer: B
Rationale: Patients with positive genetic test results from direct-to-consumer testing should be
referred for confirmatory testing and genetic counseling. Management decisions should be
made in consultation with a genetics specialist. (CMDT 2025, Ch. 1)
, Question 10: A 70-year-old man with a 45-pack-year smoking history and a 6% 10-year
cardiovascular risk asks about aspirin for primary prevention. What is the most appropriate
recommendation?
A) Start aspirin 81 mg daily
B) Start aspirin 325 mg daily
C) Do not start aspirin
D) Start aspirin only if he develops diabetes
Answer: C
Rationale: Aspirin is not recommended for primary prevention in adults over 60 years. The risk
of major bleeding (gastrointestinal and intracranial) outweighs potential cardiovascular benefits.
(CMDT 2025, Ch. 1)
Question 11: A 48-year-old woman has a 15-year history of smoking (1 pack/day) and a family
history of breast cancer. Which of the following is the most appropriate screening
recommendation?
A) Mammography starting at age 50
B) Mammography plus breast MRI starting at age 40
C) Clinical breast examination every 6 months
D) No screening until age 45
Answer: B
Rationale: Women at high risk for breast cancer (including those with BRCA mutations or strong
family history) should undergo annual mammography and breast MRI starting at age 40. The
USPSTF recommends individualized decision-making for women aged 40-49. (CMDT 2025, Ch. 1)
Question 12: A 65-year-old man with no history of smoking, diabetes, or cardiovascular disease
asks about screening for carotid artery stenosis. According to USPSTF, what is the
recommendation?
A) Carotid duplex ultrasound every 5 years
B) Carotid duplex ultrasound annually
C) No screening for asymptomatic carotid artery stenosis
D) Screening only if there is a carotid bruit
Answer: C
Rationale: The USPSTF recommends against screening for asymptomatic carotid artery stenosis
in the general adult population. The harms of screening (including unnecessary procedures)
outweigh the benefits. (CMDT 2025, Ch. 1)
Question 13: A 58-year-old woman with hypertension and hyperlipidemia asks about omega-3
fatty acid supplementation for cardiovascular prevention. What is the evidence-based
recommendation?
A) Omega-3 supplements are recommended for all patients with cardiovascular risk
EDITION – COMPLETE EXAM BANK
1,000 Questions with Verified Answers & Detailed Clinical Rationales
Based on Papadakis, Rabow, McQuaid & Gandhi | McGraw-Hill Lange | 64th Edition (2025)
CHAPTER 1: DISEASE PREVENTION & HEALTH PROMOTION
Question 1: A 55-year-old man with a 30-pack-year smoking history presents for a routine
physical. According to USPSTF guidelines, which screening test for lung cancer is recommended?
A) Annual chest X-ray
B) Low-dose computed tomography (LDCT) annually
C) Sputum cytology every 6 months
D) No screening is recommended
Answer: B
Rationale: The USPSTF recommends annual LDCT for adults aged 50-80 years with a 20-pack-
year smoking history who currently smoke or have quit within the past 15 years. Chest X-ray is
not recommended for screening. (CMDT 2025, Ch. 1)
Question 2: A 65-year-old woman has no history of abdominal aortic aneurysm (AAA).
According to USPSTF, what is the recommended screening?
A) One-time abdominal ultrasound for men aged 65-75 who have ever smoked
B) Annual abdominal ultrasound for all adults over 65
C) One-time abdominal ultrasound for all women over 65
D) No screening is recommended for this patient
Answer: A
Rationale: The USPSTF recommends one-time screening for AAA with abdominal
ultrasonography in men aged 65-75 years who have ever smoked. Screening is not routinely
recommended for women without a family history or other risk factors. (CMDT 2025, Ch. 1)
Question 3: Which of the following behaviors indicates the highest potential for spreading
infections among clients?
A) Disinfecting dirty hands with antibacterial soap
B) Allowing alcohol-based rub to dry for 10 seconds
,C) Washing hands only after leaving each room
D) Using cold water for medical asepsis
Answer: C
Rationale: The most frequent cause of infection spread among institutionalized patients is the
hands of healthcare workers. Hand washing must be performed before and after all contact
with patients. Washing only after leaving the room fails to prevent transmission between
patients. (CMDT 2025, Ch. 1)
Question 4: A 60-year-old woman with a body mass index of 32 kg/m² and no other risk factors
presents for preventive care. According to USPSTF guidelines, which of the following is
recommended for diabetes screening?
A) Fasting plasma glucose every 3 years
B) Hemoglobin A1c annually
C) Oral glucose tolerance test every 5 years
D) No screening is recommended
Answer: A
Rationale: The USPSTF recommends screening for prediabetes and type 2 diabetes in adults
aged 35-70 years who are overweight or obese. Screening should be done with fasting plasma
glucose, hemoglobin A1c, or oral glucose tolerance test, repeated every 3 years if normal.
