MKSAP - General Internal Medicine Actual Questions and
Answers 2024/2025 with complete solution
How does the ACC/AHA define severe LDL
190+
Per ACC/AHA recommendations patients that are 20 years or older with LDL 190+
should be treated with
maximum tolerated statin therapy for primary prevention of ASCVD regardles of the 10
year ASCVD risk score
Per the USPSTF adults aged 40-75 without a hx of ASCVD who have 1 or more
traditional risk factor AND a calculated 10 year ASCVD event risk of 10% or higher
should be on
low to moderate-intensity statin therapy
Women in this age range have a clear benefit to screening mammography
50-74
Duration of VTE ppx with LMWH following major orthopedic surgery
35 days (in pts who are not at increased bleeding risk)
the minimum is 10-14 days
Definition of major orthopedic surgeries
- hip arthroplasty
- knee arthroplasty
- hip fracture
FDA approved meds for painful diabetic neuropathy
- duloxetine
- tapentadol
- pregabalin
Effective tx for depression at the end of life
methylphenidate - takes 24-48 hours to work
Medication that may have benefit in cancer-associated fatigue
methylphenidate
Factors that increase the probability of bacterial conjunctivits (3)
- redness of the conjunctival membrane obscuring the tarsal vessels
- matting of both eyes in the morning
- purulent discharge
Abx choice in routine bacterial conjuncivitis
TMP-polymyxin B or erythromycin
Abx choice in conjunctivitis in contact lens wearers
topical fluroquinolone to cover for Pseudomonas
Treatment of choice for acute bacterial prostatitis and duration
TMP-SMX (Bactrim) or ciprofloxacin for 6 weeks
In immunocompetent adults who don't have immunity against MMR, should they
get the vaccine?
Yes, at least 1 dose if they don't fall into the high risk category
These types of patients should receive 2 doses of MMR vaccine 28 days apart
, - healthcare workers
- postsecondary students
- household contacts of immunocompromised patients
- international travelers
The following are associated with what:
- fatigue of at least 6 months accompanied by substantial reduction in preillness
activites, postexertional malaise, unrefreshing sleep, and either cognitive
impairment of orthostatic intolerance
systemic exertion intolerance disease
Solid breast lesion on ultrasound should be managed how?
Biopsy
Indications for bariatric surgery
- BMI of 40+
- BMI of 35+ with DM2, CAD, OSA, or OA
USPSTF recommendations on PSA
discuss benefits and harms in men 55-69
Management of patients with unilateral tinnitus
Prompt hearing testing - if there is hearing loss then they should undergo MRI of the
internal auditory canal to rule out acoustic neuroma
If physical exam findings do not explain pulsatile tinnitus, the patient should
undergo
CTA or MRA
Pulmonary rehab is recommended for all symptomatic patients with
- FEV1 < 50% of predicted
- hospitalized with an acute exacerbation of COPD
Referral to transplant center is indicated for patients with MELD score of
greater than 15
Shoulder disorder characterized by loss of shoulder movement accompanied by
pain. Exam will show loss of both active and passive ROM.
Adhesive capsulitis
(rotator cuff disease would not cause pain with both AROM and PROM)
According to the AUA, these are the pharmocological options for premature
ejaculation
- SSRIs
- TCAs
- topical anesthetics (lidocaine)
First-line therapy for women with stress urinary incontinence
pelvic floor muscle training
Best treatment for women with genitourinary syndrome of menopause (vaginal
atrophy)
Vaginal estrogen therapy
Do patients on topical estrogen need concurrent progestin treatment?
No - the estradiol absorption is insufficient to cause endometrial proliferation
When is ospemifene indicated?
Post-menopausal women with dyspareunia who cannot use topical estrogens
Answers 2024/2025 with complete solution
How does the ACC/AHA define severe LDL
190+
Per ACC/AHA recommendations patients that are 20 years or older with LDL 190+
should be treated with
maximum tolerated statin therapy for primary prevention of ASCVD regardles of the 10
year ASCVD risk score
Per the USPSTF adults aged 40-75 without a hx of ASCVD who have 1 or more
traditional risk factor AND a calculated 10 year ASCVD event risk of 10% or higher
should be on
low to moderate-intensity statin therapy
Women in this age range have a clear benefit to screening mammography
50-74
Duration of VTE ppx with LMWH following major orthopedic surgery
35 days (in pts who are not at increased bleeding risk)
the minimum is 10-14 days
Definition of major orthopedic surgeries
- hip arthroplasty
- knee arthroplasty
- hip fracture
FDA approved meds for painful diabetic neuropathy
- duloxetine
- tapentadol
- pregabalin
Effective tx for depression at the end of life
methylphenidate - takes 24-48 hours to work
Medication that may have benefit in cancer-associated fatigue
methylphenidate
Factors that increase the probability of bacterial conjunctivits (3)
- redness of the conjunctival membrane obscuring the tarsal vessels
- matting of both eyes in the morning
- purulent discharge
Abx choice in routine bacterial conjuncivitis
TMP-polymyxin B or erythromycin
Abx choice in conjunctivitis in contact lens wearers
topical fluroquinolone to cover for Pseudomonas
Treatment of choice for acute bacterial prostatitis and duration
TMP-SMX (Bactrim) or ciprofloxacin for 6 weeks
In immunocompetent adults who don't have immunity against MMR, should they
get the vaccine?
Yes, at least 1 dose if they don't fall into the high risk category
These types of patients should receive 2 doses of MMR vaccine 28 days apart
, - healthcare workers
- postsecondary students
- household contacts of immunocompromised patients
- international travelers
The following are associated with what:
- fatigue of at least 6 months accompanied by substantial reduction in preillness
activites, postexertional malaise, unrefreshing sleep, and either cognitive
impairment of orthostatic intolerance
systemic exertion intolerance disease
Solid breast lesion on ultrasound should be managed how?
Biopsy
Indications for bariatric surgery
- BMI of 40+
- BMI of 35+ with DM2, CAD, OSA, or OA
USPSTF recommendations on PSA
discuss benefits and harms in men 55-69
Management of patients with unilateral tinnitus
Prompt hearing testing - if there is hearing loss then they should undergo MRI of the
internal auditory canal to rule out acoustic neuroma
If physical exam findings do not explain pulsatile tinnitus, the patient should
undergo
CTA or MRA
Pulmonary rehab is recommended for all symptomatic patients with
- FEV1 < 50% of predicted
- hospitalized with an acute exacerbation of COPD
Referral to transplant center is indicated for patients with MELD score of
greater than 15
Shoulder disorder characterized by loss of shoulder movement accompanied by
pain. Exam will show loss of both active and passive ROM.
Adhesive capsulitis
(rotator cuff disease would not cause pain with both AROM and PROM)
According to the AUA, these are the pharmocological options for premature
ejaculation
- SSRIs
- TCAs
- topical anesthetics (lidocaine)
First-line therapy for women with stress urinary incontinence
pelvic floor muscle training
Best treatment for women with genitourinary syndrome of menopause (vaginal
atrophy)
Vaginal estrogen therapy
Do patients on topical estrogen need concurrent progestin treatment?
No - the estradiol absorption is insufficient to cause endometrial proliferation
When is ospemifene indicated?
Post-menopausal women with dyspareunia who cannot use topical estrogens
