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. Disease Prevention & Health Promotion — Aspirin for
Primary Prevention
Stem
A 62-year-old man with well-controlled hypertension and
hyperlipidemia presents for a routine visit. He is a nonsmoker,
takes atorvastatin, has no history of cardiovascular disease, and
,asks whether he should start daily low-dose aspirin to reduce
his chance of a first heart attack.
Options
A. Start low-dose aspirin daily for primary prevention.
B. Do not start aspirin; recommend statin continuation and
lifestyle measures.
C. Start aspirin only if his 10-year ASCVD risk ≥20%.
D. Start aspirin and arrange colonoscopy because aspirin
reduces colorectal cancer risk.
Correct answer
B
Rationale — Correct (B)
For adults ≥60 years without clinical atherosclerotic
cardiovascular disease, initiating low-dose aspirin for primary
prevention is generally discouraged because bleeding risks
outweigh small cardiovascular benefits. Continued risk-factor
control (statin, BP control, lifestyle) is the evidence-based
approach. CMDT discusses individualized primary prevention
but aligns with USPSTF guidance against starting aspirin at age
≥60. USPSTF
Why the other options are incorrect
A. Starting aspirin is not recommended for primary prevention
in adults ≥60 due to excess bleeding risk. USPSTF
C. Even with very high 10-year risk, the USPSTF specifically
recommends not initiating aspirin at age ≥60. Risk threshold
guidance applies to 40–59 age group. USPSTF
,D. While aspirin has been studied for colorectal cancer
prevention, its role in primary prevention of CRC is not
established to justify routine aspirin in older adults; bleeding
risks remain primary concern. USPSTF
Teaching point
Do not start aspirin for primary prevention in adults ≥60;
emphasize risk-factor control.
Citation
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. Disease
Prevention & Health Promotion. USPSTF
2
Reference
Ch. Disease Prevention & Health Promotion — Lung Cancer
Screening (LDCT)
Stem
A 56-year-old man with a 30-pack-year smoking history, who
currently smokes, asks about lung cancer screening during a
primary care visit. He has no pulmonary symptoms and no prior
CT chest screening.
Options
A. No screening unless he has respiratory symptoms.
B. Offer annual low-dose CT (LDCT) screening now.
C. Defer screening until age 65 because benefit increases with
, age.
D. Order chest x-ray annually to screen for lung cancer.
Correct answer
B
Rationale — Correct (B)
LDCT screening is recommended for persons who meet age and
smoking-exposure criteria (shared-decision/USPSTF criteria). A
56-year-old with ≥20 pack-year history who currently smokes
meets standard criteria for annual LDCT screening to reduce
lung cancer mortality. Chest x-ray is not a recommended
screening modality. USPSTF
Why the other options are incorrect
A. Lung cancer screening targets asymptomatic high-risk
individuals; waiting for symptoms misses curable early disease.
USPSTF
C. Waiting until 65 delays detection; recommended eligibility
often spans earlier ages based on smoking history (e.g., starting
at 50 or 55 depending on guideline). USPSTF
D. Chest x-ray does not reduce lung cancer mortality and is not
recommended as a screening test. USPSTF
Teaching point
Offer annual LDCT to eligible heavy smokers; chest x-ray is not
appropriate screening.
Citation
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
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. Disease Prevention & Health Promotion — Aspirin for
Primary Prevention
Stem
A 62-year-old man with well-controlled hypertension and
hyperlipidemia presents for a routine visit. He is a nonsmoker,
takes atorvastatin, has no history of cardiovascular disease, and
,asks whether he should start daily low-dose aspirin to reduce
his chance of a first heart attack.
Options
A. Start low-dose aspirin daily for primary prevention.
B. Do not start aspirin; recommend statin continuation and
lifestyle measures.
C. Start aspirin only if his 10-year ASCVD risk ≥20%.
D. Start aspirin and arrange colonoscopy because aspirin
reduces colorectal cancer risk.
Correct answer
B
Rationale — Correct (B)
For adults ≥60 years without clinical atherosclerotic
cardiovascular disease, initiating low-dose aspirin for primary
prevention is generally discouraged because bleeding risks
outweigh small cardiovascular benefits. Continued risk-factor
control (statin, BP control, lifestyle) is the evidence-based
approach. CMDT discusses individualized primary prevention
but aligns with USPSTF guidance against starting aspirin at age
≥60. USPSTF
Why the other options are incorrect
A. Starting aspirin is not recommended for primary prevention
in adults ≥60 due to excess bleeding risk. USPSTF
C. Even with very high 10-year risk, the USPSTF specifically
recommends not initiating aspirin at age ≥60. Risk threshold
guidance applies to 40–59 age group. USPSTF
,D. While aspirin has been studied for colorectal cancer
prevention, its role in primary prevention of CRC is not
established to justify routine aspirin in older adults; bleeding
risks remain primary concern. USPSTF
Teaching point
Do not start aspirin for primary prevention in adults ≥60;
emphasize risk-factor control.
Citation
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. Disease
Prevention & Health Promotion. USPSTF
2
Reference
Ch. Disease Prevention & Health Promotion — Lung Cancer
Screening (LDCT)
Stem
A 56-year-old man with a 30-pack-year smoking history, who
currently smokes, asks about lung cancer screening during a
primary care visit. He has no pulmonary symptoms and no prior
CT chest screening.
Options
A. No screening unless he has respiratory symptoms.
B. Offer annual low-dose CT (LDCT) screening now.
C. Defer screening until age 65 because benefit increases with
, age.
D. Order chest x-ray annually to screen for lung cancer.
Correct answer
B
Rationale — Correct (B)
LDCT screening is recommended for persons who meet age and
smoking-exposure criteria (shared-decision/USPSTF criteria). A
56-year-old with ≥20 pack-year history who currently smokes
meets standard criteria for annual LDCT screening to reduce
lung cancer mortality. Chest x-ray is not a recommended
screening modality. USPSTF
Why the other options are incorrect
A. Lung cancer screening targets asymptomatic high-risk
individuals; waiting for symptoms misses curable early disease.
USPSTF
C. Waiting until 65 delays detection; recommended eligibility
often spans earlier ages based on smoking history (e.g., starting
at 50 or 55 depending on guideline). USPSTF
D. Chest x-ray does not reduce lung cancer mortality and is not
recommended as a screening test. USPSTF
Teaching point
Offer annual LDCT to eligible heavy smokers; chest x-ray is not
appropriate screening.
Citation
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
