TEST BANK FOR CURRENT
MEDICAL DIAGNOSIS AND
TREATMENT 2026, 65TH
EDITION BY MAXINE
PAPADAKIS| ALL
CHAPTERS 1 - 42|LATEST
Chapter 1: Disease Prevention & Health Promotion
1. A 64-year-old man with a 35 pack-year smoking history quit 8 years ago asks
whether he should have low-dose CT (LDCT) screening for lung cancer. Which is
the best response?
A) LDCT is not indicated because he quit >5 years ago.
B) Recommend annual LDCT screening because he meets age and smoking history
criteria.
C) Recommend chest X-ray annually instead of LDCT.
D) No screening unless symptoms develop.
Rationale: CMDT supports annual LDCT for adults aged 50–80 with ≥20 pack-year
history who currently smoke or quit within the past 15 years. This patient quit 8 years
,ago and meets criteria. Chest X-ray is not an effective screening modality compared with
LDCT.
2. A 48-year-old woman with no family history of colorectal cancer asks which
screening strategy you recommend. She prefers noninvasive testing if guideline-
concordant. Which approach best balances accuracy and shared decision making?
A) Annual fecal immunochemical test (FIT) with colonoscopy only if positive
B) Colonoscopy every 20 years starting now
C) CT colonography only every 10 years without FIT
D) No screening until age 50 given her age
Rationale: CMDT reviews multiple guideline-concordant screening options; for average-
risk adults starting at age ~45–50, annual FIT is an acceptable noninvasive option with
colonoscopy reserved for positive results. Current recommendations lower average-risk
screening initiation to age 45.
3. A 43-year-old woman with prior normal cytology presents for routine screening.
She asks about primary HPV testing instead of Pap smears. According to CMDT’s
prevention guidance, what is the preferred screening interval if primary high-risk
HPV testing is used and negative?
A) Repeat primary HPV testing every 5 years
B) Repeat primary HPV testing every 1 year
C) Switch to cytology every 3 years instead
D) No further screening until age 50
Rationale: Primary high-risk HPV testing is an endorsed strategy with longer safe
intervals; a negative HPV test supports screening intervals up to approximately 5 years
in average-risk women. Annual testing after a negative primary HPV test is unnecessarily
frequent.
4. A 46-year-old man with treated hypertension, BMI 29, non-smoker, has an
estimated 10-year ASCVD risk of 8%. He asks whether to start a statin for primary
prevention. According to CMDT’s pragmatic recommendations, what is the best
,next step?
A) Begin high-intensity statin therapy immediately
B) Initiate moderate-intensity statin after shared decision making
C) Recommend aspirin daily instead of statin
D) No pharmacologic therapy; repeat risk calculation every 5 years
Rationale: For intermediate 10-year ASCVD risk (~7.5–20%), CMDT outlines shared
decision making regarding moderate-intensity statin therapy for primary prevention.
High-intensity statin is reserved for higher risk or clinical ASCVD. Routine aspirin for
primary prevention is generally not recommended due to bleeding risk.
5. A 24-year-old man who is sexually active asks whether to receive HPV vaccine.
He has not previously received it. What do you recommend?
A) HPV vaccination is not indicated after age 21 in men.
B) Offer HPV vaccination up to age 26 for those unvaccinated.
C) Vaccinate only if he has multiple partners; otherwise defer.
D) Vaccinate only women; men do not benefit.
Rationale: CMDT supports catch-up HPV vaccination for unvaccinated persons through
age 26. Vaccination reduces risks of HPV-related cancers and genital warts in men and
women. Men benefit from vaccination; it prevents anal, penile cancers and condyloma.
6. A 78-year-old woman with COPD asks if she should receive influenza vaccine
this season and which formulation is best. She has no egg allergy. What is the best
advice?
A) Do not vaccinate because vaccines are less effective in older adults.
B) Recommend annual influenza vaccination with a high-dose or adjuvanted
vaccine for older adults.
