CURRENT Medical Diagnosis and
Treatment 2026
65th Edition
Author(s)Maxine A. Papadakis; Michael
W. Rabow; Kenneth R. McQuaid; Paul L.
Nadler; Erika Leemann Price
TEST BANK
Ch. 1 — Disease Prevention & Health Promotion (5 items)
1
Reference: Ch. 1 — Disease Prevention & Health Promotion —
Immunizations for High-Risk Adults
Question (stem): A 54-year-old man with splenectomy for
traumatic rupture presents for routine care. Which
immunization strategy is most appropriate to reduce his risk of
invasive encapsulated bacterial infections?
A. Annual inactivated influenza vaccine only
B. One dose of pneumococcal polysaccharide vaccine (PPSV23)
,only
C. Sequential pneumococcal vaccination with a conjugate
vaccine followed by PPSV23 plus meningococcal and
Haemophilus influenzae type b (Hib) vaccinations as indicated.
D. Live attenuated intranasal influenza vaccine and PPSV23 in 5
years
Correct Answer: C
Rationale — correct: Asplenic patients require enhanced
protection against encapsulated organisms; current
recommendations call for pneumococcal conjugate vaccination
(to prime robust response) followed by PPSV23, and
consideration of meningococcal and Hib immunizations as
indicated. This sequential approach offers broader, durable
immunologic coverage.
Rationale — A (incorrect): Influenza vaccine alone does not
protect against encapsulated bacterial pathogens that asplenic
patients are at increased risk for.
Rationale — B (incorrect): PPSV23 alone provides important
coverage but lacks the enhanced immunogenic priming
afforded by a conjugate vaccine in high-risk adults.
Rationale — D (incorrect): Live intranasal influenza vaccine is
contraindicated in many adults and does not address bacterial
encapsulated pathogens; timing and type are incorrect for this
high-risk patient.
Teaching Point: Asplenic adults need pneumococcal conjugate
→ PPSV23 and targeted meningococcal/Hib vaccines.
,Citation: Papadakis et al. (2025). CURRENT Medical Diagnosis &
Treatment 2026 (65th Ed.). Ch. 1.
2
Reference: Ch. 1 — Disease Prevention & Health Promotion —
Cancer Screening: Individualized Decision-Making
Question (stem): A 46-year-old woman whose mother was
diagnosed with colorectal cancer at age 62 asks when she
should begin colorectal cancer screening. She has no other
family history or genetic syndromes. What is the best
recommendation?
A. Begin colonoscopy at age 50 (general population interval)
B. Begin colonoscopy at age 40 or 10 years earlier than the
youngest affected relative — whichever is earlier
C. No screening is necessary until symptoms develop because
mother’s age at diagnosis >60
D. Begin stool-based testing at age 55
Correct Answer: B
Rationale — correct: For a first-degree relative with colorectal
cancer, screening should start at age 40 or 10 years younger
than the youngest affected relative (whichever comes first). This
earlier start detects premalignant lesions in patients at
increased familial risk.
Rationale — A (incorrect): Age 50 is the general-population
start but underestimates risk when a first-degree relative is
, affected.
Rationale — C (incorrect): Family history of a first-degree
relative still warrants earlier screening despite the relative’s age
at diagnosis.
Rationale — D (incorrect): Waiting until 55 or choosing stool
testing later is not appropriate given increased familial risk.
Teaching Point: First-degree family history → start screening at
40 or 10 years earlier than relative.
Citation: Papadakis et al. (2025). CURRENT Medical Diagnosis &
Treatment 2026 (65th Ed.). Ch. 1.
3
Reference: Ch. 1 — Disease Prevention & Health Promotion —
Smoking Cessation: Pharmacotherapy and Counseling
Question (stem): A 62-year-old heavy smoker (30 pack-years)
with prior failure of nicotine patch counseling wants to quit. He
has stable coronary artery disease. Which pharmacotherapy
offers the highest likelihood of cessation and is appropriate if
cardiac status is stable?
