Page 1 of 73
MEDICAL DIAGNOSIS AND TREATMENT 62ND EDITION
UPDATE BY MAXINE PAPADAKIS, STEPHEN MCPHEE,
MICHAEL RABOW & KENNETH MCQUAID EXAM
COMPLETE REVIEW WITH VERIFIED QUESTIONS DETAILED
RATIONALES GRADED A+
Part 1: Disease Prevention & Health Promotion (Questions 1–10)
1. A 55-year-old patient with a 30-pack-year smoking history asks about lung cancer
screening. According to current recommendations, which of the following is the most
appropriate screening method?
A) Annual chest X-ray
B) Low-dose computed tomography (LDCT)
C) Sputum cytology every 6 months
D) No screening is recommended
Answer: B
Rationale: Annual LDCT is recommended for adults aged 50–80 with a 20-pack-year history who
currently smoke or have quit within the past 15 years.
2. A 45-year-old woman with a BMI of 32 has a fasting blood glucose of 110 mg/dL. Which of
the following best describes her condition?
A) Normal glucose tolerance
B) Prediabetes
C) Type 1 diabetes mellitus
D) Type 2 diabetes mellitus
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Answer: B
Rationale: A fasting glucose of 100–125 mg/dL is classified as prediabetes, indicating increased
risk for developing diabetes.
3. Which of the following is considered a primary prevention strategy?
A) Mammography for breast cancer screening
B) Immunization against influenza
C) Cardiac rehabilitation after myocardial infarction
D) Screening for colorectal cancer
Answer: B
Rationale: Primary prevention aims to prevent disease before it occurs. Immunization is a classic
example, whereas screening is secondary prevention.
4. A 65-year-old man with no symptoms is found to have a blood pressure of 145/92 mmHg
on two separate visits. What is the most appropriate next step?
A) Start lifestyle modifications only and recheck in 6 months
B) Initiate antihypertensive pharmacotherapy
C) Order ambulatory blood pressure monitoring
D) Reassure the patient that this is normal for his age
Answer: B
Rationale: Stage 2 hypertension (≥140/90 mmHg) typically warrants initiation of pharmacologic
therapy alongside lifestyle modification.
5. A 28-year-old woman with a history of venous thromboembolism is considering oral
contraceptive pills. Which of the following is the most appropriate recommendation?
A) Low-dose combined oral contraceptives are safe
B) Progestin-only pills are a safer alternative
C) All hormonal contraceptives are contraindicated
D) She should avoid all forms of contraception
Answer: B
Rationale: Prior VTE is a contraindication to combined hormonal contraceptives due to
estrogen's prothrombotic effects. Progestin-only options are generally safer.
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6. Which of the following vaccines is contraindicated in a patient with severe
immunodeficiency?
A) Inactivated influenza vaccine
B) Live attenuated influenza vaccine (LAIV)
C) Tetanus-diphtheria toxoid
D) Hepatitis B vaccine
Answer: B
Rationale: Live attenuated vaccines are generally contraindicated in severely
immunocompromised patients due to the risk of vaccine-derived infection.
7. A 70-year-old woman has a DEXA T-score of −2.8 at the femoral neck. What is the most
appropriate diagnosis?
A) Normal bone density
B) Osteopenia
C) Osteoporosis
D) Severe osteomalacia
Answer: C
Rationale: A T-score ≤ −2.5 defines osteoporosis. Osteopenia is defined as a T-score between
−1.0 and −2.5.
8. A 50-year-old man asks about colorectal cancer screening. Which of the following is an
acceptable screening option?
A) Fecal immunochemical test (FIT) annually
B) Colonoscopy every 15 years
C) CT colonography every 10 years
D) No screening until age 60
Answer: A
Rationale: Annual FIT, colonoscopy every 10 years, and CT colonography every 5 years are all
acceptable screening options starting at age 45.
9. A patient asks about the “number needed to treat” (NNT) for a new medication. What does
this metric represent?
A) The number of patients who must be treated to prevent one adverse outcome
B) The percentage of patients who will experience a side effect
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C) The cost of treating one patient for one year
D) The duration of treatment required for benefit
Answer: A
Rationale: NNT is the number of patients who need to be treated for one additional patient to
benefit or to prevent one adverse outcome.
10. Which of the following is the most effective method for smoking cessation?
A) Unassisted quitting (cold turkey)
B) Nicotine replacement therapy alone
C) Counseling combined with pharmacotherapy
D) Hypnosis alone
Answer: C
Rationale: The combination of behavioral counseling and pharmacotherapy (NRT, bupropion, or
varenicline) significantly increases quit rates compared to either alone.
Part 2: Common Symptoms (Questions 11–20)
11. A 45-year-old woman presents with fatigue. Which of the following is the most
appropriate initial laboratory test?
A) Thyroid-stimulating hormone (TSH)
B) Serum cortisol
C) Antinuclear antibody (ANA)
D) Lyme serology
Answer: A
Rationale: TSH is a first-line test for fatigue, as hypothyroidism is a common and easily treatable
cause.
12. A patient presents with acute dizziness. Which of the following best distinguishes vertigo
from presyncope?