C) Use live attenuated intranasal influenza vaccine because it's more immunogenic.
D) Vaccinate only if there is a documented household exposure.
, Rationale: CMDT highlights annual influenza vaccination for all adults, with preference
for high-dose or adjuvanted in older adults (≥65) to improve immunogenicity and
outcomes. Vaccination reduces severe complications especially in chronic lung disease.
7. A 33-year-old woman with no prior abnormal screening presents for routine
care. Which screening strategy most closely aligns with current CMDT guidance?
A) Pap smear alone every 3 years starting at age 21.
B) HPV testing alone every 3 years starting at age 25.
C) Pap + HPV (co-testing) every 5 years is an option starting at age 30.
D) No screening needed until age 40 if asymptomatic.
Rationale: For women ≥30, co-testing (Pap + HPV) every 5 years is an accepted
strategy; Pap alone every 3 years is an alternate option for 21–29. Co-testing becomes
an option at/after 30. Delaying until 40 is not supported.
8. A 50-year-old man with no comorbidities asks when to start colorectal cancer
screening. Which statement best reflects current CMDT screening
recommendations for an average-risk adult?
A) Begin screening at age 45 with a choice of modalities.
B) Start only at age 50; earlier screening increases harms.
C) No screening needed if no GI symptoms and family history absent.
D) Colonoscopy only; stool-based tests are not acceptable alternatives.
Rationale: CMDT aligns with updated recommendations lowering average-risk
screening initiation to age 45; multiple acceptable screening options (colonoscopy, FIT,
stool DNA, CT colonography) exist per patient preference and availability.
9. A 58-year-old man with a 30-pack-year smoking history (currently smoking)
asks whether he should begin lung-cancer screening. Which criterion most
appropriately determines eligibility for low-dose CT screening per CMDT
guidance?
A) Age 55–80 years and ≥30 pack-year smoking history (current or quit ≤15 years)
B) Age 50–80 years and ≥20 pack-year smoking history (current or quit ≤15 years)
MEDICAL DIAGNOSIS AND
TREATMENT 2026, 65TH
EDITION BY MAXINE
PAPADAKIS| ALL
CHAPTERS 1 - 42|LATEST
Chapter 1: Disease Prevention & Health Promotion
1. A 64-year-old man with a 35 pack-year smoking history quit 8 years ago asks
whether he should have low-dose CT (LDCT) screening for lung cancer. Which is
the best response?
A) LDCT is not indicated because he quit >5 years ago.
B) Recommend annual LDCT screening because he meets age and smoking history
criteria.
C) Recommend chest X-ray annually instead of LDCT.
D) No screening unless symptoms develop.
Rationale: CMDT supports annual LDCT for adults aged 50–80 with ≥20 pack-year
history who currently smoke or quit within the past 15 years. This patient quit 8 years
,ago and meets criteria. Chest X-ray is not an effective screening modality compared with
LDCT.
2. A 48-year-old woman with no family history of colorectal cancer asks which
screening strategy you recommend. She prefers noninvasive testing if guideline-
concordant. Which approach best balances accuracy and shared decision making?
A) Annual fecal immunochemical test (FIT) with colonoscopy only if positive
B) Colonoscopy every 20 years starting now
C) CT colonography only every 10 years without FIT
D) No screening until age 50 given her age
Rationale: CMDT reviews multiple guideline-concordant screening options; for average-
risk adults starting at age ~45–50, annual FIT is an acceptable noninvasive option with
colonoscopy reserved for positive results. Current recommendations lower average-risk
screening initiation to age 45.
3. A 43-year-old woman with prior normal cytology presents for routine screening.
She asks about primary HPV testing instead of Pap smears. According to CMDT’s
prevention guidance, what is the preferred screening interval if primary high-risk
HPV testing is used and negative?
