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 72-year-old man with multimorbidity asks you whether
starting a preventive medication will meaningfully extend his
life. Using principles of individualized care, which step best
aligns with Harrison’s recommended approach?
Options
A. Offer the medication because population trials show benefit
for that age group.
B. Recommend against the medication because older adults
,derive no benefit from prevention.
C. Elicit the patient’s goals, estimate individualized absolute
benefit/harm, and incorporate preferences.
D. Default to clinician judgment and start the medication to
avoid liability.
Correct Answer
C
Rationales
Correct: Harrison emphasizes individualized decision-making—
aligning interventions with patient goals and individualized
benefit–harm assessment.
A: Population data are important but must be individualized;
trial averages may not apply.
B: Age alone is not a contraindication; potential benefits
depend on comorbidity and life expectancy.
D: Clinician paternalism without shared decision-making
contradicts recommended patient-centered care.
Teaching Point
Individualize prevention by estimating absolute benefit and
aligning with patient goals.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
, 2. Reference
Ch. 1 — The Practice of Medicine
Question Stem
A resident asks how to manage diagnostic uncertainty when the
probability of a serious condition is intermediate. According to
Harrison’s guidance on clinical reasoning, which action is best?
Options
A. Order the most sensitive test available regardless of pretest
probability.
B. Reassess pretest probability, consider focused testing, and
plan timed reevaluation.
C. Discharge the patient with reassurance if the exam is
nonfocal.
D. Start empirical treatment for the worst-case diagnosis
immediately.
Correct Answer
B
Rationales
Correct: Harrison recommends refining pretest probability,
selecting appropriate tests, and planning follow-up to reduce
error.
A: Testing without integrating pretest probability can produce
misleading results and false positives.
C: Reassurance without a plan risks missed diagnosis when
probability is not low.
, D: Empiric treatment may be appropriate sometimes but should
follow considered risk–benefit and diagnostic plan.
Teaching Point
Reassess probability, choose targeted tests, and schedule
reevaluation for uncertainty.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
3. Reference
Ch. 2 — Promoting Good Health
Question Stem
A clinic serving a socioeconomically disadvantaged
neighborhood plans a hypertension screening program. Which
design choice best follows Harrison’s population-health
principles to maximize equitable impact?
Options
A. Place screening kiosks only in the hospital outpatient lobby.
B. Offer single opportunistic BP checks without linkage to
follow-up care.
C. Integrate screening into community venues with pathways
for low-cost follow-up and medication access.
D. Focus screening on patients already connected to specialty
care.
(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 72-year-old man with multimorbidity asks you whether
starting a preventive medication will meaningfully extend his
life. Using principles of individualized care, which step best
aligns with Harrison’s recommended approach?
Options
A. Offer the medication because population trials show benefit
for that age group.
B. Recommend against the medication because older adults
,derive no benefit from prevention.
C. Elicit the patient’s goals, estimate individualized absolute
benefit/harm, and incorporate preferences.
D. Default to clinician judgment and start the medication to
avoid liability.
Correct Answer
C
Rationales
Correct: Harrison emphasizes individualized decision-making—
aligning interventions with patient goals and individualized
benefit–harm assessment.
A: Population data are important but must be individualized;
trial averages may not apply.
B: Age alone is not a contraindication; potential benefits
depend on comorbidity and life expectancy.
D: Clinician paternalism without shared decision-making
contradicts recommended patient-centered care.
Teaching Point
Individualize prevention by estimating absolute benefit and
aligning with patient goals.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
, 2. Reference
Ch. 1 — The Practice of Medicine
Question Stem
A resident asks how to manage diagnostic uncertainty when the
probability of a serious condition is intermediate. According to
Harrison’s guidance on clinical reasoning, which action is best?
Options
A. Order the most sensitive test available regardless of pretest
probability.
B. Reassess pretest probability, consider focused testing, and
plan timed reevaluation.
C. Discharge the patient with reassurance if the exam is
nonfocal.
D. Start empirical treatment for the worst-case diagnosis
immediately.
Correct Answer
B
Rationales
Correct: Harrison recommends refining pretest probability,
selecting appropriate tests, and planning follow-up to reduce
error.
A: Testing without integrating pretest probability can produce
misleading results and false positives.
C: Reassurance without a plan risks missed diagnosis when
probability is not low.
, D: Empiric treatment may be appropriate sometimes but should
follow considered risk–benefit and diagnostic plan.
Teaching Point
Reassess probability, choose targeted tests, and schedule
reevaluation for uncertainty.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
3. Reference
Ch. 2 — Promoting Good Health
Question Stem
A clinic serving a socioeconomically disadvantaged
neighborhood plans a hypertension screening program. Which
design choice best follows Harrison’s population-health
principles to maximize equitable impact?
Options
A. Place screening kiosks only in the hospital outpatient lobby.
B. Offer single opportunistic BP checks without linkage to
follow-up care.
C. Integrate screening into community venues with pathways
for low-cost follow-up and medication access.
D. Focus screening on patients already connected to specialty
care.