(CMDT 2025, Ch. 1)
Question 5: A 50-year-old woman with average risk for breast cancer asks about screening
mammography. According to USPSTF recommendations, what is the appropriate screening
strategy?
A) Annual mammography starting at age 40
B) Biennial mammography starting at age 40
C) Biennial mammography for women aged 50-74
D) No screening until age 65
Answer: C
Rationale: The USPSTF recommends biennial screening mammography for women aged 50-74
years at average risk. The decision to start screening before age 50 should be individualized.
(CMDT 2025, Ch. 1)
Question 6: A 45-year-old man with no symptoms asks about colorectal cancer screening.
Which of the following is an acceptable screening option according to USPSTF?
A) Fecal immunochemical test (FIT) annually
B) Colonoscopy every 15 years
C) Fecal occult blood test (FOBT) every 5 years
D) Sigmoidoscopy every 20 years
,Answer: A
Rationale: The USPSTF recommends screening for colorectal cancer in adults aged 45-75 years.
Acceptable options include annual FIT, stool DNA-FIT every 1-3 years, colonoscopy every 10
years, CT colonography every 5 years, or sigmoidoscopy every 5-10 years. (CMDT 2025, Ch. 1)
Question 7: A 68-year-old woman with a 5-year history of hypertension and hyperlipidemia asks
about aspirin for primary prevention. According to current guidelines, what is the
recommendation?
A) Aspirin 81 mg daily is recommended for all women over 65
B) Aspirin should not be used for primary prevention in this age group
C) Aspirin 325 mg daily is recommended for cardiovascular protection
D) Aspirin is recommended if 10-year cardiovascular risk is >5%
Answer: B
Rationale: Current guidelines generally recommend against aspirin for primary prevention in
adults over 60 years due to increased bleeding risk. For adults 40-59 years with >10% 10-year
cardiovascular risk, the decision should be individualized. (CMDT 2025, Ch. 1)
Question 8: A 55-year-old man with a history of smoking (quit 10 years ago) has no other risk
factors. According to USPSTF, what is the recommendation for abdominal aortic aneurysm
screening?
A) One-time ultrasound screening is recommended
B) Annual ultrasound screening is recommended
C) Screening is not recommended for former smokers
D) Screening is recommended only if family history is positive
Answer: A
Rationale: USPSTF recommends one-time screening for AAA with abdominal ultrasonography in
men aged 65-75 who have ever smoked, including former smokers. This patient meets criteria.
(CMDT 2025, Ch. 1)
Question 9: A 52-year-old woman with no family history of breast or ovarian cancer has a
BRCA1/2 mutation identified through direct-to-consumer genetic testing. What is the most
appropriate next step?
A) Bilateral prophylactic mastectomy
B) Referral for genetic counseling
C) Annual breast MRI only
D) Observation with no further action
Answer: B
Rationale: Patients with positive genetic test results from direct-to-consumer testing should be
referred for confirmatory testing and genetic counseling. Management decisions should be
made in consultation with a genetics specialist. (CMDT 2025, Ch. 1)
, Question 10: A 70-year-old man with a 45-pack-year smoking history and a 6% 10-year
cardiovascular risk asks about aspirin for primary prevention. What is the most appropriate
recommendation?
A) Start aspirin 81 mg daily
B) Start aspirin 325 mg daily
C) Do not start aspirin
D) Start aspirin only if he develops diabetes
Answer: C
Rationale: Aspirin is not recommended for primary prevention in adults over 60 years. The risk
of major bleeding (gastrointestinal and intracranial) outweighs potential cardiovascular benefits.
(CMDT 2025, Ch. 1)
Question 11: A 48-year-old woman has a 15-year history of smoking (1 pack/day) and a family
history of breast cancer. Which of the following is the most appropriate screening
recommendation?
A) Mammography starting at age 50
B) Mammography plus breast MRI starting at age 40
C) Clinical breast examination every 6 months
D) No screening until age 45
Answer: B
Rationale: Women at high risk for breast cancer (including those with BRCA mutations or strong
family history) should undergo annual mammography and breast MRI starting at age 40. The
USPSTF recommends individualized decision-making for women aged 40-49. (CMDT 2025, Ch. 1)
Question 12: A 65-year-old man with no history of smoking, diabetes, or cardiovascular disease
asks about screening for carotid artery stenosis. According to USPSTF, what is the
recommendation?
A) Carotid duplex ultrasound every 5 years
B) Carotid duplex ultrasound annually
C) No screening for asymptomatic carotid artery stenosis
D) Screening only if there is a carotid bruit
Answer: C
Rationale: The USPSTF recommends against screening for asymptomatic carotid artery stenosis
in the general adult population. The harms of screening (including unnecessary procedures)
outweigh the benefits. (CMDT 2025, Ch. 1)
Question 13: A 58-year-old woman with hypertension and hyperlipidemia asks about omega-3
fatty acid supplementation for cardiovascular prevention. What is the evidence-based
recommendation?
A) Omega-3 supplements are recommended for all patients with cardiovascular risk