A. Bupropion SR alone
B. Varenicline (with counseling)
C. Single-agent nicotine gum only
D. Nortriptyline as first-line therapy
Correct Answer: B
Treatment 2026
65th Edition
Author(s)Maxine A. Papadakis; Michael
W. Rabow; Kenneth R. McQuaid; Paul L.
Nadler; Erika Leemann Price
TEST BANK
Ch. 1 — Disease Prevention & Health Promotion (5 items)
1
Reference: Ch. 1 — Disease Prevention & Health Promotion —
Immunizations for High-Risk Adults
Question (stem): A 54-year-old man with splenectomy for
traumatic rupture presents for routine care. Which
immunization strategy is most appropriate to reduce his risk of
invasive encapsulated bacterial infections?
A. Annual inactivated influenza vaccine only
B. One dose of pneumococcal polysaccharide vaccine (PPSV23)
,only
C. Sequential pneumococcal vaccination with a conjugate
vaccine followed by PPSV23 plus meningococcal and
Haemophilus influenzae type b (Hib) vaccinations as indicated.
D. Live attenuated intranasal influenza vaccine and PPSV23 in 5
years
Correct Answer: C
Rationale — correct: Asplenic patients require enhanced
protection against encapsulated organisms; current
recommendations call for pneumococcal conjugate vaccination
(to prime robust response) followed by PPSV23, and
consideration of meningococcal and Hib immunizations as
indicated. This sequential approach offers broader, durable
immunologic coverage.
Rationale — A (incorrect): Influenza vaccine alone does not
protect against encapsulated bacterial pathogens that asplenic
patients are at increased risk for.
Rationale — B (incorrect): PPSV23 alone provides important
coverage but lacks the enhanced immunogenic priming
afforded by a conjugate vaccine in high-risk adults.
Rationale — D (incorrect): Live intranasal influenza vaccine is
contraindicated in many adults and does not address bacterial
encapsulated pathogens; timing and type are incorrect for this
high-risk patient.
Teaching Point: Asplenic adults need pneumococcal conjugate
→ PPSV23 and targeted meningococcal/Hib vaccines.
,Citation: Papadakis et al. (2025). CURRENT Medical Diagnosis &
Treatment 2026 (65th Ed.). Ch. 1.
2
Reference: Ch. 1 — Disease Prevention & Health Promotion —
Cancer Screening: Individualized Decision-Making
Question (stem): A 46-year-old woman whose mother was
diagnosed with colorectal cancer at age 62 asks when she
should begin colorectal cancer screening. She has no other
family history or genetic syndromes. What is the best
recommendation?
A. Begin colonoscopy at age 50 (general population interval)
B. Begin colonoscopy at age 40 or 10 years earlier than the
youngest affected relative — whichever is earlier
C. No screening is necessary until symptoms develop because
mother’s age at diagnosis >60
D. Begin stool-based testing at age 55
Correct Answer: B
Rationale — correct: For a first-degree relative with colorectal
cancer, screening should start at age 40 or 10 years younger
than the youngest affected relative (whichever comes first). This
earlier start detects premalignant lesions in patients at
increased familial risk.
Rationale — A (incorrect): Age 50 is the general-population
start but underestimates risk when a first-degree relative is
, affected.
Rationale — C (incorrect): Family history of a first-degree
relative still warrants earlier screening despite the relative’s age
at diagnosis.
Rationale — D (incorrect): Waiting until 55 or choosing stool
testing later is not appropriate given increased familial risk.
Teaching Point: First-degree family history → start screening at
40 or 10 years earlier than relative.
Citation: Papadakis et al. (2025). CURRENT Medical Diagnosis &
Treatment 2026 (65th Ed.). Ch. 1.
3
Reference: Ch. 1 — Disease Prevention & Health Promotion —
Smoking Cessation: Pharmacotherapy and Counseling
Question (stem): A 62-year-old heavy smoker (30 pack-years)
with prior failure of nicotine patch counseling wants to quit. He
has stable coronary artery disease. Which pharmacotherapy
offers the highest likelihood of cessation and is appropriate if
cardiac status is stable?
A. Bupropion SR alone
B. Varenicline (with counseling)
C. Single-agent nicotine gum only
D. Nortriptyline as first-line therapy
Correct Answer: B
