Harrison's Principles of Internal Medicine
(Vol.1 & Vol.2)
21st Edition Newer Edition
Author(s)Joseph Loscalzo; Anthony S. Fauci;
Dennis L. Kasper; Stephen Hauser; Dan Longo;
J. Larry Jameson
TEST BANK
1)
Reference — Ch. 1 — The Practice of Medicine
Question Stem: A 68-year-old man with multiple chronic
conditions presents with dizziness and new orthostatic
hypotension after a PCP increases his antihypertensive regimen.
Which immediate action best reflects safe, patient-centered
practice?
A. Continue medications and schedule a follow-up in two
weeks.
B. Instruct patient to restrict fluids and monitor blood pressure
at home.
,C. Perform a medication review and hold/decrease the likely
offending agent.
D. Refer patient for tilt-table testing to evaluate autonomic
failure.
Correct Answer: C
Rationales:
• Correct (C): The practice of medicine emphasizes
prioritizing patient safety by reviewing medications and
removing or adjusting probable iatrogenic causes of
orthostatic hypotension before invasive testing. This
addresses the most likely reversible cause.
• Incorrect (A): Waiting risks falls and harm; reactive follow-
up without intervening is not safe, patient-centered
practice.
• Incorrect (B): Fluid restriction would worsen orthostatic
hypotension; home monitoring alone is insufficient as
immediate management.
• Incorrect (D): Tilt-table testing is unnecessary initially
when medications provide a likely explanation and an
immediate modifiable cause exists.
Teaching Point: Always review medications first when new
iatrogenic problems arise.
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1. accessmedicine.mhmedical.com+1
,2)
Reference — Ch. 2 — Promoting Good Health
Question Stem: A 45-year-old woman with obesity and
prediabetes asks which preventive strategy will most reduce her
risk of progression to type 2 diabetes. Which recommendation
best aligns with evidence-based preventive care?
A. Begin metformin immediately.
B. Smoking cessation counseling alone.
C. Structured lifestyle intervention (diet + exercise) targeting 7–
10% weight loss.
D. Annual HbA1c screening only without lifestyle changes.
Correct Answer: C
Rationales:
• Correct (C): Harrison emphasizes that structured lifestyle
interventions achieving modest weight loss are most
effective in preventing progression from prediabetes to
diabetes.
• Incorrect (A): Metformin can be considered in high-risk
patients but is secondary to lifestyle modification and not
first-line for all patients.
• Incorrect (B): Smoking cessation is important for overall
health but alone does not target glycemic progression as
effectively.
, • Incorrect (D): Screening without active intervention fails to
reduce progression risk.
Teaching Point: Lifestyle modification with modest weight loss
prevents progression from prediabetes.
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 2. accessmedicine.mhmedical.com+1
3)
Reference — Ch. 3 — Vaccine Opposition and Hesitancy
Question Stem: A parent refuses routine childhood vaccines
citing safety concerns from social media. As the clinician, what
approach is most likely to reduce hesitancy and improve
vaccination uptake?
A. Dismiss the parent from the practice for refusal.
B. Provide a brief, empathetic dialogue addressing specific
concerns and offer credible information.
C. Insist no school entry unless vaccinated immediately.
D. Avoid discussing vaccines to preserve the relationship.
Correct Answer: B
Rationales:
• Correct (B): Harrison describes that empathetic, evidence-
based conversations that address specific fears and
provide trustworthy resources reduce hesitancy more
effectively than coercion or avoidance.
(Vol.1 & Vol.2)
21st Edition Newer Edition
Author(s)Joseph Loscalzo; Anthony S. Fauci;
Dennis L. Kasper; Stephen Hauser; Dan Longo;
J. Larry Jameson
TEST BANK
1)
Reference — Ch. 1 — The Practice of Medicine
Question Stem: A 68-year-old man with multiple chronic
conditions presents with dizziness and new orthostatic
hypotension after a PCP increases his antihypertensive regimen.
Which immediate action best reflects safe, patient-centered
practice?
A. Continue medications and schedule a follow-up in two
weeks.
B. Instruct patient to restrict fluids and monitor blood pressure
at home.
,C. Perform a medication review and hold/decrease the likely
offending agent.
D. Refer patient for tilt-table testing to evaluate autonomic
failure.
Correct Answer: C
Rationales:
• Correct (C): The practice of medicine emphasizes
prioritizing patient safety by reviewing medications and
removing or adjusting probable iatrogenic causes of
orthostatic hypotension before invasive testing. This
addresses the most likely reversible cause.
• Incorrect (A): Waiting risks falls and harm; reactive follow-
up without intervening is not safe, patient-centered
practice.
• Incorrect (B): Fluid restriction would worsen orthostatic
hypotension; home monitoring alone is insufficient as
immediate management.
• Incorrect (D): Tilt-table testing is unnecessary initially
when medications provide a likely explanation and an
immediate modifiable cause exists.
Teaching Point: Always review medications first when new
iatrogenic problems arise.
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1. accessmedicine.mhmedical.com+1
,2)
Reference — Ch. 2 — Promoting Good Health
Question Stem: A 45-year-old woman with obesity and
prediabetes asks which preventive strategy will most reduce her
risk of progression to type 2 diabetes. Which recommendation
best aligns with evidence-based preventive care?
A. Begin metformin immediately.
B. Smoking cessation counseling alone.
C. Structured lifestyle intervention (diet + exercise) targeting 7–
10% weight loss.
D. Annual HbA1c screening only without lifestyle changes.
Correct Answer: C
Rationales:
• Correct (C): Harrison emphasizes that structured lifestyle
interventions achieving modest weight loss are most
effective in preventing progression from prediabetes to
diabetes.
• Incorrect (A): Metformin can be considered in high-risk
patients but is secondary to lifestyle modification and not
first-line for all patients.
• Incorrect (B): Smoking cessation is important for overall
health but alone does not target glycemic progression as
effectively.
, • Incorrect (D): Screening without active intervention fails to
reduce progression risk.
Teaching Point: Lifestyle modification with modest weight loss
prevents progression from prediabetes.
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 2. accessmedicine.mhmedical.com+1
3)
Reference — Ch. 3 — Vaccine Opposition and Hesitancy
Question Stem: A parent refuses routine childhood vaccines
citing safety concerns from social media. As the clinician, what
approach is most likely to reduce hesitancy and improve
vaccination uptake?
A. Dismiss the parent from the practice for refusal.
B. Provide a brief, empathetic dialogue addressing specific
concerns and offer credible information.
C. Insist no school entry unless vaccinated immediately.
D. Avoid discussing vaccines to preserve the relationship.
Correct Answer: B
Rationales:
• Correct (B): Harrison describes that empathetic, evidence-
based conversations that address specific fears and
provide trustworthy resources reduce hesitancy more
effectively than coercion or avoidance.
