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
1
Reference
Ch. 1 — Disease Prevention & Health Promotion — Adult
Immunization: Influenza
Physician-level stem
A 68-year-old man with COPD presents in late October for
routine care. He is active, lives independently, and has no acute
respiratory symptoms. He received influenza vaccine last year.
,Which influenza vaccine is most appropriate this season for
optimal protection in this patient?
A. Standard-dose inactivated influenza vaccine (IIV)
B. High-dose inactivated influenza vaccine (HD-IIV)
C. Live-attenuated intranasal influenza vaccine (LAIV)
D. Recombinant influenza vaccine (RIV) for those <50 only
Correct answer: B
Rationale — Correct (B)
Older adults (≥65 years) derive greater protection from a high-
dose inactivated influenza vaccine because it produces higher
immunogenicity and reduced influenza-related complications
compared with standard-dose formulations. CMDT
recommends HD-IIV for adults ≥65 when available.
AccessMedicine
Rationale — Incorrect
A. Standard-dose IIV: reasonable if HD-IIV unavailable, but not
the preferred option for ≥65.
C. LAIV: contraindicated in older adults and those with chronic
cardiopulmonary disease.
D. RIV: licensed for adults ≥18; not restricted to <50, but HD-IIV
has better evidence in ≥65. AccessMedicine
Teaching point
Use high-dose or adjuvanted influenza vaccine in adults ≥65 for
superior protection.
,Citation (Simplified APA)
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. 1.
AccessMedicine
2
Reference
Ch. 1 — Disease Prevention & Health Promotion —
Pneumococcal Vaccination in Adults
Physician-level stem
A 72-year-old woman with well-controlled type 2 diabetes asks
about pneumococcal vaccination. She has no prior
pneumococcal immunizations. Which vaccination strategy is
recommended?
A. PPSV23 only now
B. PCV20 only now
C. PCV15 followed by PPSV23 in 6–12 months
D. No vaccination indicated
Correct answer: B
Rationale — Correct (B)
CMDT 2026 endorses use of a single dose of PCV20 for
immunocompetent adults ≥65 or adults 19–64 with certain risk
factors as a simplified regimen when PCV20 is available,
providing broad serotype coverage without the need for
, subsequent PPSV23. This is an evidence-based, guideline-
aligned option for a 72-year-old with diabetes. AccessMedicine
Rationale — Incorrect
A. PPSV23 only is acceptable historically but PCV20 offers
broader protection; not preferred if PCV20 available.
C. PCV15→PPSV23 is an alternative if PCV20 is unavailable; with
PCV20 available, sequential dosing is unnecessary.
D. Incorrect — vaccination is indicated for adults ≥65 and those
with diabetes. AccessMedicine
Teaching point
PCV20 simplifies adult pneumococcal immunization — single-
dose strategy for many adults.
Citation (Simplified APA)
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. 1.
AccessMedicine
3
Reference
Ch. 1 — Disease Prevention & Health Promotion — Herpes
Zoster Vaccination
Physician-level stem
A 58-year-old woman with rheumatoid arthritis on
methotrexate seeks advice about zoster prevention. She has no
TREATMENT 2026
65TH EDITION
Author(s)Maxine A. Papadakis; Michael
W. Rabow; Kenneth R. McQuaid; Paul L.
Nadler; Erika Leemann Price
TEST BANK
1
Reference
Ch. 1 — Disease Prevention & Health Promotion — Adult
Immunization: Influenza
Physician-level stem
A 68-year-old man with COPD presents in late October for
routine care. He is active, lives independently, and has no acute
respiratory symptoms. He received influenza vaccine last year.
,Which influenza vaccine is most appropriate this season for
optimal protection in this patient?
A. Standard-dose inactivated influenza vaccine (IIV)
B. High-dose inactivated influenza vaccine (HD-IIV)
C. Live-attenuated intranasal influenza vaccine (LAIV)
D. Recombinant influenza vaccine (RIV) for those <50 only
Correct answer: B
Rationale — Correct (B)
Older adults (≥65 years) derive greater protection from a high-
dose inactivated influenza vaccine because it produces higher
immunogenicity and reduced influenza-related complications
compared with standard-dose formulations. CMDT
recommends HD-IIV for adults ≥65 when available.
AccessMedicine
Rationale — Incorrect
A. Standard-dose IIV: reasonable if HD-IIV unavailable, but not
the preferred option for ≥65.
C. LAIV: contraindicated in older adults and those with chronic
cardiopulmonary disease.
D. RIV: licensed for adults ≥18; not restricted to <50, but HD-IIV
has better evidence in ≥65. AccessMedicine
Teaching point
Use high-dose or adjuvanted influenza vaccine in adults ≥65 for
superior protection.
,Citation (Simplified APA)
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. 1.
AccessMedicine
2
Reference
Ch. 1 — Disease Prevention & Health Promotion —
Pneumococcal Vaccination in Adults
Physician-level stem
A 72-year-old woman with well-controlled type 2 diabetes asks
about pneumococcal vaccination. She has no prior
pneumococcal immunizations. Which vaccination strategy is
recommended?
A. PPSV23 only now
B. PCV20 only now
C. PCV15 followed by PPSV23 in 6–12 months
D. No vaccination indicated
Correct answer: B
Rationale — Correct (B)
CMDT 2026 endorses use of a single dose of PCV20 for
immunocompetent adults ≥65 or adults 19–64 with certain risk
factors as a simplified regimen when PCV20 is available,
providing broad serotype coverage without the need for
, subsequent PPSV23. This is an evidence-based, guideline-
aligned option for a 72-year-old with diabetes. AccessMedicine
Rationale — Incorrect
A. PPSV23 only is acceptable historically but PCV20 offers
broader protection; not preferred if PCV20 available.
C. PCV15→PPSV23 is an alternative if PCV20 is unavailable; with
PCV20 available, sequential dosing is unnecessary.
D. Incorrect — vaccination is indicated for adults ≥65 and those
with diabetes. AccessMedicine
Teaching point
PCV20 simplifies adult pneumococcal immunization — single-
dose strategy for many adults.
Citation (Simplified APA)
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. 1.
AccessMedicine
3
Reference
Ch. 1 — Disease Prevention & Health Promotion — Herpes
Zoster Vaccination
Physician-level stem
A 58-year-old woman with rheumatoid arthritis on
methotrexate seeks advice about zoster prevention. She has no