A) Vertigo is associated with a spinning sensation; presyncope is associated with
lightheadedness and near-fainting
B) Vertigo is always central in origin
C) Presyncope is always benign
D) Vertigo is not associated with nausea
MEDICAL DIAGNOSIS AND TREATMENT 62ND EDITION
UPDATE BY MAXINE PAPADAKIS, STEPHEN MCPHEE,
MICHAEL RABOW & KENNETH MCQUAID EXAM
COMPLETE REVIEW WITH VERIFIED QUESTIONS DETAILED
RATIONALES GRADED A+
Part 1: Disease Prevention & Health Promotion (Questions 1–10)
1. A 55-year-old patient with a 30-pack-year smoking history asks about lung cancer
screening. According to current recommendations, which of the following is the most
appropriate screening method?
A) Annual chest X-ray
B) Low-dose computed tomography (LDCT)
C) Sputum cytology every 6 months
D) No screening is recommended
Answer: B
Rationale: Annual LDCT is recommended for adults aged 50–80 with a 20-pack-year history who
currently smoke or have quit within the past 15 years.
2. A 45-year-old woman with a BMI of 32 has a fasting blood glucose of 110 mg/dL. Which of
the following best describes her condition?
A) Normal glucose tolerance
B) Prediabetes
C) Type 1 diabetes mellitus
D) Type 2 diabetes mellitus
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Answer: B
Rationale: A fasting glucose of 100–125 mg/dL is classified as prediabetes, indicating increased
risk for developing diabetes.
3. Which of the following is considered a primary prevention strategy?
A) Mammography for breast cancer screening
B) Immunization against influenza
C) Cardiac rehabilitation after myocardial infarction
D) Screening for colorectal cancer
Answer: B
Rationale: Primary prevention aims to prevent disease before it occurs. Immunization is a classic
example, whereas screening is secondary prevention.
4. A 65-year-old man with no symptoms is found to have a blood pressure of 145/92 mmHg
on two separate visits. What is the most appropriate next step?
A) Start lifestyle modifications only and recheck in 6 months
B) Initiate antihypertensive pharmacotherapy
C) Order ambulatory blood pressure monitoring
D) Reassure the patient that this is normal for his age
Answer: B
Rationale: Stage 2 hypertension (≥140/90 mmHg) typically warrants initiation of pharmacologic
therapy alongside lifestyle modification.
5. A 28-year-old woman with a history of venous thromboembolism is considering oral
contraceptive pills. Which of the following is the most appropriate recommendation?
A) Low-dose combined oral contraceptives are safe
B) Progestin-only pills are a safer alternative
C) All hormonal contraceptives are contraindicated
D) She should avoid all forms of contraception
Answer: B
Rationale: Prior VTE is a contraindication to combined hormonal contraceptives due to
estrogen's prothrombotic effects. Progestin-only options are generally safer.
,Page 3 of 73
6. Which of the following vaccines is contraindicated in a patient with severe
immunodeficiency?
A) Inactivated influenza vaccine
B) Live attenuated influenza vaccine (LAIV)
C) Tetanus-diphtheria toxoid
D) Hepatitis B vaccine
Answer: B
Rationale: Live attenuated vaccines are generally contraindicated in severely
immunocompromised patients due to the risk of vaccine-derived infection.
7. A 70-year-old woman has a DEXA T-score of −2.8 at the femoral neck. What is the most
appropriate diagnosis?
A) Normal bone density
B) Osteopenia
C) Osteoporosis
D) Severe osteomalacia
Answer: C
Rationale: A T-score ≤ −2.5 defines osteoporosis. Osteopenia is defined as a T-score between
−1.0 and −2.5.
8. A 50-year-old man asks about colorectal cancer screening. Which of the following is an
acceptable screening option?
A) Fecal immunochemical test (FIT) annually
B) Colonoscopy every 15 years
C) CT colonography every 10 years
D) No screening until age 60
Answer: A
Rationale: Annual FIT, colonoscopy every 10 years, and CT colonography every 5 years are all
acceptable screening options starting at age 45.
9. A patient asks about the “number needed to treat” (NNT) for a new medication. What does
this metric represent?
A) The number of patients who must be treated to prevent one adverse outcome
B) The percentage of patients who will experience a side effect
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C) The cost of treating one patient for one year
D) The duration of treatment required for benefit
Answer: A
Rationale: NNT is the number of patients who need to be treated for one additional patient to
benefit or to prevent one adverse outcome.
10. Which of the following is the most effective method for smoking cessation?
A) Unassisted quitting (cold turkey)
B) Nicotine replacement therapy alone
C) Counseling combined with pharmacotherapy
D) Hypnosis alone
Answer: C
Rationale: The combination of behavioral counseling and pharmacotherapy (NRT, bupropion, or
varenicline) significantly increases quit rates compared to either alone.
Part 2: Common Symptoms (Questions 11–20)
11. A 45-year-old woman presents with fatigue. Which of the following is the most
appropriate initial laboratory test?
A) Thyroid-stimulating hormone (TSH)
B) Serum cortisol
C) Antinuclear antibody (ANA)
D) Lyme serology
Answer: A
Rationale: TSH is a first-line test for fatigue, as hypothyroidism is a common and easily treatable
cause.
12. A patient presents with acute dizziness. Which of the following best distinguishes vertigo
from presyncope?
A) Vertigo is associated with a spinning sensation; presyncope is associated with
lightheadedness and near-fainting
B) Vertigo is always central in origin
C) Presyncope is always benign
D) Vertigo is not associated with nausea
