Test Bank For Current Medical Diagnosis
And Treatment 2026, 65th Edition By Maxine
Papadakis| 9781266135545| All Chapters 1 -
42|LATES
,
,Exam: CMDT 2026 (65th Edition) Sample Questions
1. A 68-year-old man with a 40-pack-year smoking history presents with progressive
dyspnea on exertion and a chronic cough. Spirometry shows an FEV₁/FVC ratio of 0.65 and
FEV₁ 55% of predicted. Which of the following is the most appropriate next step in
pharmacologic management according to the 2026 GOLD guidelines?
• A) Inhaled short-acting beta-agonist as needed only
• B) Long-acting muscarinic antagonist (LAMA) plus long-acting beta-agonist (LABA)
• C) Inhaled corticosteroid (ICS) as monotherapy
• D) Oral prednisone 40 mg daily for 2 weeks
Correct Answer: B
*Rationale: GOLD 2026 recommends LABA+LAMA as initial therapy for Group B (symptoms and
exacerbations) or Group E (high exacerbation risk) patients. This patient has moderate
obstruction (GOLD 2) and symptoms, so dual bronchodilation is preferred over monotherapy.*
2. A 55-year-old woman with hypertension presents with acute onset of severe, tearing
chest pain radiating to her back. Blood pressure is 100/70 mm Hg in the right arm and
80/50 mm Hg in the left arm. Which imaging study is most appropriate to confirm the
suspected diagnosis?
• A) Transthoracic echocardiogram
• B) CT angiography of the chest, abdomen, and pelvis
• C) Magnetic resonance venography
• D) Standard chest X-ray
Correct Answer: B
Rationale: The presentation is classic for acute aortic dissection. CT angiography is rapid, widely
available, and highly sensitive/specific for identifying intimal flaps and extent of dissection.
3. A 32-year-old man who returned from a business trip to Brazil 5 days ago presents with
fever, severe retro-orbital headache, myalgias, and a maculopapular rash. Laboratory
findings include thrombocytopenia (platelets 85,000/µL) and leukopenia. Which of the
following is the most likely diagnosis?
• A) Malaria
, • B) Dengue fever
• C) Yellow fever
• D) Chikungunya
Correct Answer: B
Rationale: Dengue fever (especially classic dengue) presents with fever, severe headache
(“breakbone fever”), myalgias, rash, and thrombocytopenia after a 4–7 day incubation. Travel to
an endemic area (Brazil) supports this.
4. A 45-year-old woman with no prior liver disease presents with jaundice, fatigue, and
dark urine. Labs: AST 1200 U/L, ALT 1500 U/L, alkaline phosphatase 110 U/L, total
bilirubin 5.5 mg/dL. Hepatitis A IgM is positive. Which of the following is the best
management recommendation?
• A) Start oral ribavirin immediately
• B) Administer hepatitis A vaccine
• C) Supportive care with hydration and monitoring of liver function
• D) Order anti-hepatitis E virus IgG
Correct Answer: C
Rationale: Acute hepatitis A is self-limited in immunocompetent patients. No antiviral therapy is
indicated. Supportive care is standard. Vaccination is for prevention, not treatment.
5. A 62-year-old man with diabetes and CKD stage 4 (eGFR 28 mL/min) has poorly
controlled HbA1c (9.2%) despite metformin 2000 mg daily. Which of the following
antihyperglycemic agents is most appropriate to add?
• A) Metformin extended-release (increase dose)
• B) Empagliflozin
• C) Pioglitazone
• D) Sitagliptin
Correct Answer: D
*Rationale: Sitagliptin (DPP-4 inhibitor) is safe in CKD with dose adjustment (eGFR 30–50 → 50
mg daily). Empagliflozin is not recommended if eGFR <30. Pioglitazone can cause fluid
retention. Metformin is already at max dose.*
And Treatment 2026, 65th Edition By Maxine
Papadakis| 9781266135545| All Chapters 1 -
42|LATES
,
,Exam: CMDT 2026 (65th Edition) Sample Questions
1. A 68-year-old man with a 40-pack-year smoking history presents with progressive
dyspnea on exertion and a chronic cough. Spirometry shows an FEV₁/FVC ratio of 0.65 and
FEV₁ 55% of predicted. Which of the following is the most appropriate next step in
pharmacologic management according to the 2026 GOLD guidelines?
• A) Inhaled short-acting beta-agonist as needed only
• B) Long-acting muscarinic antagonist (LAMA) plus long-acting beta-agonist (LABA)
• C) Inhaled corticosteroid (ICS) as monotherapy
• D) Oral prednisone 40 mg daily for 2 weeks
Correct Answer: B
*Rationale: GOLD 2026 recommends LABA+LAMA as initial therapy for Group B (symptoms and
exacerbations) or Group E (high exacerbation risk) patients. This patient has moderate
obstruction (GOLD 2) and symptoms, so dual bronchodilation is preferred over monotherapy.*
2. A 55-year-old woman with hypertension presents with acute onset of severe, tearing
chest pain radiating to her back. Blood pressure is 100/70 mm Hg in the right arm and
80/50 mm Hg in the left arm. Which imaging study is most appropriate to confirm the
suspected diagnosis?
• A) Transthoracic echocardiogram
• B) CT angiography of the chest, abdomen, and pelvis
• C) Magnetic resonance venography
• D) Standard chest X-ray
Correct Answer: B
Rationale: The presentation is classic for acute aortic dissection. CT angiography is rapid, widely
available, and highly sensitive/specific for identifying intimal flaps and extent of dissection.
3. A 32-year-old man who returned from a business trip to Brazil 5 days ago presents with
fever, severe retro-orbital headache, myalgias, and a maculopapular rash. Laboratory
findings include thrombocytopenia (platelets 85,000/µL) and leukopenia. Which of the
following is the most likely diagnosis?
• A) Malaria
, • B) Dengue fever
• C) Yellow fever
• D) Chikungunya
Correct Answer: B
Rationale: Dengue fever (especially classic dengue) presents with fever, severe headache
(“breakbone fever”), myalgias, rash, and thrombocytopenia after a 4–7 day incubation. Travel to
an endemic area (Brazil) supports this.
4. A 45-year-old woman with no prior liver disease presents with jaundice, fatigue, and
dark urine. Labs: AST 1200 U/L, ALT 1500 U/L, alkaline phosphatase 110 U/L, total
bilirubin 5.5 mg/dL. Hepatitis A IgM is positive. Which of the following is the best
management recommendation?
• A) Start oral ribavirin immediately
• B) Administer hepatitis A vaccine
• C) Supportive care with hydration and monitoring of liver function
• D) Order anti-hepatitis E virus IgG
Correct Answer: C
Rationale: Acute hepatitis A is self-limited in immunocompetent patients. No antiviral therapy is
indicated. Supportive care is standard. Vaccination is for prevention, not treatment.
5. A 62-year-old man with diabetes and CKD stage 4 (eGFR 28 mL/min) has poorly
controlled HbA1c (9.2%) despite metformin 2000 mg daily. Which of the following
antihyperglycemic agents is most appropriate to add?
• A) Metformin extended-release (increase dose)
• B) Empagliflozin
• C) Pioglitazone
• D) Sitagliptin
Correct Answer: D
*Rationale: Sitagliptin (DPP-4 inhibitor) is safe in CKD with dose adjustment (eGFR 30–50 → 50
mg daily). Empagliflozin is not recommended if eGFR <30. Pioglitazone can cause fluid
retention. Metformin is already at max dose.*