A) Repeat primary HPV testing every 5 years
B) Repeat primary HPV testing every 1 year
C) Switch to cytology every 3 years instead
D) No further screening until age 50
Rationale: Primary high-risk HPV testing is an endorsed strategy with longer safe
intervals; a negative HPV test supports screening intervals up to approximately 5 years
in average-risk women. Annual testing after a negative primary HPV test is unnecessarily
frequent.
4. A 46-year-old man with treated hypertension, BMI 29, non-smoker, has an
estimated 10-year ASCVD risk of 8%. He asks whether to start a statin for primary
prevention. According to CMDT’s pragmatic recommendations, what is the best
,next step?
A) Begin high-intensity statin therapy immediately
B) Initiate moderate-intensity statin after shared decision making
C) Recommend aspirin daily instead of statin
D) No pharmacologic therapy; repeat risk calculation every 5 years
Rationale: For intermediate 10-year ASCVD risk (~7.5–20%), CMDT outlines shared
decision making regarding moderate-intensity statin therapy for primary prevention.
High-intensity statin is reserved for higher risk or clinical ASCVD. Routine aspirin for
primary prevention is generally not recommended due to bleeding risk.
5. A 24-year-old man who is sexually active asks whether to receive HPV vaccine.
He has not previously received it. What do you recommend?
A) HPV vaccination is not indicated after age 21 in men.
B) Offer HPV vaccination up to age 26 for those unvaccinated.
C) Vaccinate only if he has multiple partners; otherwise defer.
D) Vaccinate only women; men do not benefit.
Rationale: CMDT supports catch-up HPV vaccination for unvaccinated persons through
age 26. Vaccination reduces risks of HPV-related cancers and genital warts in men and
women. Men benefit from vaccination; it prevents anal, penile cancers and condyloma.
6. A 78-year-old woman with COPD asks if she should receive influenza vaccine
this season and which formulation is best. She has no egg allergy. What is the best
advice?
A) Do not vaccinate because vaccines are less effective in older adults.
B) Recommend annual influenza vaccination with a high-dose or adjuvanted
vaccine for older adults.
C) Use live attenuated intranasal influenza vaccine because it's more immunogenic.
D) Vaccinate only if there is a documented household exposure.
, Rationale: CMDT highlights annual influenza vaccination for all adults, with preference
for high-dose or adjuvanted in older adults (≥65) to improve immunogenicity and
outcomes. Vaccination reduces severe complications especially in chronic lung disease.
7. A 33-year-old woman with no prior abnormal screening presents for routine
care. Which screening strategy most closely aligns with current CMDT guidance?
A) Pap smear alone every 3 years starting at age 21.
B) HPV testing alone every 3 years starting at age 25.
C) Pap + HPV (co-testing) every 5 years is an option starting at age 30.
D) No screening needed until age 40 if asymptomatic.
Rationale: For women ≥30, co-testing (Pap + HPV) every 5 years is an accepted
strategy; Pap alone every 3 years is an alternate option for 21–29. Co-testing becomes
an option at/after 30. Delaying until 40 is not supported.
8. A 50-year-old man with no comorbidities asks when to start colorectal cancer
screening. Which statement best reflects current CMDT screening
recommendations for an average-risk adult?
A) Begin screening at age 45 with a choice of modalities.
B) Start only at age 50; earlier screening increases harms.
C) No screening needed if no GI symptoms and family history absent.
D) Colonoscopy only; stool-based tests are not acceptable alternatives.
Rationale: CMDT aligns with updated recommendations lowering average-risk
screening initiation to age 45; multiple acceptable screening options (colonoscopy, FIT,
stool DNA, CT colonography) exist per patient preference and availability.
9. A 58-year-old man with a 30-pack-year smoking history (currently smoking)
asks whether he should begin lung-cancer screening. Which criterion most
appropriately determines eligibility for low-dose CT screening per CMDT
guidance?
A) Age 55–80 years and ≥30 pack-year smoking history (current or quit ≤15 years)
B) Age 50–80 years and ≥20 pack-year smoking history (current or quit ≤15 years)
